The Role of Psychedelic Plant Medicines in Addiction Treatment

Psychedelic plant medicines have the potential to help many people who are in recovery from substance use disorder dig deep into the roots of their addiction and come out of the other side. Plant medicines like psilocybin, ayahuasca, and particularly ibogaine, have demonstrated unprecedented results for those who use them as a tool on their recovery journey.While the legal status of many of these substances is still murky (depending on where you consume them), the ongoing research, decriminalization efforts, and shift in public narrative is promising. Hope lies on the horizon for wider access to these medicines, but right now, what’s needed is raising awareness and informed decision-making around their consumption.Here is how psychedelic plant medicines can help those that struggle with addiction and what people should consider before choosing this path.Ancient healing practices reconcile with modern sciencePsychedelic plant medicines have been used for healing purposes by indigenous cultures for thousands of years, and there is mounting evidence that shows their ability to integrate with modern addiction therapy. Research around the potential of ibogaine to treat opiate addiction is still in its infancy, but shows promising results. Ibogaine, which comes from the Iboga shrub, has been used historically in ceremonies in West Africa by practitioners of the Bwiti spiritual tradition since the late nineteenth century. The roots and bark of the tree are consumed ceremoniously in large doses to provoke a near-death experience, and in smaller doses during rituals and tribal dances. It is not considered a recreational substance by users, yet is classified as a Schedule 1 drug in the US.One 2017 study funded by the Multidisciplinary Association for Psychedelic Studies (MAPS) observed opiate addiction treatment delivered by two independent ibogaine clinics in Mexico. One month after the study, half of participants reported using no opiates in the month following the study. The researchers found that “ibogaine was associated with substantive effects on opioid withdrawal symptoms and drug use in subjects for whom other treatments had been unsuccessful.” Another study on the long-term efficacy of ibogaine-assisted therapy in New Zealand found that a single ibogaine treatment reduced opioid symptoms and resulted in no opioid use or reduced use in dependent individuals over 12 months. Healing that gets to the rootAyahuasca is a psychoactive Amazonian brew traditionally used in the indigenous communities of South America. Research on the brew is grounded in its potential to support healing by allowing for a deeper connection to oneself and due to the spiritual context in which it is taken. One 2017 study published in the International Journal on Drug Policy used qualitative analysis through long-term field work and participant observation in ayahuasca communities, as well as conducting interviews with participants with problems of substance abuse.The study found that “ayahuasca’s efficacy in the treatment of addiction blends somatic, symbolic, and collective dimensions. The layering of these effects, and the direction given to them through ritual, circumscribes the experience and provides tools to render it meaningful.”Researchers from a 2013 Canadian study, sponsored by MAPS, concluded that ayahuasca-assisted therapy for stress and addiction was correlated with improved mindfulness, empowerment, hopefulness, and quality of life-outlook and quality of life-meaning. The same study found that ayahuasca, when administered in a ceremonial setting, may have contributed to reduction in cocaine use in dependent participants.There have also been studies that show the benefit of psilocybin mushrooms in allowing people to overcome addictive or damaging behavior. A 2014 study from the Johns Hopkins Center for Psychedelic and Consciousness Research found that 80% of previously addicted smokers abstained from smoking six months after they were administered psilocybin. Remarkably, 60% continued to abstain two and a half years after the study.“Institutions like MAPS and the Imperial College London are pioneering the way forward with this evidence-based approach to psychedelic medicine—a necessary effort if these compounds are to be integrated into the mainstream,” said Gaurav Dubey, clinical biologist and content editor at Microdose Psychedelic Insights.“Though, we have a lot of catching up to do,” said Dubey. “We need to do better in understanding the psychotherapeutic mechanisms of these incredibly unique compounds and the only way to uncover that is through science and research.“The clinical data that strongly supports the therapeutic use of these compounds in addiction treatment will be fundamental in making them accessible to recovering addicts around the globe,” he added.Journeys to an addiction-free life, supported by plant medicinesKat Courtney is the founder of AfterLife Coaching, a trained ayahuasquera, and has been working with the plant medicine ayahuasca for over a decade. Courtney first began her journey with ayahuasca in Peru in 2006, while suffering with alcoholism and bulimia.“Not only did ayahuasca help me face and deal with the traumas and programming that created these destructive behaviors, she helped me access an authentic space of self love and gave me tools to work with in lieu of the addictions,” said Courtney.“They fast-track the healing and awakening process and ground us into our bodies so we can move past stages of self-destruction. They help us to move the trauma that is stored in the body through crying, purging, and all kinds of different forms of release.”But Courtney stresses that the act of taking these medicines is only part of the deal: “We absolutely have to be committed to integrating these experiences and making the life changes that support sobriety,” explained Courtney. “Otherwise, plant medicine ceremonies can become distant memories.”Alternative approaches offer a chance for healingAeden Smith-Ahearn is the founder of Experience Ibogaine Clinic, based in Mexico. Aeden first tried ibogaine in an effort to overcome his dependency on multiple substances, including heroin. “Ibogaine got me comfortably off opiates,” said Smith-Ahearn. “I had almost no withdrawal symptoms, and I had a very profound experience which helped give me a motivational boost in the right direction.