The question becomes, what can be done to help Baby Boomers who need treatment to overcome substance abuse today? This is especially important if the boomer happens to be in your immediate family. It may be your spouse or your parent, or even your child, if you are the elderly parent of the boomer.

• Consider an intervention – If your loved one who is a Baby Boomer is resistant to the idea of accepting treatment, you may wish to consider a professional intervention as a means of convincing him or her that treatment is the best option. Enlist the support and participation of other close family members, as well as friends, and definitely make the call to obtain a trained interventionist to handle this possibly life-saving intervention. Make sure that you look for a board certified interventionist.
• Consider residential treatment – Whether or not you need to use an interventionist to get your loved one into treatment, you will need to make arrangements for the treatment itself. For many Baby Boomers trying to overcome substance abuse, a residential treatment facility is the best option. After initial screening, a personalized treatment plan will be created for the boomer, and will consist of education about substance abuse, learning how to recognize and identify triggers to using, learning methods of coping with cravings and urges to use, and considerable time spent on relapse prevention. One-on-one counseling, group counseling, and possibly prescription medications to assist in lessening anxiety and/or depression may be utilized. Private insurance may cover most of the residential treatment for the Baby Boomer, or there may be financial assistance available through federal, state or local programs.

Relapse Prevention

What happens during the relapse prevention phase of treatment for Baby Boomers as they are overcoming substance abuse? According to SAMHSA, a successful relapse prevention treatment approach utilizes the cognitive-behavioral and self-management intervention in a counselor-led treatment setting to help older adults overcome substance use disorders. Treatment modules should consist of the following:

• An analysis of substance use behavior – The first module consists of having the individual learn how to analyze their behavior by looking at their substance abuse behavior patterns what prompted it, the behaviors themselves, and the consequences associated with that behavior.
• Learning how to manage social pressure – Refusal skills are an important method for individuals to use when social pressures create high-risk situations for substance abuse relapse. Here the objective is to teach the individual how to control their behaviors while still being able to socialize.
• How to manage situations at home and alone – Learning how to cope with boredom and loneliness and manage leisure time is taught in this module.
• How to manage negative thoughts and emotions associated with substance abuse – This module teaches the individual how to recognize repetitive thoughts and negative self-talk, how to interrupt those negative patterns, and to find ways other than substance abuse to cope with mood changes.
• How to manage anxiety and tension – It’s important that the individual learn how to manage feelings of anxiety, ways to avoid situations that produce these feelings, as well as skills on how to reduce those feelings.
• How to manage anger and frustration – The importance of using assertive behavior to handle feelings of frustration and anger are taught in this module.
• How to control substance abuse cues – This involves recognizing personal substance abuse cues as well as practicing skills on how to avoid those cues.
• How to cope with urges – Here the individual learns that urges last for various periods, have a beginning and an end, even during abstinence; can be waited out; become weaker and end sooner each time they are resisted; and become easier to resist each time they are successfully managed.
• Preventing a slip from becoming a relapse – One slip doesn’t have to lead to a relapse, negative self-talk can be replaced with positive self-talk, and self-management skills and requests for help can be used to avoid a relapse.

How Long Will It Take and Will Treatment Be Effective?

A natural question that anyone would have is whether treatment for substance abuse will be successful. Along with that is how long will it take. The answer depends on the individual’s particular situation. How long has he or she been abusing drugs and/or alcohol? What is her or her drug of choice? Are there medical conditions or mental health disorder also present? Is there a family history of drug or alcohol abuse? These are just a few of the screening questions that help the professionals at the treatment facility create a tailored treatment plan to help the Baby Boomer overcome substance abuse.

Some individuals may do well in a 30-day or short-term treatment program while others with chronic substance abuse may need a treatment program lasting 60 days or even longer. Aftercare or continuing care programs are also important to help ensure long-term effective sobriety. Family programs can help others in the household learn how to support the Baby Boomer post-treatment as he or she begins recovery.

There is, however, no guarantee that treatment for substance abuse will be effective with Baby Boomers just as there’s no guarantee that treatment will work for any other age individual. What is known is that without treatment, substance abuse will only worsen. So, too, will the complications and consequences associated with substance abuse, and this is particularly true with older adults.

It is also a fact that just getting detoxed, coming clean from alcohol or drugs (or both), is not enough. You can’t just dry out and expect that everything is going to be fine from this day forward. Without counseling and education to learn how to manage stresses and life changes without self-medicating with drugs and alcohol, the cycle will continue to be repeated. That’s why it’s important that the Baby Boomer who goes into treatment remain in treatment after detox. The only way treatment will be able to prove effective for the boomer is if he or she stays in the program that’s been tailored for him or her through completion.

Following treatment, participation in self-help groups, peer-support groups, and family support and encouragement are recommended for the Baby Boomer to maintain sobriety.

Substance abuse among Baby Boomers is indeed growing. But this doesn’t have to be a foregone conclusion or result in tragedy. Treatment can help.

But is it really recovery, or is using methadone just a substitute addiction? Let’s explore the subject further.

What is Methadone?

