Writing Prompts for your Recovery Journal

Writing prompts for recovery journal

Journaling in recovery can be a great tool for healing. Getting your thoughts, feelings, emotions out onto paper means they aren’t jostling around in your head. When you write, you are working through your problems in a tangible way and releasing pent up feelings which can be very therapeutic. Furthermore, a journal can show you how far you’ve come, reduce stress, and be a creative outlet for your ideas and memories. Using writing prompts in your recovery journal can help you connect to yourself in ways you may not have thought of.

 

Types of Journaling

First of all, we should note there is no wrong way to journal, whatever feels right for you is what you should do. But, there are lots of different methods out there that might inspire you, so we thought they were worth sharing. 

There is the classic diary, wherein you reflect on and write about your day, your experiences, and your emotions. You can look back and see how you were feeling in a particular moment and reflect on the past. Often you will find you’ve grown a lot when you read old entries. 

Gratitude journaling is another popular writing method. Thinking about the things you are thankful for can help you see the world in a positive light. Rather than focusing on what we don’t have, we focus on the things we do have. 

Goal-setting journals can help track our accomplishments, big and small, and keep us on track to take actionable steps to achieve our goals. Writing down the steps we’ve taken to reach our goals keeps us accountable and helps us remain motivated. 

 

Journaling Prompts 

Questions

What am I grateful for today? 

What about recovery scares me the most? 

Where am I in my recovery journey? 

What advice would I give my younger self? 

What are you most proud of yourself for today? 

If it weren’t for my recovery, where would my life look like right now? 

What does it mean to love yourself? 

What does showing up for myself look like? 

Is there something I wish others knew about me? 

What am I happy about? How can I hold onto this feeling in dark times? 

What am I worried about? How can I cope with this worry? 

Am I angry about something? How can I resolve this anger? 

Is there something I am sad about? How can I cope with this sadness? 

 

Write a letter to… 

Your younger self.

Yourself when you were in active addiction.

Your future self.

Yourself right now.

A significant person in your life.

 

Unpacking the Past

Write about your… 

First love. 

Parents. 

Sibling. 

Someone you lost. 

Childhood friend. 

First pet. 

A time you were truly afraid. 

A time you were truly happy. 

 

Goal Setting

Short-term goals (1-3 months)

Medium-term goals (1-2 years)

Long-term goals (5-10 years) 

 

Lists

Choose a number for each list and commit (i.e. 10 things that I like about myself):

Things that make me smile.

What I like about myself.

Things I want to accomplish this year.

What I like about my pet.

What my recovery gave me.

Things I did for others this week.

Things I did for myself this week. 

Actions I can do for self-care when I feel down

 

Milestone Prompts

At each milestone of your recovery, whether it’s one week, one month, one year, take a moment to congratulate yourself, think back on this time and what it has given you, what you have given yourself by remaining committed to your health and wellbeing. Write about it all. 

 

A Final Note

We hope these writing prompts inspire you and your recovery journal. If you have any prompts that have helped you, we’d love to hear from you on our social media

And if your recovery journal isn’t enough and you are struggling, please do not hesitate to reach out. Call us anytime, we’re here to listen. 

Myths About Medication Assisted Treatment (MAT)

Medication Assisted Treatment for Opioid Addicts

At Harmony Recovery Group, we offer Medication Assisted Treatment (MAT) plans that help patients to manage opiate cravings in the long-term and help them build a new life in sobriety. However, there are many myths and misconceptions about Medication Assisted Treatment that we would like to clear up. 

Firstly, many types of Medication Assisted Treatments exist, encompassing medications like Suboxone, Subutex, Methadone, Vivitrol, and Naltrexone. 

In our facilities we use Suboxone, which we consider the safest option for an assisted recovery. Suboxone works because it binds to the same receptors as opiates in order to reduce withdrawal symptoms and cravings. It binds 7x stronger than morphine. Because of this, patients are unable to abuse opiates with Suboxone because they will have no effect due to the binding effect on the receptors. 

Suboxone use reduces the risk of relapse significantly. Studies have shown that Suboxone reduces the risk of relapse by 3x compared with other forms of MAT such as Vivitrol and Naltrexone. And those forms of treatment have a 3x reduction in relapse compared to going cold turkey. Compared to non-medication assisted treatment, there is a 75% improvement in retention rates in sobriety programs. 

We spoke with Dr. Jill Thompson, Board Certified Doctor in Addiction Medicine and our Medical Director at our facility Midwood Addiction Treatment, to discuss the common myths and misconceptions around Medication Assisted Treatment. 

 

Myth: “Medication Assisted Treatment is Just Legal Heroin”

Beuprenorphine, the primary ingredient in Suboxone, is not heroin. It is made a different way. Narcotics like Oxycontin, Hydrocodone and other opiates are called Full Agonists whereas Buprenorphine is a Partial Agonist. Even though Buprenorphine binds to the same receptors that narcotics do, it acts very differently. For example:

1. You can never become tolerant to Buprenoprhine.

With any other narcotic the more you take it, the more you start to need. A dose that once created a feeling now feels like nothing at all because you develop tolerance to it.  With Buprenorphine you are always on the same dose and you never need to go up in dosage. Jill says, “For example, I had a patient who was on the same dose for 17 years. Unfortunately he passed away in a car crash a few years ago but we had never once changed his dose the entire time I treated him.”

2. Buprenorphine has what’s called a Sealing Effect

This means you cannot take more and more of the medication and get higher and higher. As Jill says, “Your receptors become saturated at a certain dose and that’s it. You can’t take more and more and feel euphoric like you can with opiates.” 

3. Unlike opiates, it is nearly impossible to overdose on Buprenorphine.

The only reported incidents of overdose have been when the medication was mixed with high amounts of other medications such as Benzodiazepines. There is no known case of overdose from Buprenorphine on its own. 

 

Other MAT medications, like methadone do not have this protection against tolerance nor the sealing effect, making them quite different from the safety of Suboxone. For example, with methadone, a patient can become tolerant and need higher doses and they can also take higher doses and become high. 

 

Myth: People Who Use MAT Aren’t Actually Clean

This simply isn’t true. What is your definition of “Clean?” Does it mean not getting high? Not getting altered or impaired? Being able to function in everyday life? If the answer to these questions is “yes”, then people on MAT are in fact Clean and Sober. 

Dr. Jill puts it this way: “There is a difference between addiction and dependency. Addiction encompasses having a physical and psychological craving for something that is so strong you will do anything to get it. Dependency is the same as if you were a Diabetic and had to take insulin everyday. You are dependent on your insulin for your disease. Yes, someone who is using Suboxone in their MAT program is dependent on it, but it is the same as any medication out there to treat chronic illness. You still have to go to meetings, you still need to do the work, but you have help in managing your condition.” 

Because Suboxone does not impair patients and the sealing effect means there is no way to take more and feel altered, they can get a job, they can concentrate, and they can function as normal. 

Taking a pill once a day for your medical condition does not mean you are not clean. 

 

Myth: Medication Assisted Treatment is a Lifelong Commitment 

Many people think that if they start taking MAT, they will never be able to get off of it. The truth is, with the exception of using it in Detox for a week to get off of drugs, Suboxone is not a short-term fix but it is not a life-long commitment either. You can come off of it if you want to. 