“The medicine put me in my place, and that’s exactly where I needed to be. I got a fresh start, on top of a head start into my recovery,” he explained.Prior to his ibogaine experience, Smith-Ahearn had tried several programs in an attempt to break free from his addictions, which he describes as “cold turkey, three meals a day, and a therapist once a week.”“These programs work for many people, but they didn’t do the job for me. The problem was that I did not want to change, and was therefore unwilling to work towards something I didn’t want,” he said.Smith-Ahearn credits ibogaine with huge potential for recovering opiate addicts specifically because of how it interacts with the brain’s receptors. “The hardest part about breaking out of opiate addiction is getting over withdrawals,” he said. “The medicine alleviates withdrawal symptoms [for some patients], which is a godsend for someone who is in over their head with opiate addiction.”Like Courtney, Smith-Ahearn stresses that ibogaine is not a cure-all. “It’s crucial that patients of the treatment put their effort into a quality aftercare plan.”Charles Johnston, director of client success at Clear Sky Recovery, has also historically struggled with opiate addiction and subsequently used ibogaine as a tool to help him overcome his dependency.“Ibogaine was the medicine that interrupted my addiction, and for the first time let me fully witness the root cause of my addiction: self-hatred. It provided me with a path, purpose, and mission to support others and see that addiction is a blessing of self-discovery,” explained Johnston.“Ibogaine allows the individual to feel how they would after months of detox with conventional methods and if supported properly, encourages a whole new paradigm of accountability and acceptance,” he continued.With these and other accounts of personal transformation, it’s clear that ayahuasca and ibogaine have potential to assist people struggling with addiction on a path to recovery. However, these treatments should not be treated lightly and come with a number of risks to the patient if not administered responsibly.What you need to consider before trying psychedelic therapyPsychedelics generally have very little risk of abuse, but when taken in the wrong setting, or without proper guidance or structured preparation and integration, they can result in negative consequences.There are some short term health risks which are important to consider. “Using ibogaine comes with risks to your physical health, such as seizures, gastrointestinal issues, heart complications, and ataxia,” says board-certified psychiatrist and addiction specialist Dr. Zlatin Ivanov. “There have also been unexplained fatalities in people who have ingested ibogaine, which may be linked to the treatment.”Charles Johnston of Clear Sky Recovery explained that “if someone has heart issues, liver problems, other major health complications, serious psychological issues, or are expecting a quick fix, ibogaine may not be the right path.”The same largely goes for users of other plant medicines, including ayahuasca. Users of SSRI antidepressant medication have run into an adverse reaction while drinking the medicine with the drugs still in their system.“People need to do careful research and not fall foul of misleading things that they see on the internet. A lot of people have expectations that the medicine may not offer, like profound psychedelic experiences guaranteed to change them or no withdrawal whatsoever,” said Aeden Smith-Ahearn of Experience Ibogaine.Those seeking treatment with psychedelic plant medicines should make sure they go to a reliable and reputable center. In recent years, the number of tourists flocking to Peru to drink ayahuasca has boomed, resulting in illegitimate retreats run by people lacking in the experience required to administer the medicine.In many countries, including the US, these substances are illegal to consume. Many people do however seek out treatment in countries where the medicines are not outlawed, such as Mexico, Costa Rica, Peru, and Colombia. In the US, ayahuasca is legal within specific religious groups, such as the Santo Daime.A path to accessibilityLooking ahead to the future of psychedelic treatment, progress is being made on the legalization front, with Oakland and Santa Cruz, California, and Denver, Colorado, voting for decriminalization of psilocybin-containing mushrooms in 2019 and 2020. Oregon and Washington D.C. also have votes ahead on the decriminalization of psychedelic-containing plants and fungi.Meanwhile, Canada is seeing a number of legal ayahuasca centers open up, on the part of religious groups who have special permission from the government to use the medicine. However, ultimately, it will be a continuation of the scientific research that paves the way for increased access to psychedelic therapy.“We need more large scale, gold-standard clinical trials examining these compounds in the context of addiction treatment, such that their impact can no longer be ignored—even by the most stubborn of policymakers and world leaders,” said Dubey.“There needs to be a shift in global drug policy so these powerful medicines can be reclassified and reintegrated into our society in an effort to heal the masses.”In essence, psychedelics need to go mainstream and lose the stigma that they have held for decades so that the public appetite can develop and further drive policy changes. In addition to research, diverse voices and experiences, along with mainstream support, will be key in the psychedelic renaissance maintaining its momentum.The value of psychedelic plant medicines for addiction recovery is difficult to overstate, but is a path that should be explored carefully, mindfully, and while armed with the right information and support. And there’s hope that a future where accessibility isn’t an issue is on the horizon: The ongoing research and changing societal attitudes towards psychedelic plant medicines demonstrate promise. Education around these medicines and their proper use is vital for this renaissance to continue.By shining a light on the potential of psychedelic plant medicines to help and heal, we can contribute to forming more pathways to change and legitimate channels for people to benefit from their treatment.

