substance abuse

Addiction Recovery and the Brain

June 18, 2018 // by Lauren// Leave a Comment

It is no secret that substance abuse can impact the brain severely. The brain stem, cerebral cortex and the limbic system, among other parts of the brain, are particularly affected. A severe consequence of alcohol misuse can be Korsakoff’s Syndrome, a term indicating alcohol induced dementia. This is one of the reasons why, along with evidence based psychotherapy practices, AToN encourages a holistic approach to nourish the brain and promote PsychoNeuroPlasticity.

PsychoNeuroPlasticity is a term that references how the brain has the ability to heal itself under particular circumstances. According to experts, the brain requires 30-90 days of abstinence in order to attain a “clean” brain. In order to promote this healing process, multiple factors are implemented under AToN’s trained medical and clinical team:

Abstinence – it bears repeating as abstinence decreases brain inflammation
Highly nutritious meals –including high protein, healthy fats and green, leafy vegetables – AND avoiding neurotoxins such as MSG, aspartame and sugar
Supervised exercise (improved balance can stimulate PsychoNeuroPlasticity)
Hydration
Learning how to sleep naturally (AToN does not allow high risk sleep medications)
Structure! The brain craves structure when it is learning a new lifestyle such as addiction recovery
Mind/Body regulation, including relaxation, meditation, hypnotherapy and yoga
Building new neurological circuits – AToN focuses on coping skill building which assists in stimulating brain function and healing

These are just a few of the aspects of AToN’s curriculum that benefit our residents. If you or a loved one could benefit from treatment, please contact us!

Cassandra Cannon, Ph.D.
Clinical Director
AToN Center 888-535-1516

MDMA (3, 4-methylenedioxy-methamphetamine)

June 15, 2018 // by Lauren// Leave a Comment

MDMA, also known as Ecstasy or Molly, is a synthetic stimulant with hallucinogenic effects. It was discovered in Germany in 1912 by Anton Kollisch who was working for the pharmaceutical company Merck. MDMA was originally made to treat uterine bleeding.

In 1970 it came to the attention of Alexander Shulgin and David Nichols from Dow Chemical Co., who saw the potential for the drug to reduce fear in patients and increase insight. MDMA became the drug of choice at clubs, house parties and raves.

MDMA is a Schedule 1 substance. It is given this rating because the FDA sees no legitimate medical use for it and it has the potential for abuse and addiction.

MDMA causes the release of the neurotransmitters serotonin, norepinephrine and dopamine in the body. The neurotransmitter serotonin plays an important part in the role of sleep, mood, pain and appetite. When large amounts of serotonin are released while taking MDMA, it causes the brain to become depleted of this neurotransmitter and the user ends up experiencing confusion, depression, fatigue and memory problems. MDMA can even damage the serotonin-containing neurons which could cause long-lasting damage. Other long-term effects include irritability, impulsiveness, sleep problems, increased body temperature, decreased sexual interest and memory impairment.

Some of the short-term effects include euphoria, increased energy, distorted perception, increased heart rate, hallucinations, nausea, blurred vision, chills, and sweating. The most dangerous short-term effects are dehydration and hyperthermia.

Combining MDMA with other substances

MDMA and Alcohol

Mixing MDMA with alcohol will put an enormous strain on the kidneys. Heavy drinking can lead to dehydration and a worse come down from the drug. Alcohol is often involved in MDMA related deaths.

MDMA and Cocaine

MDMA and Cocaine are both stimulants and when used alone can be life-threatening, when used together the risk is compounded. The most serious effects are heart attacks, cardiac arrhythmias, paranoia, seizures, tremors, coma, dehydration and hyperthermia.

MDMA, Cocaine and Alcohol (A lethal combination)

When Cocaine and Alcohol are combined together they create a lethal combination called Cocaethylene in the liver. This is a metabolite that increase the risk of heart attacks, arrhythmias and strokes and when MDMA is added to the mix the combination can be fatal.

MDMA and drug interaction

MDMA used with other serotonergic drugs can lead to a life threatening condition called Serotonin Syndrome and a severe overdose can result in death.

MDMA and Caffeine

Caffeine increases the psychostimulants in MDMA and promotes the toxicity of the amphetamines.

MDMA and treatment

Currently there are no specific medications for the treatment of MDMA dependence; however different pharmacological tools can be helpful. There are several different sleep aids that can be prescribed to combat insomnia and anti-depressants can be used to help replenish serotonin and dopamine levels and manage depression and anxiety. An increase in fluids will be necessary to help with dehydration, and regular, healthy balance meals are essential to correct possible weight loss and anorexia.

Psychosocial treatment

Inpatient and residential treatment centers can vary from a 30-90 day stay; treatment is intensive. Some treatment centers can also include various forms of holistic.