Methadone is a synthetic narcotic pain reliever with effects similar to morphine. Methadone is also used to help reduce the withdrawal symptoms in people addicted to heroin and other narcotic drugs without producing the “high” associated with those narcotics.

Most opioids are derived from the opium poppy, and include heroin, morphine, codeine, and hydrocodone. Methadone, on the other hand, is totally a synthetic opioid. Even though it is structured dissimilar to naturally derived opioid products, methadone nevertheless acts on the same sites in the body as the other opioids. It’s for this reason that methadone has been used in the treatment of heroin addiction.

What is different about methadone versus heroin and other opioids? For one thing, the onset is slower and it lasts longer in the body. Methadone is usually taken orally as a syrup, rather than by injection.

But methadone is still a narcotic, and it is addicting. Granted, it is less addicting than heroin or other opioids, but addiction is addiction. Why substitute one addictive substance for another?

There isn’t the rush that’s associated with heroin, and the withdrawal phase is not as severe. This is the primary reason many heroin addicts choose methadone as a kind of middle ground between heroin use and total abstinence. Indeed, going “cold turkey” from heroin addiction is almost never successful. Addicts are simply unable to tolerate the severe withdrawal pain and the cravings are insurmountable. It’s far easier to just revert to heroin use.

How Methadone is Used

Tapering off and gradually reducing the dosage of methadone is one way of kicking the heroin habit. Another use for methadone is as daily maintenance. Why would someone choose methadone maintenance? Using methadone in this manner allows the heroin addict to try to rebuild parts of their lives that have been damaged by heroin addiction. It’s not a perfect solution, but it can be useful as a temporary one.

Still, methadone is not a safe drug, as many accounts and numerous studies have found. It is a Schedule II narcotic under the Federal drug classifications, requires a special license to dispense, and carries a high risk of dependence.

Brand names of methadone include Amidone®, Methadose® and Dolophine®.

Side effects of methadone, depending on dose, include dizziness, drowsiness, constipation, lethargy, lowered respiration rate and elevated mood.

Methadone can also serve as a gateway drug for other narcotics. Another reason methadone isn’t safe is that it is dangerous in combination with alcohol and other types of drugs an individual may be taking, particularly barbiturates. Both alcohol and barbiturates act on the central nervous system

Why Methadone is not Recovery

Many addicts do not like methadone and will use the synthetic opioid only until they can return to using heroin, or when they procure a regular supply of heroin once again.

Methadone can also be considered a way to extend addiction, rather than going through the withdrawal that is necessary to get addictive substances out of the body. Extending addiction puts off the likelihood that a person will go into treatment to overcome addiction to heroin or other opioid drugs.

When a patient is dependent on methadone, it should always be dispensed with an approved treatment program. Such a treatment program should also include testing to ensure that the patient doesn’t continue to use heroin on the side.

Methadone use has other side effects as well, which may cause problems for the individual. He or she may be refused a job because they are on methadone and the job includes operating heavy machinery or equipment for which mental alertness is necessary. It is also possible that the individual’s employer will find out about the methadone use, especially if an insurance company is paying for the methadone treatment.

Newer Drugs for Treatment of Heroin Addiction

While methadone is the oldest treatment for heroin addiction, there are newer drugs that have been approved by the U.S. Food and Drug Administration (FDA) for treating opioid addiction.

One of these drugs is naloxone, marketed as Suboxone, which the FDA approved for opiate treatment in 2002. With methadone, a patient has to travel to a clinic to receive a daily dose. With Suboxone, doctors can prescribe a month’s supply of the drug, which is much more convenient for many individuals.

But methadone is less expensive than Suboxone and is more widely available.

Buprenorphine is another drug that has been FDA-approved and is useful in helping to block cravings. The combination of buprenorphine and Suboxone has proven effective in some patients.

Another medication-assisted therapy for opioid dependence is naltrexone, although studies have found that naltrexone treatment is poor except for highly-motivated patients under strong external pressure to comply with treatment regimen. With the introduction of once-monthly injectable formulations, such as Vivitrol, however, this situation may be changing. Vivitrol has been approved by the FDA for preventing relapse to opioid addiction.

Treatment for Opioid Addiction

If methadone or Suboxone and buprenorphine are helpful in allowing an individual to better manage opioid withdrawal symptoms while they are getting treatment to overcome addiction, what kind of treatment works best?

Traditional treatment for opioid addiction includes a period of detoxification (also called detox), followed by counseling and therapy that are designed to help the patient stay off the drug. There are also specific therapies that include Chinese medicine, hydrotherapy, mindfulness meditation and spiritual counseling, restorative yoga, nutritional wellness and detoxification juicing, hypnotherapy, massage therapy, dry sauna, and EEG biofeedback (neurofeedback).

How should you go about finding treatment for opioid addiction? You can start by asking your doctor for a recommendation to a treatment facility that specializes in treating patients addicted to heroin.