As Dr. Jill says, “People are very different and this is a very individualized thing. The phrase “longer term” will be different for different people. Some people may want to come off in a year or two, some people may want to be on it for the rest of their lives. At this point in time, we do not know of any reason people cannot stay on it indefinitely.” In fact, the FDA recently released a statement saying that they advocated using Suboxone for indefinite treatment. However, if patients do want to come off of it, they certainly can. 

If and when you want to come off the medication, it’s important to reduce the dose in a slow and controlled manner. When people decide to skip their dose at random or get off on their own, this creates a very high risk of relapse. If the medication reduction is down systematically with a trained professional, you should not run the risk of relapse. This is because with careful tapering, you won’t be feeling bad or noticing you are withdrawing from it. Dr. Jill suggests patients plan on committing 6-12 months to tapering off slowly and safely.

 

Myth: Suboxone Causes Precipitated Withdrawal

This is a common misconception among opiate users and is not true. Buprenorphine, the active medication in Suboxone, has been around for decades. But, in the early 2000’s Buprenorphine was approved for use in drug treatment. At the time its brand name was Subutex and it was purely made of Buprenorphine. 

Unfortunately heroin users realized that it could be abused and began to liquify it and inject it. In this manner, a user can in fact get high from Buprenorphine. But, it’s most important use to users was the drug’s ability to stave off withdrawal. If a heroin addict is going to run out of heroin they will typically go into withdrawal within 6-12 hours. With Buprenorphine (brand name Subutex), they won’t go into withdrawal for 2-3 days. 

When Subutex began to flood the streets for this purpose, the manufacturer changed the formula to include Naloxone. Thus, the combination was named Suboxone.  

As most people know, Naloxone is the medication that can stop an overdose. It works intravenously by immediately removing all the heroin left on the body’s receptors. However, Naloxone only works when injected. If Suboxone is administered orally, as intended, the small amount of Naloxone is inert and will not have this effect.

Now, if a heroin user tries to shoot up Suboxone, the Naloxone is fully effective. The user will go into immediate, precipitated withdrawal. This means that all the withdrawal symptoms a user would experience over 48 hours happens in the next two hours. 

No Need To Fear Suboxone

Heroin users are often afraid of Suboxone, thinking they will go into immediate withdrawal if they take it. This is absolutely false. If taken as recommended, orally, Suboxone will block cravings and prevent withdrawal symptoms. In the case that there is heroin in your system, the Suboxone will knock it off and bind to receptors instead, because it is much stronger. If you try to use heroin on top of Suboxone, you will feel nothing because the Suboxone binds that much tighter. That is why it is so effective in preventing cravings. The Naloxone in the pills is simply to prevent intravenous abuse on the street level. It is completely inactive in pill form. 

In the end, choosing the type of treatment for your needs is a very personal choice that should be made with the guidance of a trained professional. We hope this cleared up some of the myths around Medication Assisted Treatment. If this sounds like the right fit for you, or if you are seeking any type of substance abuse treatment, please contact us today. We are here to help. 

 

Ibogaine Treatment for Addiction

Ibogaine Treatment for Addiction | Recovery By The Sea

Ibogaine is a psychedelic drug that can induce effects similar to those associated with LSD or mushrooms. Although the substance can lead to short-term side effects, including anxiety related to experiencing hallucinations, it has also been touted for a few years as a potential treatment for addiction problems. Recently, research in the West has begun to focus on ibogaine for this reason, and it has been found that it may be beneficial for those who are addicted to alcohol, opioids, methamphetamine, and cocaine especially.

Anecdotal reports suggest that ibogaine, which is derived from a plant found in the African rainforest, modifies brain chemistry in a way that reduces withdrawal symptoms and cravings in people struggling to recover from substance abuse. However, researchers exploring the potential of this drug in addiction treatment do not imply that ibogaine ultimately ends addiction, and, instead, it interrupts the process.

How Does Ibogaine Work?

Addiction is now widely believed to be a chronic disease caused by long-term changes to the reward centers of the brain. When a person uses ibogaine, the drug is converted into a compound that targets these regions and addictive behaviors. This compound essentially “rewires” these areas, allowing the brain to return itself to a state comparable to before addiction developed.

While it is believed that ibogaine can ease withdrawal symptoms and block cravings, this process is more like detox than actually ending an addiction. There are still many steps that need to be taken, such as comprehensive therapy and counseling, after a person is no longer physically dependent on a substance.

Success Rates

Medical providers who have employed ibogaine report a 50-80% success rate among those with meth addictions. That said, long-term recovery and relapse prevention also depended largely on undergoing a rehab program after using ibogaine as directed under a doctor’s supervision.

One physician reported a 70-80% success rate with effective aftercare and noted that, when people recovering from meth addiction used ibogaine but returned to the same environment in which they had originally used meth, there was a 90% percent rate of relapse. This finding is believed to be, at least in part, because visual cues and emotional associations are more prominent for people with meth addiction compared to those who are battling opioid addiction.

Ibogaine treatment for a few addictive substances results in a 20-50% rate of abstinence at a one-year follow-up, and that included people working to overcome opioid addiction. These numbers may not seem significant, but, comparatively, Suboxone treatment for opioid addiction shows only an 8.6% success rate once the person no longer requires its use.

A review from Brazil, where ibogaine is uncontrolled and often used in conjunction with psychotherapy to treat alcohol, cocaine, and marijuana addiction, showed higher rates of success. It should be noted, however, that subjects in the study underwent a combination of ibogaine treatment and therapeutic follow-up care. Still, one-time ibogaine treatment resulted in abstinence of more than five months on average. Significantly, repeated sessions of ibogaine treatment resulted in abstinence on average for more than eight months.

Ibogaine Treatment for Addiction | Recovery By The Sea

Although ibogaine treatment may be effective for some individuals, it may not be for everyone. For example, a 2012 study of subjects who received a one-time ibogaine treatment that struggled with opioid addiction revealed that 80% relapsed within the first six months. Another 20% stayed abstinent for more than six months but less than a year, and just 13% successfully remained abstinent for more than a year.

Those who did relapse during the study, however, were found to use fewer opioids when compared to their previous levels of use. One of the first studies involving ibogaine from 1983 suggests that multiple treatments using the drug may be more beneficial. The study revealed that four treatments helped a person in recovery maintain abstinence for three years, while one treatment was effective, on average, for about six months.

It’s vital to remember that drugs like ibogaine, which is controlled in the U.S., should not be obtained illicitly and self-administered. In other words, if you are interested in what ibogaine might have to offer, you would need to travel abroad to get medical care and appropriate comprehensive therapy. Fortunately, however, effective treatment can also be accessed in the U.S., and new potential approaches are continually being researched. The FDA is also approving addiction treatments found to be relatively safe and beneficial.

Getting Treatment for Drug or Alcohol Addiction

At the time of this writing, Recovery in Tune does not offer ibogaine treatment. Although it is used in other countries to treat various addictions, it remains illegal in the United States. Instead, we offer several other solutions for addiction to substances, including Suboxone for opioid dependence and naltrexone, which is a medication that relieves cravings over the long term for both alcohol and opioids.

In addition to pharmaceuticals, we offer comprehensive programs, in both outpatient and partial hospitalization formats, tailored to the unique needs and goals of each individual. Our programs feature a variety of evidence-based services, such as psychotherapy, counseling, and group support.

If you are suffering from an addiction to opioids, other drugs, or alcohol, contact us today to find out how we can help you get on the road to recovery, one step at a time!

