Suffering Addict Shows For Christmas

But just for today….
Leave your judgments, questions, and whispers in your car when you walk in and see the chair that has been reserved for me for all these years that has sat empty is occupied today.

 

Hey… Yeah… It’s Me…
Yes, good to see you too..

Here I am in all my glory.
The black sheep of the family.
The let down.
The disgrace.
The addict.

I’m not really sure why I showed up today.. I can feel all your eyes resting upon me with every move I make. I’m not here for your entertainment, I do know that much.
Seeing everyone I haven’t seen since I was a kid is a bit overwhelming to me right now.
Please don’t push me into a corner and surround me with your questions.
And please, don’t offer your advice unless you have walked the crooked mile that I am on.

In your mind it is so simple, just stop doing drugs. Go right on out there and get yourself a job tomorrow and buy that little house on the corner by the end of the year.

It sounds great.. just so puke perfect. When you are talking to me about what I should do with my life, keep in mind that it is easy to sit back and preach to someone when you have never encountered even the smallest of my problems in relation to your perfect little world.

I know that it makes for a good conversation starter.. but I am not living anywhere permanently, and I am not employed. Truth be told, I am wandering through this world relying on dope to keep me numb, so that I do not have to feel any emotion whatsoever.

I don’t have time to explain to you “how it makes me feel when I do drugs” or “when I am going to get myself together”. I’m broken.

What I do need from you right now is to be shown some respect, even though I know you do not respect me at all in my current state of mind.. please.. be a good sport and pretend.

I need to look around and see the faces of my family, enjoying their Christmas time together.. not blank faces and glares from those of you who think you are better than me because of the decisions that I made, and still make.

I’m probably not going to have much of an appetite, considering that my stomach is filled with anxiety and I don’t really eat much these days.

Please don’t insist on loading my plate with all the things you want me to try, I am not going to eat the things I know that I like, much less something that you are forcing me to take.

Let’s all sit down and just be family. Just be here, together.. laughing and cutting up about old memories, and let’s pass around all the new babies.

Don’t pull me to the side with the “Can I talk to you for a minute” scene.. and take me outside to tell me how I need to do this or that. You don’t know what I need. I’m not me.

When it’s time to pass out presents, don’t make excuses of why you would have got me this or that.. but… Listen carefully, I do not want gifts from anyone in this room. That is not why I am here.

The greatest gift that you can give to me right now is a taste of normality.
Look at me and talk to me like I never fell off the wagon.. like I am not a junkie.
Let me remember what it was like to be me. Before my demons drug me into the life I live now.
If only for a moment, let’s pretend that I am me again.
Let’s act like I can look you in your eyes with confidence while we carry on a random conversation about the news, or sports, or the weather.

I need to find me.
I am so lost.

Please don’t bring up my past, or the life that I lived before.
Do not ask me when I am getting my children back from CPS.

Befriending me in order to get me to open up to you about my life and then using my words against me later on will cut me to the core. Let’s avoid that at all costs.

Please do try to include me in things.. Invite me outside to play tag football with the rest of our cousins. I am an addict, not a stranger to our family traditions after Christmas dinner.

And last, but not least.. don’t feel sorry for me.
I am grown.
These are my choices, and my consequences.
And I live with them every single day.

But today.. I want to feel normal again.
If only just for the afternoon.

Even though you don’t understand…
Help me remember what it’s like to be me again.

And if you happen to be present in one of the emotionally frail moments and breakdowns that I am bound to have happen sooner or later, the longer I am here.. Just sit here in the silence with me. Don’t ask what’s wrong. I’m not sure.

Maybe I just miss me a little more today.
And maybe tomorrow I will keep one of those promises that I make to myself every day when I try to get clean and stop using.

But just for today….
Leave your panoply of  judgments, questions, and whispers in your car when you walk in and see the chair that has been reserved for me for all these years that has sat empty is occupied today.

I am here.
That’s all I need for now.
Love,
The Still Suffering Addict

My friend: Danielle R. Gilliam, we will get through this.

RecoveryRadio.FM Review

These guys are all forces in the recovery community but together WOW, you can expect lots of inspiration, differences of opinions and thanks to Bobble every topic will be explained so that everyone will understand completely.

 

December 1st RECOVERYRADIO.FM went live out of Palm Beach, Florida. Three huge names in recovery are hosting the show, RJ ViedJames Sweasy and Bobble. These guys are all forces in the recovery community but together WOW, you can expect lots of inspiration, differences of opinions and thanks to Bobble every topic will be explained so that everyone will understand completely.

The show runs for three hours every Tuesday and Thursday from 9 pm to 11 pm on

96.1FM for Pompano to West Palm / 97.5FM for West Palm to Jupiter/ 1340AM for all of West Palm County. You can also watch the show live on RECOVERYRADIO.FM OR on Facebook at www.facebook.com/recoveryradio.fm

If you aren’t familiar with these guys, let me tell you a little about them from my perspective.

RJ Vied is a Recovery Advocate who is a talented writer, speaker and all around genuine guy. I guess you could say he is the eye candy of the show…at least that’s what all the ladies are saying but don’t take my word for it, check him out yourself. You can follow RJ Vied on Facebook at www.facebook.com/rjvied. Don’t think that means he is just pretty to look at, this guy has a genuine passion for reaching the addict still suffering and supporting those in recovery. RJ Vied is a triple threat, intelligent, talented and honorable. The eye candy part is just a bonus.

