What Is Dry January? How to Start Your 2021 Alcohol-free.

Dry January is a health trend that encourages people to start the new year alcohol-free. If your quarantine drinking has become a problem, Dry January can kick start a positive change.

What is Dry January?

Dry January is a movement to go without alcohol for the month of January. It gained popularity in the UK, but since has expanded to the US and beyond. People’s motivations for participating in Dry January vary, from wanting to kick up wellness in the New Year to starting a recovery journey from alcohol addiction.

The movement is not without debate. People who struggle with the life-threatening disease of alcohol use disorder can find those giving up alcohol as a wellness-driven lifestyle change to be flippant about the seriousness of their condition. Science continues to show that excess alcohol consumption hurts your body and your mind, and making a small change like reducing booze consumption or quitting entirely can benefit anyone.

What are the benefits of Dry January?

Can giving up alcohol for only thirty days make a positive impact in your life? The research answers with a resounding yes. Even in thirty days, your body can experience benefits such as:

  • A healthier liver
  • Reduced risk of some cancers
  • Weight loss
  • Clearer focus
  • Better sleep

These benefits will be more prominent the more you drink, but even those who only consume alcohol in moderation will notice some benefits of taking a break, including:

  • Saving money spent on alcohol
  • Finding other ways to de-stress
  • Enjoying sober activities with friends and family

How to avoid being a sober tourist

One of the debates around giving up alcohol as a lifestyle change for health is that people out there are struggling with a real disease of addiction. A break from alcohol is beneficial to anyone, regardless of your reason for quitting. If you don’t identify as someone who struggles with alcohol use but want to try Dry January as a positive change, here’s how you can be a recovery ally in your journey:

  • Avoid bragging: If giving up alcohol is a breeze for you, that doesn’t discount the challenges that some people face in getting sober. For people with full-blown substance-use disorder, it can be freakin’ hard. 
  • Don’t damper everyone’s fun: On the flip side of this, remember that the people in your life who are still drinking don’t need to be constantly reminded of your lifestyle change. Don’t put your expectations onto your friends or family who may not want to participate in Dry January.
  • Understand that sobriety is a lifelong process: For many people in recovery, sobriety is a life-long journey that may include therapy, medication, and regular support groups. It’s not a whole-30 diet or detox fad. It’s a matter of life or death. 

How to make it 30 days alcohol-free

If Dry January sounds like just what you need to start 2021 off right, congratulations! Giving up alcohol for 30 days (or just reducing your consumption) has many benefits. Depending on how much you’re drinking, you might find it simple to go alcohol-free or might need some support along the way. No matter your path, remember Dry January is 100% do-able. Here are some strategies to survive a month without alcohol:

  • Talk to your medical team: If you’re drinking more than 3-4 drinks a day, or over 7-10 drinks a week, talk with your doctor before you quit drinking entirely. Alcohol withdrawal can be unpleasant and in some cases life-threatening. A clinician can walk you through the best steps to quit safely. Workit Health offers clinical care in certain states to those interested in giving up alcohol.
  • Find support: Some online therapy programs like Workit Health offer coaching to help you stay on track. If counseling isn’t appealing, join a Dry January group on Facebook or encourage a few friends to go alcohol-free with you. Let your friends and family members know you’re participating in Dry January, and ask them not to pressure you to drink.
  • Manage stress: If you unwound with alcohol in the evening, it’s important to find other ways to relieve stress. Take up meditation, try a new workout, or give yourself permission to watch a favorite show and do nothing else guilt-free for an hour.
  • Try alcohol-free beverages: Break your habit of reaching for booze by finding alcohol-free drinks that you enjoy. Luckily, going alcohol-free is gaining in popularity and there are many booze-free beverages out there to try. Try whipping up a mocktail instead of a cocktail.

Regardless of your motivations for going dry this January, reducing alcohol consumption can increase your physical and mental health. Stay in tune with how you feel when you’re alcohol-free, and if you choose to add alcohol back into your routine in February, notice any negative effects you experience from an increase in alcohol consumption. Sometimes, taking a break from a habit can help us gain insight around whether or not it helps us in the long run. This type of self-awareness can kickstart your journey to health for the rest of 2021.

This is Your Brain on Opioids

Part 1: A Frying Pan of Reward and Pleasure

In the late eighties, the Partnership for a Drug-Free America released its now-iconic series of public service announcements featuring the infamous “This is your brain on drugs” tag line. The basics of the spots were this: an egg is your brain, a hot frying pan represents drugs. Someone cracks the egg into the frying pan. It, well, fries. “Any questions?” a man asks.

Yes. In fact, tons of them, especially since the addiction landscape has changed so much in the last two decades. Still, it was a good start and the heart of the message remains true: simply put, drugs alter your brain. Obviously it’s a little more complicated than the ads implied, and as the opioid epidemic grows and treatment modalities evolve, it’s more important than ever to understand what, exactly, opioids do to our brains–and the long-term effects of opioid use.