For Pregnant Women, Stigma Complicates Opioid Misuse Treatment

New and expectant mothers face unique challenges when seeking treatment for an opioid use disorder. On top of preparing for motherhood, expectant mothers often face barriers to accessing treatment, which typically involves taking safer opioids to reduce dependency over time. The approach is called medication assisted therapy, or MAT, and is a key component in most opioid treatment programs.But with pregnant women, providers can be hesitant to administer opiate-based drugs.According to a study out of Vanderbilt University, pregnant women are 20% more likely to be denied medication assisted therapy than non-pregnant women.“In the beginning, I was so scared as a new provider to write my first prescription for medication assisted therapy to pregnant women,” said Dr. Linda Thomas-Hemak of the Wright Center for Community Health in Scranton, Pennsylvania.The health center serves low-income individuals who are underinsured or lack insurance altogether, many of whom struggle with opioid misuse.“Pennsylvania was hit particularly hard by the opiate epidemic that really has plagued, terrified and challenged America,” said Hemak, who is a board certified addiction medication specialist.On this episode of the podcast, we speak with Dr. Hemak about whether medication assisted therapy is safe for new and expectant mothers and how the Wright Center is helping women overcome opioid dependency during pregnancy.Direct Relief · For Pregnant Women, Stigma Complicates Opioid TreatmentListen and subscribe to Direct Relief’s podcast from your mobile device:Apple Podcasts | Google Podcasts | SpotifyDirect Relief granted $50,000 to The Wright Center for its extraordinary work to address the opioid crisis. The grant from Direct Relief is part of a larger initiative, funded by the AmerisourceBergen Foundation, to advance innovative approaches that address prevention, education, and treatment of opioid addiction in rural communities across the U.S. In addition to grant funding, Direct Relief is providing naloxone and related supplies. Since 2017, Direct Relief has distributed more than 1 million doses of Pfizer-donated naloxone and BD-donated needles and syringes to health centers, free and charitable clinics, and other treatment organizations.Transcript:When it comes to getting treatment for an opioid use disorder, pregnant women have an uphill battle.Most patients undergoing opioid treatment are prescribed safer opioids that reduce dependency while limiting the risk of overdose and withdrawal.This kind of treatment is called medication assisted therapy, or MAT.But with pregnant women, providers can be hesitant to administer opioids.According to a study out of Vanderbilt University, pregnant women are 20% less likely than non-pregnant women to be accepted for medication assisted therapy.“In the beginning, I was so scared as a new provider to write my first prescription for medication assisted therapy to pregnant women,” said Dr. Linda Thomas-Hemak.Hemak is a board-certified addiction medication specialist and CEO of the Wright Center in Scranton, Pennsylvania.“Pennsylvania was hit particularly hard by the opiate epidemic that really has plagued, terrified and challenged America,” said Hemak who has been practicing in the state for several years.In 2016, the health center launched a comprehensive opioid treatment program to address the growing crisis in their community. They quickly realized a number of patients were pregnant—and had specific needs, from prenatal care to job support. And so, a new program was born.“The Healthy MOMS program is based on assisting mothers who are expecting babies or have recently had a child, up until the age of two,” explained Maria Kolcharno — the Wright Center’s director of addiction services and founder of the Healthy MOMS program.“We have 144 moms, through the end of August, that we have served in the Healthy MOMS program and actively, we have enrolled 72.”The program provides new and expectant moms with behavioral health services, housing assistance, educational support; providers have even been delivering groceries to moms’ homes during the pandemic.But the crux of the program is medication assisted therapy.Moms in the program are prescribed an opioid called buprenorphine—unlike heroin or oxycodone, the drug has a ceiling effect. If someone takes too much, it won’t suppress their breathing and cause an overdose.Nonetheless, it’s chemically similar to heroin, which may raise eyebrows. But while some substances, like alcohol have been shown to harm a developing fetus, buprenorphine isn’t one of them.“Clearly there are medications, like alcohol, that are teratogenic. And there’s medications like benzodiazepines that have strong evidence that they are probably teratogenic. When you look at the opioids that are used and even heroin, there is no teratogenic impacts of opiates on the developing fetus,” Dr. Hemak explained.So, opioids like buprenorphine can be safe for pregnant women. What’s not safe is withdrawal.If someone is abusing heroin, overdose is likely. In order to revive them, a reversal drug called Naloxone is used, which immediately sends the person into withdrawal.But when a woman is pregnant and goes into withdrawal, it can cause distress to her baby, lead to premature birth, and even cause a miscarriage.Which is also why these women can’t just stop taking opioids.“Stopping cold a longstanding use of an opiate because you’re pregnant is a very bad idea and it is much safer for the baby and the moms to be transitioned from active opiate use to buprenorphine when pregnant,” explained Hemak.Because buprenorphine has a ceiling effect and is released over a longer period of time, women are less likely to overdose on the drug.Regardless, there’s still a risk their baby goes through withdrawal once they’re born. For newborns, withdrawal is called neonatal abstinence syndrome or NAS.Babies may experience seizures, tremors, and trouble breastfeeding. Symptoms usually subside within a few weeks after birth.Fortunately, the syndrome has been shown to be less severe in babies born from moms taking buprenorphine versus those using heroin or oxycodone.That’s according to Kolcharno who has been comparing outcomes between her patients and those dependent on opioids, but not using medication assisted therapy.