Category: Motivation

168194-173344

Methadone Treatment May Prolong Addiction

00Addiction, Diet, Environment, Fear, Featured news, Health, Motivation, Psychopharmacology, Resilience, Sleep, Spirituality, Stress, Trauma January, 15

The conventional treatment for opioid dependence is to prescribe methadone.

Similar to morphine, methadone is a synthetic opioid sometimes referred to as a narcotic. It is useful at preventing opioid withdrawal, minimizing drug cravings, and is said to reduce the risk of HIV, Hepatitis C and other diseases associated with intravenous drug usage. Methadone is also cheap, and best of all legal.

Despite the advantages, methadone is highly addictive, and has many side effects such as dry mouth, fatigue, and weight gain.

Treatment involving methadone requires a weekly medical visit to renew the prescription, sometimes leading those who are addicted back to the very environment and people that they need to avoid to stay clean.

The Trauma & Mental Health Report recently spoke with Leslie (name changed for anonymity), a patient who has been receiving methadone maintenance treatment (MMT), who says, “Sometimes I wait all day to see the doctor. During that time, you can’t help but associate with other users, hear “drug talk”, or even see drugs being passed around. The methadone doctor doesn’t push counseling and is not there for support. I’m only going to get my prescription.”

Toward the end of treatment, methadone dose is slowly tapered to prevent withdrawal. But most users don’t wean off completely. Leslie says she didn’t have the motivation or tools to do so until she started seeing her drug addictions counselor:

“I’ve been trying to get off of methadone for 18 months now. It has helped with the withdrawal symptoms, and life is easier to manage since I’m not running the street 24/7 looking for my next fix. And I have more time to get my life on track. But, In order to ‘knock’ the addiction you need to figure out what your personal triggers are. My counselor has helped me with this. She also provides a safe place for me to go and discuss my problems and any issues I have with MMT.”

The greatest fear is relapse. Although part of the recovery process, relapse can have physical and emotional consequences. But it helps to identify personal triggers: cues that provoke drug-seeking behavior, the most common of which are stress, environmental factors such as certain people or places, and re-exposure to drugs.

The most important missing link in MMT is drug counseling. Meeting with a counselor is not mandated and patients seldom see one. Those who seek counseling benefit from help determining personal triggers, and preparing for potential relapse. A counselor may help create a healthy living plan that focuses on improving mental health with nutrition, exercise, sleep, building healthy relationships, and spiritual development.

Better family relationships also help with recovery. Including family members in treatment increases commitment to counseling and also helps family members understand what the person is going though.

Opioid addiction is more than physical dependence. Initial detox is a start. Methadone helps with the physical aspects of withdrawal, and helps users lead a more normal life. But without the help of a drug counselor, MMT isn’t enough.

Without counseling, social support, a drug free environment, and the desire to change, we lead the patient only part way there. And part way isn’t enough.

– Contributing Writer: Jenna Ulrich, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

Photo Credit: www.123rf.com/stock-photo/lonely_man.html

This article was originally published on Psychology Today

159025-163284

Dr. Mom and Dad

00ADHD, Anxiety, Attention, Child Development, Depression, Environment, Featured news, Health, Intelligence, Leadership, Motivation, Parenting, Psychiatry, Psychopharmacology, Self-Control, Sleep September, 14

We live in a world of self-diagnosis. With access to online medical databases like WebMD and kidshealth.org, it is easy to type symptoms into Google, find a diagnosis and present findings to the family physician.

Self-diagnosis may seem harmless, but it can become problematic when we diagnose ourselves or our children with more complicated conditions, behavioral disorders like Attention Deficit Hyperactivity Disorder (ADHD).

The over-diagnosis of ADHD and the over-prescription of medications like Ritalin, Adderall, and Vyvanse (to name a few) have been longstanding problems in the health care community. Clinical psychologists Silvia Schneider, Jurgen Margraf, and Katrin Bruchmuller, on faculty at the University of Bochum and the University of Basel found that mental health workers such as psychiatrists tend to diagnose based on “a rule of thumb.” That is, children and adolescents -often males- are diagnosed with ADHD based on criteria such as “motoric restlessness, lack of concentration and impulsiveness,” rather than adhering to more comprehensive diagnostic criteria.

Parentsmotivation to get help for their child’s problems along with free access to online information may play a role in the over-diagnosis of ADHD.

A study by Anne Walsh, a professor of Nursing at Queensland University of Technology found that close to 43% of parents diagnosed and 33% treated their children’s health using online information. Of concern, 18% of parents actually altered their child’s professional health management to correspond with online information. Considering the questionable quality of some online health information, these numbers are worrisome.

Furthermore, as primary caregivers can sometimes be persuaded, it is possible that parental conviction of the child’s diagnosis may play a role in physician decisions to treat. With basic diagnostic criteria for ADHD readily available online, some parents may be quick to self-diagnose their “restless and impulsive child.”

“It sometimes happens that parents come to me convinced that their child has ADHD [based on their own research] and in many circumstances they are correct,” says Dan Flanders, a pediatrician practicing in Toronto, Canada.

 According to Flanders, there are certain traits that make a child more likely to be misdiagnosed with ADHD. “Children who have learning disabilities, hearing impairment, or visual impairment may be mistaken as having ADHD because it is harder for them to focus if they can’t see the blackboard, hear their teacher or if they simply cannot read their homework.”

Flanders adds that gifted children, children with anxiety or depression, and children with sleep disorders are commonly misdiagnosed with attention disorders. “Gifted children learn the class objectives after the first 10 minutes of a class whereas their classmates need the whole hour. For the remaining 50 minutes of class these children get bored, fidgety, distracted, and disruptive. The treatment for these children is to enrich their learning environment so that they are kept engaged by the additional school materials.”

Children with anxiety and depression can be misdiagnosed with ADHD because there may be an interference with a child’s ability to learn, focus, eat, sleep, and interact with others. For children with sleep disorders, “one of the most common presentations of sleep disorders is hyperactivity and an inability to focus during the day. Fix the sleep problem and the ADHD symptoms go away.”

It is, however, important to note that these disorders are not mutually exclusive of each other. “A child can have a learning disability, anxiety, and independent ADHD all at the same time.” 

While it is often beneficial for parents to consult online databases for background information, Flanders warns against relying solely on information found online because the information may not be up-to-date and cannot replace a thorough psychological assessment.

Why, then, do parents resort to this quick fix of information?

Walsh reported that parents use online health information for a range of reasons including feeling rushed and receiving limited general lifestyle guidance from their doctors.

Flanders points out that the doctor’s approach should always be to review the data honestly and objectively with parents and then openly present the treatment options available to them.

“The most important part of ADHD treatment is making sure of the diagnosis. There are so many children who are started on medication inappropriately. Throwing medication at the problem is not the answer unless the diagnosis is well established and the differential diagnoses have been exhausted.”

– Contributing Writer: Jana Vigour, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today