James Sweasy is one of those magnetic guys that when they talk you just know you need to listen. Sweasy is from my hometown Louisville, KY and his no-nonsense approach to recovery has made him one of the most followed Public Persona’s in Recovery, and he is just getting started. Sweasy’s fans are die hard and with Sweasy’s creative video angles and call it like it is approach this guy going to be HUGE…ok he already is huge so how about Enormous. Relatable is Sweasy’s middle name. If you aren’t a Sweasy Fan, you need to hope on over to www.facebook.com/jamessweasy and learn you a thing or two. That’s what us Kentuckiana’s like to say.

Last but not least is Bobble. Bobble is a musician that is rocking the recovery world with his relatable rhythms and hip hop recovery music. I don’t know a bunch about Bobbleother than thank goodness for him being on this show. Sure enough, when I am scratching my head about some odd term, idea or recovery approach Bobble is quick to say, HUH? Please explain that so we all can understand it. You can follow Bobble at www.facebook.com/bobblemuzikRAW

I am going to give www. recoveryradio.fm a ten on a scale of 1-10. If you missed the show last night, you could listen to it on their website www.recoveryradio.fm anytime.

Be sure to check out their next show every Tuesday and Thursday. They encourage people to call in but remember this isn’t a podcast so no swearing or you will be disconnected immediately.

RECOVERYRADIO.FM is a great concept with incredible talent, I look for this show to have a long successful run. Congrats guys, we will be listening, that is for sure.

Christmas & Addiction

With some awareness and understanding, Christmas might be great again.

I love Christmas, it’s truly magical to me, in my mind.  Since being an addict for over 20 years, most of my fantastic Christmas’ have been fantasies in my mind.  The truth of Christmas for me always ends up the same.  I was clean last year and have had 4 or 5 clean Christmas’ during my 20 year run with opiates.  The crazy thing is it doesn’t matter, at least not yet, if I am clean or not.  Christmas always ends up making me feel like a subhuman.

These are some ways that Christmas would be easier for me, and this is using or not.  If your loved one is actively using or even new to recovery, they may not have something nice to wear to the get together you want them to attend.  A week or two before the event if you know they don’t have anything to wear, take a bag of hand me downs over and tell them so and so was cleaning out their closet.  Don’t mention they can wear any of it to Christmas, they will figure it out.

As a kid, we craved the approval of our parents. As we mature, very little changes in our need for approval (often beyond just our parents). So if you are the parent, family member or friend of someone struggling with addiction, do your best to let them know that they are cherished and valued. This underlying message opens the doors of communication and brings them that much more likely to confide in you when they are ready for help or just for an ear while they are on their recovery path.  If I ever look into my mother’s eyes and see something other than disappointment, it will be the happiest day of my life.

For the person abusing substances, as well as for family and friends, gifting can be tough. Before exchanging elaborate holiday wish lists, consider trading in material objects for “healing gifts.” This can relieve tremendous pressure that may be placed on addicts who are often just getting back on their feet financially and can’t afford to purchase presents. So you can do like letter writing to each other instead of gift exchanges.  Something where the addict can express their feelings and give a gift without it costing money.

You will be surprised at what a difference even a minor attitude change can make in behavior. Your loved one is likely under a lot of stress just keeping up with the rest of family or friends and staying in high spirits, so remind them of a phrase that’s said a lot in recovery: “It’s progress, not perfection.” It’s a valuable reminder for them to continue moving forward like they say one day at a time and, though it might not always feel like it, a holiday is just another day like any other in the broad scope of one’s sobriety journey.  If the person is still using and they show up to the holiday events that could be a big step in the right direction but make sure that no one yells out OH LOOK WHO GRACED US WITH THEIR PRESENCE, stuff that seems very simple but is huge to an addict.  Just writing this has got me in tears.

Don’t Hover:  Have the strength to let your loved one feel safe, even if it means giving up some control.  If they need to skip out on the customary touch-football game to go to a meeting or meet up with recovery friends, you should give them room to do that and permit their absence at this event. No accusations, no judgments. Period.

With some awareness and understanding, Christmas might be great again.

don’t make them live your drama

i don’t have the inside scoop
on heroin addiction
call it what you need to
it’s a personal affliction
i don’t have an inside view
of this new epidemic
but i survived an alcoholic
so here is my polemic
i was asked so i will say
and i may come down hard
window-bear-163812_960_720
please protect the children
or the children will be scarred
if you have a child
but you can’t be
a dad or momma
get the kid to someone safe
don’t make them
live your drama
let them grow up happy
as every child should be
come back to them
when you get clean
they’re the priority
picture by public domain pictures, courtesy pixabay.com
created by special request for inside out at holyaddiction.com to help bring attention to the growing heroin epidemic