Turns out, it’s all about neurotransmitters, which is incredibly helpful unless you fell asleep in science class and don’t remember what a neurotransmitter is. Really a neurotransmitter is just a chemical that controls communication in your brain. Your brain releases neurotransmitters from a nerve cell and transfers it to another nerve cell and so on, sort of like a brain game of telephone except the message remains the same. All of our basic functions require neurotransmitters to do their jobs, as nerve cells communicate with one another and share information.

“Your brain releases neurotransmitters from a nerve cell and transfers it to another nerve cell and so on, sort of like a brain game of telephone except the message remains the same.”

In fact, you’re probably at least familiar with the names of two of our neurotransmitters: serotonin and dopamine. The first helps control important functions like mood, sleep, and appetite. That’s why a lot of antidepressants are designed to increase our serotonin levels. Dopamine is also linked to how we think and feel, as well as to our brain’s pleasure and reward centers.

In our systems, we also have neurotransmitters that are called endogenous opioids, which just means opioids that our body produces internally. You’ve probably heard of endorphins, especially in reference to exercise or a runner’s “high.” (Here’s an interesting fact: the term endorphins actually comes from “endogenous morphine.)

These neurotransmitters are our natural stress and pain fighters, but our bodies can’t produce enough of these organic opioids to save us from feeling severe or chronic pain or from suffering from extreme stress. Which is where taking opioids comes in. Opioids basically act like those naturally-occurring neurotransmitters but in much larger quantities. They attach to your brain’s natural opioid receptors and go to town. Opioids flood the brain’s reward and pleasure systems, signaling our brains to block out the pain, lower our stress, and calm us down.

“Opioids flood the brain’s reward and pleasure systems, signaling our brains to block out the pain, lower our stress, and calm us down.”

Over time, adding these opioids –whether in the form of heroin or morphine or codeine– actually alters our brain chemistry. According to the Journal of Neuroscience, “the repeated use of opiates induces alterations in neurotransmitter and neuropeptide systems that regulate incentive–motivation and stress–responsiveness. Increasing evidence indicates that the dysregulation of these systems underlies the compulsive use and loss of control of drug-taking that characterizes opiate and other addictions.” Got that?

Just in case that wasn’t clear, here’s the bottom line: repeated opioid use changes our brains at the cellular level. Once altered, our brains literally respond differently to stress and pain. We need more. Our natural opioids aren’t nearly enough. Long-term opioid use also alters the way our brains respond chemically to triggers. We can be triggered to use simply by being around the people, places and/or objects associated with our drug use. So it’s not a matter of willpower or character weakness that we’re triggered when we get around old haunts–it’s an actual alteration in our brains as a result of sustained opioid use.

It’s all pretty daunting, but the good news is that just as opioids have changed our brains, we have the ability to heal them. And that’s what we’ll explore next in our series.

Ready for more? Check out the rest of this series:

Side Effects of Suboxone

Suboxone is a common prescription medication for opioid addiction. Essentially, it causes the withdrawal symptoms of harsher opioids like heroin to be less daunting.

It may be the exchange of one drug for another, but suboxone is far less dangerous than drugs like heroin or pain pills like oxycodone. When taken as directed by a doctor specifically to help get off such drugs, it can be quite helpful to get people free from addiction.

While suboxone may be great for helping people get off the harsher opioids, it still has some risks and side effects. The risks increase if someone abuses or misuses the drug.

What Are the Side Effects of Suboxone?

Suboxone’s main ingredient is buprenorphine, which is a partial opioid agonist that acts upon the same opioid receptors in the brain that the harder drugs like heroin do. The difference is that it doesn’t act as strong.  It does not produce the intense high, but it does activate the receptor, making withdrawal symptoms more tolerable.  

Common side effects of Suboxone include:

  •         Headache
  •         Nausea
  •         Vomiting
  •         Dizziness
  •         Increased sweating
  •         Constipation
  •         Sleepiness
  •         Muscle aches
  •         Erratic heartbeat
  •         Difficulty concentrating
  •         Numbness in the mouth
  •         Trouble sleeping
  •         Respiratory depression (slower breathing)

According to experts, the most concerning side effect is respiratory depression. Those that abuse or misuse Suboxone are more susceptible to this side effect and should consult medical treatment immediately if it occurs.

How to Decrease Suboxone Side Effects

Suboxone is a great drug for those going through opioid detox but using it long-term may cause some psychological or physical issues.  Not every doctor understands the ins and outs of suboxone. They prescribe it for those trying to get off opioids but don’t educate their patients or set them up on a timeline. Many of these people will remain on Suboxone for months or years, which can cause medical problems.

To decrease suboxone side effects, take as prescribed by a doctor who understands Suboxone. Also, it’s best to only use Suboxone as a short-term solution to opioid addiction. Some people who have used it to get off heroin or opioid pain pills report that when they finally did try to get off Suboxone, the withdrawal effects were worse than the initial opioid detox.

