Opiates: Addiction to Recovery Section 2 Dominic Vangarelli, M.A., C.A.D.C., ICADC

Post Acute Withdrawal Syndrome (P.A.W.S) Patterns and Symptoms

Post Acute Withdrawal (PAW) symptoms. Thought Disorders - Difficulty in thinking clearly. Affective Disorders - Difficulty with feelings and emotions. Memory Disorders - Difficulty remembering things. Sleep Disorders - Difficulty sleeping restfully. Psych-Motor Disturbances - Difficulty in physical coordination. Stress Sensitivity - Difficulty in managing stress.

Relapse Process myth, unrealistic expectation, Post Acute Withdrawal: Stress Sensitivity Crisis, Addiction, Chaos (Comfortable) 10 Relapse Process Healthy Stress (uncomfortable) myth, unrealistic expectation,

Road to Recovery

Dialectical Behavior Therapy

Dialectical Behavior Therapy Mindfulness: Is the skill of learning to focus on the present moment in a non- attached manner. Distress Tolerance: Coaches patients to tolerate uncomfortable emotions and difficult situations without making matters worse. Interpersonal Effectiveness: Provide a clear and concise blueprint for asking for what one needs, or for asserting oneself in saying “no.” Emotion regulation skills: Coaches patients the adaptive and functional nature of emotion and the importance of embracing feelings as helpful rather than something to avoid in recovery.

Dialectical Behavior Therapy

The Geisinger Marworth Disease Management Program Engagement Outcomes:   In just over 9 months we are following 150 patients in our Disease Management program: 86% remain engaged in the disease management program. 96% report abstinence from mood altering chemicals and alcohol since discharge. 95 % are using Dialectical Behavior Techniques (an evidenced based therapy approach) on regular basis assisting them in maintaining their recovery.        The Geisinger Marworth Disease Management Program Engagement Outcomes:

Holistic Treatment Approaches

ACUPUNCTURE The most common benefits associated with acupuncture in addiction treatment include: Decreased cravings Decreased depression Decreased anxiety Decreased anger/irritability Decreased headaches Increased concentration Increased sleep quality

Young Adult Recreation Therapy Interventions Include: Workout groups in the Fitness Center Adventure Therapy/Ropes Course activities Team sports activities Stress management Music/Film appreciation Expressive Art activities Leisure education discussions Off grounds activities (community reintegration) Ice cream making

The Wall of Addiction Each Patient is asked to identify a personal wall they are trying to overcome. Common walls are denial, fear, anxiety, anger etc. After the activity we transfer the learning and relate getting over the Wall to personal walls.

Music Therapy Interventions Drum Circles Relaxation/Guided Imagery Song Writing Movement to Music Band Group Team Cohesion Musical Games Music Therapy Interventions

Sand Tray Therapy Trauma Addiction Grief and loss Attachment issues Defense mechanisms Verbal communication Confronting painful emotions

Recovery Yoga Yoga is a physical practice but is designed to unite the mind, body and spirit. It helps connect what is disconnected. Benefits: improved quality of sleep, decreased anxiety, improved attention and feeling energized. Patients are encouraged to continue with yoga post discharge to aid in their overall recovery.

MAT Medication Assisted Therapy

MAT Medication Assisted Therapy Buprenorphine + Naloxone = Suboxone VIVITROL

VIVITROL

NARCAN Pennsylvania estimates it is spending $6.5 million a year on the overdose-reversal drug naloxone. (Feb, 7 2018)

The Continuum of Care Residential/Rehab/Inpatient Day Treatment/Partial Hospitalization Intensive Outpatient Outpatient Treatment Extended Care Halfway House Sober House Transitional Living MAT

Listen without prejudice. Separate the person from the disease. Always look through a lens of compassion.