Know Your Rights When Fighting Child Protective Services

Know your rights when fighting Child Protective/Welfare Services
Here are some of my recommendations. Keep in mind that I am not an attorney and this is not legal advice — so consider the source. Get an attorney if at all possible, and discuss these things with him/her. Your attorney will understand local procedures better than I possibly could.
What would you do if a child protective services (CPS) social worker came to your door with false accusations? What would be the best way to handle that. Read this to be prepared, before it happens to you, as it has happened to so many others…. people who believed it would never happen to them.
Stay Calm
As you deal with the interview, remember to be polite. Child protective services workers may become angry at hostile and terrified parents, thinking they must have something to hide. Treat the social services caseworkers respectfully, but don’t give them any personal or self-incriminating information, or leads to more information.
They may need to see your children in order to close the case, and they will probably want to talk to both parents. Don’t be afraid. Do whatever needs to be done in order to get the case closed.
The less said, the better. Child protective services social workers usually show up at your door with little to no evidence. If they are acting on an anonymous tip, they have NOTHING. They cannot get a court order based on an anonymous tip. The only thing they can use against you is information you give them.
Record and Document Everything
Check your state recording laws. Print out a copy of your state’s recording law, and put it in a file folder titled “Child Welfare Agents” near your front door. Have an audio recorder or video camera handy in the house at all times. If a child protective services social worker shows up at your door, be prepared to record the interview. You can, at that time, show them that you have a copy of the recording law.
Don’t be coerced not to record — this is your legal right if your state law says it is. Video is better than audio, if you can afford to do that instead.
Furthermore, you must document everything that happens in writing! Take notes. An English activist recommends you write down every word and insist that the worker must wait until the words are properly recorded. You have the right.
Keep a spiral-bound notebook on hand and use it to document every contact with child protective services or child protective services appointed “service providers”. Don’t back down on this! Prepare in advance, and stand firm against CPS agents! After each contact, write a letter (some recommend having such a letter notarized) detailing what occurred, and request that the social worker confirm or deny the facts as you understand them within ten days of receipt of your letter. If no letter disputing the facts is received, then your statement of facts will be automatically confirmed. This form of documentation can later be used as evidence in your favor in juvenile court. See: Your Case Notebook – Is It Up To Date?
Don’t Invite The CPS Worker Inside
You are under no obligation to let a child protective services social worker into your house. Under the basic law of our land, the United States Constitution, Amendment Four, you have the right to privacy in your home. No government agent of any type is allowed to enter your home without your permission. We know of many cases where entry was coerced by statements such as “let me in or I’ll take your kids”. Do not give in! Do not give up your Constitutional Rights! Stand firm on this! If your rights are not honored, you can sue them later, but it is so much better to force them to honor your rights now. Check out Forced Entry Lawsuit.
The only exception would be if the child protective services agent shows up with a law enforcement officer bearing a search warrant. Usually that doesn’t happen — and I will tell you why. The child protective services agent is there at your door to gather evidence. Usually he doesn’t have enough real evidence to detain your child right away and there is not enough “probable cause” to obtain a search warrant. Typically, he will be just working on a phoned-in tip from someone who wants to retaliate against you for something. If you talk a lot, your words will be twisted in such a way as to be used against you in court. Also if you allow this person into your home, he will most likely find something there to complain about and use against you in court. A sink with 8 dishes needing washing can show up in his report as “a sink full of dirty dishes and a filthy kitchen” which of course would serve to make you look bad to a judge. Therefore, just don’t let these people into your home. You have no idea what an issue a child protective services social worker can make out of a pile of laundry sitting next to your washing machine!
If the complaint the child protective services social worker is there to investigate is that your house is dirty, you can go inside, take a few digital photos, and then go back outside to show her the house is just fine. Or, you can tell her that without a court order there will be no entry into your private home thanks to the Fourth Amendment of the US Constitution. If she’s working with only an anonymous tip, she will not be able to get a court order. If instead, she has credible evidence, she may be able to get one.
Say As Little As Possible
Of course, when you first see child protective services social workers on your doorstep, you want these people to go away and close their case. This will make you want to tell them things to clarify that you are not a danger to your children. Be careful what you say. As any activist will tell you, anything you say can be twisted and used against you!
For example, I thought it was good that my spouse and I were already involved in therapy and a 12-Step group for adult children of alcoholics. However this statement was used against me. It was used as evidence that I had problems and needed “services”. The fact that I was already taking care of my own needs and didn’t need a court order to do these things didn’t help.
Another thing you really shouldn’t tell CPS agents is whether you were once in state custody. When you tell them you were a foster child, first of all they know there’s a file out there with your name in it from which they can pull documents to use as “evidence” against you. In my case, most of the paperwork in our thick file was pulled from my spouse’s very thick state custody file. They claimed they had evidence that he was violent from the time he was in kindergarten and they were prepared to use that juvenile file against us, even though he had never harmed our child. Second, if you tell them you were a foster child, it marks you as a victim and makes them think you can be victimized more. Former foster children have their children detained at a rate much higher than most, so just be on the safe side and don’t mention that fact if it pertains to you. It really is none of their business. You should not open your mouth to help them make a case against you.
It is also not wise to tell them something like, “I am not an abuser – I should know what that is – I was abused as a child.” What this says to them is that you were abused therefore you are likely to be an abuser. Believe me, no matter what terrible situation you went through as a child, it is better not to mention that to a social worker. They will not feel so sorry for you that they will just go away. No, it doesn’t work that way. They are looking for bad things to say about you to pad their caseworker report when they present it to a judge.
Yet another thing you shouldn’t say is whether your child was detained in the past. A history of child protective services interference in your family tells a caseworker you are on their hit list. If you have ever had a child taken from you by Termination of Parental Rights (TPR) move to another state or better yet, out of the country, and keep it a secret! There is a 1996 law (ASFA – the Adoptions and Safe Families Act) that gives the child protective services agents the right to take away all future children if you ever had a TPR in the past. If this law is used against you, there will be no reunification plan, no “reasonable efforts” to keep your family together, and most likely no visitation.
Another thing to beware of: they may ask you for referrals to people to help prove your fitness to parent. For example, I was asked for my ex-husband’s phone number. Thinking he would give me a good referral, I complied. As it turned out, he was told that making a statement against me would help him keep custody of our children. The most damaging “evidence” they got against me were false statements signed by this ex-husband and his girlfriend, who had only met me briefly once and had never been in my home! This woman had the gall to make a twelve page false statement typed on legal paper regarding my parenting abilities! She called it an “affidavit” but did not sign it under penalty of perjury, and for good reason! Therefore I advise that you NOT give them “leads” to your friends, family, ex-spouses, therapists, doctors, etc. They are just looking for “evidence” against you and they are experts at coercing this sort of evidence from people who know you. Make them find their own evidence — don’t help them find or make contacts!
So, if CPS agents are at your door, stand firm and say as little as you possibly can! If you feel they are making a case against you anyhow, get an attorney to help you through an interview in your attorney’s office.
Don’t Trust CPS Social Workers
In other words, know the enemy. Know who child protective services workers are. I used to work with child protective services workers in the Dept. of Public Social Services, Visalia, California, so I think I’m in a position to tell you what these government agents are like, though I’ve never been one. (I was a welfare eligibility worker.) The typical child protective services social worker is there for one reason: to have a job to pay his/her bills. This worker cannot afford to lose the job, so s/he will do whatever the supervisor says in order to maintain employment.
Now, if this child protective services social worker is put into a unit assigned to go investigate referrals and to make decisions regarding detainment of children, then naturally this person would be suspect if s/he never detained a kid! In order to maintain employment, this child protective services social worker will have to take a certain number of children into custody… therefore when they are at your home, they are thinking to themselves, “what can I find out about this family to build a case aimed at taking their kid?” They must have a case to take into court, and they are there, looking for evidence.