The Length of Suboxone Withdrawal Symptoms

Yes, getting off heroin or pain pills may cause intense withdrawal symptoms for five days or so, but Suboxone withdrawal can last weeks or months. Some say that the psychological withdrawal symptoms, such as anxiety or depression, can linger on for a long time, creating challenges in all aspects of life.

It’s helpful to work closely with an addiction recovery specialist when using Suboxone for opioid addiction recovery.  Don’t be afraid to ask questions, especially about the timeframe that the physician typically uses for opioid addiction recovery.

In addition to using Suboxone for treating opioid addiction, there are other therapies that can be used to help the patient recover from addiction.  While some may do fine only using Suboxone to treat opioid addiction, others may benefit from added therapies, such as:

  •         Counseling – There are counseling therapies quite helpful with addiction recovery, such as Cognitive Behavioral Therapy (CBT) or Motivational Interviewing (MI). Many treatment centers have therapists on staff that offer such counseling. Family therapy can be helpful as well, as addiction tends to affect everyone in the family one way or another.
  •         12 Step Programs – Many patients report that attending a 12 Step Program like Narcotics Anonymous helps them navigate their sobriety path.
  •         Outpatient Treatment – There are outpatient treatment programs where you attend a certain number of sessions per week to work on addiction recovery.  The number of hours will vary depending on the particularities of each person.

Recovering from Opioid Addiction

While it is true that opioid addiction is at an all-time high, it’s also true that it’s treatable in a variety of ways.  Harm reduction methods like Suboxone treatment have helped many people get off the harsher opioids like heroin, Oxycodone, OxyContin, and more. The side effects associate with Suboxone tends to be viewed as much less daunting, as long as the treatment does not go on for years and years.

Of course, there are some people who abuse Suboxone or don’t take it as prescribed. Or, they may not be ready to fully step up to the “recovery plate”.  In these instances, the chances of long-term recovery decrease.

Struggling with Opioid Addiction?

If you’re struggling with opioid addiction, you don’t have to try to quit on your own. Whether you try Suboxone or another type of therapy, the reality is that treatments are out there for your benefit. Ask your doctor or treatment specialist about medications like Suboxone. Get the facts on side effects and how long treatment lasts.

Reach out for help today.

11 Easy Ways to Say ‘No’ to Alcohol

Phrases That Can Help You Stay Sober

You thought you left peer pressure behind when you outgrew those high school football buddies, but Sam from marketing is here to tell you otherwise. He’s urging you with every bit of his bad suit, toothy grin, and slicked back hair to take a shot with the rest of the staff.

Or maybe you don’t know a Sam, but you’re reuniting with an old friend for dinner. Great conversation is flowing, but they are hating that you won’t take them up on their offer to split a bottle of Merlot.

It can be challenging, especially in the early phases when you decide to quit drinking, to find the right words to say ‘no’ to alcohol. So we’ve found them for you. As we’ve said before, if there were ever an occasion for stretching the truth, sticking to your sobriety goals is it. Here are 11 easy ways to say ‘no,’ from the straight up to the indirect to the fibbing.

“No thanks, I’m good with what I’ve got.”

The power of the mocktail, club soda with lime, or mineral water is not to be underestimated. Having a non-alcoholic drink in your hand will not only help you feel more natural, it will also put those around you (including bartenders) at ease.

“Thanks, I’m okay.”

Although Nancy Reagan’s ‘Just Say No’ campaign wasn’t a hit in the eighties, often all you need is a confident ‘no’ stated with a smile. If you’re questioned further, you can then decide to go into your personal choices or not. But a brief, polite refusal with no explanation is absolutely socially acceptable.

“I’ve had enough to drink, thanks.”

And you clearly have, right? Or you wouldn’t have decided to stop.

“I’m allergic to alcohol, I break out in handcuffs when I drink.”

This is a popular joke within the recovery community, and it’s a clever way to refuse alcohol. Just expect some questions about your history if you choose this line.

“It’ll give me a massive headache.”

What, when, and who you reveal your new lifestyle choice to is entirely up to you. If now isn’t the right time to announce to your coworkers that you’ve been hitting the booze too hard every night and you need a change, then a physical ailment is a perfect excuse not to drink.

“I’m waking up early in the morning.”

Everyone understands the need for a restful night of sleep. Is there any better reason not to hit the bottle?

“I’m on antibiotics (supplements, another medication) right now.”

If you don’t feel like faking the migraine, but still don’t want to give up too much information, this is another white lie that many people choose to use. Booze and pills don’t mix, and people will respect that.

“I’m picking up my kids on the way home.”

Very few people will hassle with you wanting to provide a safe ride for children. No children? Sub in another important person if you feel comfortable. Better yet, offer to be the designated driver if you’re in an inebriated crowd.

“I’m in a green juice phase.”

Why let alcohol ruin your healthy vibes? Grab a green juice and you’ll be good to go.