“Babies born in the Healthy MOMS program, we’re finding, that are released from the hospital, have a better Apgar and Finnegan score, which is the measurement tool for NAS and correlates all the withdrawal symptoms to identify where this baby’s at,” said Kolcharno.But NAS is not the only concern women have post-partum.During and after delivery, doctors often prescribe women pain killers. For those with an opioid dependency, these drugs can trigger a relapse.Dr. Thomas-Hemak says preventing this kind of scenario requires communication.The Wright Center works with their local hospital to ensure OBGYNs are aware of patient’s substance use history.“We want the doctor to know that this may be somebody that you’re really sensitive to when you’re offering postpartum pain management,” said Hemak.That way, doctors know to tailor patients’ post-partum medication regimens. Instead of prescribing an opiate-based pain killer they can offer alternatives, like Ibuprofen or Advil.Maintaining an open line of communication between addiction services and hospital providers also helps to reduce stigma.Women with substance use disorders have long been subject to discriminatory practices by both providers and policy makers.From denying them treatment to encouraging sterilization post-delivery, women struggling with opioid dependency can be hard-pressed to find patient-centered health care.But Dr. Thomas-Hemak says, she’s learned to set her opinions aside.“I think one of the magical transformations that happens when you do addiction medicine really well is, it’s never about telling patients what to do.”It’s about allowing them to make informed choices, she says, and understanding it’s not always the choice you think is best.This transcript has been edited for clarity and concision.

How (Not) To Date in Sobriety: My Dinner with Steve, the Movie

I thought, “I’m building intimacy!” He called it stalking. I said I was sharing. He said oversharing. Through ten years of sober dating in New York City on the heels of a devastating divorce, I tried it all—from celibacy to the polyamory scene to IRL meetups. Along the way, I made every mistake possible. To my surprise, I’ve landed in a happy marriage, but I will never forget the stories that brought me here. Such tales are at the heart of My Dinner with Steve.As someone with long-term sobriety, I never tire of addiction stories. Likewise, I’m always interested in stories about flawed women. When I sat to write my own film, I wanted to see these two worlds come together. There are so many movies that deal with battling addiction, but there are very few that portray the experience of living in recovery. If the recent #WeDoRecover challenge is any indication, I’m not alone.The hashtag was born during the first presidential debate, when the incumbent spewed a poisonous—and untrue—tirade about Hunter Biden, a recovering addict. His father, former Vice President and current presidential candidate, Joe Biden, was not rattled. Instead, he rallied to support his son, and all of us recovering from addiction, by first affirming Hunter's recovery and then stating, “I’m proud of my son.” In the wake of that, there’s been an avalanche of support for people recovering from addiction, much of it in the form of people sharing their own #WeDoRecover stories.Into this hunger for content comes the short I wrote and starred in, My Dinner with Steve. The film tells the story of Jen, a newly sober, 40-something woman whose divorce has left her shattered. She’s finally landed a date with her teacher crush, but mistakes Googling with familiarity and turns their dinner into an addict's confessional. We shot it in St. Petersburg, FL, over two days in March, just before the Covid-19 lockdown. Already the movie has been seen all over the world in festivals, with more to come.My approach to the film was something I’d learned through recovery—I asked for help. I’d never written a film before, let alone acted in and produced one, so I turned to people in the industry for guidance. I’m lucky that several key team members, notably our director Eugenie Bondurant, were early supporters of the project. The work has been so gratifying that I’ve already written more, a series with recurring characters offering humorous tales to convey serious messages—primarily, that overcoming addiction is not only possible, but just the beginning. One of my greatest fears about getting sober was that it would mean the end of fun. As the recent #WeDoRecover challenge has shown, that’s been far from true for me and countless others. And it made me reflect on why I felt compelled to write these episodes.First, the longer I’ve stayed sober, the more clearly I’ve seen that sobriety is a gift. It wasn’t bestowed upon me through some kind of deserving behavior, far from it. It was grace alone. Through my recovery, I’ve met many wise, humble, and generous people. Many have given freely of themselves to show me a better life, one free of blackouts, institutions, health crises, destroyed relationships, and enslavement. These interactions are at the heart of the films I want to write. Because no one recovers alone. There is no single wise influencer, leading us all to an Instagram-worthy photo shoot. Our lives continue, in all the mess and glory. But if we stick together, we do recover.These experiences are what I want to commemorate in film, and My Dinner with Steve is the first outing in that effort. While the story is based on actual experiences, it’s not a true story. And as much as this short speaks to the recovery community, I see these stories as having a broader audience, in the same way that a film like Requiem for a Dream – just now celebrating its 20th anniversary with a re-release – wasn’t intended for drug addicts only.We all experience obstacles in life, but those of us in recovery need to refrain from using our drug of choice to cope, whether that’s sugar, sex, or a substance. So, it’s important that this film look like others out there, and speak to a broad audience. And there’s no better way to foster empathy than through storytelling. For more information and to see the trailer, visit the website for My Dinner with Steve.

