Outpatient Therapy ???

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I start outpatient therapy tomorrow morning.  Since it's the weekend I cant call about questions.  I looked on their web page a bit closer on FAQ's.  There is a question that asked if they support 12 step programs. This was the answer:  

Yes. The 12-Step Model is an important component of our comprehensive chemical dependency treatment programming, and we encourage all clients to participate in AA/NA meetings both during their treatment experience and as an essential part of their lifelong aftercare plan.

My question is because it says "encourage" I'm thinking it's not necessary.  Any thoughts on how to read that.  Also, any thoughts on what anyone has gone through during outpatient therapy.  I've only done inpatiend rehab back in 2002 so I don't know what to expect from outpatient therapy.  I'm sure it all difers but curious as to what others think.

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  • Posted

    It depends on who is doing the therapy and what it involves. Can you provide a name so we can Google it, don't provide a link or it wiil get modded, or at least put the equivalent of google dot com.

    If you are an oupatient, have you had a detox or any medical treatment, you may have previously said, but I struggle to remember at what stage everybody is.

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    • Posted

      I have an appointent in 2 hours.  I've done all the googling possible but I'll let you know how I make out.  

      Long story short. I went to acohol recovery for help in quitting drinking. They told me the only stipulation is that I don't drink.  I said admit me, lol.  At that point my life was out of control.  I went to rehab in 2002.  Came back and did outpatient in another area. I did the AA and counseling and group sessions.  I stuck with AA for about a month until I told my sponsor I didn't understand their concepts.  She told me I need to go out and hit rock bottom and come back when I'm ready.  I cried in front of a bar for about an hour.  I finally pulled it together and thought there has to be other ways than AA!  I stayed sober for 11 years.

      In 2013 curiousity got the best of me.  I wondered could I drink socially.  I did for about a year.  But, for the past two years it's been creeping up on me.  It turned into an every day habit.  It has NOT effected my family or friends this time.  It's effecting my job and my health.  In the past year I've tried to quit several times.  The longest being a month.  The last being 2 weeks.  Since then I don't drink every day but at least 4 times a week.  I think I have it pin pointed that every time I cut back on the meds OR have a stressful time in life (which now there are MANY) no exxageration - those are the times I relapse.  If I could get 3 months of "less" stress I think I could do it.  When I talk stress it's mostly my health and really wanting to just numb pain.  I tried AA 6 times in 3 different locations and it's just not for me.

      Getting ready for appt.  WIll check back later.  Thanks for the info! 

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    • Posted

      That's where I find Campral useful, when I have a massive row with the wife (insert what sets you off on drinking), I would always head down the pub for a couple of hours to calm down. Plus if she was up for round two when I got back, she knew it would be pointless, as I just wouldn't care at that stage.

      Now when that sort of thing happens, I don't get stressed much by it and the reaction of dealing wiht it by going to the pub is hardly there at all, and fairly easy to ignore.

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    • Posted

      Partly yes. Naltrexone is meant to help control your drinking, it can lead to abstinence or just allow you to drink socially. Most seem to use it to drink socially.

      Campral is for abstinence and helps stop the cravings. But you do not suffer any side effects if you relapse one night and go on a bender, you just keep taking it and carry on as you were.

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  • Posted

    Hi Kelly I have been to various outpaitent programs.  They are like the inpatient programs...just you get to leave and go home.

    ​Alot of talk about triggers and how to combat them.  Usually personal therapy will be assigned to you...The one I went to had a schedule of sessions for the day..a lunch break...a meeting time for your therapist...and I had a psychiatrist there that evaluated my medications.

    ​Usually about a week.  AND YES...they enourage AA...That means they will constantly talk about AA and you will constantly be asked about your thoughts on AA....and given statistics on how many people stay sober without it...(more than those that stay sober alone). 

    ​Just stick to your guns on your opinions and keep pushing back...unless they say something that catches your interest. 

    You ARE in a recovery group...so you can share that with them.   And the fact that most of your nights after work will be filled up with this group...you may have no time for anything else...cause you also don't want to overwhelm yourself to the  point where it is something that is stressing you out instead of helping you.

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    • Posted

      I guess I'll find out more tomorrow morning.  Ha!  Then I have a dentist appointment.  Actually since they're making me a new denture I'll have appointments for about a week.  Let's how sane I stay.  

      I think when you have to commit to NOT drinking when you're going to inpatient counseling.  Am I correct?  I'm not sure how strong I am to quit.  That sounds terrible but part of me knows I have to quit and another part don't care.  

      I'll check in tomorrow after both of my appointments.  

      Hope you are doing good Missy!!