Office-based opioid treatment providers often refer their patients to substance abuse counselors, social workers, psychologists or nurses for counseling, but physicians can also provide counseling to their patients as part of medication management. Weekly urine testing early in treatment has been recommended by most clinicians. That is because it is expected that patients will have at least some ongoing use. Prescription intervals can be used as a contingency to help motivate patients to abstain from opioid use, or at least spur them on to a recovery trajectory.

Another avenue to finding therapy is to use the Treatment Facility Locator (http://dasis3.samhsa.gov/) maintained by the Substance Abuse and Mental Health Services Administration (SAMHSA). This is an online searchable directory of drug and alcohol programs showing the location of facilities around the country that treat alcoholism, alcohol abuse and drug abuse problems.

Included are listings for residential treatment centers, outpatient treatment programs and hospital inpatient programs for drug addiction and alcoholism. Select “Detailed Search” and click the box for specific services desired to search for treatment facilities offering such services in addition to detoxification and treatment (including counseling).

Heroin relapse rates are quite high which often necessitates repeated stints in rehab. For this reason, recovery from opioid addiction is usually considered an ongoing process.

In combination with treatment, participation in various 12-step self-help groups such as Narcotics Anonymous is strongly recommended. Indeed, most treatment programs include mandatory participation in 12-step meetings as part of the overall treatment plan.

Outcome for Opiate-Dependent Individuals Entering Treatment

While the path toward recovery from opioid addiction may seem uncertain, with relapse rates high and multiple stays in rehab often required, the outcome is not negative. Indeed, with each treatment stay completed, patients do seem to make progress, according to numerous research studies.

The fact that many opioid-dependent individuals also have other substance abuse problems, specifically alcohol abuse or addiction, and/or use of cocaine or other illicit substances, along with possible co-occurring mental health disorders (including depression, anxiety, bipolar disorder and others), means that it may take longer for the comprehensive treatment to begin to work effectively.

Bottom line: If you are addicted to heroin or OxyContin or other opiates, going into treatment, sticking with it, and developing a strong support network will put you on the road to recovery. It may take you a while to get there, but you can and will see progress as long as you remain committed to sobriety and do the hard work necessary to maintain it.

Is recovery worth it, no matter whether you go the methadone route or another of the FDA-approved treatments for opiate addiction, coupled with counseling, 12-Step meetings and so on, of course? Only you can decide. But your future very much depends on your decision. Why wait? Seek help today so that you can begin to learn how to overcome what very likely is impacting your life in a negative way.

The Call to Serve

Charlotte dedicated her life to God at age 11. During adolescence, she took her own will back and began to lead a life that wasn’t what God had intended for her. Finding herself addicted to drugs and estranged from her family, Charlotte needed something dramatic to remind her of what really mattered. In her early 20s, Charlotte had a clear and unmistakable conversion experience.

“The Lord intervened and I rededicated my life to Him. I vowed to serve Him and be singly devoted to His will and purpose in my life,” Charlotte says. “The Lord has had His hand over my life ever since.”

Knowing God had a plan and purpose for her life, she left a career in music, pulled up her roots in New York and moved to South Florida. When The Recovery Place first opened its doors in 2007, Charlotte was hand-picked to lead the Christian addictions program.

“God called me and equipped me for this kind of work,” she says. “He could’ve used anybody on the face of the Earth to develop a Christian program like this, but He chose me, and I feel so blessed. I know I’m here for a reason.”

Helping Others Find Their Way

On any given day, Charlotte can be found leading Christian counseling sessions and Bible studies, educating clients about the disease of addiction, or scheduling church barbecues, concerts and other activities in the community. She is constantly in search of new ways to reach people struggling with addiction and help them realize that God has a plan for their lives. Many of her clients feel blessed to have found a Christian drug rehab program that understands their beliefs and faith.

In the Christian addiction treatment program, clients are cared for by other Christians who love the Lord and are experienced in addiction recovery. They learn about the 12-Step principles and attend regular church services and Celebrate Recovery support groups, in addition to participating in therapy, outside AA/NA meetings and other traditional addiction treatments.

“Clients who choose the Christians addictions program grow in their faith as well as their recovery,” Charlotte explains. “They come to The Recovery Place to find out what God has planned for their lives. Our message to those struggling with addiction is that God loves you in your woundedness and in your most vulnerable, dysfunctional moment because that’s who He is.”

Now in recovery for 20 years, Charlotte describes herself as an “out of the box Christian.” Her fun personality, attentive listening style and client-centered approach help her build instant rapport with clients. Every day, she says she feels blessed to work with a team of people who are as passionate, focused and empathetic as she is, and who are willing to go above and beyond to put their clients’ needs first.

“The minute my foot hits the front door my spirit is lifted,” she says. “When you’re doing what God calls you to do, it doesn’t feel like work anymore. I owe everything to Jesus Christ, the one whom I love.”

Ms. Mueller, just 34 years old, is checking into an inpatient rehab center that provides long-term treatment. She was seen just days ago at an L.A. airfield entering a private jet which purportedly whisked her to the undisclosed treatment facility. Her representative made it plain that Ms. Mueller wished to be out of the spotlight and would not be providing any further details regarding her care. This, he said, is her time to be free of distractions in order to focus more fully on recovery.

