Medical Cannabis Shown to Be an Effective Alternative to Opioids

Chronic Pain (CP) is widespread, and, typically, opioids are prescribed for patients who experience CP. Opioids are ineffective for the treatment of CP, notably Fibromyalgia, and the adverse health risks, addictiveness, and side effects make long-term use of opioids a poor choice for this population. This cross-sectional survey of CP patients in Michigan assesses self-reported measures of quality of life, opioid use, pain management, and negative side effects. Among the participants in the survey, 64% reported reduced opioid use and 45% reported incresed quality of life. On the heels of the JAMA study in 2014, which showed significantly lower deaths by accidental opioid poisonings in states with Medical Marijuana laws between 1999-2010 (Bachhuber, et al., 2014), this study warrants additional research.











Boehnke, K., Litinas, E., and Clauwz, D. "Medical cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain." The Journal of Pain. 17.6: 739-744. http://doi.org/10.1016/j.jpain.2016.03.002

1 in 5 patients become long-term users of opioids after 10 days

We know all too well the dangers of opioid misuse in our society. The epidemic has been widely publicized, and the damage caused to communities across our country is staggering. This study puts into a frame of reference just how addictive these substances really are. The data shows that even a one-day supply leads 5% of the sample to use opioids for a year or longer. The probability skyrockets from there. Of the subjects given a 10-day prescription, 20% were shown to continue to use opioids for a year or longer. These numbers are are alarming.





Shah A, Hayes CJ, Martin BC. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use — United States, 2006–2015. MMWR Morb Mortal Wkly Rep 2017;66:265–269. DOI: http://dx.doi.org/10.15585/mmwr.mm6610a1

Massachusetts city makes policy shift on the opioid crisis

Massachusetts State Law has a provision, called Section 35, which gives the Judiciary the ability to court-order treatment for individuals with severe Substance Use Disorders for up to 90 days against their will. This is often a sticking point for many in the recovery world. Many adhere to the belief that non-self-initiated recovery will not achieve positive outcomes. However, from a public policy standpoint, with the old mill towns in Middlesex County being decimated to such a horrific degree, standing by and waiting for individuals to come to change on their own timeline is no longer an acceptable tact. The public health crisis in Lowell, MA, has forced the city and its new harm reduction and outreach program, CO-OP, to take drastic steps. The early data has shown a reduction in opioid overdoses in Lowell by 55%, dropping to 22 in the second half of 2016, compared with 40 in the first six months.

Thoughts?


http://www.fox25boston.com/news/section-35-saving-the-lives-of-addicts-that-dont-want-to-be-saved/496578709

A new therapy model for individuals with co-occurring SUD and PTSD

Researchers at Ryerson University in Toronto, ON, CA are formulating a new therapy model for the treatment of individuals who experience co-occurring SUD and PTSD. This model, RBR (Relationships-based Recovery), is an amalgam of empirically-based models, and employs person-focused counseling with a trauma-informed and harm reduction approach. Primarily a cognitive-behavioral technique, RBR emphasizes interpersonal relationships as integral to the recovery process and encourages a significant figure in the person in recovery's process to engage in the work. This loved one does not attend sessions, nor do they have any contact with the therapist. The person in recovery implements and practices strategies developed in sessions at home with their significant other. 
This paper discusses the framework of RBR and provides a case study into one individual and their measured positive outcomes after the 16-week manualized therapy program, which warrants further study. 


Wanklyn, S.G., Brankley, A.E., Laurence, G. et al. (2017). "Relationship-based recovery case study: An interpersonally empowering approach to recovery from Substance Use Disorder and PTSD." Journal of Contemporary Psychotherapy. 47:41 doi:10.1007/s10879-016-9340-9

http://link.springer.com/article/10.1007%2Fs10879-016-9340-9

Psilocybin shows to be effective treatment for depression and anxiety

In a randomized, double-blind clinical trial, consisting of 56 terminal cancer patients with significant depression and death anxiety, psilocybin has been attributed to an increase in quality of life and mitigation of depressive symptoms. This study, from Johns Hopkins Medical Center, is significant, in that most studies into psilocybin for this purpose have focused on microdoses, whereas this study correlates similar outcomes for those who ingest high doses, in addition to microdoses. 80 % in the study reported fewer depressive symptoms after one treatment, and 78% were reported to be in remission after 6 months from anxiety and 83% in remission from clinical depression diagnosis after 6 months.