PAWS Symptoms (Post-Acute Withdrawal Syndrome)

PAWS Symptoms | Recovery By The Sea Addiction Treatment

Drug or alcohol withdrawal syndrome is characterized by effects that occur when a person has become dependent on a substance abruptly discontinues use. Both illegal and prescription drugs can induce withdrawal symptoms, and they may persist anywhere from a few days to several weeks or longer. Although the physical side effects from dependence usually subside after a week, people in recovery may experience emotional symptoms for much longer—months, in some cases.

Doctors usually try to work with their patients to control withdrawal symptoms related to prescription drugs, such as benzodiazepines or other depressants. However, those who have an addiction to illicit substances may face intense withdrawal effects if they try to stop using the drug abruptly or “cold turkey,” or if they are forced into abstinence due to the drug becoming unavailable to them.

Post-Acute Withdrawal Syndrome (PAWS)

Although acute withdrawal symptoms can be extremely unpleasant, most usually subside in one or two weeks, especially when the person is medically monitored during the detox process. However, some substance abuse can result in a longer duration of withdrawal effects that continue for months. People who use drugs or alcohol heavily for a prolonged period are more likely to experience this unfortunate problem, also referred to as post-acute withdrawal syndrome or PAWS.

PAWS is a condition hallmarked by a combination of ongoing withdrawal symptoms, which are typically psychological, emotional, and involve depression, anxiety, agitation, and mood swings. These effects can persist long after acute withdrawal symptoms have diminished.

Although post-acute withdrawal symptoms rarely include aches and pains, nausea, cramping, or other physical effects common to withdrawal, it can be just as intense and unpleasant as short-term withdrawal. If this condition is left untreated, it may ultimately place an individual at an increased risk of relapse, as they may resort to substance abuse in an attempt to alleviate their discomfort.

About PAWS

People who encounter symptoms related to PAWS can feel like they are undergoing a rollercoaster of adverse effects and emotions that wax and wane without warning. Each episode can last for several days and continue to reoccur in a cycle for up a year. These symptoms can manifest after the prolonged use of any intoxicant, although PAWS most often occurs among people who discontinue the abuse of the following substances:

Alcohol

Suddenly discontinuing alcohol use can be hazardous and even life-threatening, because it can induce a severe condition known as delirium tremens (DTs) that includes seizures and psychosis. Furthermore, if this occurs, it may also increase the likelihood of PAWS occurring. Alcoholics who experience PAWS may suffer for months with anxiety, sleep difficulties, cravings, and impaired concentration, and impulse control.

PAWS Symptoms | Recovery By The Sea Addiction Treatment

Antipsychotics

Antipsychotics attach to dopamine receptors in the brain to reduce symptoms related to hallucinations, delirium, and other psychiatric issues. When their use is terminated without a tapering schedule, the person could encounter withdrawal symptoms, such as major mood swings, for months.

Benzodiazepines (Benzos)

Benzos are medications that can be beneficial for many people who have anxiety and panic disorders, but they also have the potential for physical dependence and abuse. Most doctors do not prescribe benzos long-term because addiction can develop.

Withdrawal symptoms related to benzos tend to resemble anxiety and panic disorders, making it much more difficult to discontinue use. PAWS symptoms, which are not unlike those related to alcohol, may include insomnia, fatigue, and intense cravings that can last for months after physical dependence has diminished.

Opioids

Whether opioids are misused by prescription or abused illicitly as in the case of heroin, long-term exposure to these drugs can result in the development of PAWS if they are not tapered off properly. Moreover, people who experience very intense acute withdrawal are more likely to encounter PAWS, which can include intense cravings, exhaustion, and cognitive impairments that may not improve much for an extended period.

Stimulants

Prescription drugs, such as Adderall, and illicit stimulants, such as cocaine, can contribute to PAWS if withdrawal from them is not executed appropriately. A person who has detoxed from stimulants may encounter extreme fatigue, severe depression, and physical weakness long-term, and these effects can be challenging to manage.

Other potential effects of PAWS other than the aforementioned include the following:

  • Hostility
  • Aggression
  • Loss of libido
  • Anhedonia (inability to feel pleasure)
  • Memory impairments
  • Hypersensitivity to stress

PAWS Symptoms Causes: Theories

PAWS is a complicated syndrome with no single, specific cause. Psychiatrists and doctors do not completely concur on the exact reasons for the syndrome. Still, some posit that stress response in addition to changes to specific regions of the brain during active addiction may contribute to the onset of PAWS.

Theories about factors that are related to the development of PAWS include the following:

Homeostatic Regulation

A person’s chemical dependence on drugs or alcohol results in brain chemistry changes over time, and when the system is denied the substance’s presence that triggers neurotransmitters to release, it can no longer reach a balance or stabilize on its own. It can take a prolonged period for the brain to achieve equilibrium fully, and this delay can lead to fatigue, moodiness, insomnia, and other psychological symptoms.

Stress

PAWS Symptoms | Recovery By The Sea Addiction Treatment

It can be psychologically challenging to quit using a psychoactive substance, especially for those who attempt to do it abruptly or without medical supervision. This stress can lead to relapse or otherwise result in the continued appearance of withdrawal symptoms as the individual attempts to reestablish an emotional life balance without the use of drugs or alcohol.

Habit

One of the main objectives of rehab is to help individuals alter their behaviors and responses to the use of drugs or alcohol. Recovering heroin addicts, for instance, may have fond memories of cooking and injecting drugs, while others who are in recovery from alcohol use disorder mourn the loss of certain social situations. Returning to habits associated with substance abuse frequently results in relapse. Still, the loss of that practice or ritual can also produce stressful psychological symptoms, such as depression, cravings, or anxiety, eventually contributing to PAWS.

Getting Treatment for PAWS

Because PAWS symptoms are primarily psycho-emotional, continued support from counselors and therapists early in recovery is essential for reducing the severity of this experience.

The following are measures that medical and addiction health professionals may take to help patients relieve chronic withdrawal symptoms:

  • Provide education about the process of detox and withdrawal and what to expect
  • Encourage recognition of completed milestones and having patience throughout the process
  • Find natural methods to help with sleep disorders, such as melatonin
  • Encourage exercise and a healthy diet
  • Prescribe certain medications that help reduce symptoms
  • Evaluate potential co-occurring conditions, which may re-emerge during recovery
  • Encourage participation in peer support groups

The risk of encountering PAWS symptoms can sometimes be reduced by undergoing a medical detox, enrolling in an intensive rehab program, and receiving long-term support well after initial addiction treatment has been completed.

If you suspect that you or a person you love is addicted to drugs or alcohol, we urge you to contact Recovery By The Sea today to discuss possible treatment options. We help people achieve longlasting sobriety so they can begin to experience the fulfilling lives they deserve, one step at a time!

A Guide to Surviving the Holidays Sober

Surviving the Holidays Sober | Recovery By The Sea

There is a lot of support out there for people dedicated to recovery from drugs or alcohol, especially during the holidays. The added stresses of buying gifts, going to events and parties, and seeing relatives can amplify urges and undermine resolve that was recently solid and taken for granted.

There are many people and organizations that have put out guides to staying sober such as this. We urge all to whom this applies to consider these ideas very carefully and implement as many safeguards as possible beforehand.

