Sunday, 25 October 2020

You Become What You Think

Interestingly, this medication can also be used to achieve a goal of moderate drinking, as it has been shown empirically to reduce heavy drinking. This type of moderation goal, however, is typically not discussed in American treatment settings, where moderation goals are not well accepted. Studies have shown that this medication has greater effectiveness for men (specifically) with a paternal history of alcohol problems in their family. From a motivational standpoint, the differences between these two medications are pronounced, as one presents a black-and-white barrier and decision to be totally abstinent, while the other offers a softer leading edge. People more readily accept the latter, but naltrexone is not necessarily the best path. The ultimate effectiveness of naltrexone is less dramatic, as it has been found to be effective with a relatively small percentage of people, whereas Antabuse almost always has the expected effect. Medication Options in the Ongoing Treatment of Opioid Use Disorders But your mission isn't to make them feel acceptable, shower them with love and attention, or bring them up to speed with the way things are done. Your mission is to support them in who they are. Maybe you're the teacher students come to when they can't talk to anyone else, the nurse who shows their patients how to work the system, or the judge who helps an immigrant evade detention. You intervene in people's lives because it's the right thing to do--even if that means putting your job on the line. Uranus in Virgo is a common astrological placement for civil disobedience. However, Virgo is still an earth sign, which means you believe things work best when there's a system in place. Your aim is to reform, not revolt. You connect people in need with the support, tools, and resources to stand on their own two feet so their voices will be heard. The establishment will have no choice but to listen. Virgo Uranus . We are relational beings. Social stimulation keeps the mind active and tuned in to a whole host of subtle emotional cues. Not only are nurturing relationships essential for feeling good, they're necessary for maintaining good cognitive function.

There are two types of relationship dangers related to cognitive decline: Too little relationship degrades the brain. Without enough social stimulation, the brain loses mental capacity. What's important, however, is not just the quantity of relationships but their quality. Beyond Loneliness to Aloneness Aloneness is a state of being, being comfortable in your own skin. In aloneness you can connect with yourself more deeply. There are several medications approved for use with opioid users. These fall into two categories: 1) blocking the effects of opioids, and 2) replacing the abused opioid with a different, longer-acting opioid for maintenance on that medication. Opioid replacement or maintenance therapy has a long and documented history of effectiveness and safety. Opioid blocking medications, while basically safe, have been poorly received by the client community. We hope that the effectiveness profile of blockers changes with the advent of new, long-acting (one-month) injectable blockers (Vivitrol), but evidence is still being collected. Blockers: Naltrexone/Vivitrol: This blocks opioid receptors (yes, the same naltrexone from the alcohol category, but used for opioids for an entirely different effect). Naltrexone is given daily and orally and therefore has compliance problems because people can simply stop taking the medication and get high within a couple of days. Vivitrol, an injectable form of naltrexone that blocks opioid receptors for one month, is showing promising results in improving compliance. This medication does not reduce cravings and as a result is less effective for many people who suffer from not-uncommon painful and protracted craving states. Opioid Replacement Medications: Buprenorphine (Suboxone) and Methadone: These medications are themselves opioids, so the decision to begin their use is a decision to remain on an opioid, including being physically dependent on that opioid (stopping the medication would produce withdrawal). Electrifies: Virgo Suns when it speaks truth to power. Gadflies: Leo and Libra Suns because it takes on lost causes. Enlightens: Cancer and Scorpio Suns by changing it up.

Overthrows: Gemini and Sagittarius Suns when it pulls at the one loose thread that makes the whole thing unravel. Galvanizes: Taurus and Capricorn Suns by speeding up the process. Is anyone's guess with: Aries and Aquarius Suns by making them dot every i and cross every t. Sometimes good because it makes these fast-moving signs double-check their work, sometimes bad because it also makes them anal. Opposes: Pisces Suns. You see others as having no time for you. When Uranus is opposite your Sun sign, you don't connect to its energy naturally, so you always get thrown for a loop until you do. By contacting yourself more fully there is a psychic renewal that can't come any other way. Constant contact with others can block the inner channels of self-awareness by which the self is nourished through contacting its own deeper source. One of the great gifts of meditation and spiritual practices is that they open up the interior spaces of the psyche and are a kind of training in how to be alone. In opening to the inner depths of your subjective awareness, you encounter new sources of peace, joy, love, inspiration, creativity, and contentment. Such a state of aloneness is very different from the more common experience of loneliness. Loneliness is a deficiency state, an inner sense of deprivation that comes with insufficient contact or not fitting in with people around you. All human beings require a good deal of loving, nourishing interaction with others, continually, throughout the life span. Loneliness is a sign your interpersonal needs aren't being met. It's the subjective experience of feeling lonely that's key. This means it's the quality of your relationships that's important, not the quantity. This may seem counterintuitive (Aren't we trying to get him off drugs? However, evidence shows that people who have become physically dependent on opioids (whether heroin or prescription opioids like OxyContin, Percocet, and so on) have very poor track records of getting off and staying off them. The problem is not so much with getting off of opioids (detoxing)--which can be accomplished by completing a medically managed detox.

