Turn Over A New Life Newletter 
December, 2013

Prescription Drug Abuse Quickest Growing Addiction

   Prescription drug abuse is America’s fastest-growing drug problem. Every 19 minutes, someone dies from a prescription drug overdose in the United States, triple the rate in 1990. And according to the Centers for Disease Control and Prevention, prescription painkillers (like oxycodone) are largely to blame. More people die from ingesting these drugs than from cocaine and heroin combined.
   In 2012, approximately 7 million persons were current users of prescription pain relievers, stimulants, and antidepressants but not for valid medical reasons (2.8 percent of the U.S. population). This class of drugs is broadly described as those targeting the central nervous system, including drugs used to treat psychiatric disorders.
   Prescription drug abuse is the intentional use of a medication without a prescription; in a way other than as prescribed; or for the experience or feeling it causes. It is not a new problem, but one that deserves renewed attention. For although prescription drugs can be powerful allies, they also pose serious health risks related to their abuse.
   The medications most commonly abused are: Pain relievers - 5.1 million; Tranquilizers - 2.2 million; Stimulants - 1.0 million and Sedatives - 0.4 million
   Among adolescents, prescription and over-the-counter medications account for most of the frequently abused drugs by high school seniors (excluding tobacco and alcohol).
Nearly 1 in 12 high school seniors reported nonmedical use of Vicodin; 1 in 20 reported abuse of OxyContin. When asked how prescription pain relievers were obtained for nonmedical use, 59 percent of 12th graders said they were given to them by a friend or relative. The number obtaining them over the Internet was negligible.
   Among those who abuse prescription drugs, high rates of other risky behaviors, including abuse of other drugs and alcohol, have also been reported.
Abuse of prescription drugs is reportedly America’s fastest-growing drug problem. And, illustrated through the eyes of one user, prescription addicts may be at least as resistant to getting help as persons addicted to alcohol or illicit drugs.
   Jake (named changed) was a professional who sought pain relief medication for ongoing injuries suffered from a car collision.  Initially, the prescriptions were taken normally, but it was almost impossible not to develop drug dependence on the large dosage prescriptions initially prescribed from his doctor.  He received a 3 month, 90 day prescription to take two 40mg Oxycontin pills daily, or as needed.  The pills were helpful, but after about 4 weeks, the pain seemed to continue,  even worsen and the only relief came from taking more pills that he was prescribed.
   He ran short before the end of the first prescription and went back early for renewal.  There was no hesitation on the part of his doctor, because he just shared that the pills were working.  He then went to another doctor that same day to receive another prescription for the pain killer so that he would not run out of them early. 
   This began years of doctor shopping and even prescription pad thievery and forgery.  When confronted by friends, he rationalized that the pain is getting worse and these pills are the only things that give me relief.  Before he was arrested for forgery, he was taking up to 400 mg of Oxycontin everyday with the pain returning within 12 hours of the last pill.
   What Jake did not realize that Opiate based pain relievers can actually begin to cause dependence within 30 days, and this occurs when just following the prescription.  As opiate dependence grows, tolerance occurs and more drugs are needed to quell the pain.  Many abusers of pain relievers begin simply by following the instructions of their prescription and escalate from there.
   The best time to address potential addiction problems is at the earliest possible time.  If you are challenged with addictions to pain killers, please seek help today.

Carroll Institute will Begin Cognitive Behavioral Intervention for Substance Abuse (CBISA)

   Last summer the Governor's Criminal Justice Initiative opened the doors for funding to better care for individuals that might otherwise be sent to our county jails and state prison.  Remarkably, as many as 85% of offenders presently housed in South Dakota correctional facilities are incarcerated either directly or indirectly due to drug and alcohol use.  Multiple DUIs require harsher sanctions from the courts and those committing crimes to pay for their drug use face severe penalties.  But at the root of these individual’s criminal actions is a treatable addiction that can and must be addressed effectively.
   The state sought to seek out the best treatment curriculum for these individuals most likely to relapse and return to jail or prison without intervention.  The University of Cincinnati had developed and researched a cognitive behavioral approach that they tested in numerous Ohio correctional facilities.  They found that by implementing a treatment program that offered elemental education helping addicted offenders connect their feelings to thoughts and then their thoughts to actions, offenders were able to break the automatic responses that led so many to return to addiction and criminal behavior.   The essential focus enables clients to replace old destructive habits with new functional responses.   The process is methodically administered with much clinical demonstration of desired behaviors and this is followed by the client/offender practicing the various skills presented so that these behaviors can become natural to the offender.  The goals for the addicted offender include developing an array of necessary social skills through practicing empathy, discerning discrepancy, rolling with resistance, building self-efficacy and identifying future pitfalls and relapse triggers.  The measured evidence and results for the offenders who are most likely to relapse and re-offend has been significant and noteworthy.
   Carroll Institute will begin this new treatment program the first week in December and it will run for 16 weeks.  The CBISA component will be 1and ½ hours each day, three days a week and Intensive Outpatient Programming will fill another 1 and ½ hours for a total of 3 hours each day.  If you have questions about CBISA or other Carroll Institute services, please don’t hesitate to call, Brad Patterson at 605-275-1306.

