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Exploring the pain of opioid addiction in a powerful new musical

GUEST POST by Shale Marks, LCSW, CADC

SunCloud Health’s core philosophy met the artistic world on the evening of April 20, when staff therapists attended the performance of “Contact High: A New Musical” at the Northbrook Theatre.

Sally McQuillen, LCSW and I were honored to meet the cast and creators of this new musical drama, which focuses on the lives of high-school students who are caught in a web of mental health issues that include opioid addiction.

Participating in a talk-back after the show gave us the chance to answer questions from the audience about opioids, recovery and other mental health challenges. Conversations like these are a crucial part of SunCloud Health’s mission, as we actively seek ways to contribute to the community’s understanding of mental health.

A young opioid addict with nowhere to hide

As I sat watching the musical, it struck me how deeply the character named Jean struggled with her addiction. She seemed to ache for connection, not only with herself but also with friends and the community. Like many young people, Jean seemed like a leaf blown by the wind, desperately searching for comfort – yet suffering the extreme discomfort of her disease as it dragged her from one moment to the next. She sought a resting place in a world where it seemed there was no friendly direction, no safe spot to hide.

It struck me that Jean is exactly the kind of person we hope to reach at SunCloud Health. The ache in her heart is the same ache that echoes in the hearts of all of our patients. It reminded me of the commitment we’ve made to our clinical philosophy, which is a tapestry of principles that hold our team accountable to our patients and each other. Our philosophy empowers us to perform what we think of as “soul surgery” for the people we serve.

The healing value of empathy

At SunCloud Health, we are guided by an agreement that places empathy at the core of everything we do. Our agreement states:

“We agree to search for non-pejorative or phenomenologically empathic interpretations of our client’s, our own, and other team members’ behavior. We agree to assume we and our patients are trying their best, and want to improve. We agree to strive to see the world through our patients’ eyes and through one another’s’ eyes. We agree to practice a nonjudgmental stance with our patients and one another.”

As we work with people in group settings, we challenge their belief systems, providing the care, compassion and attention they may have missed in their formative years. We welcome them as therapists who acknowledge our own humanity and fallibility and are ready to guide them as they move forward in recovery.

If we as a community could truly touch empathy, I believe there would be a deeper understanding of the underbelly of addiction. So often, conditions such as PTSD, depression and other mood disorders are the driving force behind substance use. Our ability to acknowledge and treat these conditions is often the first meaningful step toward healing.

Sally and I felt honored to discuss these issues with everyone who came out to see “Contact High” – and we thank show creators Kyle Reid Hass and Jeremy Swanton for inviting us to be part of this unique production, which will soon make its New York debut. I feel certain that this new musical will open hearts and minds with every performance.

At SunCloud Health, our hope is that we can continue to contribute to the community in an authentic way, addressing the power differentials that exist between therapist and patient, government and citizen, parent and child so that we can all move a little bit closer to humility, compassion, empathy and healing.

Amid the Opioid Crisis, the Addiction Crisis Rages On

At SunCloud Health, we are very concerned about the record level of deaths caused by opioid overdoses. At the same time, we are mindful that the opioid epidemic is part of a much larger problem – the addiction epidemic.

It is crucial to remember that addiction is a brain-based illness that is not caused by a specific drug or substance. (Here is the official ASAM definition of addiction.)

When we focus on the drug and not the underlying problem, we’re in danger of missing the bigger picture.

Understanding the ways addiction plays out in our lives

As we’ve seen, addiction to opioids can kill – and kill quickly. Addiction to these drugs has claimed the lives of hundreds of thousands of people nationwide. And while worried parents are focused on the dangers for their children, the truth is that people of all ages from all walks of life can become addicted.

While we can’t turn away from this reality, we need to realize that other addictions kill, too. People who suffer from food addiction can lose their lives, though the pattern usually works more slowly and subtly than with opioids. Alcohol addiction claims 3 million lives worldwide each year, far more than opioids.

Lethal overdoses can also come from mixing highly addictive substances such as benzodiazepines – sold under brand names like Xanax, Klonopin, Ativan and more – with other drugs, including opioids. The news is filled with tragedies involving deadly combinations like these.

When we realize how many ways lives can be lost, we begin to see that the story doesn’t begin and end with saying, “Opioids will kill you.” In and of themselves, these drugs don’t kill, and in fact, they have many beneficial medical uses. Opioids kill only when someone develops an addiction to them. Addiction is the deadly root cause that we must address – in all of its various forms.

How people recover from addiction

At SunCloud Health, we have successfully worked with hundreds of people facing addiction to drugs, alcohol and specific behaviors such as gambling, eating, or relationships, sex and love. In helping them recover, we focus on the underlying brain disease of addiction rather than their drug or behavior of no-choice per se. (We refer to substances this way because we know that when someone is addicted, they can’t stop by will power or choice alone.)

Effective recovery begins with exploring the unique history of the person suffering from addiction. We look at the individual’s life from a biological, psychological, spiritual, and social perspective. Details of family history, including any sources of trauma, are taken into account.

