Best of the week from Choose Help Opioids Increase Depression & Depression Increases Opioid Misuse Learn how opioids can lead to depression, how depression worsens pain and what to do when you have both pain and depression. Depression and pain go hand in hand – pain and disability can cause or worsen depression and depression worsens pain and disability… what a mess! And to further complicate matters, though depression worsens pain perception and analgesic need, people with depression also get less pain relief from opioid medications.1 Fortunately, it's not all doom and gloom - here’s the good news: If depression ups your pain, treating the depression will almost certainly reduce pain and disability and improve your quality of life. If you’re on high-dose opioids and suffer with pain and depression, you might find that reducing your daily dose improves both pain and mood. If you have an addiction problem, dealing with your substance misuse generally eases pain and depression. Read on to learn more about how pain and depression interact and about how to deal with this tough co-morbid situation. Co-Occurring Depression and Addiction Longer Opioid Use = Increased Depression An argument for time-limited opioid use. In one major study of 50,000 military personal, researchers found that compared to people who used opioids for between 1 and 89 days:2 People who used for 180 days or longer were 53% more likely to develop a first or new incidence of depression. People who used for between 90 and 180 days were 25% more likely to develop a first or new incidence of depression.  Also, people who used higher doses experienced more depression than people maintained on lower doses. Depression Ups Opioid Misuse Risk People with depression – even those with no history of substance abuse, are far more likely to take opioids for reasons beyond pain control than people from the general population. In one study, researchers from Western Illinois University found that people with severe depression were 2.4 times more likely to use opioids for reasons other than pain control and 2.89 times more likely to use more opioids than prescribed than people without depression.3 A huge Kaiser Permanente study which looked at the medical records of tens of thousands found that pain patients with a history of depression were three times more likely to receive a prescription for opioids than pain patients without a history of depression.4 Why Are Opioids and Depression So Interlinked? Opioids systems affect mood – and when things go wrong, this can cause depression. Opioids can produce intense pleasure (highs). Long term opioid use may disrupt reward pathways in the brain, making it harder to feel pleasure from normal everyday events like a good meal or the company of friends.  Opioid receptors are located in areas of the brain that regulate emotion and cognition and opioids play a role in mood and anxiety regulation – for example, the brain releases endogenous opioids to self-soothe social rejection.5 So when opioid systems get dysregulated through over-stimulation, this affects emotional and stress systems as well. 6 Chronic opioid use can lead to decreased testosterone, which can cause depression. People experiencing depressive symptoms are more likely to use opioids to self medicate psychological symptoms. This type of misuse ups addiction risks. Depression can worsen the perception of pain, causing a need for greater analgesia and higher opioid doses. Higher opioid doses increase addiction risks and can exacerbate depression. People with depression often have pain that doesn’t respond well to standard pain interventions. This leads to increased medication use - and increased addiction risks. People misusing opioids are less compliant on depression treatment directives.  Opioid abuse may lead to life-consequences that worsen depression.7 Worryingly, opioids increase the lethality of suicide attempts among people with psychiatric disorders. Guidelines for Using Opioids when Depressed According to the Canadian Guidelines for the Safe and Effective Use of Opioids for Chronic Non Cancer Pain, people with depression should:1 Titrate their opioid dose more slowly at the start of treatment. If you are working with a psychiatrist or psychologist, ask your prescribing physician to consult with this professional on the use, benefits and risks of opioid therapy for your situation. To prevent serious problems (like addiction) ask for frequent doing intervals and other conservative measures that prevent misuse. Monitor your mood and consider how opioids affect your functioning. Stop opioid therapy unless the medications work well – providing more than 30% pain reduction.  Consider Lower Doses If you take a high daily opioid dose, you may actually get better pain relief and experience less depression by slowly tapering down to a lower dose.8 In one study, doctors in California examined a group of patients who were on a very high daily opioid dose (300 mg per day or higher of morphine equivalent). At the start of the study, the average depression score among the patients was 13.5 on the Patient Health Questionairere-9; a score which indicates major depression. All patients agreed to a very gradual program of dose reduction, reducing at rates from 4% to 16% per 10 days, to a final dosage of 30% the starting dosage. After achieving this final reduced dosage, average patient depression scores dropped to 9.5. Study patients also reported less pain on the lower dose and less pain interference in quality of life. The results indicate that for some people, chronic high opioid doses may actually worsen pain and depression, rather than alleviate suffering.   Consider Addiction Treatment Though lower doses may reduce depression and pain, once addicted, you probably can't control your daily usage. Once addicted, to manage depression and pain, you likely need addiction treatment. Though the thought of facing withdrawal symptoms, un-medicated pain and depression all at once seems scary and overwhelming, It’s probably not as bad as you think, in fact, most people find that pain and depression get better once they address addiction issues:7 On average, addiction treatment causes reduced depression, particularly maintenance treatment with methadone or Suboxone. Results are further improved by supplementing addiction treatment with depression-focused cognitive behavioral therapy. In fact, though reducing opioid use alone can reduce depression, untreated depression ups relapse risks, so it’s important to address both the addiction and the mood disorder at the same time.9 Take Home Messages Since longer opioid use and higher doses are associated with greater depression, be cautious with using opioids for persistent pain. If you must use opioids, make sure to supplement medication with active forms of pain management, such as exercise, relaxation exercises, mindfulness and acceptance techniques.  People with chronic pain and depression commonly use opioids to self-medicate depressive symptoms. However, since depression worsens pain and reduces pain intervention effectiveness, it’s very important to treat the depression and pain at the same time. Simply relying on pain medication to relieve the depression isn’t a good strategy; in fact it’s likely to worsen depression and pain. If you find that pain gets worse, even with increasing opioid doses, you should consider whether depression affects your pain management. People on high opioid doses may experience less pain and depression by reducing daily dosages. Opiate addicted people will generally experience less depression and less pain by getting addiction treatment, especially MAT. Read in browser »   Recent featured articles: Discover the Value in Adding Spiritual Practices to Recovery When Someone You Love Uses Heroin - 6 Ways to Support Positive Change The Neurological Model for Food Addiction – How the Overconsumption of Food Causes Addiction-Like Changes to the Brain Working it Through: A Closer Look at The 12 Steps of AA – Part 2 of 2 Working it Through: A Closer Look at The 12 Steps of AA – Part 1 of 2 And, as always, thank you for reading! All the best to you and yours, Martin Schoel, founder of Choose Help P.S. If you’d like to dive into the conversation, make sure to follow us on Twitter or like us on Facebook (40K+ people do). FORWARD THIS MESSAGE TO A LOVED ONE Do you or someone you know need rehab? Click or 'Tap' to speak with us now: (877) 333-5266 Facebook Twitter Google Plus Pinterest