Even if they seem nice and harmless, remember, this is how child protective services makes money. To keep their jobs, they must take away children from their families. They are wolves in sheep’s clothing. They come to your door saying, “I’m just here to help.” The next thing you know, your children are in state custody and you are in court trying to prove your innocence. Remember, even if you like the person, behind every pleasant personality is a need to keep the child protective services social worker job. Behind every seemingly nice caseworker there is a more experienced child protective services supervisor who may tell your caseworker to “find something” to use to detain your child. You would not believe some of the idiotic allegations I have seen in caseworker reports… but if they can get a judge to rubber stamp their side of the story, they can get away with keeping your children in state custody. Don’t trust these people!
Service Plans
You need to understand that child protective services funding is closely tied in with “service providers”. It is likely that the social worker will offer some kind of deal, saying you can keep your kid if you agree to “services” like psychological testing, drug testing, therapy, etc. What this offer really means is that they don’t have enough evidence to take your child into their custody, but if you will just go to their “service providers” they may get the “evidence” they need through these “service provider” reports.
Say, for example, you are accused of drug use. They want you to go to a drug testing service to prove your innocence. You say, “Okay, I’m not a drug user, I’ll go”. But then you find yourself facing false-positive results … or if you miss an appointment, you are told that will count as a positive drug test. Your life is being severely interfered with because you have to go to scheduled appointments, miss work, make special child care arrangements, etc. Believe me, all this is not a “service” to you, no matter what they call it! It is only a way for child protective services social workers to try to get “evidence” against you so they can take your children away.
What I recommend based on what I’d do in similar circumstances: Do NOT sign their plans. Do NOT admit to anything. Force them to PROVE their cases in court, in a FULL TRIAL. Don’t accept just a hearing where you are coerced to sign guilty to the charges. They will try every trick in the book to get you to agree to their sick “service plans”. Stand firm and just say “no” when they ask you to sign your legal rights away.
Just Say “NO” To Private Interviews With Your Child
The CPS agents will want to talk to your child alone. Just say “NO”. Tell the agents that your child has the right to have an attorney present, and that if he insists on an interview then you and the attorney will be present and the interview will be recorded, preferably on videotape. Of course, if your child is attending a public school, you probably won’t get a chance to say “no”. What would happen is that the social worker would go to the school and, behind your back, get permission to talk with your children from the school employees. You can tell the school ahead of time (in writing) that you don’t permit such interviews, or anything other than basic education activities, however you cannot trust school employees to go by your wishes. It might help to ask your attorney to write a letter to the school forbidding interviews with CPS workers. Keep in mind that the public schools are one of the major sources of CPS referrals. I have heard that caseworkers complain that public school employees actually want more child detentions than CPS agents do!
My advice is not to trust the schools, and to homeschool if possible. I am a big homeschooling advocate because I believe it is best for kids, and one of these days I will write a page about that too… but in the meantime, just keep in mind that it is hard to say “no” to interviews if your child’s school will say “yes”.
Already the government puts child protective services social workers into public schools to look for target children. Eventually, this may be the case in every public school. I think this is a good place for me to mention that I support the separation of school and state. Please check it out.
Be sure your children know that they have the right to say, “I don’t want to be interviewed without my parents and an attorney and a tape recorder present.” Child protective services social workers will not tell your child that s/he has the right to say that. If there is still time, you must be the one to train your child how to deal with government agents. Be sure your child knows the consequences of child protective services interviews. If anyone is detained, it is the child. If they say the wrong thing, they can be taken into custody and removed, possibly permanently, from parents, siblings, friends, their home town, their pets, and everything else they hold dear in life! They will be traumatized by that separation, and probably put on harmful adult psychotropic drugs to deal with the separation. See: Drugging Foster Children.
If they complain too much about being incarcerated in state custody homes, they may be put into mental hospitals, or placed in restraints, which are known to be deadly. “Teach your children well,” as the old song goes. We live in perilous times. We owe it to our children to help them learn to deal with government agents that may harm them. Remember, children are eight to ten times more at risk of abuse in foster and group homes, so we are not over-reacting in teaching our children these self-protective measures.
Advance Preparation
I’ve suggested that you keep the following things on hand: a tape recorder, blank tape, video camera, spiral-bound notebook, and a file folder marked “Child Welfare Agents”. If you have time to prepare for a visit before it happens, you are very lucky. Most people don’t take the threat of government interference in their lives seriously — until after it happens to them.
To prepare, I suggest the following items be printed out from the internet and placed in your folder: your state and federal laws regarding child welfare services; court cases that ensure your rights; the Bill of Rights, newspaper articles and statistics showing that children are not safe in state custody homes. Be prepared to show these things to the social worker that comes to your door, and question them about the wisdom of taking children into state custody where they are eight to ten times more at risk of abuse.
If they want to take your kids, question them about the “reasonable efforts” requirement to keep families together, and about what “pre-placement preventative services” they are offering. If they want your child, ask about what “imminent danger” exists. Let them know that you know the laws!
For example, if they claim something happened on Monday to your child but they show up on Friday afternoon to pick your child up, you should be telling these social workers that obviously no “imminent danger” exists or they would have acted on the report right away! If you don’t stand firm and point out their mistakes, they will walk all over you and violate their own laws in many different ways. Yes, your child still might be detained, but if you show them you know their laws and can speak their lingo, they will think twice before choosing you as a new client.
In addition to the paperwork detailed above, keep on hand in this “Child Welfare Agents” file your pediatrician’s doctor reports showing that your child is healthy. Every time your child sees a physician, request in writing that the full report be sent to you. You should not give these reports to a CPS agent, but you can let him know you have evidence showing that you are a good parent, not an abuser. Flash the papers before his/her face, don’t hand them over to be read… these are your own valuable documents and you don’t need to share or tell the worker who the child’s doctor is. Let the worker find evidence on his/her own. Don’t help a CPS agent try to build a case against you.
The point of having this folder is to let the social worker know that you know the laws and you are prepared to defend yourself! You are not going to share your “evidence” with a social worker. They have no right to it unless the case goes to court, and then you share it with your attorney only – or if you’re representing yourself, you can enter items like pediatrician reports into the court records as evidence.
Coercion
Be prepared to face coercion, even from your own court appointed attorney. Just like many others, I too was told by my county attorney that I could take my child home that day if I would just sign guilty to the charges, and I was so desperate to get my baby, I signed. Thousands of us have done that. Believe me, it is better to say “No – I want a full trial – you must prove your charges!” If you give in to the coercion, you will be jumping through their “service plan” hoops for months to come. If you go through with a trial, there’s a possibility you will win your freedom from this government interference in your family’s life.
If you go through a trial, and your child is adjudged a state ward, and you are court-ordered to complete a “service plan” or “reunification plan,” then of course you should do your best to complete every part of it before the next court hearing. This plan will most likely include psychological testing and counseling — that is a standard waste of taxpayer money. If the social workers want to court order you to anything that does not apply to your case, you should insist that your attorney fight this requirement in court. For example, if they want you to go to drug testing despite the fact that you are not a drug user and they have no evidence that you might be, then fight it! After the court hearing, if social workers try to force you into “services” that are not in the court-ordered plan you can refuse to cooperate. You are only required to do things that the judge has ordered. You should document all such illegal requests for additional services that haven’t been required by a judge. You can request a state administrative hearing from the state social services department to discuss these requests with an Administrative Law Judge.
Likewise you may find that child protective services social workers are trying to delay setting up services that are court ordered. You must document your repeated requests for such services and the excuses the child protective services social workers give for delaying the start of such services. Child protective services agents have been known to delay services so that your case will last longer. If your child is in state custody for 15 months, your parental rights can be terminated on that basis alone. Your goal will be to get your child returned at the next court hearing, so don’t allow delays!