The celebrity wife and actress (she appeared with Paris Hilton in "The World According to Paris") has been in drug and legal trouble before, as recently as this past summer, but would only commit to outpatient day treatment. Those around the troubled star say that her problem is such that she needs the protracted and focused attention that long-term inpatient rehab provides.

While in Aspen just weeks ago, Ms. Mueller was found to be at fault in an assault charge as well as in possession of an amount of cocaine that left her open to charges of drug distribution – charges that carry a six-year jail sentence if she is found guilty.

Sources report that the twin boys she mothered with Sheen were with her in Aspen, though she had left them in the care of a trusted nanny while she went clubbing. Those boys will be staying in their California home with the nanny and grandparents, trying to maintain as much normalcy as possible during mom’s extended absence. Mr. Sheen is reported to have flown home from Colombia in order to take over the boys’ care, but Ms. Mueller has retained custody and the boys will not be handed over to their father.

Rehab is hard work and the patient needs to be fully invested in making serious changes. Tired of her repeated offenses, her parents have taken a hands-off approach this time hoping to convince Ms. Mueller that full and lasting changes are needed.

A recent study provides additional evidence that the programs are a critical part of protecting the health and safety of Canadian citizens. The study, published in the online version of the journal Addiction, was conducted by the Centre for Addiction and Mental Health and the Institute for Clinical Evaluative Sciences.

The study, in which data was collected before the new government policies for monitoring were enacted, shows that a significant number of individuals who were being treated for opioid addiction with methadone were also receiving prescriptions for other opioids. Methadone is commonly used as a treatment for opioid dependence.

The study finds that 18 percent of those who are undergoing methadone maintenance therapy were also provided with prescriptions for opioids that would last them at least a week.

Dr. Paul Kurdyak, the head of CAMH’s Emergency Crisis Services and Research, explains that combining methadone with other types of opioids can often result in overdoses or even fatalities. The researchers found that the methadone patients examined had an average of 12 additional opioid prescriptions in a one-year period, with data examined from 2003 to 2010. Almost half of those included in the study were prescribed methadone and opioids from multiple doctors and pharmacies.

This information is critical, because it shows a significant gap in methadone and opioid prescribing. Given the danger of administering methadone in addition to other types of opioid medications, the patient must be monitored carefully by the doctor who prescribes the methadone.

The study’s data was collected by utilizing the Ontario Drug Benefit database. The researchers used the database to identify records that contained prescriptions for methadone and looked at other prescriptions for the 18,759 individuals who were undergoing methadone maintenance therapy.

Co-author of the study Dr. David Juurlink explained that methadone therapy should never have been combined with long-term use of other types of opioids. Dr. Juurlink believes that the widespread patterns of patients using multiple doctors and pharmacies indicates that at least some patients are deceiving their doctors to receive opioid prescriptions.

Dr. Juurlink believes that many of the problems revealed by the study could be remedied by the use of a prescription monitoring system that links doctors to the prescriptions that each patient already possesses.

In order to more fully comprehend what’s at stake and look at where this kind of thinking may be a bit off, let’s look at what Suboxone is and what it is intended to do.

Suboxone: What it Is

Suboxone is a brand-name for the medication buprenorphine. This is an opioid medication used to treat opioid addiction, either in the privacy of a physician’s office, in drug rehab, or dispensed for take-home use by prescription.

Suboxone (buprenorphine) is a safe and effective treatment for individuals addicted to opioids, according to the Center for Substance Abuse Treatment, Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction, Treatment Improvement Protocol (TIP) Series 40.

Buprenorphine is different than other opioids in that it is a partial opioid agonist. Because of this property, it may allow for the patient to experience less euphoria and physical dependence. It has a lower potential for misuse, a ceiling on opioid effects, and a relatively mild withdrawal profile.

Appropriate dosage of buprenorphine may suppress opioid dependence symptoms, decrease cravings for opioids, reduce illicit use of opioids, block the effects of other opioids, and help patients stay in treatment.

The Food and Drug Administration (FDA) approved Suboxone tablets (buprenorphine hydrochloride and naloxone hydrochloride) and Subutex (buprenorphine hydrochloride) for the treatment of opiate dependence in October 2002. These are the only buprenorphine-based products approved to treat opioid addiction. On October 9, 2009, the FDA approved a generic version of Subutex.

Examples of opioids are painkillers such as morphine, methadone, hydrocodone, and oxycodone. Heroin is also an opioid and is illegal. Opioid drugs are sold under brand names, including OxyContin, Percocet, Percodan, Vicodin, Tylox, and Demerol, among others.

What Works Better: Counseling and Medication

Because opioid dependence is more than just a physical condition, successfully overcoming addiction to opioids requires more than merely dosing the individual with prescription drugs, including Suboxone.

It’s no secret that individuals cannot "go it alone" to overcome their addiction. This applies to all types of addiction, whether to painkillers or alcohol or process addictions such as compulsive gambling, workaholism, or other types of compulsive behavior.

Yet it is amazing how many individuals come to believe, often with their doctor’s encouragement, that taking a prescription medication will end their troubles.