People suffering from addiction have often been hurt in other ways before turning to their drug of no-choice for reward or relief. If you grew up in environment where you were abused, ignored, criticized or neglected, you have a greater-than-average chance of developing mental health issues later in life, including addiction. We take all these factors into account as we create a treatment plan to help you.

At SunCloud Health, you will benefit from a skilled and caring staff that views you as a whole person. We know that you are more than just your addiction. Even with your current struggles, you have many strengths. We will show you how to tap these strengths as you work to get your life back on track.

Specialized help for people who have more than one diagnosis

Sometimes, people who are dealing with addiction have more than one mental health condition. You may have heard the term co-occurring disorder or dual diagnosis before. These terms simply mean that there is more than one issue to deal with – and they must be seen as part of a total pattern within the person’s life.

At SunCloud Health we specialize in helping people who are suffering from multiple diagnoses. Many are affected by mood disorders, post-traumatic stress syndrome, eating disorders and other serious issues. They may misuse alcohol and drugs, or develop addictions to work, love and sex, gambling, shopping and other activities.

If you’re reading this article and feeling worried about yourself or someone close to you, now is the time to reach out. You’ve already taken the first step by seeking information and understanding. Take the next step by making a confidential call to 844-202-3161, or email us here. We are ready to support you or your loved one.

Worried About Opioid Abuse? A Closer Look at the Prescription Pain Medications You or Your Family May Be Taking Right Now

If you’re concerned about someone you know who is taking opioids for pain, then you are not alone.

Throughout the Chicago area and around the country, more and more people are becoming addicted to prescription drugs that are meant to relieve discomfort. Ironically, using these drug for even a short time can lead to opioid addiction – even when we’re following doctor’s orders to the letter.

You may have heard the chilling statistics confirming that opioid overdoses have risen 100 percent from 2015 to 2016. You can’t listen to a newscast without hearing about the mounting deaths. In some communities, local morgues can’t take the bodies in fast enough.

Hospitals and substance abuse treatment centers are stocking up on Naloxone and Narcan, drugs used to treat overdose victims. But many people who overdose don’t seek medical help because they’re afraid they’ll be arrested and thrown in jail.

Understanding the opioid crisis that surrounds us

Looking at these terrible trends, we’re just as worried as you are.

I’ve written before about the classification of pain, because I want it to be clear that doctors aren’t blameless in this situation. Many have unwittingly fueled the opioid overdose statistics by prescribing opioids when other pain management solutions might have worked just as well.

But with the Centers for Disease Control reporting that more than 1,000 Americans end up in emergency rooms every single day, we need to look beyond the causes and work together to find real solutions.

Why some of us shouldn’t take opioids at all

One challenge is figuring out who will have a problem with opioids and who won’t.

It’s clear that some patients are more vulnerable to opioid addiction, yet there is no simple test to help doctors predict who will get hooked. As a result, scripts often end up in the hands of people who are very likely to become dependent.

The website Drugabuse.gov reports that:

  • Nearly 30% of patients who are taking prescription pain medications will become addicted to them.
  • About 4% to 6% of those on prescription painkillers will eventually move to using illegal heroin instead.
  • Around 80% of current heroin users originally started with prescription meds.

How big pharma contributed to the opioid epidemic

In the 1990’s, a surge of new prescriptions for opioids laid the groundwork for the current crisis. Doctors adopted new diagnostic scales to evaluate the level of discomfort their patients were feeling. Many believe that the makers of prescription pain medications pushed for these changes, directly contributing to the epidemic of opioid overdoses and deaths we’re seeing now.

The CDC says the opioid crisis came in 3 overwhelming waves:

  • The first wave hit when a record number of Americans became addicted to the prescription pain medications their doctors gave them.
  • The second wave came when prescription opioid addicts switched to heroin in record numbers, causing a new surge of addiction and deaths.
  • The third wave came when fentanyl, a synthetic and often deadly form of heroin, hit the streets, further fueling the crisis.

Opioids don’t pick and choose their victims

All of us who work in health care are seeking answers, right along with you. We are reading the reports that show where resources and attention are needed most.

Opioid overdose statistics show the greatest number of deaths in Kentucky, West Virginia, Ohio, Pennsylvania and Tennessee, all areas that suffer from high rates of unemployment, poverty and occupational disability.

Clearly, communities that struggle to provide a good quality of life are seeing higher levels of opioid addiction. But that doesn’t mean that people in more affluent areas are immune to the problem.

At SunCloud Health, we treat patients from all over the Chicago area. We know that wealth, influence and education are no protection from the addictive power of these dangerous drugs.

How to help someone you love who is struggling

If someone you care about is taking prescription opioids right now, don’t panic. Millions of people are able to use these medications without becoming addicted. However, you should take a closer look to ensure that things really are all right.

Look for signs that may indicate your loved one is in trouble. This helpful guide from the Mayo Clinic is a good place to start.

