Another characteristic that may require special attention in substance abuse treatment is a condition called alexithymia. The term refers to a person’s inability to process understand or describe their emotions.

There is a high rate of alexithymia among those with substance use disorders, with patients at a level of 67 percent for this condition. Despite this high rate, there has been little research exploring the outcomes of patients in substance abuse treatment who also have alexithymia.

In previous research, cognitive behavioral therapy was found to be somewhat successful in treating substance abuse patients who struggled with alexithymia. However, while the dropout rate was low among these patients, follow-up information indicated that relapse was increased.

For the current study, published in the Journal of Psychotherapy and Psychosomatics, researchers wanted to determine whether there might be support for using a screening to identify patients who may be inhibited in their treatment by alexithymia. To measure this, the researchers examined whether alexithymia was a predictor for relapse, expecting to find evidence that alexithymia was negatively linked with recovery outcomes.

The research team examined 187 inpatients for substance use disorder using the European ASI (EuropASI) and the Dutch edition of the Toronto Alexithymia Scale (TAS-20). The EuropASI was used again at a three month follow-up from the initial cognitive behavioral therapy sessions (CBT) or a combined CBT with shared decision making intervention (CBT-SDMI) group.

All of the patients met criteria for at least one substance abuse disorder. In addition 36.9 percent were identified as being highly alexithymic, and an additional 33.2 percent met criteria for a low level of alexithymia. A higher level of alexithymia was associated with lower academic achievement and more frequent unemployment.

Those with a higher level of alexithymia also scored higher relating to problems at work, with income and education. However, low and high level alexithymia patients had similar rates of completion for the treatment programs. In addition, 54 percent of high-scoring alexithymia patients and 45.7 percent of low-scoring alexithymia patients were absent at the follow-up session.

The authors of the study acknowledge that the study’s results may be limited by some factors, including the use of self-report to determine abstinence in the participants.

The results indicated that patients with a high level of alexithymia are not necessarily at an increased risk for relapse. The authors report that patients with alexithymia can benefit from CBT.

Substance Use Treatment for Those Who Struggle to Express Emotions is a post from: Drug Addiction Treatment

Alcohol and drug addiction puts a serious strain on our economy and the health-care system. The rise of absenteeism and decrease in productivity as well as work-related accidents can be a direct result of illegal drug use by the 70 percent of addicts who are employed. Even health care costs can account for a nearly 300 percent increase compared to those who do not use alcohol. Overall, drug addiction costs about $250 billion annually.

With one out of every eight Americans suffering from some form of alcohol or drug addiction, there is a push to find help for these individuals. 12-step programs like Alcoholics Anonymous gives them the tools to eliminate the desire to use alcohol and drugs. The techniques offered during this program create calm for the anxiety associated with quitting. It helps to calm and soothe those particular impulse emotions.

But there may be another way to create a sense of calm and serenity. Yoga is growing in popularity as many people are realizing its health benefits. The same concepts to find that inner peace can be used to settle the storm within alcoholics and drug abusers. The benefits of yoga continue to be researched, but have already been shown to increase physical health as well as mental health. It can give users another route to learning coping mechanisms, respect for themselves and hope.

Yoga Can be Used to Assist in Treatment of Alcohol and Drug Addiction is a post from: Drug Addiction Treatment

Nicotine Replacement Therapy (NRT) comes in many different varieties and formulas, such as the transdermal patch, spray, gum and lozenge. NRT is based on the theory that maintaining a low, constant level of nicotine in the body will help prevent withdrawal symptoms, which are often responsible for continued smoking. Unfortunately, many smokers will stop smoking tobacco and switch to abusing one of the NRTs.

Zyban, or bupropion, was initially sold as Wellbutrin, an antidepressant, and was repurposed for nicotine addiction when users reported a decrease in tobacco cravings without the associated weight gain. By blocking the reuptake of certain catecholamines, such as norepinephrine and dopamine, Zyban offers users some stimulant effects and takes the place of food for someone who is in the early stages of tobacco withdrawal.