There are plenty of other ways to say no. It’s up to you to weigh the pros and cons. Try to plan in advance which excuses you are comfortable with and prepare for any potential resistance. Refusing alcohol in social situations is an art, not a science. It might feel funny at first, but with practice, it becomes second nature.

Feel like all you do is refuse booze? It might be time to add some new people and places to your life. But there will always be another work party with an open bar. Luckily, there’s also an endless amount of ways to refuse alcohol.

PRESS RELEASE: Workit Health’s Tele-MAT Digital Addiction Treatment Joins Horizon’s Network

Horizon Healthcare Services, Inc. collaborates with telemedicine addiction care provider Workit Health to offer digital treatment to those struggling with opioid and alcohol use disorder.

Workit Health today announced the expansion of its health care service to include Horizon Healthcare Services, Inc., New Jersey’s oldest and largest health insurer. Workit Health’s telemedicine program offering evidence-based digital treatment for opioid and alcohol use disorders will be covered under all Horizon Commercial, Medicare and Medicaid plans. 

Horizon members are now able to sign up for Workit Health’s digital addiction care online or over the phone without a referral, and clinicians in primary care and emergency department settings are able to refer those who need care electronically. Treatment is provided via Workit Health’s web and phone apps, and includes therapy from licensed counselors, medication management with buprenorphine/naloxone or naltrexone, and a personalized curriculum of evidence-based interactive courses. 

“We know people using buprenorphine are twice as likely to stay in treatment — we’ve seen its efficacy reflected in our outcomes, with our adherence rates beating those of traditional treatment by 60 percent, for one-tenth of the cost,” said Workit Health’s Co-CEO, Lisa McLaughlin. “Innovative health plans can lead the way to making buprenorphine more available, and we applaud partners like Horizon for prioritizing the overdose crisis and its members with substance use disorders,” McLaughlin said.

“As people in recovery ourselves, Lisa and I understand how the recovery support system can fail,” said Robin McIntosh, Workit Health’s Co-CEO. “We’ve lost many loved ones to overdose, and we’re committed to reaching the 90 percent of people struggling with addiction who currently are not receiving the help they need. We’re looking forward to providing Horizon members with access to evidence-based and judgment-free care, while reducing costs for everyone.”

Despite buprenorphine/naloxone being the gold-standard FDA-approved medication to treat opioid use disorder, only one-quarter of addiction treatment providers in New Jersey offer the medication. Horizon members struggling with opioid use disorder will now be able to receive ongoing buprenorphine/naloxone treatment on their phones, following up with their clinician via telemedicine after a single in-person visit. The digital program also includes 24/7 messaging with their care team, online recovery groups, and clinically-verified drug testing, and therapeutic interactive courses reviewed by licensed counselors. Currently Workit Health has a clinic location in Hamilton Township, Mercer County, with plans to open additional locations throughout the state in the coming months.

For Horizon members struggling with alcohol use disorder, no in-person visit is required and all care is completed via Workit Health’s 5-star rated web and phone apps. The program offers multiple options for recovery, with options to focus on moderation that utilize naltrexone with the Sinclair Method, or abstinence with naltrexone or Vivitrol. Workit Health practices a harm reduction philosophy in which members aren’t punished for substance use and are able to choose what behavior they’d like to change, and when. 

“The shelter in place environment from COVID-19 has dramatically heightened the need to bring telehealth options to our members who battle every day on their journey to recovery from a substance use disorder – it’s, unfortunately, the perfect storm which requires tremendous support in the recovery community and easily accessible telehealth treatment solutions,” said Suzanne Kunis, Horizon’s Vice-President of Behavioral Health. “The Workit telemedicine platform makes it possible for New Jersey-licensed physicians, clinicians, therapists, and certified coaches, at no cost to the Horizon member during the COVID-19 Pandemic, to assess the unique needs of each member and to tailor solutions that will support their journey to recovery from their own home. Workit offers a comprehensive, holistic approach to Medication-Assisted Treatment including prescribing FDA approved medications with concomitant therapy and peer support utilizing phones, laptops, tablets and other smart devices. Workit is a great addition to Horizon’s network and we are honored to work with their team.”

While nearly eight New Jersey residents die from drug overdoses each day, New Jerseyians have often relied upon high-cost, out-of-state treatment programs which may not offer medication. Medications like buprenorphine have been proven to cut death rates from overdose in half and increase the likelihood of long-term recovery. Workit Health was created as a direct response to this crisis by two experienced founders in long-term recovery and has been working with national clinical experts and organizations since its foundation, including Itai Danovitch, MD, the Commissioner of California’s Mental Health Services Oversight and Accountability Commission. Both the National Science Foundation and the National Institute on Drug Abuse have awarded Workit Health grants for their innovative offerings.