Tips for Holiday Sobriety

1. If you are considering drinking or using, think about how you will feel tomorrow.

Relapse can happen in seconds, but the effects can be much longer-lasting. When that moment is gone, and you are now facing the next day, you are probably going to be riddled with regret. This may be coupled by another hangover, a comedown from using drugs, in addition to depression, anxiety, and negative emotions.

Everyone in recovery should know that sobriety takes place in the present. Saying yes to using substances places sobriety in the past and the potential future. There’s a lot to be said for the latter, but ask yourself if you really want to undermine your recovery by giving up even a single moment, hour, or day?

2. If necessary, admit to your family and friends that you don’t want to drink or use, and why this is the case.

If you have been through rehab, there’s a good chance a lot of people already know this. Still, the holidays are a special time, and many people have to face enablers and others who don’t understand why you can’t have just one drink, toke, or whatever. Sometimes you just have to be firm with people, especially those who you have gotten drunk or used with in the past.

3. Carry some other drink in your hand so you can readily turn down other drinks.

If you are already drinking something non-alcoholic, this can serve more than one purpose. If you are new to recovery, staying hydrated and having drinks that are sugary and taste good, such as soda, hot cocoa, or eggnog, can help you resist cravings. It’s a well-established fact that alcoholics in recovery frequently experience sugar cravings, and allowing yourself to indulge might be vital to staving off temptation.

Of note, this approach might not work as well if you are addicted to other substances, such as opioids, cocaine, or meth.

Surviving the Holidays Sober | Recovery By The Sea

4. Call another sober person or sponsor or go to a meeting.

Many people in recovery find it beneficial to “bookend” holiday events with meetings or conversations with AA sponsors. Locating meeting places and times in advance can help you schedule and structure your day around group support rather than relying on family and friends alone.

If meetings are not an option, having another sober friend or sponsor on hand can also be helpful. If tempted to drink or use at a family gathering or other event, you can step away and call this person and solicit advice. In some cases, you might be able to take this person with you, and that can add further accountability and confidence to this day in recovery.

5. If this is your first holiday being clean or sober, consider making alternative plans if you feel certain situations could trigger you to drink or use.

In addition to going to meetings, there are other ways to structure your time away from people or places that may cause you stress. It’s okay to decline holiday plans this year if you feel it’s necessary. Instead, consider going out to dinner with someone else who will be sober, to a movie, volunteer at a shelter, or celebrate at home.

There is no wrong way to experience the holidays as long as you have the emotional support you need at hand and realize that you are not alone. Nearly every person who is in recovery from drugs or alcohol will have to go through this. And yes, that is millions of people.

6. Go about your day like any other when it comes to your recovery.

Regardless of whether it’s Christmas Eve, Christmas Day, or New Year’s, it is critical that you continue to engage in the healthy, productive behaviors that have helped to keep you sober thus far. These may include exercise, meditation, daily affirmations, etc. You shouldn’t neglect self-care because this day might unfold a bit differently. If you let yourself break free from your routine, this may result in an unconscious signal to the addict in you and might trigger thoughts or feelings that can sabotage your efforts in some way.

7. No matter what happens, be committed to not drinking or using.

Surviving the Holidays Sober | Recovery By The Sea

Ultimately, all the planning in the world, while helpful, can’t save you at any given moment. You have to do it for yourself. There are no excuses—it doesn’t matter if you are stressed out or upset for some reason, you know that relapse is the wrong decision. If you are telling yourself anything else, you are lying to yourself. And others might be lying to you, as well—don’t listen.

Sometimes, the best way to ensure this doesn’t happen is just to accept that you should not put yourself in a position of temptation. As noted, it’s okay to stay home or do something that doesn’t involve being around people who are using substances. But you do have to have emotional support.

But If You Do Relapse, What Next?

Unfortunately, relapse is often a part of recovery, and sometimes, in weak moments, the unthinkable can happen. If this does happen, steps need to be made immediately to rectify the situation.

Remember, not all relapses are created equal. If you quickly return to a recovery routine that includes leaning heavily on sponsors, meetings, or even going back to rehab, you can break the cycle and prevent yourself from hitting rock bottom again. One of the most unfortunate aspects of relapse is that those who succumb to them allow themselves to wallow in guilt and shame, and this is the last thing someone in this position should be doing.

Moreover, beating yourself up isn’t going to help you or anything else—it will only serve to encourage you to continue to drown your sorrows in drugs or alcohol. Instead of doing this, be gentle on your emotions while being firm in your resolve to fix the problem before it gets any worse and take steps immediately to do so.

Getting Help for Substance Abuse and Addiction

If you are concerned that you are going to struggle during your recovery over the holidays or need help for addiction, we urge you to contact us today! Recovery By The Sea offers all of our clients comprehensive programs to treat substance abuse and mental health that is tailored to each individual’s unique needs and goals.

Please do not suffer alone during this time by taking advantage of professional treatment and services! Addiction is a chronic, long-lasting disease, but it can be effectively treated and managed for life in many cases. Call us today if you are ready to take the first step on your journey to sobriety and wellness!

⟹ READ THIS NEXT: Step 1 of Alcoholics Anonymous

What Is Partial Hospitalization Drug and Alcohol Rehab?

Partial Hospitalization Drug and Alcohol Rehab | Recovery By The Sea

A partial hospitalization program (PHP) is an intensive form of drug and alcohol rehab that often follows detox. It is characterized by an extended treatment period, which can last A partial hospitalization program (PHP) is an intensive form of drug and alcohol rehab that often follows detox. It is characterized by an extended treatment period, whi up to a month or sometimes longer, depending on an individual client’s needs. PHP patients will spend their days at the center receiving therapy, counseling, and other forms of treatment and support.

Who Benefits From PHP Drug and Alcohol Rehab?

PHP is especially beneficial in any of the following situations:

1) When a patient has completed an even more intensive form of treatment, such as a long-term residential stay.

2) When a patient’s addiction is not so severe that it cannot be addressed without overnight stays and complete inpatient care.

Residential drug rehab can help anyone who has completed a detox or inpatient program, but still needs some supervision and treatment for substance use disorders or any potential co-occurring disorders. Ultimately, anyone who is dedicated to recovery, able to commit to intensive treatment, and wants to improve their outcome and reduce their chance of relapse can benefit.

Overall, PHP programs offer an ideal environment for persons in recovery who are not yet fully prepared to face life’s temptations and challenges. PHP allows clients to interact and grow in an understanding and caring community of people who are facing the same difficulties with substance abuse.

One of the main drawbacks to PHP is the fact that people in this program may be more apt to experience a relapse than those in residential treatment. Moreover, this program requires that an individual be highly motivated to continue their recovery and be accountable for themselves. For those who have completed inpatient treatment, this is a great way to begin transitioning back to the outside world.

Components of PHP Drug and Alcohol Rehab

All clients enrolled in a Recovery By The Sea PHP rehab program will participate in therapeutic activities that help them improve their coping skills and function in daily life.

Features may include the following:

  • Comprehensive assessment, treatment planning, and case management services
  • Sessions with mental health professionals, such as individual cognitive-behavioral therapy
  • Recreational therapies, such as yoga and meditation
  • Community meeting groups and daily group therapy that discuss a variety of topics, such as substance abuse, grief and loss, trauma, interpersonal relationships, self-esteem, and assertiveness
  • Music, art, and adventure therapy
  • Family and relationship counseling
  • Nutrition and wellness education
  • Trauma recovery therapy
  • Recreational activities
  • Aftercare and discharge planning

What Is Cognitive-Behavioral Therapy?