If you’re concerned, find a non-confrontational way to discuss what you see. Here are some very thoughtful tips from Sharon Osbourne, a wife, mother and performing artist who’s definitely been there. Sharon’s wisdom will give you many practical ways to open a conversation with your loved one.

Even if you don’t succeed in getting through to your loved one, you may need to take action. If it’s clear your loved one can’t stop using prescription meds, or s/he has moved on to illegal drug use, contact us right now. Your call or email message is 100% confidential and we’ll help you both find the help you need.

More than anything, please promise me you won’t blame yourself. You didn’t cause your loved one’s addiction. But you can provide the loving support they urgently need to begin recovering. So don’t put it off. Get in touch with us today.

A Positive Step in Curbing Opiate Addiction

Everyone knows the drill: within seconds of entering a doctor’s office for a routine check-up, someone sticks a thermometer in your ear, pumps up a blood pressure cuff, records your respiratory rate and takes note of your heart rate.

These are your vital signs; if any one of your vitals is abnormal it serves as an indicator that there may be an active illness or disease state present.

Although the four vital signs were the standard of care for decades, in the 1990’s, level of pain was added as the fifth as part of a Veterans Administration initiative and became a Joint Commission standard in 2002. One problem at the outset with this movement is that pain, which is subjective, was referred to as a “sign.” Signs on the other hand, can be measured objectively, like the four original vital signs in medicine. If a thermometer indicates that the temperature is 96, then that’s what it is.

Regarding pain, the patient reports subjectively a number to rate their experience of it, typically between one and ten. Unfortunately, instead of taking the appropriate steps to determine the underlying cause of the pain or considering other alternatives, many doctors simply write a prescription for opiates; they do so without informing the patient, or even being aware themselves, of the risks involved with taking pain medication.

It has long been believed that this subjective assignment to pain and the doctor’s willingness to supply opiates is a contributing factor in today’s epidemic of pain killer abuse.

The American Medical Association (AMA), our nation’s largest medical society, seemingly agrees and now recommends dropping pain as a vital sign.

To its credit, the organization admits to culpability in this nationwide problem, saying physicians played a key role in starting the opioid epidemic by overprescribing pain medication, and now must do their part to end it. Another large piece of the problem is the lack of addiction training in medical schools and residency training programs across the country.

By improving physician training, improving prescribing practices, raising patient awareness through honestly describing risks and benefits of pain medication in the informed consent process, we can positively impact the opioid epidemic that is killing hundreds of thousands of Americans unnecessarily. Moreover, we can do so in a way that protects access to opioid pain management for those people for whom these medications are truly appropriate.

Addiction…A Choice?

Addiction to drugs or alcohol is a medical illness, a disease of the brain. And yet, there are those who continue to insist that substance addiction is a choice.

Several weeks ago, Matthew Perry, who portrayed Chandler Bing on the highly successful Friends sitcom, traveled to the UK to lend assistance to a new drug program involving the courts. While there, he appeared on a television show alongside journalist and anti-drug campaigner Peter Hitchens. A heated debate ensued.

Regarding his own addiction, Perry said, “I’m a drug addict and if I have a drink I can’t stop… if I think about alcohol, I cannot stop.”

Hitchens responded: “People have problems with drugs and drink. People like taking them and don’t want to stop. It doesn’t mean they have a disease.”

“Don’t want to stop?” How about the truth: so many addicts desperately want to never use again, but they can’t stop. Why? Because they are addicted, physiologically as well as psychologically.

Saying that a person addicted to drugs can “just stop” is like telling a diabetic they can simply toss out that insulin and be fine. That person will not be fine – that person will die.

Addicts don’t have a choice about whether or not they have an addiction, their choice is not in whether or not they have the disease but in whether or not they are willing to get the help they need on a daily basis to recover.

The “functional” addict

One of my favorite things to talk about with patients is their perspectives on functional alcoholism or addiction — whether in their own selves, their parents, or others in authority such as bosses, or the President. I ask with a curious mind, what is the definition of functional? Most people define functional as the ability to keep a job, show up at work, and even succeed professionally. Sometimes people mention the ability to show up at home or for social events. This is one way people defend themselves against the pain of acknowledging what they missed out on — the subtle, or not so subtle, cravings of their soul for nourishment that were left unmet.

Never has a patient answered me by defining functional as “being consistently emotionally and spiritually available.” The impact of active addiction on the soul and on emotional well-being is usually not considered.

We now have research from neurobiology on the impact of active addiction on our higher level cognitive functioning; animals that are “addicted” show a transfer of behavioral control from more highly evolved cortex of their brains to the dorsal striatum (less developed, reptilian brain). Scientists believe we will find the same in addicted humans.

We might consider what all of this means for us as a nation — we who chose a President who may be dependent on nicotine. Could he be an even better leader, think with a sharper mind, feel with a stronger soul, and breathe with clearer lungs without the cigarette?

Most people I know with addictive disorders are highly talented, creative and special people. Some are perfectionists, many are overachievers. The sad fact for every “functional” addict is that we will never know what his or her true potential is. In recovery, this potential does have the potential to be realized.

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