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Why Naloxone Should Be a Part of Your Relapse Prevention Plan

There are two fundamental questions that bear answering in exploring this topic: “What is Naloxone?”, and “What is relapse prevention?” If you have been around those in recovery, been to treatment or have ever experienced a non-lethal overdose, you are likely familiar with these concepts. 

What is Naloxone?

Put plainly, Naloxone, otherwise known as Narcan or Evzio, is an FDA-approved medication introduced in the early 2000’s that reverses opioid overdoses. Packaged either as a nasal spray or auto-injectable, advances in technology and litigation have gotten this so-called “miracle drug” into the hands of lay people (friends and family of those who struggle with addiction) who in some studies, claimed to have successfully reversed 25,000 opioid overdoses in the eighteen years between 1996 and 2014.  Naloxone works by restoring breathing to individuals experiencing the depressive effects of high doses of opioids, where breathing slows, and lack of oxygen to the brain causes the body’s organs to begin shutting down. Through a process of binding to the opioid receptors, thus blocking the further effects of any other dosage, naloxone provides individuals with a 30 to 90 minute window of time where they are able to receive further emergency treatment.  Naloxone is now readily available at all major pharmacies, and the associated education of learning to recognize the signs of an opioid overdose takes only about five to ten minutes. Both of these figures contributes to the widespread success of this product, and explain the importance of including naloxone distribution and education to close family members and friends as a vital aspect of your relapse prevention plan. 

What is a Relapse Prevention Plan?

This brings us to the second important question of the post: what is the purpose of a relapse prevention plan? In essence, it is the aim of verbalizing or drafting a plan to avoid relapse; to be fully prepared for future cravings, or when facing triggering situations. A good relapse prevention plan will help you to identify your triggers ahead of time, remind you of healthy coping skills to employ, as well as contain a list of supportive people that you can call when in need. Not only should it focus on people or places important to avoid, it should also help to define what you are like when you are “well”, and the self-care maintenance practices to use on a daily or weekly basis that will help to keep you there.  While a large portion of the plan may require individual motivation and effort, the participation and education of close family and friends of the best ways to support you in your recovery journey should not be overlooked. Teaching them communication strategies to help point you in the right direction, giving them permission to help keep you accountable, and arming them with a life-saving tool like naloxone are key aspects of setting yourself up for success in recovery.  This is just a brief overview of the key contents of a relapse prevention plan, and far from conclusive. For further information and assistance in your recovery journey, consult one of our admissions specialists today!
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Why Choose Sober Living?

You may have heard that going back home after a sting at rehab is actually not always be a good idea. But why? 

The Difficult Decision

Most people get out of rehab, convinced that they can return to the same negative environment that once fueled their addiction and manage to stay clean for the rest of their lives. However, it’s true what they say that being at an in-patient program is the easiest part of maintaining sobriety.  This is because you are safely tucked away in a setting that safeguards your choices and keeps you in check. In that sober environment, you don’t have the stress of everyday living to worry about or are forced to deal with triggers like particular locations or specific people. This is why most individuals leave rehab feeling very confident in their sobriety only to return home and find that they cannot cope with daily responsibilities, toxic relationships, and everything else that comes with being sober. 

The Right Choice

This is where sober living programs come in handy, and it is, by all means, the right choice for people who are fresh out of treatment. While these programs are a lot less intensive than rehabilitation centers and provide clients the freedom to leave if work or responsibility demands it, and even attend outside meetings and visit loved ones, they have been shown to offer the best defense for long-term sobriety.   No two sober living facilities are alike; however, what the most reputable facilities have in common is that they provide structure while offering support and encouragement through early recovery. They also ensure that the safety of the residents comes first, which means that they aren’t allowed to bring contraband such as drugs and alcohol while additionally being required to submit to random drug and alcohol tests to mitigate unsafe behavior. Sober living homes are designed to be more intensive for a shorter length of time, however, since they are funded primarily by the residents, individuals can typically stay for as long as necessary.   A licensed and fully furnished sober living home like Riviera Recovery offers countless learning experiences, opportunities, therapies, and essential life skills that patients can incorporate into their daily life in order to make the transition back into society much easier. In addition to regular drug testing, such facilities tend to also provide individual therapy, family therapy, animal therapy, group therapy, and so much more.   Anyone who wants to learn to live without the use of alcohol or other drugs needs a structured and safe, reminiscent-of-home type place that is dedicated to creating a supportive, safe, substance-free environment. Therefore, if you or a loved one is thinking about entering a sober living home, ensure the facility you join has the following characteristics to receive the highest quality care possible:
  •   Offer numerous support services
  •   Provide employment or education assistance to help you establish a healthy, fulfilling lifestyle and a new sense of purpose
  •   Provide both off and onsite support staff, while enforcing strict resident rules and regulations
  •   It should be a clean, structurally sound facility that provides comfortable beds, furniture, and fully functional appliances
  •   Provided regular, scheduled interventions including drug and alcohol tests to keep you accountable to your sobriety goals
   
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What is Drinking in Moderation?