Outpatient treatment can vary in length from 8 weeks – 6 months. An outpatient program is a good option for someone who has gone through a recovery program, but still needs to gain more knowledge about addiction.

The Matrix Model in an intensive outpatient program of approx. 16 a weeks and is helpful for addiction to stimulants. This model includes relapse prevention, urine testing, self-help, therapy and family education. A therapist plays the role of coach and fosters a positive environment and focuses on self-worth.

Cognitive Behavioral Therapy (CBT) is based on the idea that human behaviors, thoughts and feelings are interconnected. The approach is to change unwanted behaviors and develop different coping strategies and self-monitoring practices.

Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment that helps people learn and use new skills and strategies to develop a life that they experience as worth living. DBT skills include skills for mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.

Future research

There has been some positive data to show that MDMA could be useful for individuals diagnosed with PTSD or for social anxiety in adults suffering from autism, but more research is needed to determine the benefits of MDMA as a treatment option.

References:

National Institute on Drug Abuse. (2013). MDMA (Ecstasy, Molly). Retrieved online from www.drugabuse.gov/drugsabuse/mdma-EcstasyMolly
americanaddictioncenters.org

Johnina Noar, CADC-II
AToN Center 888-535-1516

Thoughts

May 16, 2018 // by Aton Center

Our thoughts are powerful. So powerful, that an entire style of therapy has been centered around how we identify and manage our thoughts. Cognitive Behavioral Therapy is an evidenced based treatment for substance dependence, and AToN’s curriculum is centered on this treatment. Our residents learn how to identify their “automatic thoughts” which in turn influence their emotions.

Our private rehab residents not only learn how to identify these thoughts, but they also learn how to modify them into rational thoughts, which in turn can stabilize emotional distress. These techniques, once learned, must be continually utilized for maximum effect.

If you are interested in learning how to utilize Cognitive Behavioral Therapy to help you with relapse prevention and mood stabilization, AToN’s private rehab in San diego may be a good fit for you. Don’t hesitate to call AToN when you are ready to make the next step.

Cassandra Cannon, Ph.D.
Clinical Director
AToN Center, Private Rehab in San Diego 888-535-1516

A Message to Families of Substance Abusers

April 8, 2018 // by Aton Center

Many of you may have heard that Jackie Chan, who is a Narcotics Control Ambassador for the Chinese police, and is an anti-drug advocate, has been struggling with some recent events. It has become known that his son, Jaycee, has been arrested for drug related charges. Per RTE Ten news, the elder Chan stated, “With regards to the incident involving my son Jaycee, I am very angry and shocked. As a public figure, I am ashamed. As a father, I am very sad and his mother is heartbroken. I told Jaycee: if you have done something wrong, you must bear the consequences. As your father, I am willing to face the road ahead with you.”

I think many of us can relate to the Chan family – conflicting emotions, including anger, confusion, and sometimes self-blame can be experienced when drug use comes to light. I think we can learn from the Chan’s response, which includes acknowledging natural emotions, encouraging loved ones to experience the natural and logical consequences of their behaviors, and finally to “share the road ahead,” during the difficult process of recovery. At the AToN Center, our residents participate in family work, which includes acknowledgement of how use has affected the family, how the family can assist in recovery, and creating expectations and guidelines for the resident after discharge. Sometimes, additional family sessions are held when necessary.

Ultimately, the AToN Clinical Team hopes to assist the families in whatever way may be needed; sometimes that includes education on enabling, or problem solving current or potential issues that may arise. All in all – the AToN Clinical Team recommends that families receive their own support; whether that be from their own individual therapy, attending SMART Friends and Family, or Al-Anon.

Cassandra Cannon, Ph.D.

Clinical Director

AToN Center 888-535-1516

Triggers

January 28, 2018 // by Aton Center

One topic that we address consistently is how to manage triggers. I also see many of the AToN principles incorporated into the following steps. I hope this can help someone in a pinch!

How to Deal with Triggers:

Stop, breathe, calm yourself.
Think about what just happened. . .what exactly was triggering? Why? What feelings did it provoke? Were those feelings a rational reaction to the situation?
Tell yourself verbally that you are not going to let this hinder your recovery.
Make a list of all the reasons for recovering.
If there is someone you can talk to, go to them. Even if you don’t go into specifics, let them help.
Allow yourself to feel upset about the trigger – you can’t hide away your feelings! Acknowledge that the situation affected you and take steps toward carrying on regardless.
Remember the bigger picture – the end goal: FREEDOM
You are loved and worthy.
Do something that pleases you.
Relax, you’re doing so well, I believe in you.