Griffiths, R., et al. (2016). "Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial." Journal of Psychopharmacology, 30(12), 1181–1197. DOI: 10.1177/0269881116675513

Study points to possible effectiveness of TMS for treatment of Cocaine Use Disorder

Cocaine-seeking behavior is marked by significant reduction in activity in the prefrontal cortex. This research cohort of scientists in the U.S. and Italy have tested their hypothesis that radial transcranial magnetic stimulation to help activate the prefrontal cortex can be used to mitigate cravings for cocaine among individuals in early recovery from a CUD. Their initial findings show that, within the test group, cravings for the substance were reported 2.5 times more in the control group versus the those who received the TMS treatment. This study warrants further research, as identifying non-therapeutic options for treatment of CUD is needed, and the pilot study's results are positive. 


http://www.europeanneuropsychopharmacology.com/article/S0924-977X(15)00361-2/pdf

Terraneo, A.; Leggio, L.; Saladini, M. et al. Transcranial magnetic stimulation of dorsolateral prefrontal cortex reduces cocaine use: A pilot study. European Neuropsychopharmacology: 2016.  26(1):37-44. Epub 2015 Dec 4. PMD 26655188.

Dutch man euthanized, by his choice, to escape his alcohol use disorder

Euthanasia laws are always a hot topic issue, as much debate exists over the right for a human to choose death as a humane escape route from hopeless and terminal medical conditions. However, in this case, as with the case of another Dutch woman who experienced sexual abuse, anxiety, and depression, the assisted death of Mark Langedijk has raised flags and offended sensibilitites, especially among those in recovery. We do recover, and we do have hope, and Mr. Langedijk did not have to suffer this fate. That being said, it is easy to be indignant and protest his choice or his right to make it, yet this was absolutely his choice and legal, albeit disconcerting and sad.


Embury-Dennis, Tom. "Man in the Netherlands euthanised due to his alcohol addiction." The Independent. Web. 29 Nov 2016.
http://www.independent.co.uk/news/world/europe/man-holland-netherlands-dutch-euthanised-alcohol-addiction-alcoholic-netherlands-a7446256.html

MDMA approved by FDA for Phase 3 Clinical Trials to treat PTSD

Research into the use of psilocybin, ketamine, LSD, and MDMA to treat mental health conditions has gathered significant steam in the past few years. Positive outcomes have been reported repeatedly, especially when administered in microdoses under the care of a psychologist. MDMA is noted as an intense empathogen, removing psychological barriers and allowing for open and vulnerable work with a therapist. The story cites a 59% success rate upon initial administering of the chemical in a clinical setting to achieve significant treatment breakthroughs. However, FDA restrictions have limited studies of these controlled substances, just as medical research into the benefits of cannabis have been.
The FDA, now, has approved MDMA for the final phase of clinical trials, putting the chemical on pace to be legalized, clinically, in early 2017.


Philipps, Dave. (2016). "F.D.A. Agrees to New Trials for Ecstasy as Relief for PTSD Patients". New York Times. Web. 11/28/2016. http://www.nytimes.com/2016/11/29/us/ptsd-mdma-ecstasy.html

The US Surgeon General Report on Substance Use in America

The Surgeon General of the U.S. has issued a comprehensive report on Substance Use Disorder and Recovery. The paper advocates for an expanded and evidence-based public health approach to combat the negative effects of SUD on individuals and the nation. It calls for a significant change in public perception and barrier-enhancing stigma that impedes treatment-seeking behaviors; the Surgeon General draws parallels to the successes of HIV advocacy efforts, which disarmed the "fear and judgment" that kept individuals from receiving compassionate and effective medical treatment. The report also looks at the SUD crisis from an economic cost analysis basis, illuminating the public expenditures lost to the unchecked epidemic and the strain put on the public health system as a result.

Office of the Surgeon General. Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health. Washington, DC: US Dept of Health and Human Services; November 2016. http://addiction.surgeongeneral.gov. Accessed November 23 2016.

https://addiction.surgeongeneral.gov/surgeon-generals-report.pdf

The research into the effectiveness of micro-dosed psychedelic chemicals upon mental health therapies continues to grow. This research article shows promising results, warranting further studies, for the use of pure MDMA (not street ecstasy or molly) to help treat social anxiety in adults on the Autism spectrum. Famous as a profound empathogen, MDMA appears to facilitate social interactions; 77% of the individuals studied in this trial reported the MDMA therapies made it "easier to talk to other people," notably the clinicians with whom they were working (Danforth, et al, 2015).



Danforth AL, et al, MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults, Prog NeuroPsychopharmacol Biol Psychiatry (2015), http://dx.doi.org/10.1016/j.pnpbp.2015.03.011

What is the main reason you chose collegiate recovery?

