Harm reduction is a term that really should not be used. (Used here as that is the term that is being used in the public domain). The concept of harm reduction is essentially meeting individuals where they are at in the course of their addiction; focusing on what they identify as their goals, and helping them overcome whatever obstacles are in their path towards optimal health and wellness.
Why should we get away from using the term “harm reduction”? In essence, it trivializes what should be the mainstay of treatment. Many professionals view harm reduction as some lesser form of treatment or giving people “permission to use”. This is nonsense; if we force our goals on people they simply stop coming for help. This is not the outcome we are looking for if our goal is to help people. Ongoing engagement is the key, and to do that we need to collaborate with our patients not push them away. We are not “giving people permission to use” but rather recognizing that people struggle to control their addictions. We provide a non-judgmental, compassionate, collaborative environment that will not push people away if they are not doing things the way we want them to or continue to struggle with the very addiction they came for help with.
Why the general medical community struggles with the concept of harm reduction is a mystery, after all, this is how we treat all other chronic medical conditions. Imagine if practitioners started dismissing all patients from their care who were not meeting their goals for diabetes, hypertension or obesity?
No, in fact the effectiveness of residential, abstinence based 12 step oriented rehab programs is widely reported at 10% or less.
No. Nothing will be required of you except your desire to get well. If AA is helpful for you, we will support your using it. We also suggest other community support programs such as peer support, Smart Recovery and others if you find them beneficial. It is ultimately your choice in what you find useful in supporting your goals in treatment.
Yes, clinics such as ours have shown high rates of success in treating a wide variety of addictions including alcohol use disorder, opioid use disorder and stimulant use disorder amongst others. Success is better defined in the context of what your goals are. In a similar practice we are modeled on, over 70% of patients were highly satisfied with the results they achieved based on their own goals.
No. That is one of the unique differences at The Remedy. We treat all of the addiction and mental health issues you have at the same time with both appropriate psychiatric care and psychotherapy. This approach offers much higher rates of success and satisfaction amongst our patients.
No. Person centered care means that we start with what your goals are and help you see what is working and what is not. The plan may change as you produce whatever results you produce along with recommended medication and psychotherapy. Some people are able to manage their addictions and limit the harm they will cause while for others, abstinence may be the best approach. You get to decide based on how the journey is going for you.
Addictions truly are a chronic disease. This has been stated for a long time yet most programs do not treat addictions in this way and most “dual diagnosis” programs do not adequately treat psychiatric disorders. The episodic nature of rehab programs is also not a fit for a chronic condition.
We treat addictions like we would treat any other psychiatric disorder. You meet with the psychiatrist and therapist, develop a plan, and are seen as often as you need to be seen for as long as you need to be seen. If you struggle achieving your goals, we help you see what the barriers are and how to overcome them.
Can you imagine if you had diabetes and after a few visits with your doctor your services were terminated because you were not able to achieve the goals THEY created for you?
No. For many withdrawal symptoms we may be able to treat you in our out-patient setting with appropriate medication and support. The best approach would be for you to call us so we can discuss your particular concerns and recommend options.
We are very accessible, which again distinguishes us from other programs/clinics.
Some people with a history of severe withdrawal, particularly from alcohol or sedatives, may require more intensive medically supervised withdrawal services in a hospital setting.
No. Our therapists are highly trained and skilled at a master’s level in both addiction and mental health disorders. They also have additional training in treating PTSD/Trauma using cutting edge, effective techniques such as EMDR and Brainspotting, amongst others.
The National Alliance of Advocates (addiction resources)
Not necessarily, some surgeons and dentists will want you to do this, however, there are ways to stay on your Suboxone and still have appropriate treatment of your pain. Ideally your surgeon or dentist can collaborate on a plan with us that best matches your circumstances.
This article is very useful for your surgeon, doctor or dentist to review to help create the best plan for you.
Yes. This is a highly personalized decision that is best reached after thorough discussion with your doctor and therapist. Although many people start Suboxone with the idea that they only want to take it for a brief period of time, many find that they feel and function so much better that they choose to remain on it longer term.
More and more studies are showing that people who remain on Suboxone longer term do better in terms of ongoing recovery, less recurrence of use, mood stability, health, wellness and a much lower risk of death due to opioid overdose.
Yes, there are many highly effective medications for alcohol use disorder, some are FDA approved, and others that are used in an off label manner with many studies showing their benefits.
Unfortunately, studies show that less than 10% of people diagnosed with alcohol use disorder are even offered medication in treatment, mostly due to ignorance, programs not having skilled physicians or psychiatrists, or stigma.
We are highly trained and skilled in using these medications to increase your chances of managing your addiction and improving your overall quality of life, health and wellness.
No. At The Remedy, we treat you as the whole person that you are. Our psychiatrists are highly trained in psychopharmacology but also recognize the value of a full mind-brain-body perspective as well as psychotherapy and coaching.
No. The question stems from decades of the myth of “cross-addiction” being perpetuated by 12 step and rehab programs. There has never been any research to support the concept of “cross-addiction”. Given what we know about addiction; that it is a highly complex neurobiologic disorder each with its own natural history and genetic pattern, the idea that all addictions are the same is preposterous.
Imagine if your doctor gave you penicillin and you had an allergic reaction. The doctor then told you that you had an allergy to “medicine” and you can never take any kind of medicine again. Given what we know about medications; that they are all chemically and structurally different, are metabolized differently based on certain genetic patterns, affect different physiologic systems in the body…that would make no sense. Neither does the construct of “cross addiction”.
No. These are highly individualized decisions made by your psychiatrist and you together.
In many circumstances, treating ADHD with effective medication may be an important component in preventing recurrence of your primary addiction.
No. Although there have been concerns about higher rates of overdose in people on benzodiazepines like Xanax and opioids, this is again a very individualized decision made between you and your psychiatrist. Many people require effective control of their anxiety to prevent recurrence of their primary addiction.
In fact, FDA Commissioner Scott Gottlieb addressed this issue with a “drug safety communication” report issued in 2017:
No. This is a highly personal decision between you and your psychiatrist based on your particular circumstances, the risk of recurrence of your alcohol use disorder, whether you are in stable, sustained remission from your alcohol use disorder and what other options there are to treat your anxiety.