Open Letter to the Addict Haters

Dear Addict Haters:

Hello, you don’t know me but I am an addict.  I am one of the “junkies” you love to bash whenever someone mentions addiction on Social Media or hear it in conversation.  I know it’s hard to forgive the things we sometimes do because of our addiction but I have a question for you.

WHAT IS THE WORST THING YOU HAVE EVER DONE?

Obviously, I won’t get an answer to this question but think about it.  The thing that you hate that you did.  You know, that one thing that not too many people even know about. Well, what if everyone knew about it.  What if for the rest of your life you were labeled by that one act that you would erase in a second if you had the chance?

That is what being an addict is like, kind of.  Now I don’t feel like being an addict is the worst thing a person can be or do.  You, however, feel like it’s a terrible thing.   Don’t get me wrong, if I could erase it from my life I would.  In an instant, it would be gone, but I don’t have that option.  I can’t even do what you do and pretend that this thing I did, didn’t happen. In order for me to ensure it never happens again I have to work hard on making sure it doesn’t. If I don’t my disease will tell me I can have a drink or do a line and not fall back into full-blown addiction, but I will.

DO YOU WORK HARD TO MAKE SURE YOUR WORST THING NEVER HAPPENS AGAIN?

Let me guess, you are thinking, addiction is not a disease…it’s a choice, right?

 Yes, all addiction starts with a choice.

The same damn choice you made when you were young and hanging out with friends.

You drank the same beer I drank.

The same pot I smoked.

You even tried the same line of white stuff someone put in front of you at a party.

You were able to walk away and not take it to the extreme.

Since I have the disease, I will spend the rest of my life either struggling to stay high or fighting to stay clean.

As  children, we don’t decide we would rather be an addict instead of a cop.

You don’t see children pretending that their dolls and stuffed animals are dope sick.