A key cog in the SUD recovery support continuum is the emergence of academic-based peer supports, notably Collegiate Recovery Centers (CRC), Collegiate Recovery Programs (CRP), and Recovery High Schools (RHS). For young people in early or long-term recovery, realizing a purpose-driven existence, together with a network of contemporaneous peers who share in the joys and challenges of academic life in recovery, is indispensable. This research article qualitatively analyzes students' self-reported experiences with collegiate recovery and their chief reasons for joining their respective programs.
In the comment thread below, please feel free to post your reasons for getting involved in a CRC, CRP, or RHS...


Alexandre B. Laudet PhD, Kitty Harris PhD, Thomas Kimball PhD, Ken C.
Winters PhD & D. Paul Moberg PhD (2016) In college and in recovery: Reasons for joining
a Collegiate Recovery Program, Journal of American College Health, 64:3, 238-246, http://dx.doi.org/10.1080/07448481.2015.1117464

UNT CRP OBJECTIVES: Promote recovery from substance use disorders, behavioral (process) addictions, and mental health illness by providing support and services to self-identified recovering college students

By creating a climate of openness at colleges and universities across the United States, more students will feel like they are able to be recovery from a multitude of disorders regarding substance use, addiction, and mental health. Recovery at a young age is a difficult and often shameful process regarding college, and not having resources to combat the issues during such a stressful time can cause higher dropout rates, or many people not attending college at all due to an obvious lack of available resources. With the UNT CRP being an integrated program not only for substance misuse, but behavioral and mental health, UNT is working to create and prosper more resources for students. A hefty percentage of the dropout rate for college freshmen is due to mental health concerns, which are typically co-occurring with substance use disorders. More students can successfully complete degrees while at college by utilizing resources at a college level. With an increased level of advocacy for these concerns, more people can attend college, complete degrees, and in turn successfully be members of the ever growing educated workforce. 

K.F.

UNT CRP Objectives: Provide formalized training courses for workforce development in the peer recovery, addiction treatment and prevention fields

The Collegiate Recovery Program at University of North Texas provides formalized training courses for workforce development in the peer recovery, addiction treatment, and prevention fields. As a program within the Department of Disability and Addiction Rehabilitation, many opportunities are available to the student staff and members of the program. We have held trainings for Peer Recovery Coaching, SMART recovery, Mental Health First Aid, among many others. We believe in equipping our students with a comprehensive toolbox on which to draw for the betterment of each person in recovery and future professionals in the field of substance misuse. We regularly partner with other prevention efforts on campus, and off, to increase awareness and educate people to make healthy and informed choices. Staff members of our program have also been active in assisting professionals become more holistic and recovery-focused by working with the department to disseminate SAMSHA’s Recovery-to-Practice Initiative in the State of Texas. We believe in empowering our students, and we believe in affecting change on a wider scale, through advocacy and education.

-T.W.

UNT CRP Objectives: Empower students to promote quality of life improvements

"The first objective of the Collegiate Recovery Program at UNT is to empower our students to promote quality of life improvements. Our program depends on the peer to peer support to build the recovery community we have here at UNT.  Recovery is a lifelong journey.  Through case management and peer recovery coaching we work to guide our students to become experts in their own recovery.  By sharing new skills and working with students to build their own recovery toolkits, they learn what helps make them stronger in their own recovery.  As we recover together, we each get stronger in our own recovery.  By empowering our students to take charge in their own recovery they start working towards additional goals in their lives.  Our students are learning empowerment and realizing they have the power and control over their lives and their future.  With increased academic goals new standards are being set.  Involvement in our recovery community is reducing student isolation.  The Collegiate Recovery Program at UNT is giving students the opportunity to regain a positive identity, find a sense of purpose and value, and work on becoming the person they want to be."

-

A.C.

Some of our objectives that we follow here at the CRP are "Emphasize social support as a mechanism for initiating positive lifestyle changes"

My first stint in college went miserably. Not only did I not have community, but I didn’t have the confidence to find one. I think the University tried very hard to set me up for success, but with 50,000 students, just ended up crippling me with a false sense of security. When I needed support services, they just did not come through. However, UNT became a different story entirely. I don’t say that because that’s where I ended up, attempting to make the best of my decisions. What I have done to get this far has culminated in a beautiful family that I call the CRP. Every choice that I made, every wrong turn, every hill climbed, it got me here.

