Recovery Michigan

The 2016 National Pain Strategyhas placed self-management firmly in the spotlight as a critical pathway to better treat pain in the U.S.

Cue Dr. Kate Lorig, the Godmother of Self-Management. Dr. Lorig spearheaded the development of self-management education and treatment at Stanford University 3 decades ago, beginning with the Arthritis Self-Management Program. She and colleagues studied participant outcomes for her program and demonstrated some of the best results for any behavioral or educational intervention — doubly impressive due to their incredible durability. Randomized controlled trials show that self-management programs confer improvements in self-efficacy and health status — improvements that are sustained at 4 year follow-up (Lorig KR et al 1993). What’s more, similar results are found for the internet-based adaptations of her programs across various pain conditions, including rheumatoid arthritis, osteoarthritis, and fibromyalgia (Lorig KR et al 2008).

A first-in-class neurostimulation device to relieve symptoms of opioid withdrawal is approved for marketing, the FDA announced Wednesday.

"Given the scope of the epidemic of opioid addiction, we need to find innovative new ways to help those currently addicted live lives of sobriety with the assistance of medically assisted treatment," said FDA Commissioner Scott Gottlieb, MD, in an agency press release. "While we continue to pursue better medicines for the treatment of opioid use disorder, we also need to look to devices that can assist in this therapy."

Device approval was based on a study that evaluated the clinical opiate withdrawal scale (COWS) score -- measuring symptoms on a scale of 0 to more than 36 (0 being the least severe) -- in 73 patients undergoing opioid physical withdrawal. Study results showed that all patients had a reduction in COWS of at least 31% within 30 minutes of using the device and that 88% of patients transitioned to medication-assisted therapy after 5 days.

Indianapolis on Tuesday filed a federal lawsuit against several opioid makers and drug distributors, joining more than 75 cities and states that have pursued such action. 

In the suit, filed in U.S. District Court for the Southern District of Indiana, Indianapolis blamed the drug companies for the city's burgeoning opioid crisis. As opioid pain medication flooded Marion County, according to the suit, the companies failed to "identify, report and stop suspicious orders."

Further, the suit alleges, the companies used deceptive marketing campaigns to fuel the crisis while collecting "blockbuster profits." 

Bullying and violence in the workplace were linked with an increased risk for type 2 diabetes in a large Scandinavian cohort study.

Today’s new findings show that:

• MicroRNA expression may serve as an indicator of sleep loss in rats and humans, suggesting a possible method for predicting those at risk for diseases and cognitive deficits typically associated with sleep debt.
• Three species of spiders have amazingly fast circadian clocks, raising questions about how they avoid the negative effects typically associated with deviating from the normal biological timeframe.
• The brain preferentially reactivates negative memories during sleep, prioritizing the retention of these emotional memories.

Other recent findings discussed show that:

• A computerized algorithm can determine whether people viewed images of faces or houses by comparing patterns of electrical activity in the brain during sleep.

Investigators at the University of Buenos Aires, in Argentina, found that patients taking second-generation antipsychotics who experienced a high level or an intermediate level of metabolic changes had an almost threefold increased risk of experiencing a cardiovascular event ― especially stroke ― compared to their counterparts taking medications that were associated with a lower risk for metabolic changes.

The authors state that the higher risk for major cardiovascular events among those taking intermediate- or high-risk agents "appears to be mostly driven by the enhanced risk of stroke among our population, something that might be due to the high prevalence of patients with dementia or related to potential direct or indirect effects of antipsychotics."

Some people with post-traumatic stress disorder (PTSD) experience heightened anxiety. This may make them more sensitive and overly responsive to stimuli and events in the world around them. This state of increased sensitivity is called hyperarousal.

In this article, we look at the symptoms and causes of hyperarousal, as well as how a person can manage it. We also look at how people can help loved ones experiencing hyperarousal better cope with their condition.

Symptoms of hyperarousal

Sexual harassment in the workplace is nothing new, but the issue is seeing a tidal wave of recognition and attention as celebrities, co-workers and others step up to accuse Hollywood heavy weights like Harvey Weinstein, Kevin Spacey and Louis C.K. of sexual misconduct. Through their stories, we've learned that sexual harassment can wreak havoc on its victims, and can cause not only mental health issues, but physical effects as well.