When is the last time you talked to a little girl that told you she couldn’t wait to grow up so she could turn tricks to feed the insatiable hunger of her drug addiction?

My best friend didn’t tell me about exciting  plans to become homeless.

My Dad, not one time, told my Mother to think twice before marrying him because he had high hopes of becoming an angry drunk.

My sister in law didn’t blow out her candles as a child wishing for an  S.U.D.  ( Substance Use Disorder ) because she couldn’t wait for the day her children were taken into foster care.

Nobody WANTS to have Substance Use Disorder.

Some of us just do.

So always remember –

YOU MADE THOSE

SAME CHOICES TOO

YOU JUST GOT LUCKY

IT WAS ME

AND NOT YOU.

If you still have doubts you can take those up with the Center for Disease Control ( CDC ) or the United States Surgeon General.  Since they have classified addiction as a disease, but then again I am sure you know more about it than they do, right

screen-shot-2016-10-21-at-1-39-59-pm

So to you, I pray that you don’t have to reevaluate these opinions because you find out your child or parent is an addict.  If you do, just know that we will accept you into our community. We will help your loved one.  Do you know why we would do that?  Because we are good people that just want the chance to live like everyone else.

So please, before you post another post bashing people who are suffering think about it. Not only are you hurting the people who, have the disease, you could be hurting everyone that loves them.  You have people on your friend’s lists or that overhear you at work who have children who are suffering right this moment from addiction.  What did they do to deserve the awful things you put out into the universe, that does nothing but perpetuate hate and judgment?

You have a right to your opinion, but no matter what, hurting people is wrong.

 

 

 

Suboxone Tapering

This is the best information I can find about tapering off of Suboxone.  Please if you have tapered from Suboxone and had success send us a message so we can share your story.  When I came off of Suboxone I didn’t taper.  I went to a three-day medical detox where they gave me a cocktail of nonnarcotic meds to help with the withdrawal from the Suboxone and 20 years of Xanax ( benzo ) use.  The withdrawal was very tough and lasted for months.  I was successful though and you can be too.

 

Summary: The purpose of a taper (instead of just stopping) is to gradually reduce tolerance, thus distributing withdrawal symptoms over a longer period of time minimizing the discomfort experienced on any single day.

Ending the taper at the manufacturer’s lowest available dose (2mgs for Suboxone Film® and generics or 1.4mgs for Zubsolv®) can still result in significant withdrawal.1,6 Here we lay out the rationale for tapering to much lower doses. As the data will show 2mgs/day is closer to the midpoint of a typical taper than it is to the end.

General rule: Pace the taper with the body’s ability to adapt to each decrease. Dose decreases of 25% separated by at least 10 days has been reported to be tolerable by many.1

The whole point of buprenorphine treatment is to suppress cravings and withdrawal so that you can make big changes in behavior, routine, living situation and thinking. It’s these changes which, in effect, rewire the brain and reverse some of the craving-causing brain adaptations. If this is not done first the taper will likely be shortly followed by relapse.

Have you made significant changes in behavior and had a period of time to gain experience with those behaviors? Have you been able to deal with stress, anxiety, and depression without craving drugs? This takes time and doesn’t happen on its own, it is a deliberate effort. If you have been in stable treatment less than six months, tapering is NOT advised.

Buprenorphine is NOT a detox medication, it is a treatment medication. If you are not clear on this distinction go to the treatment page and understand it before tapering. But assuming you are ready to taper there are some things to consider.

Tapering to very low doses minimizes withdrawal

taper
Before we continue, it should be noted that the following is a detailed explanation for those interested in the nuances of tapering and not necessary to conduct a taper. It does however, help make sense of why certain protocols are likely to be more effective than others.

Cut pieces of film
Fig. 1. Suboxone Film can be cut into small pieces. Accuracy is not that important when cutting the dose. Blood levels will average out over a few days. Also, it is not a certainty that the medication is evenly distributed throughout the film or tablet, so super-precision in cutting isn’t warranted.
To understand the tapering process there are a few concepts you should understand:

The Ceiling Effect of Buprenorphine:
In short, at a certain dose of buprenorphine, nearly all available opioid receptors become occupied with buprenorphine.3 Each helps induce a small opioid effect.4 The cumulative effect created from all receptors is the maximum effect or the ceiling effect.4 The minimum dose to reach this point is the ceiling dose. Taking more than the ceiling dose involves so few additional opioid receptors that patients are unable to detect any additional opioid effect.4 Whether the patient’s dose is at, near or above the ceiling dose, they experience virtually the same opioid effect. For this reason, tapering can be more aggressive (per mg.) at higher doses than at lower doses when more receptors are affected by dose decreases.2

petscan

PET scan
Fig. 2. PET scan showing available opiate receptors at various doses.
Fig 2 is a PET scan showing the amount of available opioid receptors at various doses.3 From this evidence it is clear that, for this particular patient, at some dose above 2 mgs. and below 16 mgs. the ceiling dose is reached, as the amount of available receptors have diminished to insignificant levels.3 If we extrapolate this admittedly very limited dataset and apply a curve shape common in biology, we can estimate approximate receptor involvement at various doses. Fig 2a illustrates this concept. It should be noted that there is great variability in reality and liberties have been taken with this particular graph, but it is meant to illustrate the point that the amount of receptors involved is not a linear relationship with dose. Therefore cutting the dose in half from 32mgs to 16mgs doesn’t mean that half as many receptors are affected, in fact due to the ceiling effect there would be no discernible difference.receptor

involved receptor graph
Fig 2a. Approximate amount of buprenorphine-occupied mu receptors/dose
If a taper should follow a steady and gradual decrease of involved opioid receptors, then 2mgs would be about the midpoint of the taper. In one of the few taper studies, both long and short tapers ending at 2mgs resulted in very low success rates.6 The researchers concluded: “For individuals terminating buprenorphine pharmacotherapy for opioid dependence, there appears to be no advantage in prolonging the duration of taper”. They apparently gave no consideration to the possibility that maybe 2mgs is too high of dose to stop at. We will show it is and suggest their conclusion is wrong in that extending the taper well below 2mgs for a much longer period of time is beneficial.