Have you ever sat back and taken a hard look at your relationship with alcohol? Better yet, have you done a deep dive into understanding your own motivations for drinking or even attempted to discover your limits regarding how many drinks are too many in your opinion?  It is well known that people use alcohol to cope, to fit in, to socialize; however, factors such as genetics, personality, or environment can also play a significant role when determining the type of drinker one is. For example; social drinking is associated with moderate alcohol use. However, there are people in this category who will drink out of peer pressure or fit in because drinking to them is mainly a social pastime.   There are some active drinkers whose sole purpose is to drink in order to feel drunk, while others may not necessarily drink heavily, but will do so as a way of ‘fitting in.’ People who use drinking as a coping mechanism are more likely to be men and women who tend to consume large amounts in response to emotional triggers and progress to more dangerous levels of drinking behaviors.

Drinking in Moderation

A decision to drink less and stay within moderate limits is meant to avoid any health, personal, family, social, job-related, financial or legal problems. Similar to Alcoholics Anonymous and other 12-step groups, there is Moderation Management (MM) who seeks to understand and delineate the lifestyle of a moderate drinker as someone who considers an occasional drink to be a small, although enjoyable part of life, and has interests, hobbies and other ways to enjoy life that do not involve alcohol. They describe someone who has a healthy relationship with alcohol engaging in their own limit-setting in terms of time and rate, as well as involved with others who have similar views, always comfortable and never secretive about their use.    In terms of amount, what is considered moderate drinking is consuming up to one drink per day for healthy women and two drinks per day for men. Moderate drinking may also be defined as maintaining a blood alcohol concentration (BAC) of below 0.55 and in most cases, limiting the speed at which you drink to ensure that your BAC remains at a safe level. One’s BAC can also be influenced by other factors other than the type of drink and the speed of consumption, for example:
  • Gender-wise, men’s tolerance is higher, therefore they can consume larger amounts of alcohol than women because of their physicality as well as the higher concentration of water in their bodies
  • Certain medical conditions and their over-the-counter treatments
In addition, those with a family history of alcoholism are at greater risk for developing alcohol dependence and should consider their family history before consuming even moderate amounts of alcohol. Especially for those who have a history of addiction themselves, there truly is no amount of “drinking in moderation” that is considered “safe”, especially when in active addiction, alcohol use was paired with other dangerous drugs.  True, there are lots of reasons why people should avoid drinking under all circumstances or consume alcohol moderately. Regardless of your reasons, it is important to keep a watch on your patterns when it comes to drinking behavior and the possibilities that present a risk for developing an addiction. 
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Motivational Enhancement Therapy

Often the hardest aspects of recovery is changing our thought processes and actions, especially while dealing with various life challenges stemming from past trauma, depression, anxiety, and other byproducts of addiction. Motivational Enhancement Therapy (MET) is a motivational style of counseling that employs principles of Motivational Interviewing, a technique that itself was developed by two clinical psychologists, Stephen Rollnick, and William R. Miller. MET offers itself as an alternative to 12-step programs and is a form of addiction therapy that helps patients in recovery to overcome uncertainty related to a change in their self-destructive drug or alcohol behavior. It is well known that substance abuse alters the wiring of the brain, affecting neural circuits associated with pleasure, mood, and even one’s sleep-wake cycle. Consequently, it also affects a persons’ way of thinking, their decision-making abilities, how they take in knowledge, their memory, and management of performance. The primary aim of MET is all about motivating someone to face and change their damaging behaviors. As you may well know, that often even though people who have an addiction are aware of the negative impact their habit has on their lives and those around them, they are not willing to change or are not able to change their behavior. Motivational enhancement therapy is a form of communication that helps the patient to see inconsistencies in their self-destructive behavior and move them from a pre-contemplation state to one of action. MET applies particular focus on areas where he or she is hesitant about introducing potentially beneficial actions in their life, thus overcoming ambivalence. 

MET is based on five fundamental tenets:

  1.     Creating an environment of trust by expressing empathy, listening, and understanding their experiences and feelings to help an individual see their destructive behaviors
  2.     Developing discrepancy and elaborate on various incongruities by promoting differentiation in the patient’s mind to clearly show them where they are currently in their state of abusing drugs or alcohol and where they would like to be in a substance-free future.
  3.     During a MET interview, a therapist will do all they can to avoid arguments that may result in the client being distrustful, resistant, and oppositional. Instead, they will use techniques that will ultimately encourage trust and comfort.
  4.     MET counselors are trained to understand resistance to change instead of confronting it head-on, meaning they neutralize opposition by listening and being attentive without judgment or defensiveness. This is an effective way to promote trust and lower the levels of hostility.
  5.     A MET therapist will support a client’s self-efficacy by offering positive thoughts, reinforcement, and feedback to help an individual feel hopeful and boost their self-worth and esteem while at it.
Motivational Enhancement Therapy is customized to the specific needs of the person receiving treatment. Not only has it proven beneficial to those with a substance abuse disorder, but MET has also shown to also be helpful in the management of anxiety, eating disorders and gambling addiction as well as treatment for individuals who may be going through identity issues or trying to establish their autonomy. It is clear to see how this sort of methodology is complementary to other treatment modalities such as cognitive behavioral therapy or dialectical behavior therapy.