Chantix, or varenicline, is a newly FDA-approved nicotine addiction drug that blocks the reward mechanism associated with nicotine. The body’s nicotine receptors, alpha-4 beta-2, typically cause the release of dopamine when nicotine is introduced. Varenicline mildly stimulates and occupies the receptor, but not enough to cause dopamine to be released. Varenicline also prevents nicotine from activating the dopamine, thus eliminating the positive feelings associated with smoking. This reduces nicotine cravings, which can lead to abstinence.

Drug Treatment for Alcohol Addiction

Most common alcohol addiction treatment programs do not replace alcohol with a pharmacotherapy, such as Antabuse. However, these treatments do exist and have shown modest success, at least in the short-term. Like many anti-addiction medications, patient compliance is the biggest hurdle to success.

Antabuse, or disulfiram, is the most well-known of the anti-addiction medications for alcoholics. Antabuse prevents the body from effectively breaking down alcohol, resulting in an increase of acetaldehyde. If a person drinks and levels of acetaldehyde increase enough, the person will begin to feel ill and experience flushing, nausea and heart palpitations. Unfortunately, Antabuse is not very effective in that it requires the patient to adhere to a strict dosing schedule, compliance with which is not very high. Some motivated individuals, however, take Antabuse prior to particularly challenging situations, such as social functions where alcohol is being served. Others allow a medical professional or family member to routinely administer the medication in order to ensure compliance.

Also used for opioid addiction, naltrexone blocks the neuroreceptors that control the positive effects of drinking and cause alcohol cravings. In heavy drinkers, defined as those women who drink four or more alcoholic beverages a day or those men who drink five or more a day, naltrexone can reduce relapse and cut the relapse risk in the first 90 days after sobriety by about a third. However, naltrexone is less helpful in helping drinkers maintain sobriety.

Campral, or acamprosate, may help alcoholics maintain sobriety for several weeks or months, even if the patient has a particularly severe form of dependence. The drug targets the gamma-aminobutyric acid (GABA) and glutamate neurotransmitters and may alleviate some symptoms of protracted withdrawal such as depression, restlessness, sleep disturbance or anxiety.

Topiramate is the newest anti-drinking medication and has not yet been approved by the FDA; little is known about how it acts on the body. Studies suggest, however, that Topiramate increases GABA’s inhibitory transmission and reduces glutamate’s stimulatory transmission. Topiramate was studied in a recent clinical trial and found to be effective in increasing the number of drinkers who stay sober for 28 days or more.

Using Drugs to Treat Tobacco and Alcohol Addiction is a post from: Drug Addiction Treatment

According to a recent article in the Prague Post, the prescription pill Subutex is being injected intravenously. Many are shooting up with it instead of weaning themselves from their heroin habit. Subutex is used as a low threshold type of treatment for addiction to heroin and can be prescribed by any type of general practitioner without prior therapy or counseling. It has become increasingly popular on the black market due to addicts misusing the drug , leading to a widely publicized crisis in Prague.

Prague police and city officials say the prescription pill has become the main source of problems for their city center area, where between 70 and 80 percent of the drugs sold in are Subutex. It is easy for people to obtain more than one prescription because they can visit several doctors and it is much cheaper than illicit heroin.

Officials believe the drug should be dispersed in a much more controlled environment, like that of methadone, and should only be administered in clinics where patients must visit daily in order to receive their doses. Outreach workers in Prague are fully aware of the problem with Subutex and are working to develop newer approaches and develop informational campaigns about the drug and its risks.

Drug Used to Treat Heroin in Prague May Be More Problematic Than Heroin is a post from: Drug Addiction Treatment

Anything that gives someone pleasurable feelings can become addictive – from food to gambling to shopping or drugs. Experts believe the foundation of addiction toward a behavior or a substance is similar, and is connected to the release of endorphins in the brain that release good feelings.

The cycle of dependence begins when the person begins to take part in the addictive activity to keep getting those feelings, or a “high,” regardless of the cost. In reality, the person is addicted to the chemicals produced inside his or her own brain; the behavior or substance may act as the trigger for releasing these chemicals.