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STAY CONNECTED           Rockers In Recovery Going Back To Our Roots "With Help From Our Friends"  RockersInRecovery.Org , MusicianStream.Com and JustBelieveRadio.com have joined forces to bring live streaming of all Future RIR Festivals/Concerts. See Upcoming Events Click Here > http://goo.gl/A6NAtA Upcoming Rockers In Recovery  Addiction Awareness & Prevention Through Rock-N-Roll Events Will Be Streaming Live at http://musicianstream.com/rockersinrecovery/  Please Get To know Rockers In Recovery Unplugged Addiction Network: They also give back by support community events across the united states, through our mission of Addiction Prevention & Awareness Through Rock-N-Roll. These organizations are true givers to our communities. Please get to know them all.    Revive Detox Center - You can reach Beth Iris Beth Iris Lugo-Hernandez or Marisa at: 772-203-8550 or click here > http://goo.gl/9uEpt6 Just Believe Recovery Center - Get to know Frank Marino click linkhttp://goo.gl/NuYq9o or by calling 561-729-4318 The Florida Association of Recovery Residences (FARR) Get to know John Lehman click link http://goo.gl/kiVxm2 or by calling 561-288-1721 Above All Recovery Center - Get To Know Steven Schwartz Click Link >http://goo.gl/Jv7lxt or by calling 954-825-9242 Destination Hope - Get To Know Candice Conway Click Link >http://goo.gl/0MwvNC or by calling 954-200-9480 The Shores Treatment and Recovery - Get To Know Lyle Fried Click Link >http://goo.gl/gR6qbB or by calling 772-332-8711 All About Recovery - Get To Know Stephanie Humphries Click Link >http://goo.gl/vCTCPN or by calling 561-502-7874 Fellowship Living - Get To know Rick & Susan Riccardi Click Link >http://goo.gl/BHUDQk or by calling (954) 249-5589 Marchman Act Attorney Robert Gluck - Learn more on how you can help a spouse, family member, loved one or friend by calling Robert Gluck your Marchman Act Attorney at 877-GLUCK-LAW. ChemPath Diagnostics - Get to know Larry Waldman by calling 305-733-3811 Director of Addiction Education - John Giordano,  Doctor Of Human Letters, CCJS, MAC, CAP: John Giordano 30 years sober  is an expert in the treatment of addiction and the founder of The National Institute For Holistic Addiction Studies (NIFHAS). He is the author of "Proven Holistic Treatment For Addiction & Chronic Relapse," and his most recent book is the acclaimed: "How To Beat Your Addictions And live A Quality Life." Mr. Giordano has contributed to over sixty-five research papers with his close friend and colleague Dr. Kenneth Blum, discoverer of the addiction gene. Their papers have been published in peer-reviewed medical and scientific journals such as: Medical Hypotheses, BMC-Cases Journal, The IIOAB Journal, Journal of Psychiatry and Neuroscience, BMC- Medical Case Reports, Medical Hypothesis, Journal of Post Graduate Medicine, Neurophramacology, Psychiatry and Neuroscience Journal, and American Journal of Psychiatry. In his pursuit of organizing and developing new holistic treatments for addiction, Mr. Giordano founded the National Institute for Holistic Addiction Studies (NIFHAS); a think-tank and research facility where world-renown scientists and addiction professionals conduct clinical studies in developing evidence-based new and alternative treatments for addiction.   Learn More   A U.S. military veteran commits suicide every 65 minutes  Dear Colleagues: As you know RIR and The Substance Abuse and Mental Health Services Administration (SAMHSA) have partnered on many great prevention and awareness projects, this new project is very important to our veterans that are suffering. A U.S. military veteran commits suicide every 65 minutes, on average, according to a recent study from the Department of Veterans Affairs. Please share the following information everywhere your organization can, so our veterans know there is help. Rockers in Recovery & SAMHSA has partnered with the Department of Veterans Affairs so that their National Suicide Prevention Lifeline could act as the single point of entry to help meet the special needs of veterans and service