Question: Read your article about Alcoholic thinking and shared it with my Dad who is an alcoholic and would like to fine the right help. He is 76 and has tried just going to AA but really had trouble finding a sponsor he could respect and trust. I am thinking a good local therapist might be very helpful to him. Is there any one that you know of in Orange County, CA?

Jim LaPierre Says...:

Hi there and thank you for your question. It can be tough to find a good therapist and unfortunately, I'm about 3,000 miles away from Orange County. It's my experience that the best local clinicians - especially those knowledgeable about addiction are well known by the members of Alcoholics Anonymous and (for yourself) Al Anon. I would urge you to see who they recommend as those folks tend to have strong appreciation for those of us who "get it." Please take excellent care of yourself while you seek to help your dad and if I can be otherwise helpful please email me counseling@roadrunner.com

Best,

Jim

Question: My son is a D&A addict with MH issues. He needs a longer term rehab facility that can also assist him with his MH issues. He recently lost his job and has no insurance. A few days after losing his job he was hospitalized in a BHU where he was started on meds for his MH issues. When he left there he went to a residential program paid for by the county for ten days. From there he was taken to a homeless shelter in the middle of a heavily drug affected area in a nearby, small city. He used again in just a few days. He desperately needs and wants help but we don't know how to get him help and my husband and I cannot afford to send him to a treatment facility. We live in PA. All help will be appreciated!

Jim LaPierre Says...:

Thank you for reaching out with an important question. My heart goes out to your son and to your family. Treatment of every form is very expensive and for the uninsured it's often unattainable. The best resource I have seen for the uninsured are faith based rehabilitation programs. The Salvation Army in particular has been helpful to a lot of folks I've served. The Christianity of programs like these is objectionable to a lot of folks in early recovery and I urge them to use the "buffet approach" (take what you like and leave the rest). Try this link from SAMHSA for further options: https://findtreatment.samhsa.gov/ Very best to you and yours, JIm

Question: In Massachusetts, what is the usual amount of time prescribed for mandatory heroin addiction treatment? Is there an average or a usual amount? The law says up to 90 days. Do most addicts get the full 90 days?

Jim LaPierre Says...:

Hi there and thank you for your question. The short answer is that while there is a lot of variance from state to state, there is also variance (in my experience) from judge to judge. I would expect the number of past convictions would be factored, as well as any existing probation and parole requirements to be factored in. I encourage folks to consider getting as much treatment as possible. If you are to appeal to the court for less treatment, it should be based on economic hardship and/or needs of family members, in which case I would encourage you to seek day treatment or outpatient services. Your best bet may be to get an assessment completed by an addictions professional and present those findings to the ADA in charge of your case. Good luck and please make your recovery a priority!

Question: What exactly is a man in his mid 70s who is drinking too much supposed to do. My uncle retired only a couple of years ago but since he did he’s come adrift and all he does every day now is sit in the local hole in the wall bar and drink quarts of beer from mid morning onward. I’ve talked to him about it and he says he knows he’s got a bit of a problem but he doesn’t know what to do about it. He’s a really good man but he’s a bit cranky and set in his ways he’s just not going to do well in any situation with younger people like AA. He’s not well off but he needs some help and I am not sure he should be living on his own really. What can a senior citizen on a pension do when he needs serious help with his drinking?

Jim LaPierre Says...:

Hi there and thank you for your excellent question. We've seen a lot of folks struggle with retirement and for many, they drink because they're just not sure what else to do or because they're trying to fill an emptiness in their lives. I'm a big believer that people need a reason to get out of bed in the morning. In the absence of structure - if it doesn't really matter what day of the week it happens to be, the pitfalls of depression become more common and harder to get out of.

I'd ask your uncle what he misses and what he love/loved doing. Volunteerism, mentoring, and other ways to invest in the lives of others can be extremely rewarding if he is open to it. Enjoying his life more seems key to his recovery.

Of course I also want to encourage him to speak to his doctor and discuss his drinking, the risks and how he can mitigate them. Then I want to talk about AA because in addition to the countless benefits of the program, the median age of most meetings is NOT young people - unless he is in a very rural area, I'd expect that if he were willing to attend a variety of meetings, he'd have no problem at all meeting folks in their 50s and 60s and perhaps even folks in their 70s.

Being "cranky" is often simply depression without vulnerability. The twilight years (terrible euphemism) are hard. Getting into something that's more fun than drinking feels like something he may be amenable to - if you're willing to involve him, help him find something he can feel good about doing or to have a greater purpose, then I like his chances. Good luck and blessed be!

Question: Is it necessary to submit myself in a rehab center?