The problem is staying off opioids. Opioid replacement medication is most effective when people stay on it for a more extended period of time (eight to twenty-four months), stabilizing at a dosage and using the time to stabilize their life in ways that support abstinence and positive change before they consider coming off the medication. Typically, coming off or tapering is then best accomplished over an extended period as well, a matter of months, not weeks. People trying to overcome a physical dependence on opioids often experience prolonged craving states and relapse frequently. They are also at high risk of overdosing when they relapse, as the risk of overdose is higher after stopping for a period than it is with regular use, because tolerance is reduced. Maintenance opioid medication substantially reduces the risks involved with relapse in three ways: 1) by reducing cravings for opioids, 2) by reducing most of the high if there is a relapse, and 3) by buffering the brain against the possibility of inadvertent overdose in the event of a relapse. The usual course of treatment for opioid dependence actually increases the risk of death by overdose: inpatient detox and inpatient rehab rarely include an opioid maintenance medication or an opioid blocker, while the evidence could not be more clear that both of these treatment options decrease the risk of death by overdose. The best way to harness this energy is to work yourself into their busy schedule. They're not going to stop for you. You're going to have to keep up with them. Volunteer to help out, tag along, or collaborate on a project. Make yourself useful and people will wonder how they ever lived without you. URANUS IN LIBRA For someone who refuses to be tied down, it's amazing how much time you spend in relationships. If you're not on the phone consoling a plaintive ex, then you're touching base with your spouse or thinking up new ways to make the person you're currently seeing feel special and included. It's a never-ending balancing act, but it's better to have too many people in your life than too few. Uranus in Libra mates for life, but nowhere is it written how many mates you'll share your life with. A person can have many social contacts yet still feel lonely, just as it's possible to feel nourished by a few, high-quality relationships and feel alone, not lonely. Isolation and loneliness bring cognitive decline. Loneliness is associated with a 40% increase in dementia risk in one study.

Forty-six percent of Americans say they feel lonely sometimes or always. In older adults the figure is higher. More than one-third of Americans over fifty live by themselves. Loneliness affects cardiovascular health equivalent to smoking fifteen cigarettes a day and is associated with premature death. The toll on the brain and mind is equally strong. An earlier study showed that people who felt lonely had more than double the risk of developing Alzheimer's compared to those who didn't. Feeling lonely is also associated with other unhealthy behaviors linked to dementia, such as excessive drinking and not exercising. The procedure of withdrawal from opioid use in detox or rehab is too short for most people and leaves them at their highest craving level and greatest vulnerability to overdose when they leave the safety of the inpatient setting. A doctor can't prescribe methadone (another long-acting opioid maintenance medication) on an outpatient basis; For a multitude of historical reasons, methadone programs have often been underfunded, not well staffed, and not psychiatrically sophisticated, so personalized care is in short supply. The advent of Suboxone/buprenorphine in this country in the early 2000s was a huge step forward; It is important that your loved one get a thorough assessment and think through his personal needs in deciding whether to go for maintenance, to detoxify completely from all opioids, or to use blockers. In any case, we urge you to support what works, and not give in to the pull of getting him off of everything. What's hard about this . Isn't this just Suboxone abuse? As outpatient providers, we have heard many people express concern about the abuse potential for opioid replacement medications like Suboxone, including those who have tried to manage it without any real medical support. These clients may have bounced between opioid use and Suboxone use without any real, consistent plan, trying to detox themselves and then relapsing back to use. It takes a lot of stars to make up your constellation, and you're true to every single one of them--albeit in your fashion. Interestingly, you need a lot of space but not a lot of freedom--as evidenced by your jam-packed schedule. In fact, you don't do well when you have too much time on your hands.

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