Dr. Colleen Cullen, a licensed clinical psychologist, notes that for victims of sexual harassment, the most common diagnoses are depression, anxiety, and even post-traumatic stress disorder (PTSD).

"An experience [with sexual harassment] can either trigger symptoms of depression and anxiety that are new to the person; or it can exacerbate a previous condition that may have been controlled or resolved. Patients may also see a worsening of symptoms," says Dr. Cullen. "Some research has found that sexual harassment early in one's career in particular can [cause] long-term depressive symptoms."

I was able to manage my substance abuse issues with support from friends, but depression was another matter...

https://goo.gl/zsuc2S

A study from the Recovery Research Institute at Massachusetts General Hospital (MGH) has estimated, for the first time, the number of Americans who have overcome serious problems with the use of alcohol or other drugs. More than 9 percent of those responding to their survey of a nationally representative sample of U.S. adults indicated they had previously had such a problem but no longer did, and a little more than half of them reported accomplishing this with some sort of assistance. Only 46 percent of successful respondents considered themselves to be "in recovery."

"The number of people who have overcome serious alcohol and other drug problems and exactly how they have achieved that has been a question of increasing general interest and public health interest," says John Kelly, PhD, director of the Recovery Research Institute in the MGH Department of Psychiatry, who led the study, which has been published online in Drug and Alcohol Dependence. "Understanding how people recover and sustain remission is important from both a policy and a service provision standpoint, and finding that many people can and do resolve significant problems on their own is an important message that we hope can enhance individuals' sense of hope, personal agency and increased confidence in their ability to change."

It has been estimated that as many as 80 million Americans deal with some sort of alcohol and other drug (AOD) use problem - around 22 million of whom meet the criteria for a full substance use disorder, such as alcoholism or opioid addiction. To identify individuals who believe they've overcome any sort of AOD problem, the researchers surveyed members of the KnowledgePanel of the market research company GfK, a representative sample of 55,000 U.S. adults who are regularly surveyed on a broad variety of topics.

For this study, a group of almost 40,000 KnowledgePanel participants were asked the question "Did you used to have a problem with drugs or alcohol, but no longer do?" More than 25,000 panel members answered the question, and the 2,047 who indicated they had overcome an AOD problem - 9.1 percent of all those responding - were sent a link to the full study survey. A few of those either did not respond completely or responded in ways suggesting that they did not truly have an AOD problem, leaving 2,002 responses for analysis.

Almost 54 percent of those who reported resolving an AOD problem used some kind of assistance, most commonly mutual self-help groups like Alcoholics Anonymous or Narcotics Anonymous. Next most commonly used were professional medical treatment - including the use of anti-craving/anti-relapse medications - in either inpatient or outpatient settings. About 20 percent used other recovery support services, including sober housing, recovery community centers and faith-based groups. A significant number - 37 percent - used two or more types of assistance in combination.

Respondents who indicated receiving assistance to resolve their AOD problem tended to be those who began using substances at a younger age, reported using several substances - both factors indicative of greater severity - those who had been diagnosed with substance use disorder or another mental health disorder, or those with a criminal history, particularly having been seen in drug courts. Use of assistance was highest among participants whose primary problem was with opioids and lowest in those primarily using cannabis. Only 46 percent of those who reported resolving an AOD problem considered themselves to be "in recovery."

By that point, I hadn’t slept in weeks. I’m not a good sleeper to begin with, and then one dose of Cymbalta — which my psychiatrist had prescribed in the hopes that it would help manage not just my moods but my increasingly debilitating joint pain — broke my brain. I stopped sleeping altogether; even an increased dose of my extra-strength prescription sleeping pill couldn’t touch it. I couldn’t eat. I couldn’t read. I couldn’t write. My mind moved in rapid circles, the same awful cycles of thought over and over again. My muscles ached from a body that was locked in constant state of fight-or-flight. Day bled into night bled into another day bled into another night bled into yet another day.

I tried breaking my days and nights down into hour-long increments, then into quarter hours. I told myself that if I could survive from 3:15 am to 3:30 am, then I would be all right. But of course after that I always found myself staring down the barrel of another fifteen excruciating minutes.

Then one grey June afternoon I felt like I couldn’t survive even one more minute. I downed a bottle of sleeping pills and some whiskey, wrote a note, and got into bed. A few minutes later I got out of bed, shoved a few things into my backpack, stumbled down to the street and took a cab to the hospital.