The Role of Trauma in Treating Addiction

The word trauma is used today more than it ever was ten years ago. While some people might feel like the word is overused, many mental health professionals would say that we’ve just become better at recognizing the lasting impact that events — from losses to abuse — can have on our psyches.Many people with substance use disorder have trauma in their backgrounds. Trauma causes residual lasting mental pain. If you don’t address the trauma, you might find yourself self-medicating to escape the mental pain. Although that might work for a moment, using drugs or alcohol to cover your mental pain will just cause more difficulties in the long run. That’s why it’s so important to find a treatment center that understands the interplay of trauma and addiction.Understanding TraumaThe American Psychological Association (APA) defines trauma as an emotional response to a terrible event. What constitutes a terrible event varies from person-to-person. An event that is traumatic for one individual might not cause trauma for other people, even if they experience the very same event. Anything from abuse to a natural disaster to an accident can cause trauma.It’s normal to experience some psychological distress after a major event. Consider the stress that we all experienced early on during the pandemic. But, for most people, the stress gets better with time. If you find that your stress continues to interfere with your life, you might have trauma. Symptoms of trauma can include flashbacks, headaches and nausea.Sometimes, trauma can evolve into post-traumatic stress disorder (PTSD). PTSD is characterized by lasting effects of trauma that impacts life. People with PTSD might have flashbacks or nightmares; they might avoid certain situations that remind them of the traumatic event.The Connection Between Trauma and AddictionThere’s a close connection between trauma and addiction. A 2019 study compared people who were getting treatment for opioid abuse disorder with healthy individuals. It found that the people in treatment reported more severe traumas and more instances of trauma in their lives. The study found that the more trauma people experienced, the more likely they were to experience addiction.The connection can be particularly strong for people who experience trauma as teens or children. Among teens who needed addiction treatment, 70% reported trauma in their backgrounds. In addition, 59% of teens with PTSD go on to develop a substance abuse problem.Research like the ACEs study — which looked at adverse childhood experiences — have solidified the connection between trauma and addiction. Even seemingly minor ACEs, like growing up with divorced parents, can increase the risk for substance use disorder later in life.Treatment for TraumaIf you have experienced trauma or ACEs, and particularly if you believe you may have PTSD, you need to access a recovery center that is trauma-informed. Trauma-informed treatment centers have knowledge about the ways that trauma impacts the brain. They are able to help you address your substance abuse disorder, while also helping to control your trauma.Of course, it is also a great idea to get specific treatment to help you overcome PTSD, if you are experiencing that condition. EMDR — Eye Movement Desensitization and Reprocessing — is a type of therapy that is particularly effective for treating PTSD. During EMDR, you recall your traumatic event while doing to back-and-forth eye movements. Scientists don’t understand exactly why this is so effective at reprocessing the traumatic event, but research shows that people make huge improvements in just a few sessions.The TakeawayTrauma is extremely common: up to 70% of American adults have experienced a traumatic event in their lives. Some people recover on their own, while the trauma lingers for others. Too often, people use drugs or alcohol to try to numb or escape the trauma.Oftentimes, people need help to overcome trauma in their lives. Finding and utilizing a treatment center that has a trauma-informed approach to treating substance use disorder can help you understand the role that trauma plays in your addiction. Then, by addressing the underlying cause of your addiction, you’re better able to stay sober long-term.Learn more about Oceanside Malibu at http://oceansidemalibu.com/. Reach Oceanside Malibu by phone at (866) 738-6550. Find Oceanside Malibu on Facebook.