About Workit Health: Workit Health is a Joint Commission-accredited B-Corporation offering online, on-demand evidence-based addiction treatment including telemedicine medication for opioid use disorder. We partner with healthcare organizations to deliver an innovative digital health solution that blends the best of human-centered design, technology, and science. Through our mobile and web apps, members meet with clinicians and counselors, join recovery groups, and complete self-set recovery goals. Our interactive curriculum of online courses keeps members on track in the comfort of home. We offer 24/7 recovery that fits into daily life, designed by experts. For more information, visit www.workithealth.com.

How to Quit Drinking Without Going to AA

Want to quit drinking without AA? Alcoholics Anonymous (AA) is free, accessible, and simple. But it’s no longer the only house on the block.

There are endless options to try for support and guidance if you’re struggling with alcohol. Here are a few tips on how to quit drinking without going to AA…

Find Support In A Different Group

AA isn’t the only support group out there anymore. You can find one more suited to your beliefs or recovery style. Here are just a few examples:

•Yoga of 12 Step Recovery connects the dots between the practical tools of 12-step recovery, the ancient techniques of yoga, and modern research on trauma healing and neurobiology.

•Refuge Recovery is a mindfulness-based addiction recovery community that practices and utilizes Buddhist philosophy as the foundation of the recovery process.

•LifeRing is an abstinence-based, worldwide network of individuals seeking to live in recovery from addiction to alcohol or to other non-medically indicated drugs, with a focus on encouraging personal growth and continued learning through personal empowerment.

•Smart Recovery is a self-empowering addiction recovery support group.

•Secular Organization for Sobriety is a nonprofit network of autonomous, non-professional local groups, dedicated solely to helping individuals achieve and maintain sobriety/abstinence from alcohol and drug addiction, food addiction and more.

But why stop there? My own company, Workit Health, has created our own recovery meeting format, called Workit Together. These meetings focus on personally defined self-care goals. We built out this option so we could include employees who weren’t in recovery from addiction to substances, but still might struggle with other issues.

If none of these options sound good to you, you can build the recovery community you feel is lacking in the world. Start a group in your area or on a social networking site like Facebook, and watch it grow.

Talk With A Therapist Or Counselor

Many folks get sober using therapy. There are sober coaches, counselors, and psychologists out there happy to support you on your recovery journey.

Seeing a psychiatrist doesn’t hurt either, if you feel like you have underlying anxiety or depression you are managing with alcohol.

Learn more about Workit Health’s online therapy.

Go Online

There are also online programs to help you quit drinking without AA. My company, Workit Health, has offers online, science-backed courses to help you beat alcoholism, all from your computer or phone. Whether or not you do 12-step along with it is up to you.

Start online courses to help you quit drinking.

Talk To Your Doctor

Medication is currently used to treat alcoholism as well. None of it is a magic bullet — if that pill existed, we’d all be on it! But if you aren’t interested in 12-step meetings and are seeking a different solution, there’s no reason you can’t look into some sort of medication: Antabuse, Naltrexone, Campral, and Topomax are all used in treating alcoholism.

Learn more about cutting-edge medication to treat quit drinking.

Work Out

Exercise boosts your brain, battling the brain disease of alcoholism. This isn’t talked about in 12-step much but it’s a life-saver. Check out why person in long-term recovery and counselor, Chrissy Taylor, encourages exercise in early sobriety. Exercise will get your endorphins pumping, reduce cravings, and make you feel better.

Change Your Social Scene

A main reason 12-step works (in my opinion) is it sets you up with a new social scene, full of folks just like yourself. The value of this can’t be minimized. If you choose to quit drinking without AA, it’s important to consider your current social scene and whether or not you’d like to change that. If you need sober friends and don’t do support groups, Meetup has great local activities that will allow you to get out of the bars and meet people in positive environments.

Get Spiritual

AA also puts the meaning back in life for people. It helps you find a power greater than yourself, and gets you involved in service with others in your community who need help. Whether or not you are interested in a spiritual program, finding something to live for (other than booze) can motivate your recovery. Whether this is some sort of spiritual program, giving back to your community, getting involved in recovery activism, is all up to you. It’s your recovery.

Recovery from alcoholism or addiction is a personal journey, and no two people’s paths will look similar. For many years, we sent folks to 30 day inpatient treatment or told them to go to AA. But there are other options, and we’re beginning to realize that those other options work. If you’ve stopped drinking without AA, let me know what worked for you in the comments!

 

This article was reviewed for accuracy by Sherrie Rager, PhD CADC II..

Heroin Detox: The First Three Days Survival Guide

Ready to detox from heroin? Here’s how to handle the cravings and physical withdrawal.

Congrats on deciding to make a change for the better in your life. Once you can kick the dope, you won’t be a slave to your addiction anymore. But you probably already know, if you’ve ever run out of your supply, that detox isn’t easy or fun. It’s a hard process with a huge payoff. It’s like you’ve got to get through a gauntlet of physical and mental obstacles to get to the freedom waiting on the other side. Trust us, it’s worth it.

Need more support? Workit Health has online addiction programs to support your recovery.

