Relapse in the treatment of alcoholism is common—but not inevitable—for several reasons, including post-acute withdrawal symptoms, stress, and the fact that recovery programs are voluntary, and most importantly because it is easy to forget that addiction is a fatal disease. Post-Acute Withdrawal When we stop using drugs or alcohol, we enter an acute withdrawal phase of withdrawal, the […]

In an effort to respond to this ongoing rise in abuse of opioids, the Substance Abuse and Mental Health Services Administration (SAMHSA) recently published a guide for physicians on medication-assisted treatment for opioid dependence in the outpatient office setting. Many addicted patients are very reluctant to seek inpatient treatment. It is estimated that 80% of patients suffering […]

Certain circumstances, including sights, sounds, tastes, and smells, can trigger our senses and our memory banks to tap into the files in our past and recall those incidences where drugs were used to make us feel a certain way. Enormous happiness, elation, celebration, devastating sadness, isolation and loneliness, anger, and exhaustion—these can trigger our memories […]

Drug addicts’ stories are infinitely varied and specific, but they have a near-universal common core. Each addict’s tortured journey begins with “experimenting”—using drugs with friends who use the same drugs. It starts out with no problems. This innocent flirtation progresses, sometimes rapidly, sometimes slowly, into an abusive chemical love affair as drug-caused problems emerge and […]

In a previous piece I discussed Awareness, being conscious of what is happening around us and inside us. In Twelve-Step recovery, awareness is noticing when our behavior is being driven by a character defect (such as dishonesty) rather than a spiritual principle (such as honesty).  When we are aware of our behaviors and the motivations […]

The psychoactive qualities of lysergic acid diethylamide, first synthesized in the 1930s, were first reported by Dr. Albert Hofmann of Sandoz Pharmaceuticals in Switzerland in 1943. Although some psychiatrists initially felt that LSD might have therapeutic value, military and intelligence agencies conducted experiments to determine its potential for more global purposes. Its desirability as a recreational […]

Awareness. Awareness is being conscious of what is happening around us and inside us. When we’re walking down the street and are aware of our surroundings we are conscious of businesses across the street, of the people walking behind us. We’re aware of the expressions on people’s faces, aware of whether it’s sunny or cloudy, […]

There is a plethora of research indicating opioid dependence can be successfully treated with either buprenorphine alone or with buprenorphine in combination with naloxone (Suboxone®; Subsolve®). However, we encourage caution in long-term maintenance using these drugs, even considering the lack of any other FDA approved opioid maintenance compound to date. Our concern has been supported […]

The importance of stress reduction cannot be overstated when addressing the management of these disorders. Stress results from a number of sources, and is a bio-psycho-social phenomenon. It can be treated by a number of interventions, including medications, psychotherapy, exercise, meditation, hypnosis, and other nonpharmacologic strategies. A critical stress reduction strategy is sleep. Sleep is […]