Many drug addictions, like heroin or alcohol, also trap the addict with a mental and emotional element that can last a lifetime. Some alcoholics, for example, will desire a drink for years following their recovery.

General behaviors seem to be present with any addiction, such as an obsession or preoccupation with the substance or behavior, even to the point of harming job performance and social relationships. An element of compulsion is also present. This means even if they try to stop, the person is compelled to keep repeating the action. When the behavior is finally stopped, withdrawal occurs, including anxiety, restlessness, mood swings and several other psychological or physical symptoms.

If someone tries to intervene and stop an addiction, the addict may show signs of resentment. They may feel threatened and anxious, or become extremely defensive about their ability to control the situation.

Causes of addiction remain under debate. Some behaviors people become addicted to are described as diseases, while others say the behavior is a reaction rooted between genetic and situational factors. Generally recognized addictions include alcohol, drugs, food, gambling, shopping, sex or exercise. Other conditions, like compulsive work, Internet usage and video games are being considered as formal addictions.

The American Society of Addiction Medicine looks to genetics as a strong factor in addictive behaviors, as well as a person’s level of tolerance toward the substance and their environmental considerations. Even a person’s ability to cope maturely with life situations can be considered as part of the problem.

No absolute consensus model for treating addiction exists, leading to confusion for both patients and professionals. Some prescribe the total removal of the addictive behavior or substance, and others believe carefully replacing an addictive drug, for example, with a substance like methadone, is a better option.

Some addictions, like food or working out, would never call for total abstinence. Therefore, treatment plans that include a variety of options – such as 12 Step group recovery programs, professional counseling, replacement behaviors and even medications to control cravings – are useful to many addicts and their families.

The first step in helping someone treat an addiction is recognition. Learning about addictions and their symptoms can be very helpful. Professionals also suggest family members continue to be firm with a supportive, loving attitude, until the person makes their decision to embark on recovery.

Addiction Theories Vary, but Recognition is Key is a post from: Drug Addiction Treatment

The style of motivational interviewing differs from other types of counseling because it is directed toward the goal of resolving conflicting attitudes or feelings. First developed to help people with alcohol addictions, the therapy is now used across a spectrum of behaviors and addictions and shows promise toward successfully encouraging a change in behavior.

Experts describe the central premise of motivational interviewing with several key characteristics, such as a desire to bring about specific changes in the patient’s attitudes and goals, which will be reflected in changes in behavior. There is also the belief that it is up to the client, not the therapist, to explain and rectify the clash between two sets of feelings, such as elation and guilt – also known as ambivalence.

Motivational interviewing does not involve direct statements that the person must change their behavior, nor does the technique allow for specific treatment recommendations to the patient. The approach, instead, relies heavily on client feedback and input as the counselor tries to guide the patient toward ending a destructive behavior pattern.

A large part of the process is the patient talking about the benefits and the consequences of their confusing conflicting feelings. For example, the client may say that if they quit indulging in emotional eating they may lose weight, but they will also have to learn to work through life stress in a new way. Direct urging or persuading the client to stop a behavior is avoided, believing that this may trigger a negative response. Instead, the counselor calmly encourages the patient to weigh the pros and cons of a behavior until they arrive at a workable conclusion. This assumption is that patient indecision toward a behavior can be resolved with the patient’s input.

Due to the client-centered nature of motivational interviewing, the process can take longer than other more direct methods of resolving unwanted behaviors. Therapists are also encouraged not to move too quickly beyond the patient’s pace, as this could deter the likelihood of change.

Despite its relatively lengthy approach, other techniques for drug or alcohol addiction have stemmed from the motivational therapy practice. The Drinkers Check-Up is a relatively quick question/answer strategy for people with addictions to alcohol or other problems, relying on feedback from the client to explore drinking patterns and comparing this feedback with standards that are considered norms.