So how do you do you get through the first three days?

Before D-Day (Detox Day)

Prep yourself. Make yourself a detox kit that includes OTC meds including Imodium for diarrhea, Tylenol for muscle cramps, and Benadryl or Dramamine for nausea. Get some ice packs and pop them in your freezer. Choose a comfy spot to hang out and stock up your toilet paper. Get hydrating drinks, if you’re not big on water try Pedialyte, Gatorade, or popsicles to stay hydrated. I’m big on Sprite when I’m sick. If you have a comforting food or drink, get that. Get some epsom salts for the bath. Preparing yourself before you get dopesick will help you avoid a crisis when you’re withdrawing. You won’t feel up to running to the drugstore, so plan ahead.

In addition to your detox kit with meds and drinks, we’re going to load you up on some activities to keep you busy when cravings hit.

Cravings Kit

If you have cravings, which you will, you can:

  • Reach out to someone supportive, online or via phone.

  • Clean out a drawer in your house.

  • Make yourself a cup of tea and drink it.

  • Listen to a recovery podcast, watch one episode of a television show you like, or download a share online and listen to it.

  • Focus on your breathing for 2 minutes.

  • Play the tape through – Using sounds great, but what happens after the drugs wear off? Where have you ended up before? Why do you want to quit?

Anytime you have a craving that you don’t think you’ll make it through, try doing one of these tasks before you use and see if that helps your craving subside. Remind yourself that cravings are temporary, and that even if you used, the relief would also be temporary. Use simple self-care tasks like the ones listed above to stall your way through cravings, and they will come and go.

The craving will be intense in the moment, but focus on completing your simple task and making it through the next few moments without using. Can’t think of completing a simple self-care task? Focus on breathing.

Heroin Detox Day 1

Think of ways to make your life easy on yourself. In moments of craving, you won’t be able to make the right decision. So dump your dope. Delete your dealer’s number. Cancel your plans. Call your mom or your cousin and ask if they can take the kids for a few days. You will begin to get irritable, so minimize irritations.

If your restless legs are driving you crazy, alternate a heating pad and ice packs on your calves. Do gentle stretches. Try lying on your stomach. Get up and take a slow walk.

Runny nose, teary eyes, and yawning are normal.

If your muscles aches get too bad, try rolling around on a tennis ball. Try taking a hot shower, or a cold one. If that sounds too intense, try taking a bath. Add in epsom salts, as they soothe sore muscles. If hot or cold water sounds like too much, get in lukewarm water and adjust with more hot or cold once you’re in the bath.

If your skin feels creepy crawly, try taking an antihistamine like Benadryl. Try wrapping something loosely around whatever part of your body is bothering you (key being loosely here, don’t hurt yourself), to feel something different in that area and distract yourself. Try putting on some lotion (you don’t need anything fancy) – just put it on a little spot first, because this may comfort you or may bother your skin more. Test it out and see if it works for you.

Heroin Detox Day 2

Remember to take care of yourself! When using, we forget about self-care. Self-care is what keeps us healthy enough to make smart decisions.

Drink water. If you don’t like water, drink your favorite drink. Something with electrolytes, like Gatorade or Pedialyte, is extra-hydrating.

Try to eat something. If this sounds impossible, that’s okay. But try to eat a banana with peanut butter, some plain crackers with your favorite kind of soup, toast with honey on it, or some yogurt with stomach-soothing probiotics.

If you are sweating a lot, put a damp towel on your forehead. There’s no shame in changing your sheets a ton. Part of detox is sweating a bunch. It’s normal. Sleep on towels if you need!

If you are having hot or cold flashes, drink cool water or hot tea. Use an ice pack or take a cool shower, or use a heating pad and take a hot shower. When I was in rehab, someone who had been around longer than me told me showers would be my friend. They were right.

If you are having nausea and vomiting, remember that you can take Dramamine or Antivert. Remember to stay hydrated. Try to rest as much as possible.

If you are having diarrhea, take Imodium. Hydrate. Rest.

Heroin Detox Day 3

This will be peak of the physical symptoms for most people. This means the worst day. The good news? Once you’re over this, you never have to feel this way again.

Use all the tools at your disposal, including your mind. Think about your goals. Write them out and post them in your bathroom and bedroom. If you have support people in your life, ask them to come and be with you on your third day. Try to go outside, if you haven’t in the last two days.

Distract yourself from physical and mental discomfort with the simple tasks listed in your cravings toolkit. This is a great day to have a supportive friend or loved one by your side.

Still drink water. Can’t? Try a spoonful. Then another. If you feel hot, get a cool glass of ice water, press it against your face, then sip some of it.

If your stomach is upset try rubbing it in a circular, clockwise motion. Try chewing ginger chews, or drinking ginger tea. Chamomile tea and peppermint tea can also soothe your stomach. Don’t worry about trying to eat today if you are too sick.

If you are so sick you can’t hold down any fluids for 4 or 5 hours straight, head to the ER.