I found this Information from Ocd9Teen and felt it was an intelligent, concise, step-by-step “how to” that could be of benefit to anyone in recovery. I cannot take credit for the following steps – but I am grateful for all of the support that is out there for all in recovery.

Cassandra Cannon, Ph.D.

Clinical Director

AToN Center 888-535-1516

Post Acute Withdrawal Syndrome

November 27, 2017 // by Aton Center

When residents enter into treatment, often they fear the physical withdrawal symptoms and forget about the emotional and psychological withdrawal symptoms that can make long-term sobriety so difficult.

These emotional and psychological symptoms comprise the second stage of withdrawal, called “Post Acute Withdrawal Syndrome” or P.A.W.S. There is no set length of time that these symptoms may linger. It depends on variables such as age, length and type of substance misuse, environment, and recovery program.

Post Acute Withdrawal symptoms may include the following:

Lethargy
Anhedonia
Emotional Lability
Stress Sensitivity
Memory Problems
Sleep Disturbances
Physical Coordination Problems

At AToN Center, we teach you how to manage P.A.W.S symptoms by providing recovery study groups, mindfulness exercises and developing healthy habits with emphasis on the following:

Stabilization and Awareness (Mindfulness)
Nutrition
Exercise
Relaxation
Spirituality
Balanced Living

While there is no short- term “cure” for Post Acute Withdrawal Syndrome, AToN Center focuses on developing the ability to accept and manage the uncomfortable symptoms. Recovery from addiction is a process that requires learning new coping skills and developing a healthy support group to be maintained long after leaving AToN Center.

Kate Judd M.S., CADC-II
CD Counselor

AToN Center 888-525-1516

CD Counselor

Sometimes It’s The Small Things

November 25, 2017 // by Aton Center

Often times, treatment for substance and alcohol abuse can focus on big picture issues. This can include working on a marriage strained under the pressures of addiction, the need to change an unsustainable work environment, deciding that one can no longer stay sober and live in their home, and many others. These issues are very important and need their due attention, but at times, one may take comfort in focusing on the small things:

This can mean stopping everything for a cup of tea.

This can mean calling an old friend and making them laugh.

This can mean listening to your favorite song or album, laying on the carpet and breathing deeply, or doing a few minutes of yoga.

Though they may seem small, these brief moments of respite can offer you just enough grace to make it through the challenges that are presented and have one more sober day.

Chad K. Cox PsyD

AToN Center 888-535-1516

Cravings

November 19, 2017 // by Aton Center

An important part of treatment is to learn how to manage cravings when they occur. Cravings can be characterized as an intense desire to use a substance that can feel almost impossible to withstand. Fortunately, if you have learned coping management skills, you can have the self confidence to make it through these intense periods of time.

Cravings, Managing Your Cravings

SMART Recovery encourages individuals to “ride the wave” of craving. They also recommend the DiSARM Method (see the SMART Recovery Workbook), in which one personifies their craving and “fights back” so to speak, against this craving.

Many residents at AToN Center use the imagery that their craving is Darth Vader, and they are fighting against the craving (and Darth Vader!) with lightsabers. While these cognitive skills are helpful, they do not address the physiological processes of the craving that occur out of one’s awareness. Using these strategies with other physiological self management strategies can enhance success in managing cravings.

In recent years, some researchers have been analyzing the association between physiological stress management and craving intensity. The specific modality being studied is Heart Rate Variability Biofeedback, which is offered as a treatment at the AToN Center.

A new study published in the Applied Psychophysiology and Biofeedback Journal demonstrates some promise in the application of stress management utilizing biofeedback and the reduction of cravings. In this study, the researchers implemented a three-session biofeedback protocol to a portion of residents in an inpatient substance misuse treatment facility. In this very short intervention, the results were promising and warrant further investigation. Specifically, those patients who participated in the protocol experienced a medium effect size greater reduction in craving in comparison to those patients who did not receive biofeedback as a part of their treatment. Additionally, these patients also experienced improvements in mood stability.

In recovery, it is important to use every tool available to enhance treatment outcomes. At AToN, we believe that we offer a wide variety of treatments that can be tailored to individual needs. In combining Cognitive Behavioral Therapy, Relapse Prevention Skill Building and other modalities (heart rate variability biofeedback, hypnotherapy, EMDR, yoga, meditation, acupuncture, massage) we believe that we offer the very best that treatment available.

If you are a loved one is struggling with substance misuse, and are looking for a program with an individualized approach – do not hesitate to call our intake line for further information.

Cassandra Cannon, Ph.D.
Clinical Director
AToN Center 888-535-1516

Reference:Eddie, D., Kim, C., Lehrer, P., Deneke, E., & Bates, M. (2014). A Pilot Study of Brief Heart Rate Variability Biofeedback to Reduce Craving in Young Adult Men Receiving Inpatient Treatment for Substance Use Disorders. Applied Psychophysiology and Biofeedback,39(3-4), 181-192.