Motivational Interviewing Helps Substance Abusers Resolve Confusion is a post from: Drug Addiction Treatment

The documentary tells the stories of addicts as they go through 12-step and other outreach programs and practice yoga. The film shows “how people have used yoga as part of their journey in recovery programs from serious addiction problems to a new life of well-being and emotional stability.”

The filmmaker, Lindsey Clennell, is a senior Iyengar Yoga teacher at the New York Iyengar Institute. Clennell is a yoga therapist and has trained 16 times in India with B.K.S. Iyengar, his primary teacher, and the Iyengar family.

Originally a medical student in England, Clennell became a documentary filmmaker and writer, producing and directing more than 200 music videos, concert series, and specials. Among his subjects were Muhammad Ali and Mikhail Gorbachev, and he was nominated for an award for Outstanding Contribution to British Cinema by the British Film Academy.

Reflecting on one of his last film projects—which led to the release of 30 American hostages before the first Gulf War—Lindsey cites a favorite quote from Sri Aurobindo: “All life is yoga.” This concept would have been unobtainable for him without Iyengar’s teaching, which gave him the stamina to endure creative demands and stress.

You can view the entire 85-minute film here: www.adyo.org

Documentary Shows How Yoga Has Helped Recovering Addicts is a post from: Drug Addiction Treatment

Buprenorphine is a medication that virtually stops withdrawal symptoms from opiate drugs such as heroin, methadone, Vicodin, OxyContin, codeine, and morphine. Many people find it extremely difficult to recover from opiate addiction because the withdrawal symptoms are so severe, so buprenorphine ameliorates the process.

At Tompkins, opiate-dependent prisoners are started on buprenorphine about one month prior to their release date, given a 30-day supply as they leave, and then linked to a licensed provider for continuing care. New inmates can also be given the drug to help with detoxification when they first arrive. The facility’s mental health director, Dr. John Bezirganian, started the program a few years ago.

Tompkins County is the only jail outside of New York City to offer such medication-assisted therapy, and the only one in the state to use buprenorphine. Rikers Island in New York City offers short-term detoxification treatments with methadone, a drug used to help wean heroin addicts off the drug. However, methadone is controversial due to its addictive nature.

Buprenorphine, however, is not addictive. No matter how much one takes, he or she will only get 20-30 percent of the effect of a full dose of heroin or morphine. In addition, if a person taking buprenorphine tries to take heroin or another opiate, he or she won’t be able to get high. Unlike methadone, buprenorphine has no street value and can be prescribed by a primary care physician. (People using morphine must go to a licensed dispensary every day to get their dosage.)

Dr. Bezirganian said he manages many of the buprenorphine cases himself, both in jail and in the community, and that it seems to be effective. Though not all inmates prescribed the treatment continue with it upon their release, many of them do, and Bezirganian said he believes it have saved more than one life.

“It’s a highly risky time when people leave a jail. If they return to their environment, there is a high risk of accidental overdose, and relapse in general,” Bezirganian said. “This way, at least they have a shot at choosing recovery.”

In November 2006, the New York State Commission on Correction notified county sheriffs and jail administrators of new federal regulations permitting easier administration of buprenorphine, and said that safe and effective opioid withdrawal treatment in jail is part of the generally recognized standard of adequate medical care. However, Tompkins is the only jail that provides this therapy.

The Human Rights Watch report said that the other 56 New York counties could correct this problem immediately, adding that punishment for drug use in New York State prisons is severe and out of proportion to the seriousness of the offense.

Prisoners who may be drug dependent are punished for symptoms of a chronic, relapsing disease,” it said. “Drug dependence treatment is withheld from prisoners who may need it as part of the disciplinary sanction.”

New York Prison Lauded for Opiate Addiction Treatment Program is a post from: Drug Addiction Treatment

The most well known cases of PTSD are seen in war veterans. Vietnam War vets who suffered from PTSD showed significant impairment in their ability to re-integrate into the “normal” (that is, non-combat) world. Many of these vets did not seek treatment, but even more disheartening is the fact that many probably could have been treated if effective programs had been available. Now with Iraq War veterans also showing significant signs of post-traumatic stress, we are poised to either end up with another generation of battle-rattled young men or to face the problem with the resources these war vets deserve.