Partial Hospitalization Drug and Alcohol Rehab | Recovery By The Sea

Our treatment programs focus heavily on behavioral therapy. Cognitive-behavioral therapy (CBT) is one of the most effective forms of therapy used to treat recovering addicts and alcoholics. This form of psychotherapy helps individuals understand the relationship between their thoughts, behaviors, and emotional states. CBT teaches individuals to engage in more adaptive thinking, which in turn contributes to healthier behaviors.

Moreover, in CBT, patients learn to identify, manage, and modify thoughts that typically lead to negative responses. These skills can help patients prevent relapses and manage co-occurring mental health disorders that impact a person’s ability to remain sober.

Treatment for Co-Occurring Disorders

A co-occurring disorder includes one or more mental health conditions that occur in conjunction with substance abuse or addiction. The mental illness may predate the substance abuse or may be caused or exacerbated by it. Regardless of which came first, both disorders must be treated concurrently.

Examples of mental health disorders that commonly co-occur with substance use disorders include the following:

  • Bipolar disorder
  • Depressive disorder
  • Post-traumatic stress disorder
  • Eating disorders, such as anorexia nervosa or bulimia
  • Anxiety disorders, such as social anxiety, panic disorder, or obsessive-compulsive disorder
  • Personality disorders, such as borderline personality or histrionic personality disorder

Recovery By The Sea is equipped to diagnose and treat co-occurring disorders on a residential basis. Addressing mental health conditions in conjunction with addiction is almost always the preferred method clinicians use to achieve the best outcomes.

How Outpatient Programs are Different

There are several differences between PHP and actual outpatient treatment. PHP is characterized by a more intensive level of care than outpatient programs, which are often a step down from PHP treatment.

In an outpatient program, clients do not spend as much time at the center, and the work is not as intense as PHP. This flexibility allows them to maintain a work schedule and tend to any other important responsibilities, such as school or family.

Those who choose outpatient treatment before undergoing a residential stay or a PHP may do so because they cannot take time away from work or family, or because they have less severe substance abuse problems.

Getting Help for Addiction

Recovery By The Sea PHP drug and alcohol rehab programs are characterized by an evidence-based, outcome-focused treatment plan designed by our experienced medical staff. Our center incorporates a full daily schedule for clients in a nurturing, relaxing environment conducive to recovery. Upon completion of our PHP program, patients are highly encouraged to continue their treatment journey at an intensive outpatient level of care.

We are committed to ensuring that each person we serve is provided with the tools and support they desperately need to sustain long-term sobriety and wellness. You can reclaim the fulfilling life you deserve! Contact us today to find out how we can help you get started on your journey to recovery!

⟹ READ THIS NEXT: 12 Step Programs

How to Stay Sober Through Relapse Prevention

How to Stay Sober Through Relapse Prevention | Recovery By The Sea

How to Stay Sober Through Relapse Prevention – A person suffering from an alcohol use disorder (AUD)—also referred to as alcoholism or alcohol addiction—has a chronic brain disease. This condition affects the reward system, resulting in tolerance, dependence, and compulsive behaviors related to alcohol use.

People who seek help to recover from an AUD have many options available in the form of comprehensive, evidence-based treatment, which focuses on altering behaviors through therapy and counseling at a rehab program. However, because addiction is considered a chronic disease, there is a high potential for relapse.

In fact, about half of all people who suffer from addiction, including alcohol will relapse at some point, a rate similar to those of other chronic illnesses such as hypertension and diabetes. People with these conditions can go back to their doctor to adjust their treatment plan, which may include medication and lifestyle changes.

People who have an AUD can regard the concept of relapse in a comparable way—as a recurrence of symptoms of the disease that requires returning to further treatment to adjust some aspects of the care plan or the development of a new one. To appropriately treat relapse, it is vital to understand what it is. Once symptoms are identified, people should seek treatment as soon as possible.

What Is Relapse?

Receiving counseling, attending peer support groups, finding new pleasurable activities other than drinking, taking advantage of emotional support from family and friends, and cultivating ways to manage stress and avoid triggers can help people newly out of rehab stay sober. However, it is critical to realize that a relapse can happen, and being able to recognize the warning signs is among the most effective ways to avoid this and minimize damage associated with it.

Regarding addiction, relapse is defined as the for the inability to stay sober indefinitely. For those experiencing an AUD, this may result in a return to escalating alcohol use or consuming another drug that acts in a similar manner as alcohol.

A relapse doesn’t necessarily mean that treatment didn’t work. Instead, it implies that a person needs more time and help returning to sobriety, which could include additional or altered medications, better social support, or different strategies to reduce daily stress.

What Are the Warning Signs of Relapse?

How to Stay Sober Through Relapse Prevention | Recovery By The Sea

Signs of an impending relapse include the following:

Experiencing profound and uncontrollable emotions – People who have used substances such as alcohol to alter brain chemistry will have to acclimate to life without the help of self-medication. Moreover, adjusting to a job, family responsibilities, and social pressure can be challenging for a person just out of rehab. They may be able to take these tasks on and feel positive about the results, but may also be in denial about how worry and stress can wear them down.

Having difficulty accepting the changes in life – It’s not uncommon for people in recovery to experience stress related to schedule adjustments, health problems, or criticism more profoundly than others. They may have a more difficult time seeing the positive side, and subsequently, depressed or anxious feelings may lead to a relapse.

Holding the belief that relapse is improbable – In some cases, people erroneously believe that they have worked so hard to come so far that they will never relapse. Despite the statistics, they think they are somehow exempt from this risk. Falsely believing that relapse cannot and will not happen actually increases the risk of relapse.

Experiencing a loss of recovery commitment – People who stop attending support group meetings, therapy, or counseling sessions are at a heightened risk for relapse. Without mental and emotional support, the return to compulsive, negative behaviors is a looming threat.

Going to places or hanging out with friends associated with alcohol – Returning to old habits, such as visiting places where drinking occurred or tends to occur (e.g., bars or clubs), or spending time with friends who drink excessively or use drugs, places a person at risk for returning to problematic alcohol use.

Some other warnings signs that someone is in the midst of a relapse include:

  • Breath smells like alcohol
  • Being visibly intoxicated
  • Money goes missing
  • Missing or craving alcohol use
  • Bottles or debris present related to drinking
  • Being absent for extended periods or skipping work or school

How to Stay Sober: Developing a Relapse Prevention Plan

For some, relapse may seem unavoidable, but once again, this does not mean that treatment does not work. A treatment plan should also include relapse prevention strategies. Understanding relapse means one must be able to identify warning signs and find ways to avoid relapse when initial symptoms become present.

People recovering from AUD may be helped by prescription medication to mitigate cravings. For example, acamprosate and naltrexone are both prescribed in some cases to reduce cravings after the person has detoxed from alcohol. Reducing cravings helps the individual focus on their recovery and changing their behaviors concerning alcohol and finding new coping mechanisms.

Cognitive-Behavioral Therapy (CBT) is one of the most commonly employed forms of therapy, often used in rehab and mental health treatment. This type of therapy focuses on understanding the causes of behaviors, recognizing how these behaviors are not consistent with a healthy life and a person’s values, and the learning of new, healthier behaviors. Working with a CBT therapist can help a person in recovery from AUD learn about the warning signs of relapse, and practice new skills and coping mechanisms in advance of this occurring.