members in crisis. Callers to SAMHSA's Lifeline (1-800-273-TALK) can press "1" to be connected to the VA's Veterans Crisis Line in Canandaigua, NY. Visit Here For Help http://goo.gl/cseHpj  As part of this new project and prevention week, RIR will be holding a 3 day music & prevention concert in New Jersey on Memorial Day Weekend. Please Join Us:   2015 HopeFest Prevention of Suicide - Friday, May 22 Promotion of Mental Health & Wellness - Saturday, May 23 Prevention & Awareness Through Rock-N-Roll - Sunday, May 24 If you would like to help us with support for this event see more  Thank you all for your support in this project of hope and love. Sincerely, Lori Sullivan President & Founder 954-826-5968 Rockers In Recovery 9301 NE 2nd Ave. Miami Shores, Florida. 33138    Rock-N-Roll Hall Of Fame Member Using Music To Heal  My name is Lou Esposito...I know, Hi Lou... If you ask the question, what has RIR meant to me ?   It all started back in 2012 when I got invited to play at the 2nd annualRockers In Recovery Music Festival I saw lots of people, lots of very friendly people. I did sets on Friday, andSaturday. and everything went great. What I found that really impressed me was the honesty, and willingness of the people to talk about their journey down a dark road, and their struggle back again. There were lots of smiling, and laughing people, dancing in the grass, singing, and just having a wonderful time at a clean and sober event.I was floored at what I had witnessed.   The concept of a musical event for people to enjoy, along with speakers to educate the community and addiction professionals onsite for people who might want to get help, was all positive. I came home from that event on a natural high. As RIR musical director we have now years later gone on to produce 20 addiction prevention and awareness concerts/festivals across the united states. Read More .     Since 2011 - Please Get To Know The RIR All-Star Band.  RIR Musical Director and Rock Hall Member Lou Esposito, will be heading out in May with the RIR All-Stars for a couple of months of hard hittin' rock and roll. Lou and the rockers will be bringing Addiction Awareness & Prevention Through Rock -N- Roll to several cities across the United States. Lou will be announcing some very special guests, that will be joining up with the band on the road to do a few songs and help promote awareness. Their message is simple, there is help for drug addiction and mental heath issues. As RIR musical director we have now years later gone on to produce 20 addiction prevention and awareness concerts/festivals across the united states. Read More    The Story, the Music, the Therapy, the Impact:  Since 2012 "Rockers In Recovery Unplugged, does community awareness and prevention meet & greets all over the United States. RIR Unplugged also visits schools,sober events,conferences,sober houses,addiction detox centers, drug  and alcohol treatment centers all over the United States. RIR Unplugged, select members of the Rockers In Recovery band come to share their message of hope, and play an unplugged set of songs geared towards recovery, education, and fun.". Learn More.  Please Get To Know Rockers In Recovery Radio and Productions: Since 2008 Rockers In Recovery Radio and Productions is dedicated to producing addiction recovery news, interviews, meet & greet events, concerts and festivals taking place within the clean and sober community. Through Rockers In Recovery Radio and Productions Inc. we offer different platforms to carry the message of hope in an exciting new way. RIR Unplugged Meet & Greet Events, RIR Concerts,RIR Festivals, RIR magazine (in print and online), RIR Addiction Talk Radio,RIR Live Concert and Event Streaming, along with RIR Social Media makes it easy to reach hundreds of thousands of people globally with just a click of a mouse. .Find Out More.   UPCOMING EVENTS  National Prevention Week 2015: The Voice of One, the Power of All STAY CONNECTED           Rockers In Recovery Network 954.826.5968 What We Can't Do Alone, We Can Do Together.  Addiction Awareness & Prevention Through Rock-N-Roll