PTSD is not only caused by war. Any significant traumatic event or a series of traumas over time can lead to symptoms of PTSD. Some common causes are:

• Child or domestic abuse
• Living in a war zone or extremely dangerous neighborhood
• Sexual Assault
• Violent Attack
• Sudden death of a loved one
• Witnessing a violent death such as a homicide

One of the most effective treatments was discovered incidentally by Francine Shapiro, PhD, in 1987. When Shapiro was hiking and became anxious and overwhelmed, she noticed that as she scanned the environment with her eyes, moving them back and forth, she began to relax. This led her to assume that eye movements had a desensitizing effect, and when she experimented with it clinically, she found that other people had the same response. It became apparent that eye movements alone weren’t comprehensive, so she added other treatment elements and developed Eye Movement Desensitization and Reprocessing – known as EMDR.

Untreated trauma can be a significant source of psychic pain and emotional turmoil, which leads many of those suffering to self-medicate with alcohol or drugs. If those people seek treatment for drug addiction, they are at high risk for relapse if they do not find a way to re-process and cope with the trauma.

One of the current practitioners of EMDR is Los Angeles-based psychotherapist Barbara Brawerman, Psy.D, MFT a Certified EMDR therapist and an EMDRIA-Approved EMDR Consultant who has trained in affect regulation skills training as well as somatic-based psychotherapies. Brawerman became interested in EMDR when she noticed that traditional talk therapies weren’t working for her complex clients who had multiple diagnoses, particularly those who also suffered from alcohol or drug addiction. She wanted to develop a more integrated approach that treated both the left and right hemispheres of the brain, which she found in EMDR.

Brawerman teamed up with Promises, a Malibu drug addiction treatment program, to develop a trauma recovery program that uses EMDR.

“Many people struggling with addiction have underlying traumas and use alcohol or drugs to withdraw and numb their memories; when the drugs and alcohol are taken away, they’re left with a sense of emotional overwhelm that is not alleviated through talk or cognitive therapies,” explains Brawerman.

Talk Therapy Doesn’t Always Work

Brawerman founds that talk therapy often kept patients stuck in the traumatic event, essentially reliving it and even intensifying the traumatic feelings.

“Eye movements and bilateral stimulation remind the patient that they are still in the present. They’re attending to the trauma in the past while being consistently reminded that they’re now in a safe environment in the present with a therapist they can trust,” she explains. “Trauma lives in the right hemisphere of the brain, so treating just the left hemisphere, such as with talk therapy, doesn’t work. EMDR connects the left and ride sides of the brain, allowing the person to look inward and get in touch with his or her innate ability to heal and self-soothe.”

Originally designed to treat traumatic memories, EMDR has been found to effectively treat PTSD, panic disorders, anxiety, and other psychological distress that may follow a distressing experience. Several studies report a 77-90% remission in after just five treatments in those patients who have experienced a single traumatic event.

Brawerman believes this type of intervention lessens the risk of relapse. “If there’s a particular incident or belief about self that has been haunting a patient, if I can help to desensitize and reprocess their experience into a more healthy perspective, then when they are discharged, they’re less likely to be triggered by that experience,” Brawerman says.

Brawerman says that with those addicted to drugs it is critical to review any traumatic incidents during the developmental and individuation processes, whether a patient has the ability to separate themselves from others and adaptively define a personal relationship with the outside world.

Promises clients who have experienced trauma or overwhelming emotion meet individually with Dr. Brawerman for EMDR or emotion regulation skills training, in addition to weekly group meetings, called affect regulation group. The primary goal of EMDR and somatic therapy is to help those who have made the decision to get treatment for drug addiction with the most effective therapies available so that they have fewer risk factors for relapse when they return home.

EMDR to Treat Underlying PTSD in Drug Addiction is a post from: Drug Addiction Treatment