How to Stay Sober Through Relapse Prevention | Recovery By The Sea

Some other methods to lower the risk of relapse include the following:

  • Get social support through a peer support group such as Alcoholics Anonymous or SmartRecovery
  • Associating with positive people who can help improve one’s mood
  • Remembering the acronym HALT (hungry, angry, lonely, or tired), as these moods can influence stress levels and lead to bad decisions
  • Learning new coping strategies, such as mindfulness meditation
  • Knowing signs of relapse and maintaining a diary to monitor for them
  • Immediately reach out for help in the event of a relapse

Working with a therapist or counselor to devise a relapse prevention plan can be extremely beneficial. This work includes developing a daily schedule for meals, logging experiences, engaging in supportive exercise, and finding others to talk to during stressful times.

A relapse prevention plan may also include a daily checklist, a list of reminders for appointments, and ways to identify triggers when they are encountered. This plan should also include a section detailing how to manage stress and triggers.

Getting Help For Alcoholism

The first step to overcoming addiction and solidifying your willingness to begin the recovery process is to seek treatment as soon as possible. Recovery By The Sea offers integrated treatment programs in both partial-hospitalization and outpatient formats, which include essential services such as cognitive-behavioral therapy, counseling, peer group support, and more.

We employ highly-trained addiction specialists who deliver these services to patients with compassion and expertise. We are dedicated to providing our patients with the resources and support they need to achieve abstinence and stay sober indefinitely!

If you or someone you love is struggling with an alcohol use disorder, contact us today to find out how we can help!

Revia and Vivitrol Vs. Suboxone

Vivitrol Vs. Suboxone | Recovery By The Sea Addiction Treatment

Revia and Vivitrol Vs. Suboxone – Suboxone and naltrexone (Revia and Vivitrol) are medications approved by the Food and Drug Administration for the treatment of opioid addiction. Both have been clinically proven to be beneficial for those entering recovery, but which one may be more appropriate or helpful for each individual depends on their personal needs and, sometimes, the severity of their addiction.

What Is Suboxone?

Suboxone contains two medications: buprenorphine and naloxone (not to be confused with naltrexone). Buprenorphine is an opioid used to treat addiction to other opioids and withdrawal symptoms. It can be administered sublingually (under the tongue) in films or tablet form or as a once-a-month, extended release injection (Sublocade). Naloxone is an opioid antagonist that is commonly used on its own to reverse opioid overdoses.

As an opioid, buprenorphine attaches to the body’s opioid receptors, but unlike heroin or prescription painkillers, it activates these receptors only partially. That means that the maximum or “ceiling” effects of buprenorphine, such as euphoria, do not occur as frequently and at a considerably lesser intensity than other opioids. For this reason, medications that contain buprenorphine can mitigate cravings and symptoms of opioid withdrawal with much less potential for abuse than other opioids, such as heroin.

Naloxone, the other component in Suboxone is included as an additional means to prevent abuse and overdose.

Benefits of Suboxone

Withdrawal from heroin and other opioids can be incredibly unpleasant and even painful. Suboxone minimizes withdrawal symptoms and cravings, two main instigators for relapse. It allows people in this phase to feel much better and reduce their suffering so they can better focus on the early recovery process.

Potential Disadvantages

Because it is an opioid, buprenorphine can, in some cases, be abused. If this occurs, a condition known as precipitated withdrawal can result.

Precipitated withdrawal occurs when a full or partial antagonist, such as buprenorphine, is administered to a patient dependent on full agonist opioids, such as heroin. Buprenorphine has both a high affinity for and low intrinsic activity on opioid receptors, so it displaces agonist opioids from these receptors without activating the receptor to an equivalent degree.

The inclusion of naloxone in Suboxone typically helps to prevent this from happening when used appropriately, but this can occur if the medication is dissolved and injected or smoked by a person tolerant to opioids. Moreover, health providers must have a waiver to prescribe buprenorphine, and the number of patients that a physician can treat for opioid addiction is restricted by law. Therefore, some physicians may not always be able to prescribe this medication to new patients.

Vivitrol Vs. Suboxone | Recovery By The Sea Addiction Treatment

What Are Naltrexone, Revia, and Vivitrol?

Naltrexone is a medication that does not activate receptors and instead blocks the effects of opioid medication, including pain relief or feelings of euphoria that can promote opioid abuse. Naltrexone is commonly used as part of a long-term treatment program for opioid dependence. Naltrexone both minimizes cravings for opioids and prevents users from getting high if they relapse and return to drug use.

Also, because naltrexone is not technically an opioid, there is no potential for misuse. For this reason, there are no special prescribing regulations placed on health providers, and it tends to be more commonly used in drug courts and prison systems. Many people who are skeptical of medication-assisted therapy for drug abuse appreciate the fact that naltrexone is not addictive and thus does not “replace one addiction with another.”

However, because naltrexone can cause precipitated withdrawal, it must only be administered after opioids have been eliminated from the body, unlike Suboxone. Of note, for reasons that aren’t entirely clear, naltrexone may also be beneficial for the treatment of alcoholism, as it reduces the euphoric effects that alcohol can produce, thus making drinking less appealing.

Revia is a form of naltrexone that is taken in pill form once per day. This method may be more appealing to some than a painful shot (Vivitrol), but it also has a higher potential for relapse because individuals on a regimen can simply decide to stop taking it and return to drinking as normal. Vivitrol is an extended-release injection that can be administered once a month and has the same effects as Revia or oral naltrexone.

Disadvantages of Revia and Vivitrol

Before beginning Vivitrol or Revia, a person must go through a full opioid detox several days in advance, which can be very challenging to do without other medications or professional treatment. Naltrexone can reduce opioid tolerance and cause increased sensitivity to the same, or even lower doses of opioids, increasing the risk of overdose if a person relapses.

Vivitrol has advantages over Revia because once a shot is administered, a person cannot forgo their daily medication in favor of relapse. For this reason, Vivitrol has somewhat better patient compliance than oral naltrexone. Also, for some, it is more appealing than taking a pill every day. However, if during this time the person requires opioid therapy for severe pain, such as that related to an emergency situation, special measures will need to be taken.

Finally, the Vivitrol is both expensive (costing $1,000 per shot for private insurers and $500 per shot for Medicaid) and can be painful for the patient. Indeed, it also associated with several unpleasant temporary side effects. Moreover, Revia may be a better option for those who struggle with insurance coverage or are averse to needles or receiving shots in general.

So Which Approach Is Best?

Suboxone and naltrexone in either form both have pros and cons. The best recovery medication depends on each person’s situational needs and recovery goals.

On the one hand, Suboxone, if available from a prescriber, can help people reduce cravings and withdrawal symptoms in detox early in the recovery process. Naltrexone, on the other hand, is more easily accessible for some and may serve them better over the long haul (perhaps years, if necessary) for the prevention of relapse. For some, the ideal long-term treatment plan may include both Suboxone and Vivitrol or Revia.

Vivitrol Vs. Suboxone | Recovery By The Sea Addiction Treatment

Research: Vivitrol vs. Suboxone

Recent research that studied the efficacy of Suboxone vs. Vivitrol head-to-head found they were equally effective at reducing cravings and treating addiction. However, the 7-10 day detox period before Vivitrol treatment could be administered prompted some users (25%) to end their participation in the study. Conversely, only 6% of participants who were to be treated with Suboxone dropped out before they received their first dose.