Anna Deeds Says...:

I really can't answer your question without more information. What are using? How much? Have you tried to stop using? Have you tried Narcotics Anonymous or Alcoholics Anonymous meetings? I would say your best chance of recovery is going to rehab. The longer, more intensive treatment generally has the best chance of success. If you have never been to rehab before, then I would definitely suggest it. Without rehab, you probably know nothing  about how addiction works, what it does to you or how you can get better. People usually learn about addiction by going to rehab, recovery houses and NA meetings. You need this knowledge to get better. 

I hope this helps and you can find the answers you are looking for. Good luck with your recovery!

Question: My son is a heroin addict. He is 19 years old. He has been to rehab twice already. Is he too young to be on methadone? I don’t know if this is giving up on him or being realistic. He says he wants to stop but he simply can’t seem to accomplish this since he has relapsed within 2 weeks both times after feeling so good after rehab.

James Cloughley Says...:

Thank you for contacting ChooseHelp.com with your important question concerning your son's use of heroin and his challenges.

I can assure you that by supporting his use of methadone as an alternative is a good first step in his recovery process. It is much safer for him to be using methadone as an alternative than for him to continue to risk his life using heroin. When he is working a program he will be able to function normally once he is settled on an appropriate level of medication.

We all learn at different speeds and because he was unsuccessful keeping his recovery in tact previously doesn't mean that he can't be successful this time. Using methadone as a temporary measure is a great start for him. I see it as a bridge between detoxing and learning how to make different life choices based on his ability to self manage. That may take 6 months it may take a year to learn how to manage himself differently but It shouldn't take a life time. When he decides it's time to live his life without methadone he simply goes to his physician and asks him to help him, systematically, reduce his dosage until he gets down to zero. That time frame will also help your son develop a sense of self worth and self confidence that will help carry him to living a successful life without the use of drugs.

There are two medications that have been quite successful treating opioid addicts. Methadone, which you have mentioned already, and a drug called 'Suboxone'. To answer your initial question about your son being old enough to begin taking methadone. His age will not be a barrier to participating in a program. He would need to find a methadone provider (his physician should helpful in this regard) and have his physician refer him to methadone clinic. He would begin taking the methadone by going to a local pharmacy which provides the methadone and after about a month he would get 'carries' which means that he would have enough supply at home to last him for the week. It is done this way for two reasons.

One: to build a trust level between the doctor and the client and for the methadone doctor to be certain that the addict is not using any other drugs. They are quite strict around this and non-compliance could easily result in being asked to leave the program. He could be asked to provide a urine sample to ensure any client reports are accurate.

Two: to monitor the efficacy of the dose and to make any changes deemed necessary. Once he is stable on the medication meaning he is able to function quite normally he would be allowed his carries. As with any medications there are usually some pros/cons to taking it and this is no different:

Methadone

1. There can be a risk of becoming addicted to the Methadone but that problem is taken care of by weaning down off the Methadone in a systematic and monitored way so that any risk and discomfort are almost non existent.

2. Methadone (is a synthetic opioid) has been around for approximately 60 years. There are no surprises about using methadone as a treatment for opioid addiction. Methadone is also relatively inexpensive so it you don't have any coverage you wont have to mortgage the farm.

3. It is possible to ingest a fatal dose of methadone but far less a risk than taking a fatal dose of heroin.

4. The effectiveness of Methadone is very high especially when using it to treat heavy users.

5. Some reports suggest that prolonged use of methadone can be hard on the liver but that is a question for your son to clarify with his physician while weighing the pros and cons of using methadone.

The common range for those starting out in this program is 50-100mg per day.

Suboxone

Suboxone is the other commonly used medication that is used to treat opioid users. it has been around since 2002 so it, as well, has a track record of note. There are a few differences to consider when thinking about using Suboxone as a treatment option.

1. The risk of becoming addicted to Suboxone is lower than methadone. That is because it works somewhat differently than Methadone. In both cases (Methadone and Suboxone) there is always the 'psychological' addiction that can occur when using either medication. That is a topic that would be dealt with with the clinic physician and perhaps a support group of some kind.

2. The risk of ingesting a fatal overdose is lower with Suboxone as well. Again in either case whether the addict uses Methadone or Suboxone he/she has to be committed to the process and the decision to get clean and sober if either program is to be successful.

3. Suboxone has been found to be less effective when treating heavier users

4. Suboxone is more expensive than Methadone so if finances are a consideration this may make a difference in how a decision is made.

5. The restrictions are not quite as intense around the use of Suboxone and your son could begin the program immediately without daily visits to a clinic or a pharmacy

6. Suboxone is not as proficient at managing the withdrawals from opiate use as is Methadone

The active ingredient in Suboxone is called 'buprenorphine'. If you are looking for any information on this drug before you decide on which program to access a quick look on Google should connect you to as much information as you require.

