methadone treatment


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we started a new process at the workplace for new methadone patients to provide support and education as they transition from a using lifestyle hopefully to one more geared towards recovery. it will last 3 months and the caveat for weekly contact is the promise of weekend take-outs at the end if attendance is stellar and tox screens are substance free. 
my perception of the most valuable aspect of this new approach is the more intensive support towards changing the lifestyle. becoming recovery focused is not a simple task when the majority of a person’s life is the same as it was the years before they sought recovery. they still have family relationships that are strained or broken, friends that continue to use and more, and a sense of self that is disjointed and dark. this group experience can hopefully bring some light back into their lives.  it is magical  to witness self esteem as it returns to a person and a light begins to emanate from their eyes. who needs a vacation right now. i have the gift of new beginnings.
here is an outline of the curriculum which was gleaned from a study in the uk:
Introductory session: acquaintance, coordination of expectations, overview of the
sessions schedule 1
Clinic rules (with the clinic director) 2
Methadone: facts and myths (with a physician) 3
Addiction-related diseases (with a physician) 4
Addiction: damages and consequences 5
What is recovery? 6
Coping with craving and relapse prevention 7
Recovery Support 8
Anger management 9
The addict and his/her family 10
Maintaining Change 11
Summary and separation 12
i am very excited and hopeful about the prospects here. there is a very good chance that this type of introduction to medicated-assisted-treatment (mat) could directly influence the culture at the clinic. people who are new to recovery definitely need to learn to live within new boundaries, but they need hope and a hand in order to aim their sites higher for themselves.
the first of these groups took place yesterday. we are holding them on saturdays and i have changed my work schedule to accommodate. if you have been following my blogs at all, you are aware that i love to get new things started. it may have actually become my life’s work. there are blessings and bloodletting that accompany life’s work and i have had the privilege and the responsibility to walk through both- not always perfectly or even with ease.
i never did opiates- well i did heroin once in 1983- euphoria is what i remember the most. i was on a cloud for a long time and i met a young man i dated for a while as i drifted in that fog. i knew that the undertow of that buzz was too strong for my constitution. i never allowed it to become a drug of choice. ergo i cannot directly relate to the struggles of the souls i am working with. but i can relate to the challenges of change and recovery. especially self-care and self-respect. these are the building blocks of a better life which can help lead us to safe harbor.

new order

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image credit… john baldessari
  “Blue Monday”

How does it feel
To treat me like you do
When you’ve laid laid your hands upon me
And told me who you are

I thought I was mistaken
I thought I heard your words
Tell me how do I feel
Tell me now how do I feel

Those who came before me
Lived through their vocations
From the past until completion
They will turn away no more

And I still find it so hard
To say what I need to say
But I’m quite sure that you’ll tell me
Just how I should feel today

I see a ship in the harbor
I can and shall obey
But if it wasn’t for your misfortunes
I’d be a heavenly person today

And I thought I was mistaken
And I thought I heard you speak
Tell me how do I feel
Tell me now how should I feel

i am just finishing a week of satisfaction surveys at my workplace. it has been both an exhausting and exhilarating week. i have had some incredible help from client volunteers and my hope is that their efforts have helped them as much as they have helped our organization. 

my understanding is that there has not been client involvement like this at our establishment in a very long time. my impression is that it has been a welcome change. there was a lot more healthy and positive verbal exchange in our hallways and waiting rooms than i can recall in the few years i have been around.

substance treatment has long had a very deep stigmatized and punitive edge to it. it usually comes about when a person has demonstrated the inability to modify their behaviors on their own volition. shame and disappointment are the very first of many self-criticisms that pull up their moving trucks and unpack their bags. and just like cockroaches or other vermin, there are many friends and family members that soon show up to add to the humiliation and defeat upon the foundation laid. 
traditionally, our workplace has reflected this punitive aspect. probationers, street-walkers, sex workers, addicts turned thieves, traumatized persons trapped in numbness make up a good portion of our daily participants. at least that is how they appear when they first enter our doors. it is our task to help the remember that they are and can still be much more than a few pigeon-holed labels. 
in a rather “medical model” tradition we have treated them with something and sent them on their way, expecting that they will find the other components necessary to remember their higher purpose outside our purview. our workplace has carried on with this belief for a very long time.
but with new leadership, along with healthcare reform, substance abuse and mental health parity, and a burgeoning national grass roots social movement, our society and medical community is learning and incorporating the idea of recovery (and more universally- change) requires more than just treatment. it involves support along a few fronts- ergo recovery support services. and my workplace is following suit.
the inclusion of clients in our current satisfaction survey hopefully represents a much larger philosophical shift within our walls. out of necessity (and some honest desire) we are looking to stronger outcomes, healthier practices, and more trauma-informed care. we have not become experts at recovery, only well informed about treatment. our schooling has not ended.
this week has ushered in another possibility which involves my daily work focus and activities. a very poignant piece of my story resides here- last summer, as i initiated the peer based recovery support services concept, i fantasized about the amazing possibility of implementing such a facet to a large public hospital clinic setting. then life continued to seesaw as is it’s custom, and i let go of that fantasy. but here i am sitting in my chair, contemplating a misplaced idea, and feeling hesitant to embrace excitement. 
i only hope i can learn to let go of fear someday.. 
i felt silly on this friday evening and thought it appropriate to post my favorite cover version of this anthem of my eighties.
but for you hardcore traditionalists, here is a remix of the undeniable classic from new order but a 90’s release on a cd appropriately titled “substance abuse” remixed by dmc.

 “let’s have some fun- shall we?”