Help Without Hurting

When problems from drug use begin to mount, such as relapses, lost jobs, school suspensions, neglect of responsibilities, DUIs, etc., friends and family members sometimes provide certain types of help that can actually be harmful. That’s right, they harm their loved ones by bailing them out or doing too much at times when these folks would be better served by learning from the consequences of their behavior and standing up on their own.For example, after binges or serious relapses, friends and family members often make excuses and try to clean up the mess. When this happens, they unwittingly teach powerlessness.You don’t have to think about what happened or make an effort to change. I’ll take care of it. You can keep doing what you’ve been doing, and everything will be ok.They also deprive people of an opportunity to learn from the experience; to figure out what was happening before the relapse, how they responded to the circumstances, and what consequences resulted from their use of drugs.Less obvious but equally damaging are subtle meta-messages that undermine self-confidence and manufacture dependence:You can’t handle this. You really need me to step in.(You don’t have to grow up or take responsibility for your life.)Sometimes, it’s important to back off and allow a person room to grow. Of course, there is a fine line because we definitely want to be kind, supportive, and give help generously. We certainly don’t want regrets, as in, “I wish I had done more.”On the other hand, we can end up saving people who don’t need to be saved; people who would be better served by investing more of their own effort and depending on their own initiative, with less help from loved ones.Saving people who don’t need to be saved is called a “rescue.” It should be distinguished from times when we save people who actually need to be saved, like throwing a life preserver or diving into the water to save someone who is drowning, or giving first aid at the scene of an automobile crash.The key to help without rescuing is to ensure that people with a problem want to make changes and are willing to do their part. We can provide support and match their efforts, but not be a “fixer” who does it all. And, we should be willing to back off when the people we are helping are not making a full-blown effort to do their part.Guiding Principles for Avoiding Drug Problem RescuesFind out if the person with a drug problem is sincere and committed to working on the problem. (Not lip service or oft-repeated promises).Find out what the person plans to do differently in the future. Get specifics.Ask if the person wants help and if so, how you could be helpful.Be clear that you are not trying to fix the problem yourself. You are providing back up.Watch to see that your effort is matched. Never do more than half the work.Watch that change is occurring. If not, discuss what further measures loved ones need to take so that your combined efforts can bring results.Be willing to back off in a kindly way, without negative judgment.Model Statement for Backing OffIf nothing is improving, your help is of no value. It’s best to back off and open a dialogue.You don’t want to discourage the person with a drug problem, but also don’t want to fail to notice the reality of the situation. You can make a statement about the lack of progress without blame or any negative judgment. You can show your love and enduring desire to help. Before backing off, make sure you have allowed time for the change to take hold. However, if you wait too long, you will probably end up angry and alienate yourself from the person you want to help. Timing is important.Here is an example of a model statement for avoiding a rescue when the person you are helping is not making changes.I’m doing (or “I have been doing” or “I have done”) what you asked. But it doesn’t seem that things are getting better. I think you may need to invest more energy or find a different strategy. There’s no point in me continuing to help until you have revised your plans. I love you (or “really care about you”) and remain ready to help when you update your approach to this problem.Signs You Might be RescuingYou feel like you’re saving someone from themselvesYou keep giving help and nothing is changingYou feel angry when you are trying to be helpfulThe same problems keep recurringDifficult and Unpleasant ChoicesPeople with serious drug problems often face exceedingly difficult and disastrous circumstances that make it hard to distinguish between help that is urgently needed (a legitimate rescue) or simply a harmful rescue that will reinforce powerlessness. For example, we may have loved ones who are about to lose their job or need transportation to maintain employment or could lose custody of a child or find themselves homeless, living under a bridge. Caring people will have an urge to jump in. Sometimes we must. These are painful and unpleasant choices with no simple answers. At these times, we have to ask ourselves: What sort of rescue is this? What will happen if I don’t step in? What are the consequences? If I do step in, would it be disempowering? Would I be resentful? Am I fostering dependence? Has the same problem been happening over and over again?Sometimes backing off means being terribly scared and uncomfortable, knowing the risk that bad things might happen, but believing it is the best choice and the only possible way things might change. It’s never easy.Help and “Help”Avoiding harmful rescues is an act of love. You want to help people when it can improve their lives, but avoid providing “help” that disempowers them, promotes dependency, and allows problems to persist. Ideally, our message should be: “You can do it. Work hard and I’ll back you up, all the way.”

Opinion: The Opioid Crisis + COVID-19 = The Perfect Storm

Addiction - a chronic relapsing brain disorder, and a disease that gets deeply personal. It gets low-down and dirty, too.If you’re not an addict yourself, you surely know someone who is.You know someone abusing their opioid prescriptions, not because it’s a barrier to their pain, but because it’s a potent way to make them feel happier. You know someone whose alcohol consumption is dangerously high and verging on alcoholic - if they’re not already there, of course. Your kids will certainly know someone who abuses recreational drugs like they were going out of fashion. They’ll also know other students who swallow ADHD prescription tablets (as a study aid) because it makes them get their grades, and keeps their parents, people like you, happy.Among the people who are in your extended family, among your circle of friends, or someone within your workplace - at the very least, one, probably several more, will be a secret drug addict or an alcoholic. At the very least.It doesn’t discriminate. It certainly doesn’t care where you live either, just like most other diseases, and now this new coronavirus - COVID-19.Arizona & The Opioid CrisisOver the last 3 years, in Arizona alone, there have been more than 5,000 opioid-related deaths. Add to that the 40,000-plus opioid overdoses that have taken place during the same period, and you realize that COVID-19 has never been the only serious health issue the state continues to face, or the rest of the U.S., for that matter.In our “new reality” of social distancing and masks, more than 2 people every single day die from an opioid overdose in Arizona. Nearly half of those are aged 25-44 years old - in their prime, you might say.Opioids are not the only addictive group of substances that is costing young Arizonan lives right now either.From the abuse of “study aid” drugs, like Adderall and other ADHD medications, to the “party