The study, which was published in The Lancet and funded by the federal government, followed 570 people with opioid use disorder over the course of six months. The study found that 52% of subjects treated with Vivitrol relapsed during that time, compared with 56% of people treated with Suboxone. And while the two medications were found to be almost equally effective, there was still a high rate of relapse for both in the study.

Treatment for Opioid Addiction

People who choose treatment programs that use medication-assisted therapy may benefit from the use of either Suboxone or a form of naltrexone, or both. In addition to medication, however, it has been clinically shown that outcomes are improved for those who also receive evidence-based services as part of the recovery process, including psychotherapy, counseling, and group support.

Recovery By The Sea offers an integrated approach to addiction and employs highly-skilled addiction professionals who render therapies to our clients with care and expertise. We are dedicated to providing each client with the tools and support they need to achieve a full recovery and experience long-term wellness and sobriety.

If you or someone you love is addicted to opioids, other drugs, or alcohol, contact us today. Find out how we help people regain their health and sanity, and enjoy the rest of their lives free from addiction!

How to Implement a Relapse Prevention Plan

Relapse Prevention Plan | Recovery By The Sea Addictiong Treatment

The process of relapse involves much more than just a moment of weakness—it occurs as a series of steps in the direction that is heading toward addictive behavior. Along the way, however, there are many opportunities to actively use new strategies and act to halt and reverse the process.

Relapse occurs for many reasons, and entertaining temptation and acting on triggers are often to blame. Moreover, at some point, the demands of sustaining change begin to feel as though they outweigh the benefits. People tend to forget that this is normal and that sustainable change is highly dependent upon resistance.

Common Triggers of Substance Abuse Relapse

  • Withdrawal symptoms manifest upon cessation (anxiety, depression, nausea and vomiting, physical weakness, etc.)
  • Post-acute withdrawal symptoms (mood swings, anxiety, irritability, and sleep disturbances)
  • Poor self-care
  • Continuing to socialize with people who use drugs or drink alcohol
  • Going to or near places where one used to buy drugs or drink
  • Seeing items such as drug paraphernalia (e.g., needles or pipes that remind one of using drugs
  • Unpleasant feelings (H.A.L.T.: hungry, angry, lonely, tired)
  • Stress related to relationships or sex
  • Isolation—too much time spent alone with thoughts
  • Overconfidence in one’s ability to regain sobriety after “normal” use of a substance

The Stages of Relapse

To understand how to implement a relapse prevention plan, you have to be able to recognize and understand the stages of relapse. An emotional relapse often begins weeks or months before the physical relapse occurs.

There are three recognized stages of relapse: emotional relapse, mental relapse, and physical relapse.

Emotional Relapse

During an emotional relapse, the person is not actively considering using. But emotions and behaviors, however, are positioning him or her in a mindset that could lead to future relapse.

Signs of emotional relapse include the following:

  • Anxiety
  • Depression
  • Anger
  • Defensiveness
  • Moodiness
  • Social withdrawal
  • Not asking for help
  • Not going to peer support group meetings
  • Missing psychotherapy or counseling appointments
  • Poor sleeping or eating habits

The signs of emotional relapse are comparable to the symptoms of post-acute withdrawal syndrome. If you understand the process of post-acute withdrawal, it’s easier to prevent relapse, because the early stage is the easiest to reverse. In later stages, the pull to give in grows more powerful, and related events progress at an accelerated rate.

Relapse Prevention Plan | Recovery By The Sea Addictiong Treatment

Early Relapse Prevention

Relapse prevention requires you to realize that you’re in a state of emotional relapse and immediately change your behavior. Here, you need to recognize that you’re regressing emotionally and ask for help. If you don’t seek help, you’ll continue to feel alone.

If you don’t change your behavior at this stage and languish too long in an emotional relapse, ultimately you will likely become exhausted and eventually desire to escape. This state will transition you into the next stage of mental relapse.

During this time, take note if you are anxious or depressed and use relaxation techniques. If you don’t release resentments and fears through some means of relaxation, they may grow to the point where you’ll once again start to feel uncomfortable in your own skin.

You will also need to identify sleep and eating habits that are inadequate and begin to improve self-care. The most crucial strategy that you can use to prevent relapse at this stage is to take better care of yourself. People use substances to escape, unwind, or reward themselves. Therefore, they tend to relapse when they don’t take proper care of themselves.

If any of these situations persist for too long, you will probably begin to think about drinking or using drugs. But if you ask for help, learn to relax, and practice good self-care, you can prevent those feelings from accumulating and avoid a relapse.

Mental Relapse

During a mental relapse, there’s a war waging in the mind. Part of you desires to use drugs or drink, but part of you does not. Early on during a mental relapse you may be casually thinking about using, but if the stage continues, you will be unmistakably considering it.

Signs of mental relapse include the following:

  • Glamorizing or romanticizing drug or alcohol use
  • Thinking about people, places, and things associated with substance use
  • Lying or being secretive
  • Associating with old friends who use
  • Daydreaming about using
  • Considering the possibility of relapse, up to and including planning a relapse
  • Finding it more difficult to make the right decisions as the pull of possible substance abuse gets greater

Techniques for Coping with Mental Urges

Remember that as you think about using, the fantasy will probably include the possibility that you’ll be able to control your substance use this time around. But if past behavior predicts future behavior, chances are one drink or one drug dose will lead to further abuse. You’ll wake up the next day feeling ashamed, and these feelings may prevent you from stopping again the next day.

Before you know it, you are trapped in the same vicious cycle you always were. A common belief that people in recovery have is that they can get away with using if it can be kept secret from others. This is when someone’s addiction attempts to convince them that they don’t have a serious problem and that recovery is merely to please others in one’s life.

At this point, you should actively recall the adverse consequences you’ve already encountered, and the potential effects yet to come if you relapse. Moreover, if you could keep your substance use in check, you should have been able to do long so before now.

Relapse Prevention Plan | Recovery By The Sea Addictiong Treatment

Tell someone you trust that you’re having thoughts about using. Call a friend, a family member, or someone else in recovery. The wonderful thing about sharing is that the minute you start to discuss what you’re feeling, your cravings begin to subside and you no longer feel so alone.

Make use of distractions—when you start thinking about using, do something else to pass the time. Most cravings only last for about 30 minutes at most. When you have a craving, it may feel like an eternity, but if you can keep yourself occupied, it will be over before you know it.

Remember that recovery happens one day at a time—this requires you to balance your goals with emotional fortitude. When you feel strong enough not to use, then you can set goals to stay clean for the next week or month. But if you’re struggling, you can tell yourself that you won’t use for just today or the next 30 minutes.

Physical Relapse and Getting Treatment

Once you actively begin thinking about relapse and fail to use the aforementioned strategies, it doesn’t take long to descend into a full physical relapse. Moreover, it’s extremely difficult to stop the process of relapse at that point, and this is not where you should be focusing your efforts on during recovery. Rather, you would then be merely attempting to remain abstinent through brute force, and this is not recovery.

That said, relapse is not the end of the world. For many, it is part of the recovery process (although it is not recovery itself). The best thing you can do if you relapse is lift up your head, swallow your pride, and seek treatment as soon as possible before the situation gets even worse. Realize that relapse doesn’t have to send you spiraling to rock bottom, and you have the capability of turning your recovery around once again.