THE ADDICT'S MOM APRIL / MAY SCHOLARSHIPS 

TREATMENT CENTERS WILL DETERMINE WHO IS ELIGIBLE FOR SCHOLARSHIPS

**TAM DOES NOT DETERMINE ELIGIBILITY**

Applications will be forwarded to centers as soon as we receive them. Treatment Centers reserve the right to immediately admit an applicant if it is deemed necessary

The Addict’s Mom April/ May Scholarships Provided By:

1. New Beginning Ministry

Beach Lake, Pennsylvania

www.newbeginningmin.org

Scholarship Outline:

One (1) Month Inpatient Treatment Male / Female

12 Step Program Residential / Addiction/ 

Recovery Program 18 and over

No Detox included Non Medical – Faith Based Program

2. Harbor House Centers 

Lighthouse Point, FL

www.harborrecoverycenters.com

Scholarship Outline:

Outpatient Treatment and Sober Living 

Length based on Individual needs

Three (3) IOP sessions per week

Center provides program is designed for average 6 month to 1 year stay

Practical applications / life copying skills

- provide help with food stamps

- provide transportation to / from sober living to IOP

Application for TAM Treatment Scholarships

To apply for Scholarships, please complete the requirements below:

A family member of the client must be a member of both

www.theaddictsmom.com website

and

The Addict’s Mom Main Facebook group www.facebook/groups/theaddictsmom

TAM member please provide:

TAM Member Contact Information Date of application Member’s First and last Name Phone number Email address

Minimum of one paragraph that includes:

Name and Age of client/addicted person, Male or female Drug of Choice/ how much used daily, age of first drug use

Other Helpful Information if applicable:

Incarceration Previous Treatment Formal Diagnosis DSM Diagnosis if any

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APPLICANTS MAY APPLY FOR BOTH SCHOLARSHIPS:

To apply for the Treatment Scholarship at New Beginning Ministry, Inc., please send your letter to: TAMNewBeginningScholarship@gmail.com

To apply for the Treatment Scholarship at Harbor Recovery Center, please send your letter to:TAMHarborRecoveryScholarship@gmail.com

******************************************************************

ALL EMAILS MUST BE RECEIVED BY May 15, 2015

If you have any questions about our scholarships, please email katrinoleary@gmail.com

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Please do not contact our Scholarship Sponsors directly. Only requests submitted to the TAM email addresses will be considered.

TAM Disclaimer

As you consider our recommendation to any of these facilities or institutions listed given to you, TAM strongly urges you to do further research about each facility, consider consulting your family healthcare provider for input and advice.

We would also recommend that you review the SAHMSA Substance Abuse and Mental Health Services Administration (SAMHSA http://www.samhsa.gov/) website- see if the facility is listed there. Also find the licensing agency in the State the facility is located. In Florida, the State Agency that licenses Substance abuse facilities is the Department of Children & Families. (http://www.myflfamilies.com/service-programs/substance-abuse). If the facility is in another state, ask them who licenses them and check with that agency about whether there have been any complaints.

TAM does not endorse any of the specific programs. The Addict’s Mom assumes no liability or responsibility for the claims made by the service providers or institutions.

We wish you and your families the best of health and recovery!

****TAM will offer future scholarship opportunities*****

Visit The Addict's Mom at: http://addictsmom.com/?xg_source=msg_mes_network