Buprenorphine Half-life:
Buprenorphine doesn’t completely metabolize between doses. It typically takes between 24-42 hours to metabolize half of it, but could range as much as 20-70 hours.9,10,11 We use 37 hours as an average in our calculations, but be aware of the range if your results don’t meet expectations. Therefore, after the first 37 hours, only about ½ of the buprenorphine has been metabolized, while half remains to continue to elicit an effect. After another 37 hours half of that remains and so on. At typical maintenance doses, previous doses can contribute to the overall blood levels for 5-12 days (depending on actual metabolic elimination rate). At very low doses, by day three the amount of buprenorphine still un-metabolized is so small its effects are negligible.

bupe_half-life-graph

Half-life graph
Although this graph starts at 16mgs., the curve would be the same for any dose.
Buprenorphine Blood Level Buildup, Stabilization

As patients take subsequent doses of buprenorphine before the prior dose has completely metabolized, a buildup occurs in blood levels. (Fig 3) The buildup continues for approximately 5-12 days at which time the dose taken 5-12 days prior has nearly fully metabolized. This is the stabilization period. When dose is decreased the effects of this build up should be considered before the effects of the new lower dose can be evaluated.

16mgs-11day-37halflife.png
Enter a caption

 

11 day half-life graph
Fig. 3. Blood levels build up until stabilization

 

Putting It All Together
We now know that doses at or above the ceiling dose can be decreased more aggressively than lower doses. We know that 2mgs/day is not the end of the taper but closer to the midpoint. We know that due to the half-life, buprenorphine builds up in the blood and may still produce effects 5-12 days later, particularly at higher doses. Armed with these considerations we can construct a taper plan which will minimize discomfort.

Buprenorphine Taper Plan
By coupling what we learned above with anecdotal taper testament found online, we can estimate that dose decreases of 25% with 10 days between drops should be tolerable.1 Furthermore, if our initial dose is at, near, or above our estimated ceiling dose we can taper more aggressive initially, maybe as much as 50% drops. As we approach 2mgs and below, we should expect more noticeable differences between each dose decrease and may need to slow down the pace. Once at a very low dose (less than 0.5mgs) we can speed up the pace once again as the buprenorphine is metabolized down to insignificant levels in just a few days.

Emergency Buprenorphine Taper
If you find yourself in a situation where you must taper off immediately for some reason and don’t have the time or enough buprenorphine for a planned taper, you can try an emergency taper. With the emergency taper you stop all buprenorphine until the onset of withdrawal. At that time you take small doses (<= 1mg) every hour until withdrawal is tolerable. Then, take buprenorphine only when symptoms become intolerable and only enough to stop the withdrawal. Although this method minimizes withdrawal intensity for a given amount of available buprenorphine, there could still be considerable withdrawal depending on tolerance and the amount of buprenorphine available.

Which brand of buprenorphine to use
As of early 2016 there are 3 name brand and at least 5 generic buprenorphine products to choose from. For ongoing treatment something can be said for the newer brands; with their better bioavailability side effects may be fewer and some dose and copay card combinations make it the least expensive option (including generics). (see cost page) But when tapering, particularly at doses below 2mgs, Suboxone Film (as pictured above) offers the advantage of being larger thus easier to cut into the fractional doses necessary for the taper. Pieces of film left over between doses should be stored in a childproof pharmacy bottle with a silica gel pack to absorb humidity and prevent the opened film from becoming sticky. (see storage section)

When to take your taper dose
Taking your buprenorphine first thing in the morning is best. There is good reason for this. By taking your dose in the morning, buprenorphine blood levels are lowest while you are asleep. Therefore, when the buprenorphine is providing the lowest level of craving and withdrawal suppression you are asleep and aren’t dealing with it. Another reason is, you want to avoid anticipation of taking the dose, because this is the type of brain activity you want to eliminate. Anticipating the dose then receiving the reward of the dose, may be reinforcing the behavioral patterns you have worked so hard to eliminate. By taking it early in the morning, there is no need to think about it for the rest of the day. Exception: If insomnia becomes acute, you may benefit from taking your daily dose at night.

Take your full day’s dose all at once
Don’t split up the day’s taper dose. As mentioned above, taking it early prevents you from thinking about and anticipating your dose. Also, once you finally stop, it is an easier transition from taking something once a day to zero times a day, than it is from taking something 2-4 times a day, to zero times a day. Also, avoid complicated rituals like dissolving the medication in water and metering out portions for the taper. Simply cutting the film or tablet is all you need to do. Exception: Again, if insomnia becomes acute, splitting the dose up by taking some in the morning and some at night might help.

 

Remember, the taper schedule is not etched in stone. Individuals will respond differently to the same taper schedule. It is meant as a rough guide which must be tailored to match an individual’s body and circumstance. The main concept is to pace taper rate with the individual’s ability to adjust to each decrease. However, it can be helpful to have a guide to loosely follow and to estimate about how long it will take and how much buprenorphine will be required.