The truth is that, in the case of opioid dependence, cravings for the substance can occur months or even years after the patient last used the drug. And when such cravings do surface, they often appear so unexpectedly and with such an intensity that they propel the individual into a state of panic that may lead to relapse.

Here’s where evidence-based research comes into play. Studies have found that individuals who are being treated with prescription Suboxone and also take part in counseling have a much better outcome than those who continue on Suboxone alone. Why is that? Counseling can assist the individual in learning better ways to cope with events, circumstances and social situations that might otherwise lead them to using again. This is especially true of such events, circumstances, and social situations the individual associates with past drug use.

Since strong emotions and certain behavior patterns are part of the overall opioid dependence picture, it stands to reason that counseling would prove more effective at helping the individual begin to make changes in their behavior and lifestyle so that he or she can focus on long-term recovery goals. Suboxone helps reduce or eliminate the physical cravings associated with opioid dependence. That the counseling occurs in tandem with Suboxone treatment makes the process easier and more effective.

Detoxing and Getting Off Suboxone

Weaning off of opiates by using buprenorphine, Suboxone, or Subutex is the first step in the long-term process of overcoming dependence on opiates. But it shouldn’t be a life-long solution. Once you’re at the point where you have been detoxed and stabilized in drug rehab for opiate abuse, the ultimate goal should be to get off Suboxone completely.

Unfortunately, what often happens is that the individual makes the decision to quit taking Suboxone on his or her own, independent of the doctor’s advice. He or she may feel that it’s been long enough, and they don’t like the way they still feel a bit intoxicated from the drug. In addition, Suboxone tends to blunt the emotions, and what you want to feel is alive, not deadened.

There’s a problem with quitting Suboxone on your own, however, and that problem is a tendency to relapse during the withdrawal from Suboxone phase. Now, it may be true that you are the rare individual who can manage Suboxone withdrawal on your own, but the likelihood of this happening isn’t that great. When you start to feel anxiety and other issues cause the cravings to rare up with a vengeance, and they will, without clinical support and the appropriate tools, relapse is all but inevitable.

There is a safe and effective way to get off Suboxone. This is best accomplished in a detoxification from Suboxone maintenance program, and a facility that specializes in this service is the place to choose. If you’ve been previously treated in drug rehab and that facility did not offer a detoxification from Suboxone maintenance program, you can avail yourself of the opportunity to get off Suboxone by going to a facility that provides this specialized service.

What happens during this detoxification from Suboxone maintenance program? After an initial assessment, the dose of Suboxone will be gradually lowered. The tapering off schedule will be different for each client, based on dosage at the time of admission. Assessment of the client for physical or psychological effects of tapering will occur every couple of hours to ensure that withdrawal is as comfortable as possible. Some non-addictive medications may be used to ease withdrawal symptoms.

At Promises Treatment Centers, the emphasis is on integrative services, provided in individual and group formats. These include hypnotherapy, mindfulness meditation, EEG biofeedback or neurofeedback, hydrotherapy, acupuncture and Chinese medicine, restorative yoga, massage therapy, nutritional wellness groups, and other support as needed.

Does this sound like high-priced spa treatment? It may sound that way, but the fact is that these types of therapies are highly effective at helping to ease anxiety, cravings and fear during withdrawal from Suboxone.

The goal of the detoxification from Suboxone maintenance program is to give the individual tools, information and support needed to sustain his or her recovery on a long-term basis.

What About Relapse After Detoxing from Suboxone?

There are some people who may be at risk for relapse. For those individuals who have high anxiety about relapse, or who have chronically relapsed, a treatment plan at a drug rehab facility specializing in detox from Suboxone maintenance can be developed to meet their needs using a non-agonist medication that will be maintained for three to six months. The term non-agonist means that the medication does not bind to the same brain receptors as those of opiates. Suboxone is an opiate agonist. A medication called Vivitrol is not an opiate agonist.

Why is the distinction important? It is important because it means that Vivitrol is much easier for the individual to stop using at the end of his or her treatment period. Vivitrol also protects against relapse by making it impossible to get high from opiates. Let’s say that you have a moment of weakness and use opiates again, but are taking Vivitrol. You won’t get high because Vivitrol interrupts the physiological response to the opiate.

Questions to Ask Yourself

If you’ve come to the determination that you want to overcome your addiction to opiates, get off OxyContin or Percocet or Vicodin, ask yourself how willing you are to do what it takes to first detox from the opiate and then proceed with the kind of counseling and therapy you need to help ensure you will be able to maintain your sobriety once you leave treatment?

Ask yourself if you want to continue taking Suboxone indefinitely or if you ultimately want to be able to live your life without having to do Suboxone maintenance?

Do you think that taking medication forever is the best solution? Or do you believe that it should be only a short-term solution? The answers to these questions will put you in a better position to know which way to proceed.

In any case, you should not attempt to quit taking either opiates or Suboxone on your own. That’s simply a recipe for relapse. You might think you have enough willpower and determination to do it on your own, but as soon as the anxiety and the cravings kick in, that will be the end of your resolve. Believe it, because it happens every day to individuals who try to go it alone.