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    • Posted

      I went to rehab in 2002. I went to AA for one month. Realized it was not for me. Stayed sober 11 years. There years I started again out of curiosity. This time I've been trying to quit on my own with periods of 2 weeks of sobriety here and there and at one point had a month. Have tried AA again for several weeks and it's just not for me. Was a bit curious on outpatient since I've only went through it in 2002 after rehab. At that point I did not turn down the AA meetings. Now I'm convinced it's just not my way.
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    • Posted

      When I went to alcohol rehab in 2002 they offered outpatient but said I couldn't drink. I immediately said put me in rehab lol. At that point my drinking was out of control and effecting other people. This time it's more like a habit I can't break.
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    • Posted

      Kelly you may have seen this before, but if you haven't, it might be right up your alley. We've had some vets join the message boards for TSM and they say this is how VA Medical is prescribing Naltrexone for Alcohol Use Disorder right now, (with instructions to take the med an hour before drinking, so TSM in all but by name) so that could be a good resource for you if you decide it's an option you want to use in the future. 

      https://patient.info/health/sinclair-method-for-alcohol-use-disorder

      I'm using this method myself and it's been very helpful. I suppose you could get a supply that you could have on hand, or just wait to make an appointment should you find the need. If you can manage via straight abstinence, of course there are no meds involved and that's probably what you should do. If you try and relapse, try and relapse again and again, TSM has helped many to stop that cycle and get the upper hand.  About 40% decide to abstain completely after the craving is erased, others drink reasonably a few times a week to a few times a year, but the urge to drink destructively is simply removed by this method. There are other meds too, one way or the other, there's something for everyone that wants to get alch off their back.

      https://patient.info/health/sinclair-method-for-alcohol-use-disorder

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    • Posted

      I have read up on this. Actually today I spent more time with the details. I wonder if my family doctor would prescribe it. It doesn't seem to be overly popular in the US. I doubt they'll approve it in outpatient but yes I have thought about this. I want to look more into the side effects. I am EXTREMELY sensitive to medications of any sort. I also read if used for a long period of time it can cause liver damage. I suppose there are pros and cons to everything. My husband asked about this at our VA and they don't use it. Are you sober or still drinking?
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    • Posted

      yea the obvious commitment is to not drink. But if you show up and say you just aren't ready..I think that is important too.

      ​I think your ready..you made the commtiment.....wish you the best Kelly.

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    • Posted

      It's gaining steam, another has reported that Kaiser now uses this (again, not by name). On CThree Foundation's website there's a "Find a Physician" link that might help you locate a TSM doctor, the listings that have "Verified" at the top have been checked out by CThree to ensure they know how to prescribe per TSM protocol. I'm surprised your husband got the response that he did from the VA. 

      The dose used for TSM (50mg) hasn't caused any liver damage that I'm aware of, rather people that have elevated liver enzymes tend to improve as alcohol is far worse for your liver than 50mg of Naltrexone. There were reports of problems at 300mg, but TSM doesn't use those levels. 

      It's best to start at home with a reduced dose after a meal and a full glass of water, when you can hang around the house the next day (just in case). Many don't have any side effects at all, but it could be rather inconvenient if you were out and about when the side effects hit. That's par for starting most medications though.

      I'm still drinking, although I've cut back from about 84 drinks per week to 20 at just shy of 4 months in. It really didn't take any willpower on my part, I just started wanting less.

      Like I said, it's not the only way about things. RHGB uses Acamprosate and that does the trick for him, though you have to be dry for a week as I recall. Others use Baclofen, there are even other choices beyond that. 

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    • Posted

      'Like I said, it's not the only way about things. RHGB uses Acamprosate and that does the trick for him, though you have to be dry for a week as I recall. Others use Baclofen, there are even other choices beyond that.'

      That is often the way it is used, but it is not the most effective way. Because it is called an abstinence drug, people will not prescribe it until you have been abstinent for a few weeks.

      It take 5 days to get dosed up on it, that is, for your body to asorb and process the maximum amount needed for it to function. It does not react with any other medications or alcohol and is not really known to have any side effects.

      Therefore, the best time to start taking it is when you start a detox. Because a detox takes about 5 - 7 days and that way as your diazepam/Librium finishes and wears off, the Campral is up and running, leaving no gap to start craving for alcohol.

      It could even be used in different ways, if the medical industry would wake up and deal with alcohol dependency. There's no reason it couldn't be prescribed for people, for 6 - 12 months, to take time out from drinking, them their body and neuro functions recover and with counselling, maybe drink again after a year.

      It is a big fear and a big mountain to climb, to tell them they can never have another drink again in their life time and for that reason it will have  a high resistance to taking it. However if people were told, stop drinking for 12 months, they would be a lot more comfortable with that and if they got good counselling in the mean time it would really help.

      And by counselling, I don't mean talking to someone who has no idea about alcohol and is an ex heroin addict. I mean someone qualified that really understands alcohol dependency and what are the triggers. Anxiety. stress or the general buzz. They could point these out and try to find a solution where the person doesn't just slip back into the whole drink cycle.

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    • Posted

      On CThree Foundations the closest doctor to me is 3 hours away (possible longer).   The VA in our area is nothing to brag about.  My husband asked about this medication for a vetran friend struggling with alcohol.  But, his friend might have to ask in his area.  Is there another website I can find a doctor because I highly doubt my small country town doctor has heard of this although I am printing out info to take to my appoitment I have next month.  