Recovery By The Sea offers partial-hospitalization and intensive outpatient treatment programs. These programs are ideal for those who have already completed residential treatment, but have relapsed and need additional support to re-establish sobriety.

If you have relapsed and feel you need further treatment, please contact us as soon as possible. Discover how we help people reclaim their lives and experience happiness and wellness, free from drugs and alcohol!

How Long Does Precipitated Withdrawal Last?

How Long Does Precipitated Withdrawal Last? | Recovery By The Sea

Precipitated withdrawal transpires when someone with a dependence on full agonist opioids, such as heroin, replaces it with a partial opioid agonist, such as buprenorphine. Precipitated withdrawal is characterized by rapid development.

While using a commonly prescribed drug, such as Suboxone, withdrawal symptoms appear within 1-2 hours of the first dose and usually subside within a few hours, but can last as long as one full day. Precipitated withdrawal from the use of naltrexone may onset within minutes and last up to 48 hours. Withdrawal symptoms associated with naloxone, however, are short-lived, lasting only 30 minutes to an hour, on average.

Opioid Replacement Therapy and Suboxone

Opioid replacement therapy typically uses either methadone or buprenorphine during detox and maintenance treatment programs. The goal of this treatment—also referred to as opioid substitution therapy—is to replace a full agonist opioid, such as heroin, with a longer-lasting prescription opioid with less potential for misuse.

It is vital that those suffering from an opioid addiction seek and receive professional help to overcome this condition. Suboxone, a prescription withdrawal treatment that contains the partial agonist opioid buprenorphine and the anti-overdose drug naloxone, an opioid antagonist, is one of the safest and most regularly used treatments.

This drug has helped many former addicts recover from narcotic dependence, which is almost always the first step in overcoming addiction. However, no one should ever take Suboxone or other withdrawal medications without medical direction and supervision – misuse of these drugs can lead to a condition known as precipitated withdrawal, which is highly unpleasant and can contribute to relapse.

Symptoms of Opioid Withdrawal

People who have developed a physiological dependence on opioids for an extended period, even if taken as directed, will experience withdrawal symptoms upon discontinuation. This problem, however, can be lessened using opioid replacement therapies such as buprenorphine to reduce withdrawal symptoms.

Also, the person may be weaned from the original opioid using a tapering schedule until the body is no longer physically dependent upon it. Moreover, if the person quits using the drug abruptly, they are more likely to encounter uncomfortable withdrawal symptoms.

Early stage opioid withdrawal symptoms include the following:

  • Mood swings
  • Excessive yawning
  • Sweating and chills
  • Insomnia
  • Flu-like aches and pains
  • Watery eyes and runny nose
  • Irritability and agitation
  • Anxiety or depression

Late-stage opioid withdrawal symptoms include the following:

  • Diarrhea
  • Chills
  • Abdominal cramps and pain
  • Nausea and vomiting

Depending on the half-life of the particular opioid, symptoms of withdrawal can onset within just a few hours, and typically abate after 1-2 weeks. Precipitated withdrawal symptoms are more intense, however, and are marked by a rapid onset version of the above symptoms.

How Long Does Precipitated Withdrawal Last? | Recovery By The Sea

How Is Precipitated Withdrawal Different?

Precipitated withdrawal can occur when someone with an addiction to full agonist opioids replaces it with a partial agonist opioid. Although partial agonists bind to the same mu receptors as full agonists, they do not induce the same effects because they do not produce the same amount of activity at the mu receptor.

A partial agonist, however, can displace the full agonist from the receptors, so the effects of the full agonist opioid end abruptly. Because the mu receptor is not activated to an equal degree, there is a net reduction in agonist effects that result in precipitated withdrawal syndrome.

In other words, when someone still has full agonist opioid chemicals in their body because they have not begun the process of withdrawing, introducing a partial agonist such as buprenorphine can instigate a rapid-onset withdrawal.

Opioid withdrawal can rapidly occur when someone doesn’t take their next dose. By comparison, precipitated withdrawal is much more intense, and the person experiencing it can become very sick and need hospitalization.

Drugs Involved in Precipitated Withdrawal

Naloxone

How Long Does Precipitated Withdrawal Last? | Recovery By The Sea

As noted, Suboxone is a drug that includes both buprenorphine and naloxone. Naloxone is an opioid antagonist and anti-overdose remedy that removes full and partial opioid agonists from mu receptors and binds to them temporarily.

However, naloxone will only become active in Suboxone when the prescription drug is tampered with—a function designed to discourage someone from abusing it to get high off the buprenorphine. When used as directed, the buprenorphine in Suboxone reaches opioid receptors and reduces withdrawal symptoms.

As a component of Suboxone, naloxone does not induce precipitated withdrawal in those who use it. This condition is actually the consequence of the partial agonist buprenorphine replacing a full opioid agonist when the original substance is still present in the body. Nonetheless, naloxone itself can induce precipitated withdrawal by removing full opioid agonists in the brain.

Indeed, this is an approach employed during rapid detox to eliminate opioids from the body and forces the person to end their physical dependence on a drug abruptly. While withdrawal from opioids is usually not medically risky, rapid detox can be extremely painful, and, unlike therapy and counseling, it does not address the person’s habits or reasons for their ongoing drug use.

Unfortunately, because there are no therapies that address the behavioral changes involved during this method of withdrawal, the individual is at an increased risk of relapse. And, without a physical tolerance, the dose they were accustomed to receiving could produce a life-threatening overdose. For this reason, rapid detox programs are not often advised by addiction professionals.

Naltrexone

Another medication that can induce precipitated withdrawal syndrome is naltrexone. This drug is sometimes prescribed to patients after they have completely eliminated the alcohol or opioid from their body. Naltrexone partially blocks the high that these drugs produce, so if a person relapses, they do not experience the pleasure they previously anticipated.

However, if naltrexone is administered before the person has sufficiently detoxed from an opioid, the drug will induce precipitated withdrawal. For naltrexone to work effectively, there can be NO full or partial opioid agonists in the body, or else this condition will undermine the drug’s action on the brain.

Buprenorphine

If a person doesn’t have a significant opioid tolerance, a large dose of buprenorphine can act as a full opioid agonist and induce a high. Conversely, if a person has built a high tolerance to a more potent opioid, such as heroin, the higher the dose of buprenorphine, the more intense the precipitated withdrawal. Therefore, only small doses of buprenorphine should be delivered to prevent any adverse withdrawal effects.

When beginning a course of Suboxone or another buprenorphine therapy, the original drug of abuse should be discontinued and the new medication withheld until the person encounters withdrawal symptoms. The onset of these symptoms indicates that the brain cannot access the opioid as anticipated, and this, as a result, affects the behavior of neurotransmitters.

Rehab and Medical Detox to Recover from Addiction

Collaborating with medical providers and addiction professional to safely detox from opioids can prevent precipitated withdrawal or reduce its impact if it accidentally occurs.

However, it is vital to understand that detox is only the first step in recovering from addiction. Although important, interrupting the body’s dependence on a substance does not itself adequately address the chronic disease of addiction. After detox, persons are urged to undergo comprehensive therapy provided by an addiction treatment program. These programs are necessary to help the person alter their behavior and attitudes regarding drugs or alcohol, achieve abstinence, prevent relapse, and experience long-lasting, sustainable recovery.

You can reclaim your life and begin to experience the happiness and well-being you deserve. Please contact us as soon as possible—we can help!

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