specializing in addiction recovery
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909 Broad St. Durham, NC 27701
(919) 416-4800
CHANGESBYCHOICE.COM
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AVAILABLE TREATMENT COMPONENTS INCLUDE: Craving reduction
Changes By Choice is a collaborative of independent medical and mental health practitioners providing evidence-based treatment for substance abuse, addiction, and other compulsive behaviors. Our approach is grounded in motivational enhancement theory, seeing motivation for change as an internal state that can be positively influenced by a respectful and supportive therapeutic relationship. Treatment goals and components are negotiated and individually tailored. Clients can choose from a range of options according to their preferences and the nature of their difficulties. Medications such as Suboxone (buprenorphine) for the treatment of opiate dependence; Campral (acamprosate), ReVia (naltrexone) and Antabuse (disulfiram) for alcohol dependence; and Chantrix (varenicline tartrate) for nicotine dependence may be combined with counseling to facilitate detoxification, reduce craving, and ease withdrawal, enabling clients to better manage stress and make the life changes needed to support recovery. Counseling is provided in individual, couples/family, and group formats. Formal group therapy helps clients decrease feelings of shame and isolation, learn effective coping skills, and find hope in the examples and encouragement of others. We offer a wide range of evidence-based therapeutic approaches to equip you with the information, skills, and support you can use to make and maintain the changes you seek. Together with your primary counselor and/or physician, you will develop an individual plan incorporating your preferences and the professional’s recommendations based on his or her skilled assessment of your particular needs.
Outpatient detoxification
Buprenorphine/Naloxo ne (Suboxone, Zubsolv, Bunavail) for dependence on pain pills & other opiates Mindfulness meditation and other stress reduction techniques
Individual, couples and family counseling
Cognitive-Behavioral Therapy
Trauma Reprocessing Therapy (EMDR)
Twelve-Step Facilitation
changesbychoice.com
OPIOID ADDICTION: “LET’S TALK ABOUT IT.” Learn how faith communities can extend COMPASSION & SUPPORT
to people in recovery and to their families
It’s like killing yourself
Don’t Drink & Drive. GET HELP TODAY.
909 Broad Street • Durham, NC 27701 | PH: (919)416-4800 | changesbychoice.com
Feeling Down?
Don’t face opioid addiction alone. Get help today. changesbychoice.com
SAMHSA PUBLISHES BEST PRACTICES ON MEDICATION-ASSISTED TREATMENT FOR OPIOID USE DISORDER Best P actices
Treatment Improvement Protocol 63, “Medications for Opioid Use Disorder,”
reviews the use of methadone, naltrexone, and
buprenorphine, the three FDA-approved medications to treat opioid use disorders.
Data indicate that OUD-treating medications are both cost effective and cost beneficial
The Substance Abuse and Mental Health Services Administration has published new guidance to help health care professionals better understand medications that can be used to treat Americans with opioid use disorder (OUD). Treatment Improvement Protocol (TIP) 63, “Medications for Opioid Use Disorder,” reviews the use of methadone, naltrexone, and buprenorphine, the three FDA-approved medications to treat opioid use disorders. TIP 63 provides guidance for health care professionals and addiction treatment providers on how to appropriately prescribe these medications and effectively support patients using these medications for OUD treatment. “We know that people can and do recover from opioid use disorders when they receive appropriate treatment, and medication-assisted treatment’s success in treating opioid use disorders is well documented,” said Dr. Elinore F. McCance-Katz, assistant secretary for Mental Health and Substance Use. “TIP 63 emphasizes that increasing access to medications to treat opioid use disorder will help more people recover, enabling them to improve their health, living full and productive lives.” TIP 63 is part of SAMHSA’s larger response to the opioid crisis. More access to treatment with OUD medications is critical to closing the gap between treatment need and treatment availability and an important public health strategy. Data indicate that OUD-treating medications are both cost effective and cost beneficial.
CHANGES BY CHOICE 909 Broad Seet Dham, NC 27701 919-416-4800 changesbychce.c
Dead people don’t get into recovery
D. Waters Is Suboxone a Reasonable Treatment Option for Opioid Addicts? After twenty years of providing substance abuse treatment I can tell you that the ultimate goal of anyone battling an addiction is total abstinence. Every addict and alcoholic eventually figures out they can not control their usage, and moderation is unrealistic. Learning to live life on life’s terms is part of the process of learning to live abstinent. Self-help programs like Alcoholics Anonymous(AA) and Narcotics Anonymous(NA) do a great job of helping people understand their addiction, themselves, and effective solutions for coping with their disease. Dead people don’t get into recovery Opioid addicts are not terribly different from any other addict or alcoholic, except the risk of death by accidental overdose is huge. People are dying in droves from opioid overdose. The current heroin epidemic is even more dangerous than the pain killer epidemic it replaced. Relapse rates are tremendous. Unfortunately, it may take years before an individual addict is ready to give the 12-Step AA/NA
I’ve truly never seen anything work better, and when it works it’s a beautiful thing.
process the thorough try it requires to be effective. Therefore, Suboxone is a terrific option for chronic relapsers. You can’t generally get high from it, unless you haven’t used in awhile, or never used in the first place. You can’t overdose on it from use or abuse, and any other opioid you take while it’s in your system will be nullified and wasted.
Not the solution, but maybe a good step forward Suboxone is not the solution, but in many cases it’s better than nothing, and a good response for chronic relapsers who are risking death from overdose. At least the addict is getting some exposure to treatment which is more likely to lead to recovery in the long run. Suboxone buys people time and keeps them alive. There are quite a few people who’s funerals I’ve attended that I wish had gotten on Suboxone. You can’t treat the dead.