This is a very powerful way of beginning to live life without the use of substances. The decision as to which program is important and should not be made lightly. In many cases it is a life changing experience. But most importantly what it does provide is an opportunity to live life without the confusion, disorientation and unrealistic thinking that is a daily part of living a life with substance use as its main partner. This is a chance to learn how to live and maintain a lifestyle that can provide a more satisfying life experience. Isn't that the goal of most of us--just to be 'happy'? Choose wisely and work hard at it. He can have that good life if he wants it.

All the best and thanks again for selecting ChooseHelp.com for your source of support and feedback

Jim

Question: No money so how can I get treatment like a human being? I was treated like a criminal and a scumbag even though I had come voluntarily. I kid you not they even wanted to body cavity search me but I refused and they backed down because they had to admit in the end that it was not legal for them to do that because I was not a CJS offender but they would not let me stay anyway. Why would I come to detox with heroin when I want to get off dope? Can you explain to me why they treat people who volunteer to get clean like criminals?

Anna Deeds Says...:

Thank you for your question! I don't believe the detox was trying to treat you as less than human. People go to detox for many different reasons even if they are voluntary. Sometimes they go voluntarily for their family, their spouse or even because their their methadone or Suboxone treatment facility threatens to detox them if they don't get off other drugs like benzos or cocaine. Sometimes people go because they have upcoming charges or for probation and are just trying to make it look like they are getting help. I've even heard of people going to rehab just for the purpose of selling drugs because they can sell them for much more money than on the street. Demand and desperation raises the price of any product especially drugs. Because people have ulterior motives to go to detox even if they are voluntary, they may want to search people coming into the facility. The whole purpose of detox is to help people get off drugs so facilities are cautious because if one person brings in drugs, every patient in the facility is put at risk. They were just trying to protect their other patients by searching you.They really do have a valid reason for doing it. You may not have had any other motive than to get off drugs but everyone who goes to detox is not there for the same reason. Many people with substance use disorder only seek treatment when they are forced to do so by someone or some situation. I'm not faulting them for this or judging them as I know that addiction is a difficult disease and the desire to stop using doesn't always come so easy to someone in the grips of an addiction. I hope this makes sense and you can feel better about why they wanted to search you.  

Question: I am not really sure if I have a problem, or if I am going through the normal college experience. I am a junior in college, and almost every time I drink I black out and always wake up in the morning and feel so much regret. All of my friends think it's funny, no one ever expresses concern with the amount I drink. I almost always throw up, resulting in my friends having to take care of me, as well as me feeling embarrassed. This has been a problem since I was a junior in high school. I have gotten kicked out of public places for being too drunk, my best friend went to rehab to treat alcoholism two years ago, and my parents tried to threaten me with rehab too. They have even tried to call the cops on me when I come home drunk. Now that I am away at college, they don't address it as an issue anymore. I would just like to stop feeling so much regret when I drink, I want to drink and have a good time just like everyone else, but for me I always get too drunk and feel terrible.

James Cloughley Says...:

Thank you for connecting with ChooseHelp.com.

The question you pose is a good one and a very real one. I commend you for taking the risk to ask it. I encourage you to recognize it is not our job here at ChooseHelp.com to convince you that you have a drug or alcohol problem. Our job is to provide honest, accurate and unbiased information so that those who are concerned can decide, on their own, what has to happen next in order to shape their lives in a more positive way.

When I hear someone say they aren't sure if they have a problem with alcohol or drugs, it suggests to me that the person who is seeking some clarity is reasonably certain what the answer is but needs to hear it from someone outside his/her social or family circle. So let me run some thoughts by you and hopefully they will help you with your understanding about the severity of your problem.

The stories about college life and how it is supposed to be a time for cutting loose and experimenting with alternate lifestyles and so on are legendary. To some degree they are true and many folks do just that--experiment. However, what you have described here is not 'experimenting.' The majority of those who play with alcohol and drugs at school are likely away from home for the first time and become intoxicated with the freedom from the 'eye in the sky' that was their parents. Most times they recognize when they are over-doing the free and fun stage and cut back or go to abstinence on their own. You seem to be moving in the opposite direction. This would be the first serious indicator for you to consider.

The next serious indicator to be concerned about is the 'blackouts'. You need to understand what they are and what they mean to your overall well being so I suggest you go to our home page and type in 'alcoholic blackouts' in the space provided for questions. There is a good deal of explanation about what they are, what they mean and how you are affected by them.

There is always uncertainty when people are seeking the truth about what behaviours they are involved in and what the real truths are. Friends can't always be depended upon because they don't want to lose a buddy to party with. As well, If YOU decide to cut back does that mean that they may be in over their heads as well? Often times our decisions will influence how our close friends see themselves and they may not be prepared to look at themselves quite yet. Family tends to be over invested in your well being because they don't want anything awful to happen to you. So they persist in telling you all the horrible stories they have ever heard regarding substance abuse hoping they will frighten you enough to quit. Those good friends who love you and care about you have another agenda in mind. They feel obligated sometimes to save you from yourself because that's what people who care about other people do and so they try to convince you that what you are doing is wrong. again, they tend to focus on the negative things that could happen. At the end of the day you need to decide what you need to do that is in your own best interest and to do that you need accurate, honest and unbiased information to go on.