Remember, this is a gauntlet of physical symptoms and mental cravings you are climbing through to save your life. It won’t be easy, but it is possible. And once you make it past that third day, you never have to feel that way again. You’ll be free.

An Interview with Dorothy Moore, Nurse Practitioner at Workit Health

Meet Nurse Practitioner Dorothy Moore, a key member of the Workit Health Team.

Workit Health offers innovative online addiction care, including medication like buprenorphine, after a single in-person visit to our Bay Area, California location. We recently caught up with Nurse Practitioner Dorothy Moore, a member of the Workit Health team providing care in Contra Costa County and beyond.

Thanks for taking the time to answer some questions with us today, Dorothy. It takes a specific type of waiver to be able to prescribe buprenorphine — what made you interested in receiving this extra training and offering this treatment?

I switched careers midlife from tech writing in Silicon Valley to nursing. First I worked in the ICU, but eventually ended up in an emergency department in Oakland. That was way before all of the awareness of the Opioid Epidemic. I saw so many people coming in for pain, but what they really wanted were pain pills, and they’d get them, basically just to get them out the door so that we could focus on “the real patients.” The chronic pain addiction patients were often treated horribly by some staff. Since I was brand new to the ER world, and maybe because I had this whole different background, I was really shocked. There was no effort to teach, or refer. Basically, it was treat the pain and get the person out of the ER.

I eventually did my doctoral project on nurse attitudes around these patients, because nurses felt caught in the middle. As a nurse practitioner, when I learned about the CARA Act and how NPs could prescribe suboxone, getting a suboxone waiver seemed like a natural progression. Suboxone isn’t magic, but it’s the best thing I’ve seen for really helping people with opioid addiction.

“I like to practice what I call radical empathy—where you try to see yourself in the patient’s shoes. At the end of the day, we all have the same desires and feelings.”

You have a background in emergency medicine, and at Workit we’ve noticed that many emergency medicine clinicians seem to be the most passionate about providing care to those struggling with opioid addiction. How do you think ER experience has influenced the work you do today?

Well, as I said, I’ve seen many kinds of people in the ER. If you are a good ER Nurse or Doctor, you have to really learn to embrace humanity and realize that we’re all really struggling with the same things in our lives. People come to the ER in crisis. It’s the place of last resort for many people. You’d have to be pretty arrogant or ignorant or just thick headed not to eventually realize that you or a loved one could easily someday be in the same situation as your patient. I like to practice what I call radical empathy—where you try to see yourself in the patient’s shoes. At the end of the day, we all have the same desires and feelings.

Many, many people who present to the ER have some issue related to addiction—they’ve had an accident because they were under the influence; they’re in withdrawal but tell use they have the flu, and so on. But the ER is not the best place to treat addiction. If a person is lucky, he or she might get a good referral to outpatient treatment or someone might say something supportive and motivating, but all in all, it’s not the place where healing the chronic condition of addiction happens. Working in the ER has made me frustrated to want to do more to direct people to get better care and lead healthier lives.

You are not only a provider, but also a professor of nursing and researcher. Your recent research is looking into the role nurse practitioners can play in ending the opioid epidemic. Can you tell us a bit about what you’ve found?

So, I can’t really say I’m a researcher, but I’m learning! I am going to retire this summer from the ER, but continue working as a nursing professor at San Jose State University where I am trying to study addiction as best I can from a nursing perspective. Right now, I have a project going where we are interviewing Suboxone users and asking them about their experiences. We don’t use the word stigma in our questions, but we do find people bring up the fact that there’s stigma around addiction and even around Suboxone. Many patients aren’t really comfortable talking to their friends and even loved ones about it. I hope that changes over time and our society starts to look at addiction as a chronic disease. I might also add that most of the Suboxone patients we’ve interviewed say they feel normal now for the first time since their addiction process began. And normal is a good feeling.

I’m working on a project where we train Nurse Practitioners about addiction and Suboxone. What I find is that nurses get very little training on addiction in their regular curriculum and they can bring a boat load of prejudices and misconceptions into their practice. I’d like to see the waiver training get built into our NP curriculum.

“A good therapeutic relationship is built on trust. Trust is really all we have at the end of the day. ”

— Dorothy Moore

Many of us in recovery have previously had negative experiences with clinicians and the medical field, often because we’ve had fear around disclosing our struggle with addiction to a medical community that isn’t very understanding of addiction in general. Do you have any tips on how those of us in recovery can begin to trust the clinicians providing our care?

There is a lot prejudice and stigma around addiction disease, patients aren’t imagining that. I don’t know if it’s helpful, but of course try to be as honest as you can about what is going on with you so that the provider doesn’t have to guess. A good therapeutic relationship is built on trust. Trust is really all we have at the end of the day. Try to remember, and it’s very hard because of all the shaming society does, that your condition is no different than diabetes or COPD in the sense that you didn’t choose to get sick. If you feel that the provider is belittling you are treating you as less than human, then move on because that is not right. That reaction from a provider says much more about the nurse or doctor than you. Trust your own instincts. There are many, many providers who view addiction as a chronic disease, not a lack of will power or ability to “just say no,”  and who will not pass judgement on you. One of the reasons I like WorkIt is that our medical team is on the same page about treating all patients with respect.