It’s also necessary to figure out your insurance coverage or to analyze your finances to see if you can afford certain kinds of treatment. Residential addiction treatment programs are the most expensive, generally speaking, and specialty services may cost more. There may be help that you can receive to assist in payment for treatment, and this is something to explore with the particular treatment facility you’re considering.

But don’t let money stand in the way of getting off opiates for good, including Suboxone which helps you wean off opiates in the first place.

One more thing, if you’re currently going to a doctor who prescribes Suboxone for you and doesn’t encourage you to get counseling, think about getting counseling anyway. You don’t want to short-change your own chances for effective recovery, do you? And you certainly don’t have all the answers yourself as to how to deal with triggers and cravings and urges. You need some powerful tools and strategies to help you, and you get them by going through therapy and participating in 12-Step groups.

Getting Started with Counseling

There are many ways to begin counseling. Each individual needs to choose the best path to getting started. For some, counseling will be a natural offshoot of a drug rehab or residential treatment program for opioid dependence or addiction. Others will have a discussion with their doctor, likely the same doctor prescribing Suboxone, and obtain a referral to an appropriate therapist.

There are different kinds of counseling available. Again, the individual should make the decision which kind of counseling works best for him or her.

• There is private one-on-one therapy with a trained professional.
• Group counseling may be another choice, alone or in conjunction with individual counseling
• Online group counseling with a trained professional and a group of peers is another counseling option.

Beyond counseling, there are also support groups that the individual can participate in to help solidify his or her recovery. These 12-step support groups, including Narcotics Anonymous, are a terrific addition to therapy. Many individuals find them invaluable in their recovery because they are among peers with the same overarching goal: long-term sobriety.

To find an appropriate therapist, ask your doctor for a referral. You can also check out the National Alliance of Advocates for Buprenorphine Treatment (NAABT) to find a list of counselors near you.

The NAABT is a non-profit organization whose mission is to educate the public about the disease of opioid addiction and the buprenorphine treatment option, to help reduce the discrimination and stigma associated with patients with addiction disorders, and to help connect patients in need of treatment to qualified treatment providers.

Once you’ve selected the therapist, make an appointment for an initial consultation. Then, if you’re satisfied that you and the therapist are a good fit, you can get started with counseling.

Another avenue to finding therapy is to use the Treatment Facility Locator maintained by the Substance Abuse and Mental Health Services Administration (SAMHSA). This is an online searchable directory of drug and alcohol programs showing the location of facilities around the country that treat alcoholism, alcohol abuse, and drug abuse problems.

Included are listings for residential treatment centers, outpatient treatment programs, and hospital inpatient programs for drug addiction and alcoholism. Select "Detailed Search" and click the box for "Buprenorphine Services" to search for treatment facilities offering such services in addition to detoxification and treatment (including counseling).

There is also the Buprenorphine Physician and Treatment Program Locator maintained by SAMHSA.

According to The New York Times, Dr. Kim D. Janda, a professor at the Scripps Research Institute, certainly hopes so. Dr. Janda has spent 27 years trying to create vaccines against substances such as nicotine and cocaine, and his research is beginning to prove successful.

Dr. Nora Volkow, director of the National Institute on Drug Abuse, calls Dr. Janda a "visionary" who began experimenting on treating addiction with medicine decades before others did. His goal was to make antibodies against a drug of abuse before the drug could settle in the brain, just as regular vaccines signal to the immune system to make antibodies against other infectious diseases. But unlike these preventive vaccines, this vaccine would work for someone already in the grips of an addiction.

Hopes for the vaccine’s efficacy arose this past July when headlines announced that the 25 researchers in Dr. Janda’s lab had created a vaccine that dulled the effects of heroin in rats.

When rodents were given the vaccine, the heroin didn’t dull pain and they stopped pursuing the drug that had ceased to have an effect on them.

A similar effect was found in cocaine users earlier on, when Dr. Janda vaccinated them with one of his formulations. The cocaine users remarked that the cocaine didn’t have the usual effect on them and they would have felt that they had wasted their money on such a non-effect.

Even though this breakthrough seems promising, the vaccine still has a long way to go until it is approved by the Food and Drug Administration. The vaccine still needs to undergo human clinical trials and produce consistently positive results.

Dr. Janda attributes the difficulty of creating this vaccine to the tiny molecules found in cocaine, methamphetamines and nicotine. When vaccines for diseases are administered, they contain a small bit of the disease for the immune system to find and then create antibodies to fight the disease off the next time it invades the body. But the narcotic molecules are so small that the immune system can’t seem to detect them and ignores them. Dr. Janda has found ways to remedy this problem for cocaine and nicotine, but has tried and failed to make vaccines against marijuana and alcohol abuse, and even obesity.

According to The New York Times, Dr. Janda hopes that others take his research and move it forward. He has concerns about ethical problems and confirms that only those who want to quit will succeed with the help of this type of vaccine. But scientists like Dr. Nora Volkow see promise in these trials and have great hope that someday, a simple shot may help someone turn their life around and help them escape from drug addiction.