Granted, for a long time, there was no progress. For a long time I didn’t try very hard at anything. I wanted to take the easy way out, and because I was smart I got away with it. I figured out I could work a system in my favor, I did. I didn’t trust other people, or delegate responsibilities, or concede to anyone interfering with anything I had deemed important. I was insistent that I could do things my way, using my methods, on my time. However, having this community and being a part of this program has taught me that it’s not a sign of weakness, it’s a sign of strength. Allowing yourself to be vulnerable enough to let others in, to give them a chance to see the real you, and care about you anyway. It’s selfless to let go, and be strong enough to admit things to other people, allow them to judge you, to be as authentic as you can. When you are authentic, you gravitate towards others like you. You create something that you didn’t think you needed, became part of something bigger than yourself. You start serving other people and gain confidence and security from that. Then, all of a sudden, you also have this family that you chose and you made and that you love and who love you in return. It makes recovery so much easier and more tangible, because now I have something to show for myself. I have all these people who love me. I changed, I became someone worth loving. And that’s what community has done for me. 

-F.C.

Some of our objectives that we follow here at the CRP are Enhance a substance-free and responsible-use campus climate.

The UNT CRP supports a substance-free and responsible use climate on the campus of the University of North Texas. A university campus is an atmosphere that is less than conducive, and, often times, hostile to individuals living a recovery lifestyle or just simply seeking a relatively substance-free life. We believe in mitigating risks and advocate for a culture on campus that is well-informed and non-judgmental in prevention efforts. We establish our presence by being visible, tabling about the campus at various events, and promoting and collaborating on substance-free recreation for the entire student body to attend. Our goal is to establish a collegiate culture that is friendly to those who choose abstinence, and if students are to consume substances, they have all the correct information available to make healthy choices.

CRP at a Glimpse

This week, I wanted to write about something near and dear to my heart - The Collegiate Recovery Program as a whole and some of the things that we’re doing this year and the services we offer.

1.      Sober Tailgating

Every fall, some staff and CRP students tailgate with the rest of UNT out by Apogee and we typically hand out waters, Gatorade, and some type of food. We have seating under a tent where students have an area to hide from the sun and enjoy a sober, substance use-free environment!

2.      Art Benefit Gala

For the first time ever we’re putting together an Art Gala where the proceeds directly benefit the CRP. Students/artists around Denton submit artwork and we’ll have a silent auction for people to bid on throughout the night! The theme of the Art Gala, which will be on April 22^nd, is ‘RECOVERY’.

3.      Weekly Meetings

Monday-Friday every week (as long as the university is open) we have meetings from 5-6PM that are open to the community! All of these meetings are recovery based and a few of them are about Holistic Wellness, Creative Arts, Recovery Principles, and Take the Mirror Back! Our full meeting schedule with descriptions can be found here at http://recovery.unt.edu/recovery-meetings-campus

4.      Serenity Room

Not many students know about our gorgeous Serenity Room. It’s a physical room in our office/center that students have access to during business hours, or as long as a staff member is there. This room can be used for studying, napping, or really just calming down. This room is special because it’s specifically designed for students who are on the autism spectrum, and has a very relaxing effect with its sky blue walls, huge stuffed teddy bear to cuddle with, and all of the pillows a human being could ask for! (Located through Chilton 134!)

5.      Peer Support Community

My personal favorite part of the CRP is the peer support community that comes with hanging around the center and attending meetings. Every. Single. Person. That you see after walking into the office is going to ask you how you’re doing, what your name is, and a little bit about yourself. It takes one or two trips to make a good friend that will always be there for you whether it be to talk about a rough day, to get dinner because you want someone to eat with, or go to the movies because you just really need to see Star Wars again. I can’t stress enough just how amazing these people I’m surrounded by every day are, and I only hope you make your way over here to personally find out yourself. 




-Emily Thomas

 

RECOVERY (Personal)

It doesn’t feel like I have been sober for two years. Maybe it’s because I don’t fight it anymore. Maybe it’s because each 24 hour period no longer seems like years of suffering without adequate rest or nourishment, or because the hardest decision I have to make today is what I am going to eat for lunch. It’s probably because life doesn’t seem too complicated when I stay out of the way and put my faith into a power much bigger than I am. The moment I stopped fighting was the moment I was able to enjoy being alive again. Forget about the fact that I now have a car and a place to live, those material things come and go. Today I can wake up excited about the future instead of dreading the idea of living another minute. Today I can be helpful to people instead of manipulating them and robbing them blind. I’ll take peace of mind over a new car any day. ~ Ryan Addkison