How Early Preparation Can Help to Reduce Relapse Triggers

   He pounds his fist on the bar and asks, "How did this happen again?" 
   So many in recovery have experienced the pain and challenges that come from relapse, but relapses are not a requirement of recovery.  Though they do occur amongst many in early recovery, they do not happen to everyone.  Most people are anaware of how powerful relapse triggers are and how they can trip up very solid efforts to begin lasting times of sobriety.
   Triggers are the elemental events and thoughts that lead to the outcome of relapse.  Our addictions have evolved to be systemic solution to events, thoughts and feelings that we have wanted to process differently.  When we were sad, we wanted to feel differently so we used.  When we were happy, we used to amplify the moment.  When we perceived boredom, we used because we did not know what else to do and did not like feeling bored.  Our use was our solution to life and the required sobriety of early recovery tended to confound and eliminate our most used solution.
   So our triggers pop up both organically and selectively.  We do have to face life's challenge without choosing to use and life tends to be hard, especially in early recovery.  These stresses and emotions have rarely been fully processed by those addicted while still using.  Hence, developing skills to better face and resolve life's stressors and emotions has to be a working part of early recovery.  We addicts and alcoholics rarely sought help or guidance for our past challenges, rather we simply used and ignored the problems till they were too big to sweep under the rug.  The surprising and organic nature of life means that there will exist many potential triggers as we seek to clean up the collective wreckage of our past using .  We have to practice strategies that enable us to live life on life's terms and not be tripped up by it.
   But we can also select to sabotage our early recovery efforts by setting ourselves up for triggers.  Classically this is done by early relationships or unnecessary changes to existing ones.  This can throw our lives into tumult and the resulting stress triggers relapse.  We can avoid following treatment or 12 Step instructions because we are certain that we can handle our early recovery on our own.  We don't get sponsors or listen to their wise guidance.  We avoid spiritual development.  We choose bad work practices of surrounding ourselves with others still using at the job or work so much that we have no balance in our lives.  We allow ourselves to suffer only so that we find ourselves forced back to the one comfortable solution of relapse, but we rarely see the deadly consequences of all our choices that led to this tragic decision.
   To avoid all the pitfalls of triggers and relapse try the following:
Identify Your Personal Triggers
   Everyone is different, so every recovering addict’s set of triggers will be different. Some common triggers are walking by a bar or former party house, seeing someone who is drunk or high, getting paid, the end of a grueling workday or -week, getting into an argument with someone, and being bored.
Know What You Are Working With
   Triggers and cravings are a very real part of recovery. Do not try to fool yourself into thinking that they will not happen to you. Instead, know your triggers, stay open to anything that may surprise you, and have a plan for when you feel yourself being triggered.
Practice your Counter Responses to Triggers
   Role play, even just with yourself in the mirror, what you will do when you feel like using again. You may save yourself from a rough day, a temporary lapse, or a full relapse back to substance abuse.
Be Very Cautious About Testing Yourself
If you know that walking by a bar is a definite trigger for you, then do not knowingly walk by a bar to see if your recovery is as strong as you believe it to be. This is unnecessary testing. If we successfully pass the self-test, we can become arrogant about our abilities to remain sober, only to be knocked down all the harder. If the seed of a trigger is planted and not resloved, it will trip us later when we least expect it.
Most Importantly, Practice Good Self Care 
   You can handle triggers more easily when you are eating and sleeping well, exercising, striving towards emotional balance and seeking help from recovery communities. You are probably familiar with H.A.L.T.: Hungry, Angry, Lonely, Tired. These four things are said to cause more lapses and relapses.  When you are taking care of yourself you can identify when you feel any of the four, and that is when you can take action. Taking action, but not reacting, develops new coginitive pathways in your brain that will enable better decision making in the future. The trigger may be emotionally affecting you, but if you are properly caring for yourself, you will not act on the emotional difficulties. If you are hungry, you will eat. Tired? Take a nap or at least rest your eyes or meditate. Lonely and angry can be a little harder to manage, but phone a friend (or your sponsor) and talk it out.
   In 12 Step meetings, they often share that "it works when you work it."  This encouragement confirms that unless we begin the process of change from the inside out, then we cannot hope for confident results in early recovery.  Our old addictions will do everything to convince us that we don't need help and we don't need to change, but these are just lies.  Recovery can reach everybody and for even the most challenging of triggers, there are great suggestions to fortify the change that will lead towards success in sobriety.
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