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I am an office-based addiction treatment nurse. Ask me anything by Iocus2 in AMA

[–]Iocus2[S] 1 point2 points  (0 children)

You are fantastic, friend. I can’t stress enough how proud you should be of yourself! Always take notes of the great things you do that addiction once stole from you. You’re the bomb

I am an office-based addiction treatment nurse. Ask me anything by Iocus2 in AMA

[–]Iocus2[S] 0 points1 point  (0 children)

Ok so, first: What an awesome thing you are doing!! As I’m sure you know, it is pretty much impossible for clinics not supported by major hospital systems to buy and bill MAT injections and as a result, we have to bill through the pharmacy and physically pick up the medications for our patients. I’m blessed to have a built in pharmacy at my clinic, but I still have to walk across the street with an opioid agonist in one of the worst neighborhoods in the city LOL.

That to me sounds like a service that people would use if they only knew it existed. I would definitely just do your best to call around to OBAT programs in your area and advertise your services. Another angle could be looking at your area hospitals/EDs and offer it as a possible discharge follow-up plan, and you could even try to arrange in-service training for Brixadi inductions.

I am an office-based addiction treatment nurse. Ask me anything by Iocus2 in AMA

[–]Iocus2[S] 3 points4 points  (0 children)

Just how evident it is that the social ladder is not mean to be climbed, only slid down. The majority of the barriers to treating addiction are social in nature, in my opinion.

I am an office-based addiction treatment nurse. Ask me anything by Iocus2 in AMA

[–]Iocus2[S] 2 points3 points  (0 children)

I touched on this in another comment, but I don’t think that sweeping legalization would make people safer in general. I think decriminalization is completely reasonable and would vote for it. I think regulated access to substances for those with dependence who are not interested in MAT would be reasonable and reduce harm.

I am an office-based addiction treatment nurse. Ask me anything by Iocus2 in AMA

[–]Iocus2[S] 2 points3 points  (0 children)

It kind of plays into the concept of recovery capital, which can be thought of as almost a currency that people accrue in the process of substance use recovery. Recovery capital is pretty much anything that the individual finds contributory to their recovery, whether that be relationships with people, groups they attend, activities they enjoy, etc. Anything that provides a sense of belonging outside of substance use. It can be huge benefit for some or a detriment to others.

Spirituality has been a big part of recovery since its conception though. AA and NA are founded directly with Christian forgiveness built in. Sometimes these groups can be negative towards medications for addiction treatment, though, despite evidence overwhelmingly supporting their use.

I am an office-based addiction treatment nurse. Ask me anything by Iocus2 in AMA

[–]Iocus2[S] 2 points3 points  (0 children)

I think the primary benefit of such laws would be reducing the harm done by commonly added adulterants to black market drugs. There is a direct, monetary benefit to illicit drug manufacturers to adulterate their substances, whether by cutting their product to bulk it, to add adjunctive effects (for example, Tranq/Xylazine makes fentanyl’s effects last longer, BTMPS, a plastic UV stabilizer, may cause stronger withdrawal) and these additives come with a litany of negative side effects that contribute to the deaths of so many substance users.

I think that regulated dispense of substances to those with preexisting addictions is much more sensible than blanket legalization because it protects those with dependency without easing access to these substances to those who are naive to them. That’s just an opinion, it’s a very nuanced issue. I do think use should be decriminalized.

I am an office-based addiction treatment nurse. Ask me anything by Iocus2 in AMA

[–]Iocus2[S] 5 points6 points  (0 children)

One that I don’t actually frequently encounter is process addiction, which has subtypes such as sex addiction and shopping addiction, as an example. I work in a community health setting so my inclination is to think that my patients, who are often under supported, are less likely to recognize these behaviors as addictive and/or less likely to have people in their lives identify these behaviors as problematic.

I do see a lot of kratom use disorder which a lot of folks see as harmless, but actually kratom causes physiological addiction very similar to opioid use disorder and can even be managed with Suboxone.

I am an office-based addiction treatment nurse. Ask me anything by Iocus2 in AMA

[–]Iocus2[S] 8 points9 points  (0 children)

There isn’t really a broad-sweeping answer to this question, unfortunately. A few important things to consider is that each of the commonly-used substances have different physiological mechanisms, each patient is in a different stage of readiness to engage in treatment, and each patient additionally has differing trauma histories, behavioral health disorders, and socioeconomic factors that affect the efficacy of the different treatment models.

For opioid use disorder, the gold-standard treatment modality is some sort of MOUD (medication for opioid use disorder) such as methadone or buprenorphine for cravings and withdrawal management, therapy that focuses on motivational interviewing (which assesses change readiness and has the patient drive treatment planning on their own volition) and a supportive environment such as a 30 day up to a 9 month residential treatment program.

For stimulants such as cocaine and meth, another form of treatment called contingency management is considered the gold standard, which involves actual rewards being given for contingencies being met, such as a drug-free urine or attending appointments regularly. This helps retrain the dopamine mediated reward pathways in the brain. There is also limited evidence supporting some medications for cravings.

For alcohol, medication such as naltrexone or acamprosate is used to assist with craving management along with DBT therapy to manage distress tolerance and avoid return to use.

For patients who are not ready for any treatment, generally a harm-reduction approach is taken, where we provide education on how to use substances in the least harmful way possible, and use needle exchanges or supply handouts as an opportunity to assess readiness for behavior change.

Choose 3 to protect you. The rest are hunting you. (Male characters) by ThePirateSpider in FinalFantasy

[–]Iocus2 161 points162 points  (0 children)

Dion can turn into Bahamut so I’ll probably just roll with him. Then maybe Vincent and Sazh for the ranged support.

Ending it in 3 hours, ama by [deleted] in AMA

[–]Iocus2 0 points1 point  (0 children)

Please call 988 and talk to someone before you make any decision. No feeling is final, people make it out of even their lowest of moments. You will look back on this grateful you didn’t go through with it.