Buprenorphine and Pain
Buprenorphine is a painkiller. A return of minor aches and pains is to be expected when you stop taking a painkiller. This is not withdrawal, it’s the pain the painkiller was killing but isn’t killing anymore. Aleve® or some other OTC painkiller might help but only when and if you need it. Hyland’s® Restful legs tablets have also been reported to be effective especially, at night. For sleep, patients have suggested Valerian root and Melatonin. Maintaining good overall nutrition and keeping well hydrated is also important. But maybe the most important thing is to keep busy, preferably away from home. Sitting home waiting for symptoms to appear is a sure way to fail.

Pain is progress
The discomfort you feel while tapering can be thought of as an indication of your tolerance diminishing. The necessary discomfort stimulates the body to produce endorphins. If you can possibly motivate yourself to exercise, even brisk walking, the pain will be less noticeable and you benefit form the exercise. It might also help you sleep better.

Depression and Tapering
Along with being a painkiller, buprenorphine has been recognized as an anti-depressant.7,8 Just as when you stop taking a painkiller, pain comes back, when you stop an anti-depressant, depression may come back too. The severity of the depression could determine the success or failure of the taper. Be prepared to deal with the reemergence of depression, particularly if you suffered from it before starting buprenorphine treatment. This might entail working with a psychiatrist and having antidepressant medication on the ready, before concluding the taper.

Pausing the Taper
If you hit a dose level which produces unacceptable levels of withdrawal discomfort, it is acceptable to go back up in dose, one step, for a few more days. Alternatively, you can hold at that dose for a longer period of time than indicated on the taper schedule. Since everyone’s body and brain is unique, the generic taper schedule may need to be tweaked slightly. Once your body adjusts to the dose level the taper can be resumed.

Mid-taper Breaks
It’s okay to take a break from the taper if you need to, as long as it is minimal and infrequent. An example would be if you have been at 0.5mgs/ day for a week and still feel withdrawal discomfort, taking up to 1-2mgs one day will remove all withdrawal symptoms for that day and possibly the next, giving you time to refocus, get things done, and prepare for the final leg of the taper. One day at a higher dose will not increase your tolerance, thus reversing your progress, as long as you limit such higher doses to once or twice during the taper. If you can, try and not take any the following day. This may not be that difficult since about half will still be present the next day. Then resume the taper schedule.

Optional Ending Kicker Dose
Once you fill out the form above and create the taper schedule, you’ll notice that on the last day of the taper is a higher dose than recent previous doses. The idea is to take advantage of the half-life property and extend the taper a few days more. The higher dose raises blood levels, without raising tolerance, and as this final dose metabolizes blood levels slowly decrease until reaching zero, thus extending the taper. That’s the theory, but we know of no studies that have looked at this, only doctors who employ this in their taper plans.1 It’s up to you whether or not to include it. Good luck.

References:
Anecdotal evidence compiled from several social media sites over a period of several years
National Alliance of Advocates for Buprenorphine Treatment- http://www.NAABT.org
PET scans- mu receptors- Effects of Buprenorphine Maintenance Dose on mu-Opioid Receptor Availability, Plasma Concentrations, and Antagonist Blockade in Heroin-Dependent Volunteers – 2003 – http://www.nature.com
TIP-40, buprenorphine treatment clinical guidance – government document 2004
Results produced by the NAABT.org taper engine (beta)
Buprenorphine tapering schedule and illicit opioid use- Clinicaltrials.gov, Identifier: NCT00078117 -Ling – study
Buprenorphine treatment of refractory depression, Bodkin [study]
The Buprenorphine Effect on Depression, Richard Gracer, MD [article PDF]
Zubsolv full prescribing information submitted to the FDA – Zubsolv PI
Bunavail full prescribing information submitted to the FDA – Bunavail PI
Suboxone Film full prescribing information submitted to the FDA – Suboxone Film PI

Notes:
Brand names for buprenorphine/naloxone (bup/nx) combination products in the US: Suboxone Film, Zubsolv, Bunavail, and generic equivalents of the discontinued Suboxone Sublingual Tablets.
Buprenorphine products in the US WITHOUT the added naloxone safeguard:
Subutex Tablets (discontinued in 2009) but the generic equivalents remain available.
Buprenex® is an injectable, FDA approved for pain NOT addiction – illegal to prescribe for opioid addiction.
Butrans® Patch, also FDA approved for pain and NOT addiction – illegal to prescribe for opioid addiction.
Pharmacy-compounded bup or bup/nx preparations – NOT FDA approved for addiction – illegal to prescribe for opioid addiction.
Probuphine® is an insertable buprenorphine rod which goes under the skin and releases bup over the course of 6 months. It was FDA approved in May of 2016, and is for the treatment of addiction.
Belbuca™ is a buprenorphine film which goes on the inside of the cheak. It was FDA approved in October of 2015, and is for the treatment of pain – NOT FDA approved for addiction – illegal to prescribe for opioid addiction.
Download Adobe Reader to view PDF files

Disclaimer:
Nothing on this site should be confused for medical advice. The information provided here should only serve to inspire you to find out more from credible sources. We hope to help you understand the disease better so that you know what questions to ask your doctor. Never take any online medical advice over that of a healthcare professional, assume it’s all made up. Despite the links to peer reviewed studies all interpretations of said studies may be opinion, unreliable or erroneous. If some patients found something beneficial to them it’s not an indication that it will be beneficial to you, on the contrary, it may be dangerous. You, not us, are responsible for what you do with the information you get from this site or any site.

Source:

Help Me Get Off Drugs

http://www.helpmegetoffdrugs.com/taper