The Subs knock down the monster cravings almost completely, and people don’t go through the nasty withdrawal that’s so painful. Once dysfunctional people who couldn’t hold a job, or were constantly on the obsessive hunt for the next fix suddenly become much more functional, and the addiction looks like it’s in remission. They can work consistently, they stop chasing the drugs, they have more money and can care for themselves and their families, and their addiction doesn’t seem to be ruling their lives. It seems like magic! Very few people actually wean off Suboxone successfully Suboxone users often wrongly think they’re cured because they look and feel more functional. Then they think all they have to do now is wean down, or taper off the medication, which is what the clinic doctors help them manage over a number of months to years. The problem is they’ve done nothing about the underlying addiction and all the addictive thinking and coping that go along with it that drive the addiction from within. They haven’t developed any social support, or learned anything about themselves and their disease. We like to say that using, or putting some chemical into the body, is only a symptom of the underlying disease. Abusing substances is not the actual disease—just a symptom. As soon as they stop using the Subs the addiction is still there and ready to start expressing itself all over again through the many painful ways it does. Chemically addicted people cope with life stressors with chemicals—that is, unless they make some fairly significant changes. Suboxone changes nothing in the end. Suboxone changes nothing A combination of Suboxone treatment coupled with AA/NA (with Sponsor and Step work) is a great thing. At Crossroads Counseling we require anyone with a substance abuse issue
to attend AA/NA, obtain a Sponsor, and work the 12-steps. If they don’t we won’t sign-off on their program. Most Suboxone clinics require their participants to attend at least one counseling meeting a month. Unfortunately, this is almost completely useless unless the individual engages in a personal program of recovery that addresses not only the biological issues, but the social, psychological, and spiritual issues related to the disease, as well.
changesbychoice.com
SAY NO
DON’T DRUG YOURSELF DOWN Our approach is grounded in motivational enhancement theory, seeing motivation for change as an internal state that can be positively influenced by a respectful and supportive therapeutic relationship.
909 Broad Street Durham, NC 27701 919-416-4800
changesbychoice.com
While in REBUILDING
YOUR RELATIONSHIP
from Recovery
Addiction
909 Broad Street • Durham, NC 27701 | PH: (919)416-4800 | changesbychoice.com
THE FAMILY NEEDS TO
IN ONE’S RECOVERY FROM ADDICTION
changesbychoice.com
THE ROAD TO RECOVERY IS HARD ENOUGH Changes By Choice is a collaborative of independent medical and mental health practitioners providing evidence-based treatment for substance abuse, addiction, and other compulsive behaviors.
changesbychoice.com
I N AN EFFORT to encourage new treatments for opioid addiction, the Food and Drug Administration plans to begin permitting pharmaceutical companies to sell medications that help temper cravings, even if they don’t fully stop addiction. The change is part of a wider effort to expand access to so-called medication-assisted treatment, or MAT. The agency will issue draft guidelines in the next few weeks. A senior agency official provided details of the proposal to The New York Times. the agency said it would soon publish two guidances, recommendations for drugmakers, on the issue.
The new approach was signaled Saturday by the health and human services secretary, Alex M. Azar II, in remarks to the National Governors Association. Mr. Azar said the agency intended “to correct a misconception that patients must achieve total abstinence in order for MAT to be considered effective.” While the Trump administration has generally supported medication-assisted treatment, Mr. Azar’s predecessor, Tom Price, was not completely on board with it. Mr. Price caused an uproar among treatment experts when he dismissed some medications that reduce cravings through synthetic opioids last spring as substituting one opioid for another. He subsequently walked back those comments, saying officials should be open to a broad range of treatment options. Mr. Azar, who took office late last month, said he would work to reduce the stigma associated with addiction and addiction therapy, and would not treat it as a moral failing. The opioid epidemic is considered the most unrelenting drug crisis in United States history. In 2016, roughly 64,000 people were killed by drug overdoses, including from prescription opioid painkillers and heroin. to correct a misconception that patients must achieve total abstinence in order for MAT to be considered effective. Noting federal data showing that only one-third of specialty substance abuse treatment programs offer medication-assisted treatment, Mr. Azar said, “We want to raise that number — in fact, it will be nigh impossible to turn the tide on this epidemic without doing so.” Mr. Azar’s comments echo those of the F.D.A. chief, Dr. Scott Gottlieb, who has made battling opioid abuse a priority for his agency. Dr. Gottlieb has moved to reduce opioid prescriptions by doctors and dentists and to promote more medication- assisted treatment, defined as drugs used to stabilize brain chemistry, reduce or block the euphoric effects of opioids, relieve physiological cravings, and normalize body functions. The F.D.A. has approved three drugs for opioid treatment — buprenorphine (often known by the brand name Suboxone), methadone and naltrexone (known by the brand name Vivitrol) — and says they are safe and effective combined with counseling and other support. But the agency said it would soon publish two guidances, recommendations for drugmakers, on the issue.
& ADDICTION
Sometimes loneliness can lead to addiction. Other times it can result from it. In either case
it’s a slippery slope and dangerous relationship where one feeds the other if you’re not careful.
CHANGES BY CHOICE 909 Broad Street Durham, NC 27701 919-416-4800 changesbychoice.com
Bring your self to life.
It’s time to discover a new form of yourself a new
path for yourself one that reaches well past the
impulse of the moment. It’s time to wake up in a
world of self-made character of self-determination.
909 Broad Street • Durham, NC 27701 | (919)416-4800 | changesbychoice.com
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