Although I’m not a doctor, it was impossible to sit at home in front of my television that night and not fear for the safety of those wading in to the gray ash cloud that hung over lower Manhattan. Very few wore actual respirators; some wore no face coverings at all. Commentators spoke about how the steel on the Towers was supposed to be protected by fire-retardant asbestos, but few pointed out that this same cancer-causing asbestos was now flying around downtown. During those initial hours and days no safety equipment was available and few of the responders considered the potential consequences on their long-term health in the frenzy to rescue friends and family. Now we know that participation in the Ground Zero rescue, recovery and clean-up efforts has made these heroes sick, both physically and mentally.

Many first responders either knew people who worked in the Towers or had co-workers who got trapped when the buildings fell. In addition, those on the scene while the buildings still stood witnessed horrific scenes of “jumpers” from above hitting the ground or, worse, hitting those who were trying to help. Firefighters of the FDNY lost 343 “brothers” that day. Nobody can walk away from these situations completely whole.

To be blunt, the FDNY failed to adequately treat personnel for PTSD and other emotional issues related to 9/11 and, much like the US military, actively sought ways to get rid of those who had been harmed on the job.

In the immediate aftermath of the tragedy, graduate student interns from various mental health facilities were charged with counseling firefighters, providing little relief and often making things worse. These jobs lasted no more than six months, as internships ended and new students rotated through, requiring the therapeutic relationship to begin anew.

In addition, the FDNY Counseling Services Unit (CSU) did not promise to keep information gleaned during sessions confidential and was located above a firehouse, in full view of peers. These issues caused many to shun the program; only 5% surveyed indicated that they would get professional help for substance abuse problems. Which, it turns out, was a good thing, as FDNY offered very little in the form of substance abuse treatment for these workers.

Although cases of PTSD and depression were anticipated, medical professionals who were involved with treatment of 9/11 first responders noticed a gradual increase in the incidence of alcoholism and drug abuse after the attacks. Many had been self-medicating to avoid remembering the images; others suffered acute episodes after new traumas such as a death in the family. In 2004, there were 50% more FDNY firefighters and EMS workers treated for drug and alcohol addiction than in 2003. In the seven years after 9/11, twelve firefighters died from accidental overdose, and suicides were at unprecedented levels.

The Smithers Institute at Cornell University undertook a study to determine how the events of 9/11 affected emergency personnel. It found that FDNY personnel were twice as likely to develop alcohol problems than the national average and that over 25% were at risk of developing moderate to severe drinking problems. Disturbingly, FDNY brass has been accused of terminating for substance abuse violations those very same people who risked their lives on 9/11 and were self-medicating to treat their PTSD.

In 2004, right around the time that first responders were exhibiting signs of trauma-related substance abuse, the FDNY commissioner implemented a Zero Tolerance policy. Many first responders who were self-medicating with alcohol or drugs failed surprise drug tests and were told to leave quietly or risk public outing – none were given the option to enter treatment. Many were left without health insurance and with no way to get treatment on their own.

The first 9/11 Victim Compensation fund focused on providing economic support to the families of those who died and to those where injured directly as a result of the events. Cases were settled over the course of a few years and the fund was closed. However, we now know that many of the illnesses suffered by first responders took years to manifest, leaving these heroes with little in the way of compensation for their losses. Some have now lost their jobs as a direct result of their emotional scars.

Thankfully, and after much prodding, The US Congress recently passed The 9/11 Health & Compensation Act of 2010. This new fund recognizes that first responders have serious physical and mental problems as a result of their participation that were not necessarily observable before the first compensation fund closed. Congressmen from New York led the way in making this bill a reality, including the now infamous Anthony Weiner. The Act makes certain that first responders will receive specialized health care and compensation over the next five years. There are twenty-two covered health conditions covered by provisions of the new Act. In addition to respiratory issues, mental health conditions such as PTSD, depression, panic and anxiety disorders, and substance abuse are also covered. The Act also reopens the Victim Compensation Fund of 2001 and adds $2.5 billion to the bank account; as before, compensation awards will be decided by a Special Master.

It all starts with research. Here’s what Scripps Research has done so far.

The researchers have developed a highly successful vaccine against a heroin high and have also proven its therapeutic potential in animal testing. The results of the new study were published online ahead of the print edition by the American Chemical Society’s Journal of Medicinal Chemistry.

The study, entitled “A Vaccine Strategy that Induces Protective Immunity Against Heroin,” demonstrates how a novel vaccine produces antibodies, which are a kind of immune molecule, that stop not only heroin but also other psychoactive compounds metabolized from heroin from reaching the brain to create the drugs’ euphoric effects.

The study’s principal investigator is certainly optimistic about the research findings. “In my 25 years of making drug-of-abuse vaccines, I haven’t seen such a strong immune response as I have with what we term a dynamic anti-heroin vaccine,” said Kim D. Janda, the Ely R. Callaway, Jr. Chair in Chemistry and a member of The Skaggs Institute for Chemical Biology at Scripps Research.