      If I get the prescrption I'll check back and try to get more info from you.  

      Oh, I was taking Baclofen at night to help me sleep.  I have trouble with my spine and had those pills here.  I read that it helps with withdrawls so I decided to try it.  I have not used it during the day.  Is there another way Baclofen can be used?

      Good job on cutting  back so much.  I can see why "some people" are against this method.  But, I'd rather live.  Whether that's completely stopping or using "a miracle pill" as some would say to cut back drastically.  Thanks for the info!

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    • Posted

      Do you know how Baclofen is used? I did stumble across some info online and used that med to sleep.

      I mentioned that the closest CThree Foundation is 3 hours plus away.  I doubt they'll understand me at outpatient counsening but I have an appointment in 2 hours.  I'll check back.  I'm also going ask my family doctor about this but also like I said - I live in a small country town and they are not up on stuff like that like.  But, my doctor is very open minded.  I'll keep trying to find a place that'll take this seriously. 

      Thank you! 

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    • Posted

      Bacolfen is an anti craving drug. It is off label for alcohol use, which means although it has been approved for others uses, it hasn't been rubber stamped for alcohol. That does not mean that it can't be used for alcohol, but that is not seen as its mainstream use, therefore a doctor is unlikely to prescribe it for alcohol, or at least in the quantitys needed.

      It starts off at a low dose and this is continually increased to a high dose until it is seen to be working in the patient, they're then kept at this level for 8 weeks and then gradually tapered down to a lesser level.

      It is hard enough to get medication that has been rubber stamped for alcohol use, so you can imagine what it is like to get one that hasn't been rubber stamped for alcohol, even if it has been rubber stamped as a muscular relaxant.

      The issue is, although you may still get it, it will be nowehere near the quantity needed and Baclofen has been shown to be ineffective at low doses.

      There is the odd person here that has taken if, it is on label in France and is quite popular there.

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    • Posted

      Well, I have a full bottle and still two refills.  In the least, it helps me sleep when I need it.  If I'm drinking I do not take it because I don't sleep after drinking alcohol no matter what I take.  Thus, another great reason to quit! After reasearching and finding Baclofen I was glad I had it on hand.  It is useful in the evenings I'd feel cravings but have not had a drink.  I do tend to sleep better.  
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    • Posted

      I just found the meds that this outpatient uses.  I know some I'm on  or have been on.  What are your thoughts to these?  Addarall, Demerol, Fentanyl, Oxycontin, Xanax, Benzos, Dilaudid, Klonopin, Vicodin.  I know some of these are addictive.  Trying to avoid that.  I'm already on Klonopin.  Oxycontin makes me sick, Vicodin is nice but addicting - same with xanax or any other benzo's.  

      The ones I have not heard of before are Demerol, Fentanyl, and Dilaudid.  Wondering if they're addicting.  I don't have time to look them up now.

      Now I've got to leave for appt, lol. I'll check in on my phone to see if you responded beforehand on those few meds.

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    • Posted

      Baclofen is the ultimate anti alcohol drug but it's not licensed to be used in that way

      I used it last year,titrated up till I had no desire to drink but went down because I was worried about a new shipment arriving and lost the switch as they call it.Side effects can be severe when titrating up,I really didn't feel like myself and sleeping was a nightmare.I developed sleep apnoea and loads of other symptoms but after you have been on it a while symptoms subside

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    • Posted

      They appear to be a mixture of painkillers, muscle/nervous system relaxants and anxiety/panic attacks. Some of them are addictive and some of them, if not most of them, don't mix with alcohol.
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    • Posted

      You're quite welcome, Kelly! WRT doctors, I do know of some in NC and CA that aren't on the list. I can PM you the info if you're interested.

      The benzos will thwart TSM. If you need to use the opiates (Demerol, Fentanyl, Dilaudid - yes they are addticting) then you should stay away from Naltrexone. If you take opiates after Naltrexone, they will be rendered useless. If you take them before Naltrexone, you will go straight into withdrawal and what could very well be a life-threatening situation. Naltrexone (or Nalmefene) and opiates do not mix, at all. Naltrexone blocks the opioid receptors, that's why it's of value for TSM, as drinking releases endorphins that bind to and stimulate the opioid receptors. When you take Naltrexone before you drink, the endorphins can't get to your opioid receptors so your brain is denied the pleasure of drinking and begins to forget that the two are linked. 

      There's a book that covers a number of alternatives and lists the studies that support their use in Medically Assisted Treatment for AUD. It's mentioned in the last post in this thread:

      https://patient.info/forums/discuss/useful-resources-487627

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    • Posted

      I've never heard of opiates being used to treat alcohol addiction....maybe Klonopin, benzos and barbituates for withdrawal...

      Those are all very addictive...it sounds more like a list of drugs they treat addiction to...

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