The Bay Area is unique in that it offers several unique initiatives such as the ED-Bridge program and the Hub and Spoke model to ensure access to buprenorphine. Also, fentanyl hasn’t seemed to make the impact in California that it has on the East Coast. How is the opioid crisis in California unique?

I really only know California. I’ve lived in Northern California for about thirty years. I think there is a lot of access to drugs and in a weird way, we’re pretty tolerant of drug use, but then when it gets out of hand, no one wants to talk about it or deal with it. I think that’s really obvious with our highschools and teenage access to pills, which is a huge issue no one wants to really confront. I see lots of people who started using prescription pills but then had trouble accessing them and maybe even moved on to heroin. But, like you said, we do have some good support for drug treatment in this state. The Hub and Spoke model is fantastic. So many people can qualify for free or very low cost treatment through it. I hope it grows.

Drug Free All Stars Founder Stacie Burns on Fighting MAT Stigma

Stacie Burns is the founder and president of Drug Free All Stars, an Oakland and Pontiac County-based advocacy group.

After beating heroin addiction herself, it’s now her mission to help others in recovery and break the stigma of addiction. She’s also a Certified Peer Recovery coach, Motivational Speaker, Advisory Board Member for Novi Community Coalition, Certified Narcan Trainer, and Radio Talk Show host for Cave Radio. Workit Health is proud to support Drug Free All Star’s advocacy for all pathways to recovery.

We caught up with Stacie to learn about her own experience fighting stigma against MAT and her own recovery journey.

>> You are a substance use counselor, a person in long-term recovery, and the founder of the group Drug Free All Stars. Can you tell me a little bit about your path to recovery and advocacy? 

10 years ago I found myself on a bathroom floor, using toilet water to shoot heroin in my breast and decided to give recovery one more shot after 13 rehabs. I made my way into my final recovery with medically assisted treatment (methadone).

>> Both Work it Health and Drug Free All Stars are committed to advocating for all paths to recovery, including medication. Can you talk about why fighting against the stigma that exists within the recovery community is important to you?  

Because …. we are losing an entire generation of people due to pushing the traditional abstinence-based recovery on individuals. Not one single person did drugs one way, recovery should be treated the same. Just because my recovery does not look like others that does not make me a lesser valued human. We are all going the same way, just different boats.

>>Those on medication experience stigma in 12-step meetings, notably Narcotics Anonymous. How do you think those of us in the recovery community can change this? Should we try to change the beliefs within certain groups, or should we work on creating new safe spaces? 

We should do both!!! People do not like change and I get that. However, if you truly look at the literature provided by the fellowships it clearly states taking medications is fine. But others like to put their spin on it and that’s what causes the diversion of helping others!!! I would rather see anyone sitting in a meeting alive than sitting in a meeting planning a funeral it’s common sense!!!!!!

Just because my recovery does not look like others that does not make me a lesser valued human. We are all going the same way, just different boats.

>>The recovery community seems to still be trying to figure out how to adapt to medication, including allowing access to a sober home to those on medication while also being respectful to those in the home choosing total abstinence. How can sober homes adapt to medication? 

I manage a sober home that takes all pathways. If an individual can not support another because their pathway is not like theirs, I suggest they talk to their sponsor. When one of my residents asks me this very question, my response will always be the same… Is she worth saving? 

>>So many people in Michigan are still struggling with addiction — how can those of us in recovery best reach out to people still struggling with addiction? How can those not in traditional 12-step communities get more involved in community advocacy? 

For me? I went to social media and started a group, a page, provided a hotline and used my story of addiction and recovery wherever I was invited. I also pushed my way into many state of Michigan boards, legislation and so on to make recovery have a seat at the tables.

>> What are the most important aspects of your own recovery today, and how have those evolved since you first got sober? 

Teaching my children to always be kind, never judge anyone and help whenever you can. I believe our youth can change tough love into healthy love.

>> At Workit, we celebrate the smaller victories in life as Workit Wins, like turning in a work project on time or practicing healthy self-care. What Workit Wins have you recently celebrated?  

For me? I went from being a drug-dealing heroin addict to a counselor at an all women’s state-funded facility. What  I tell my girls about how I got to where I am? I stopped doing heroin, period.

>> For those reading who might not be sure recovery is possible for them, what is one thing they can do today to help themselves take a step towards recovery?

Reach out and let us reach in!! No matter what you think you can not do? Let another person in recovery take your hand and help you see what you can do!! Let us show you how to be the best version of yourselves!! Let us help you get back everything addiction stole from you!! When “I” is replaced with “we” illness becomes wellness.