“It is just extremely effective. The hope is that such a protective vaccine will be an effective therapeutic option for those trying to break their addition to heroin.”

Heroin Addiction Costly in the U.S. and a Worldwide Epidemic

In the study the authors point to the fact that injection drug abuse is a debilitating worldwide epidemic. In the U.S., heroin abuse and addiction cost an estimated $22 billion due to lost productivity, medical care, social welfare, and criminal activity.

In addition, heroin abuse and addiction are the driving forces behind the spread of HIV through needle sharing.

Scripps Research has previously created vaccines using immune molecules to “blunt the effects” of other drugs of abuse, such as cocaine, nicotine, and methamphetamine. Human clinical trials for the cocaine and nicotine vaccines are currently underway.

But other researchers’ attempts over the past 40 years have failed to create a clinically viable heroin vaccine. In part, say the Scripps Research team members in the study, this is due to the fact that heroin is an elusive target that’s metabolized into multiple substances, each producing psychoactive effects.

Scripps’ Vaccine Uses a Dynamic Approach

The Scripps Research team used a “dynamic” approach in developing this new heroin vaccine. The means they targeted not only heroin itself, but also the chemical it quickly degrades into, 6-acetylmorphine (6AM), and morphine.

The first author of the study, G. Neil Stowe, says, “Heroin is lipophilic and is rapidly degraded to 6AM. Both readily cross the blood-brain barrier and gain access to the opioid receptors in the brain.”

Without getting to technical, the researchers linked a heroin-like hapten (small molecule that elicits an immune response) to a generic carrier protein (called keyhole limpet hemocyanin or KLH) and mixed it with Alum (a vaccine additive). The result was a vaccine “cocktail.” This mixture slowly degraded in the body, thus exposing the immune system to different heroin psychoactive metabolites such as 6AM and morphine.

As Stow comments, “Critically, the vaccine produces antibodies to a constantly changing drug target. Such an approach has never before been engaged with drug-of-abuse vaccines.”

What Does This Mean for the Future?

The study found that addicted rats were less likely to “self-administer” heroin by pressing on a lever after several booster shots of the vaccine. The heroin vaccine’s effect was as dramatic as researchers have ever seen in experiments of this kind.

The team also found that the heroin vaccine was highly specific. This means that it only produced an antibody response to heroin and 6AM – not to other opioid-related drugs tested, such as oxycodone and drugs used for opioid dependence, including methadone, naltrexone, and naloxone.

Why is this important? As Janda explains, “it indicates these vaccines could be used in combination with other heroin rehabilitation therapies.”

Where does testing go from here? The Scripps Research team is now beginning collaboration with researchers at the Walter Reed Army Institute of Research to see if it is feasible to develop a dual-purpose vaccine for use against HIV and the treatment of heroin – in a single shot.

The study was funded by the National Institute of Drug Abuse of the National Institutes of Health and the Skaggs Institute for Chemical Biology at Scripps Research.

Besides Janda and Stowe, the other co-authors of the study include George F. Koob, chair of the Scripps Research Committee on the Neurobiology of Addictive Disorders, Alexander V. Mayorov and Joseph S. Zakhari from the Janda laboratory at Scripps Research; Leandro F. Vendruscolo, Scott Edwards, Joel E. Schlosburg, and Kaushik K. Misra from the Koob laboratory at Scripps Research; and Gery Schulteis from the Department of Anesthesiology at the University of California, San Diego.

Rather than condemning individuals struggling with addiction, harm reduction recognizes that addiction is a treatable disease and that complete abstinence may not be possible for everyone. Advocates create programs designed to empower addicts to find less harmful options that work for them.

Examples of harm reduction strategies used in the past include:

• Needle exchange programs (supplying free hypodermic needles or exchanging dirty needles for clean ones to prevent the spread of disease caused by needle sharing)
• Medical prescriptions for heroin taken in a supervised and controlled environment
• Safe injection sites, or hygienic, medically supervised facilities for taking drugs
• Designated driver and free-ride-home programs for individuals drinking alcohol

These programs strive to reduce the health care, incarceration, personal, and other costs associated with drug abuse by offering safer alternatives.

A Controversial Pilot Project in Vancouver

Certain harm reduction strategies are harder for some people to tolerate than others. A recent proposal by the Vancouver public health authority includes a pilot project to give addicts free crack pipes at a supervised drug injection clinic. The goal of the project is to reduce the risk of overdose and protect against diseases such as HIV and hepatitis C among addicts who share pipes.

The project has many supporters who applaud the city’s response to a shift toward crack cocaine smoking.

“We need a critical public debate about the efficacy of harm reduction,” Walter Cavalieri of the Canadian Harm Reduction Network told the National Post. “Harm reduction will save lives. It will save money. It will improve society.”

Despite the support, the new program is not without critics. Some argue harm reduction efforts enable drug use and send the message that using illicit drugs is not dangerous, which increases the behavior. Others fear that harm reduction programs will replace much needed addiction treatment programs. Still others believe that this is one more step forward in a movement to legalize drugs of all kinds.