drugs,” like cocaine and ecstacy, and so to opioid prescription meds, and, if circumstances allow, a slow and deadly progression to heroin - addiction is damaging lives, if not ending them way too soon.These drugs did so before anyone had ever heard of COVID-19, and they’ll continue to do so after, or even if the world ultimately finds another drug - the elusive coronavirus vaccine - it is hoping for.Opioids + COVID-19 = The Perfect StormWe now live in this time of coronavirus. With the ongoing opioid epidemic, the question arises:How can the addiction treatment community continue to assist people who are now being left even more isolated and desperate, still with their chronic desire to get as high as they can, or drunker than yesterday?Furthermore, coronavirus has raised questions itself about the ongoing mental health needs of our population as a whole, and drug addicts and alcoholics continue to feature heavily in any statistics you offer up about those in the U.S. living with a mental health disorder.In fact, around half of those with a substance use disorder (SUD) or an alcohol use disorder (AUD) - the medical terminology for addiction - are simultaneously living with their own mental health disorder, such as major depression, severe anxiety or even a trauma-related disorder like PTSD.How are these predominantly socially-disadvantaged people able to receive the treatment they really need when they have been directed to isolate and socially distance themselves even further?This is why I believe the conditions for a “perfect storm” of widespread deteriorating mental health and self-medication through continued substance abuse are here now, with overdoses and fatalities rising across the addiction spectrum.There will be many drug or alcohol abusers living in Arizona who will be lost to us, and the majority will be young people in the age group of 25-44 mentioned previously, left isolated and unnoticed by an over-occupied medical community.The U.S. opioid epidemic plus the global coronavirus pandemic.A deceitfully isolating disorder in a time of generalized social isolation. For some, there will be no safe harbor from this, and it will wash them away from the lives of their families and friends without any chance of rescue whatsoever. The perfect storm - our perfect storm.Today, the truth is that successful addiction recovery has become exponentially more difficult. Apart from ongoing isolation to contend with, there exists an unfounded but very real distrust of medical facilities per se, and a real personal problem in maintaining good physical and mental health practices, eg. through nutrition and physical activity.Innovation: The Ideal Recovery Answer for Isolated Substance Addicts?Digital technology has advanced far further than its creators and financial promoters ever envisaged - or has it? We have become a society where it doesn’t matter where you are in the world, you’re always close by to loved ones you wish to talk to, friends you want to have a laugh with, and colleagues you need to share information with.Communication anywhere with anyone is as simple as the proverbial ABC.However, if you think that innovation and digital technology - sitting in front of your laptop or tablet, in other words - can provide the answers to the questions raised earlier about the timely provision of professional addiction or mental health treatment to those that need it, then you’re wrong. If only it were all that simple and straightforward.Online meetings of 12-Step organizations, like Alcoholics Anonymous, Narcotics Anonymous, and others, have been available for many years. However, all of these support organizations realize that an online or virtual 12-Step meeting is not the real thing. They are a temporary substitute and no more.In fact, they are a poor substitute when compared to the face-to-face and hands-on meetings that continue to be held successfully all over the nation and all year round.The various “sober aware” and “sober curious” communities that are present online do not provide a realistic treatment option to any substance addicts whatsoever, whether their SUD or AUD has been clinically diagnosed or not. Furthermore, the current crop of online addiction treatment and recovery programs available are currently statistically unproven in terms of successful outcomes, and with no official accreditation.That said, there is limited evidence that “telemental health care” does have several benefits in terms of more timely interventions in those with mental illness generally, particularly when these people are located in isolated communities.I honestly wouldn’t know, as there is no official patient outcome data for these services. In fact, by the time that data is able to be impartially and officially collected, these groups and so-called programs may have already lost their internet presence.Online “help” (you honestly couldn’t call it an actual treatment) with addiction is severely limited and nowhere near approaching the answer. Here’s exactly why…Substance addiction is an utterly isolating disorder. It can obliterate close family bonds, destroy what keeps us close together as friends, and will happily rampage unabated through any social life you may still hold onto, accepting no prisoners. Bleak isolation like you’ve never known before.Corona has little on addiction.Addiction is the catalyst behind premature death, the end of families and their marriages, long-term unemployment, and endless legal issues. It costs financially too - countless billions of dollars every year are lost to this disorder, over double that of any other neurological disease.Let me be absolutely clear and concise - there exists no replacement whatsoever for your hand held by another when lying in an intensive care bed, scared you’ll become just another coronavirus statistic, and there exists no replacement for the smiles, warmth, and openness of fellow recovering drug addicts meeting in a daily support group, especially on those days when you came so close, so very close, to using or drinking again.There’s little difference between the two either.The online addiction treatment industry is still in its childhood. It truly is an industry too, as you’ll only buy the brand and the product; you’ll never actually meet those telling you how to best change your life.At present, it falls woefully short.Really, what would you prefer? A mask-wearing addiction professional, clinically qualified to assist with your detox, your medication if needed, and your psychological needs, located in an accredited treatment facility (formally certified as being coronavirus-free), among peers, fellow addicts, and trained medical staff?Or a video image on a computer screen of someone you will never meet, who is telling you to do things you’ve never done before? At least, successfully?As society moves towards a more home-orientated existence, with WFH (working from home) the new norm, consider this:Would a specialized medical professional treating your disease ask you to consider “getting better from home,” as an alternative to the hospital?All we can hope for - the best that we can hope for - is that coronavirus soon leaves the state lines of Arizona, and that can continue all of our recoveries as successfully as before. Until then, the advice is simple - take the best help you can from wherever you can get it. Sadly, you are yet to find it on a computer screen.One last thought before I sign off…Protective masks may well become standard attire in our unknown future. So why, oh why, can they not make these transparent? Just take a moment... We’d be able to see each other - our friends, our colleagues, even complete strangers in the street - smile again.

