Category: Spirituality

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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

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State of Emergency: Suicide in First Nations Communities

00Addiction, Anger, Depression, Education, Featured news, Grief, Health, Identity, Politics, Post-Traumatic Stress Disorder, Spirituality, Suicide, Trauma December, 14

On April 17th 2013, Chief Peter Moonias declared a state of emergency in the community of Neskantaga. Two suicides within days of each other are only the most recent in a string of sudden deaths that have ravaged the group. 

In the four months prior, seven people died, four of them from suicide, and twenty more made suicide attempts. In a community as small and remote as Neskantaga (the reserve is home to 300 people and is only accessible by plane), the residents are tight-knit. And the losses of their family members, friends and neighbours have left many struggling to cope.

Suicide is disturbingly common among some Inuit and First Nations groups, with the rate in some communities eleven times higher than the Canadian average. Overall, First Nations peoples have a suicide rate twice the norm in Canada, a statistic that has been stable for at least three decades.

Colonization of the Americas has had a profound effect on Indigenous populations. In the centuries since first contact, 90% of the American Indigenous population has been wiped out due to plagues, warfare, and forced relocations. The legacy of land seizures and residential schools still haunts these groups.

The immediate survivors of these incidents would undoubtedly be traumatized, but many of the people who have committed suicide in recent years were not personally exposed. How can trauma inflicted centuries ago have an impact on current suicide rates?

The answer lies in the concept of historical or collective trauma, which Maria Yellow Horse Brave Heart, Associate Professor at the University of New Mexico, defines as “cumulative emotional and psychological wounding over the lifespan, and across generations, emanating from massive group trauma experiences.”

Also known as generational grief, the trauma results from suffering profound losses in areas such as culture and identity, without resolution. Unresolved, deep seated emotions like sadness, anger and grief are passed on from generation to generation through parental practices, relations with others and culture-wide belief systems.

In everyday life, the trauma manifests itself through social problems like drug use, familial abuse and violence. These events can cause traumas of their own and result in depression and PTSD, both of which increase suicide attempts.

Young people are especially at risk. In the cohort of 15-24, the rate of completed suicides is five to seven times the national (Canadian) average, and suicide attempts are even more frequent 

Chris Moonias (no relation to Chief Peter Moonias), an emergency response worker in Neskantaga, told the CBC that since the end of 2012, “We average about ten suicide attempts per month, and at one time we surpassed thirty attempts in one month.”

In addition to unresolved grief, Cynthia Howard of Laurentian University identifies several factors that contribute to suicides in Aboriginal communities. These include: attendance at residential schools and abuse experiences there, forced assimilation, displacement, and adoptions. These experiences have left legitimate feelings of distrust towards dominant American and Canadian cultures and feelings of loss of culture.

Some people also feel strung between two cultures (dominant culture and their own band’s culture) while essentially belonging to neither. Feeling alienated and lacking a sense of belonging can leave many people depressed and feeling that their lives lack a sense of purpose.

Other issues such as low socioeconomic status and extreme poverty, along with low levels of education and lack of opportunity have lead to feelings of hopelessness and helplessness.

“Learned helplessness” occurs when a group or individual, usually after a series of disastrous events, believes they have no control over the outcome of any situation, and that perceived failures in the present will likely continue into the future. Without hope, people sometimes feel that living is worse than not living. This feeling is only exacerbated by a shared history of trauma and its consequences, and can culminate in suicide.

Unfortunately, many people suffering do not receive adequate help. Their families and friends are also left without professional support, continuing the cycle of unresolved grief.

Perhaps it is fitting that Chief Moonias of Neskantaga called a state of emergency. His community has reached a tipping point and must be healed in order to move forward. 

As of now, the federal Canadian government has offered some monetary and human aid, but unless we go beyond band-aid solutions, frequent suicides and their consequences will continue to haunt Neskantaga.

– Contributing Writer: Jennifer Parlee, The Trauma and Mental Health Report

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

Copyright Robert T. Muller

 Photo Credit: https://www.flickr.com/photos/kittysfotos/6235090832/”>Kitty Terwolbeck</a

This article was originally published on Psychology Today