Opioid Addiction Treatment

November 16, 2017 // by Aton Center

Clinicians and counselors who work in the field of addiction treatment commonly refer to addictive disorders as a type of “disease.” The term, though, is often used in disparate ways. While a more traditional counselor will associate the disease of addiction to character deficits, others will use the term in connection to the neurobiological changes implicated in the addictive use of substances. The former focuses on symptoms of selfishness and shamelessness, the latter on neuroadaptations that shape an allostatic load and dysregulation in the executive areas of the brain. One views addiction as a moral failing, the other as the end result of neurochemical changes in the brain.

These perspectives on the “disease” of addiction greatly opposed each other. That opposition stokes often-heated debates on how to address the country’s drug epidemic. The use of Suboxone maintenance can serve as a flash point in such debates. The more traditional counselor will argue that Suboxone can be abused, that the medication can induce a low-grade euphoria that alters mood much as other drugs of abuse do. Simply substituting one drug for another, the traditionalist contends, defeats the idea of recovery. A more progressive clinician will counter that the subtle “high” of Suboxone pales in comparison to the euphoric state triggered by heroin and oxycodone, with many who are prescribed the maintenance medication reporting that the euphoric effect is short-lived after induction.

A more blunt point in the progressive argument is – who cares? Who cares if the script trips a cheap high in the first dose or two? The script saves lives. Approx 65,000 Americans will die by overdose this year, with two-thirds of those deaths attributable to opiates. Hundreds of thousands of Americans will die by opiate overdose in the next decade, a grim fact that underscores how both traditional and more contemporary treatment models generally fail to treat opiate addictions. On the other hand, a bounty of research exists that highlights how the use of Suboxone maintenance reduces the risk of relapse by more than half (see references), its effectiveness superior to both 12-Step and CBT-based interventions in preventing an initial slip.

Reducing the risk of an opiate relapse secondarily reduces the risk of overdose and death. The risk of overdose is exponentially higher after even a brief period of abstinence. That is, the risk of fatal overdose is much greater after someone completes time in treatment, especially residential care.

The first 3 months after residential treatment are a risky time. The brain of those in early abstinence struggles to use foresight, judgment, to manage stress, exercise impulse control, and so forth. A medication like Suboxone can help bridge the time needed for the addicted brain to reset itself, so someone can more fully engage the introspective process needed to sustain change maintenance, and to reestablish a sense of self-control.

Kevin Murphy, Psy.D.
Psychologist
AToN Center 888-535-1516

REFERENCES:
Sordo, L., Barrio, G.,Bravo, M.J. Indave, B., Degenhardt, L., Wiessing, L., Ferri, M., Pastor-Barriuso, R. (2017). Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies, BMJ 2017;357:j1550

Pierce, M., Bird, S.M., Hickman, M., Marsden, J., Dunn, G., Jones, A. & Millar, T. (2015). Impact of treatment for opioid dependence on fatal drug-related poisoning: a national cohort study in England, Addiction, 111, 298–308

Potter, J.S., Dreifuss, J.A., Marino E.N. et al (2015). The multisite prescription opioid addiction treatment study: 18-month outcomes, Journal of Substance Abuse Treatment (48)1:62-69, 2015.
Weiss, R.D., Potter, J.S., Griffin, M.L. et al. (2015). Long-term outcomes from the National Drug Abuse Treatment Clinical Trials Network Prescription Opioid Addiction Treatment Study, Drug and Alcohol Dependence 150:112-119, 2015.

Kevin Murphy, Psy.D., PSY23323
Psychologist
AToN Center

True Freedom

October 20, 2017 // by Aton Center

There is a sense of freedom that comes when breaking away from the destructiveness of addiction.

When individuals are in active use of substances or behaviors there is a tendency to feel imprisoned or enslaved to the need to use, obtain and plan ahead so as not to enter into withdrawal. This can be tiring and all encompassing. Often when entering treatment or other avenues of breaking the cycle of addiction one can rest in the comfort of not having to do an enormous amount of work to keep the addiction going.

The freedom experienced here can be great but left alone can dwindle and one can begin to crave the old behavior again.

It is said that if you give recovery half the energy you put into your addiction, it can be successful. That is not too much to ask is it, half?

Most people with long term recovery will say the freedom is well worth the effort and even far beyond our wildest dreams. After all, what have we got to lose if we give it a try?

It is also said that if we give recovery a chance and don’t want it, we can gladly have our misery refunded to us…sounds like a deal to me!

Enjoy the journey!

Kristin Colton CATC II

888-535-1516

Combining MDMA with other substances

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