The Five Pillars of Recovery from Trauma and Addiction

In my forty-five years, I enjoyed twelve years of quasi-normal childhood, which ended abruptly when I was raped. I spent the next ten years in a dangerous dance with addiction, suicide attempts, and more trauma. But then I reached a turning point, and my past twenty-three years have been spent healing and learning what works for me in building long-term recovery.There is no standard set of blueprints for long-term recovery, as everyone is different, but I have identified five pillars that have enabled me to build on a strong foundation of recovery. My daily choice not to use substances forms that foundation, and these rock-solid pillars stabilize that recovery into an impenetrable structure. These five pillars are not unique, and they do require work, but once built, they will stabilize your recovery fortress.1. Maintain rigorous honesty. In addiction, our lives were built upon lies and false narratives we told ourselves and others. But recovery demands honesty—only when we can admit the truth can we begin to heal. I had to get honest with myself about my addiction. I had to own it and then take a brutally honest assessment of my life. We cannot build a sustainable recovery on a false narrative. When we lie, we enable sickness, secrets, shame, and suffering.Dishonesty makes us vulnerable in all the wrong ways, but honesty conjures the true vulnerability we require to discover authenticity. Start practicing honesty in all your interactions—beginning with yourself. This must be the first pillar because without honesty, the rest will crumble. Anything created in a lie is chaos, and anything created in chaos will end in chaos.2. Expose your secrets. You cannot soak in the joy of today if your soul is still filled with yesterday’s garbage. Take out that trash. For me, this meant diving deep and pulling forth all the trauma, pain, and sorrow that I had packed tightly away. I thought this was for my benefit—why bring up old stuff? But in fact my secrets were keeping me sick. They were smoldering under this new foundation I was building in recovery, threating to burn it all down.Secrets require silence to thrive, and they allow shame to fester inside of us. Shame is an emotional cancer that, if left untreated, will destroy our recovery. I began by slowly exposing my secrets in my journal. At first, it was the only safe space for me. As I began to trust others in recovery, I began to share those secrets, and the smoldering was extinguished by their compassion and understanding. Begin exposing your own secrets. What thoughts and memories are you afraid to give voice to? Those are the secrets that will keep you sick if you do not get them out.3. Let go. All those secrets take up a tremendous amount of space in our mind, body, and soul. We must find ways to process that pain into something productive, useful, and healing. You must unleash this pain so it no longer occupies your mind, body, and soul. When you do this, you make room for hope, light, love, and compassion.Writing is my release. But when physical emotional energy rises in me, I need more intense physical activity to push the energy out of my body. I use a spin bike and weightlifting, but you might run, walk, or practice yoga—any activity that gets your heart rate up and helps you sweat, which I think of as negative energy flowing out. When I do this, I am calmer, I am kinder, and I am more the person I want to be. Meditation is another way for me to simply let go and sit with myself when my thoughts are plaguing me or I feel stuck emotionally. I often use mediational apps, guided mediations, or music to help me meditate. When you find what works for you, do it daily. Recovery is like a muscle; when it is flexed, it remains strong.4. Remember you aren’t alone. Connection is core to feeling hopeful. By interacting with other trauma survivors and others in recovery, you become part of a group of people with similar experiences who have learned how to survive. Being able to share those pieces of your past with others is incredibly powerful. Seek out support groups in your area, attend meetings, reconnect with healthy people from your past, and pursue activities you enjoy to help you meet like-minded people. Create the circle of people you want in your life—the ones who will hold you accountable yet provide you with unconditional support and love, without judgment.In our addiction, we push these people away. We run from them because they act like mirrors to our dishonesty. In recovery, these people become the ones we turn to when things get hard. Even one such person in your life—a family member, friend, sponsor, or trusted colleague—can make a difference. Surround yourself with those who seek to build you up.5. Know you matter. In order to grow, heal, and build upon your recovery foundation, you have to believe you are worth it, that you deserve joy and love. At some point in your recovery, you will have to rely on yourself to get through a rough patch. When this happened to me, I had to really dig down and get to know myself. I had to strip away all the false narratives I used to define myself, all the ways I presented myself to the world and to myself. Who was I? What did I love about myself, and what brought me enough joy to feel worthiness?I now know what I need to feel calm, to feel beautiful, and to feel deserving of this amazing life of recovery. I matter, and my life in recovery matters so much. It is this core truth that makes me fight for my recovery, my sanity, my marriage, and my job, because they are all worth it. I am worth the fight, and so are you. Believe in yourself. Tell yourself that you deserve happiness, joy, success, and a life free from the pain of trauma and addiction. You are worth your recovery. It is the foundation on which you build your new life.Building any structure requires hard work, and recovery is no different. While we each require different tools and plans to create them, these five pillars will sustain our recovery from trauma and addiction. Jennifer Storm's Awakening Blackout Girl: A Survivor's Guide for Healing from Addiction and Sexual Trauma is now available at Amazon and elsewhere.