The following insights are offered to help you see the situation you have described from an arms length perspective:

-- Do all students who attend college go through this?

-- Do all students who party get to the blackout stage on a regular basis?

-- When you go out do you plan to drink heavily? Is blacking out the goal?

-- Do you feel the need to become intoxicated in order to fit in or to be a part of the 'crew'?

-- You used to have some fun when you went out socially but now you no longer enjoy what is happening. What has changed for you?

-- What does alcohol provide you with that you don't already have?

Let's go back to to your question. If you are asking if you have a problem or not I would say, based on the information that you have provided, that if you don't have a problem yet you soon will have, and a serious one. I would also suggest  reading "Evaluating Your Drinking or Drug Use: 5 Questions". It is an article I wrote a while back that poses 5 questions that will help you to reach a decision. It also outlines an exercise you could undertake starting right now that might be of help when trying to quit or cut down and, coincidentally, help you to evaluate the level or severity of your use.

I understand that you may have some serious nagging questions about being abstinent such as: How will I have fun if I'm not using like the others I hang with? Will I have any friends if I stop using or, at least, cut down? Will I bring others down if I'm not partying like I used to? What kind of a social life will I have? What about girls?--how will I get along there if I'm not partying any more? I get that these are all stumbling blocks to your decision making. If your good friends are your good friends they will accept your choice(s) and carry on. As for your social interactions allow your 'real' self show forth. You may be surprised how many people like you just for who you are and not for what you do.

I wish you well on your journey and feel free to connect with me again if you want. Just send your request to ChooseHelp.com

All the best, Jim

Question: I don’t have a drinking problem but I have had meth and cocaine issues in the past. These days whenever I have even a half a beer I get the cocaine itch and 2 or 3 times out of ten if I have a few beers it will end up in a cocaine binge. I don’t want to quit drinking in fact I am a restauranteur so with wine and spirits on my menu it is almost impossible for me to not drink at all. I am just getting too old to be doing this to my body. I don’t even like cocaine that much anymore that is the sad thing – I just need it. I won’t drink with people I use cocaine with. I think that helps a bit. Is there anything else I can do to separate?

Jennifer Hamilton Says...:

Even though alcohol is not the substance your brain prefers, it does activate the brain reward pathway. This pathway by passes the prefontal cortex, or "judgement" center of your brain. In other words, your brain goes on a sort of auto-pilot, not bothering to consult you about what it wants to do. Another much easier way of saying it is that alcohol is a "trigger" for you. Like any "trigger", we can deny permission to the brain to have what it wants, but it gets harder and harder as the alcohol also affects your judgement. You may know something is a bad idea, have few drinks, and it seems like a great idea. For some people this trigger happens with as few as one drink. If you are not willing to abstain from alcohol, you could experiment with how many you can have without being triggered. You also need an "emergency plan" for when you do want to use cocaine, perhaps a friend you call, like a sponsor of sorts. It is your life and you can live it the way you choose, just be willing to deal with the consequences of your choices on your body. One more thing, if your line of work makes it more likely that you want to drink because you are around it, perhaps that is a sign alcohol holds a greater importance to you than you realize, even if it is "just" psychological dependence. Thanks for the interesting question.

Question: I am getting ready to start a poppy tea detox and I am considering so things and I have accumulated an arsenal of Kratom and loperimide and tenzepam. I I wonder if I am just repeating old patterns that got me addicted in the first place I am always looking for an answer to my problems or my feelings or my state of being in a chemical and another part of me just wants to not feel the shit. Have spent so much time on forums talking with people about how to do this and it seems like a lot of these guys are just switching around their chemicals and like a merry go round. Is there any value to feeling the full pain and giving your brain a full on detox or is that just masochism?

Jim LaPierre Says...:

Hi there and thanks for your excellent question. It feels like your intuition is trying to tell you something. That small voice that tells you you're kidding yourself? Yeah - that's your gut saying, "We've been down this road before." Is there value to pain? Well, it's certainly not masochism - it's real. I hear Three Days Grace singing, "I'd rather feel pain than nothing at all."

So, yeah. It's time to get off the merry go round. It's time to break free of chemicals and stop living patterns that only go in circles. You deserve better. This requires rigorous honesty with yourself and yeah, it hurts. See your doctor and make sure you're safe. Surround yourself with some good people and get clean and clear.

Good luck to you and blessed be.