Stopping was a scary prospect but I couldn’t imagine going inpatient. You took your time and we felt very taken care of. We appreciated that you were so straight-forward with us and explained what I’d feel… It wasn’t easy but it got me off to the right start.

Client

How We View Addiction

  • No one starts using with the idea to become addicted. Use often starts as fun or as a way to cope with feelings and aspects of ourselves that we feel insecure about. If we are using to manage emotions, the behavior is especially compelling and we turn to it again and again.
  • Addiction changes the way our body perceives and manages stress via the stress hormone circuits. It changes the very way we feel about the dangers in the world and how we decide how to manage. While never the intention, we end up more anxious, more miserable, more reactive.
  • Addiction happens when a decision becomes a learned habit that tugs on our thinking, changing our values and taking effort to resist.
  • Addiction does NOT make us powerless, hijacked automata. We can make choices and learn better ways of connecting and coping.
  • No one needs to reach a rock-bottom.
  • People can come back from addictions stronger, carving a new identity. The resiliency is always there.
  • Addictive behaviors may be efforts to cope with attachment injuries but it also creates shame, aloneness and helplessness. Treatment needs to heal this deep pain and provide corrective emotional experiences that rewire our memory and responses to feelings and others.
  • Families and loved ones often, inadvertently, perpetuate a cycle of avoidance, rebellion, aloneness and shame. They can become punitive, nagging, desperate and reactive. Treatment of the family is so important. Once they are taking care of themselves, appreciating what they can do to help and setting healthy limits they are able to positively reinforce shared goals and rebuild love, connection and motivation for change.
  • The goal is not to cease the behavior or use. It is to live safer, more fully, more connected and more mindfully. We follow a Harm Reduction approach, as best described by Andrew Tatarsky.
  • Abstinence is not always necessary. It is possible to learn to use moderately.
  • To change, people need to respond to triggers differently and stay away from some triggers altogether. But to change deeply, in ways that go way beyond the addiction, that will make their whole life richer and more meaningful, people need to unwrap the emotions and thoughts that lie deep within automatic behavior, to face what has been avoided, to discover the stifled and stunted parts of themselves that need to be heard, need to contribute.

We listen to your goals and preferences, understanding that you wouldn’t be here if you didn’t want some change, using science and gentle understanding to help you feel better, live longer and feel in charge.

We commonly work with:

  • Opiate addiction, suboxone (buprenorphine) and vivitrol (naltrexone) treatment
  • Problem drinking and alcoholism
  • Sedative dependence and withdrawal
  • Cocaine, amphetamine and nicotine addictions
  • “Process” addictions like gambling and sex

We offer:

  • Home Detox from opiates, alcohol and benzodiazepines without an expensive and distressing hospitalization
  • Specialist pharmacological treatment of addiction
  • Vivitrol – The Facts About Naltrexone
  • Suboxone and other buprenorphine treatments – Pros And Cons Chart
  • Drug Testing: Urine saliva or hair toxicology testing
  • Therapy that is evidence based, effective and delivered with clarity and kindness.
  • Harm Reduction and Moderation Management approaches
  • The “Sinclair Method”

Dual Disorders

Many people have a mix of drug/alcohol use and some psychological issues, and each problem can be minor or major.

For example, perhaps you’re depressed and drinking to help turn off your thoughts at night and get to sleep. Unfortunately, the alcohol might be disturbing the restfulness of your sleep and exacerbating your anxiety or worsening your mood in the morning.

Or, you are using some opiates and your mood now goes up and down. People think you’re bipolar but it’s hard to say.

Or there’s some paranoia but is the pot helping or making things worse?

These common issues can be perplexing for many clinicians who tend to do one of two things: 1, they assign blame to the alcohol/drugs, saying you have to quit before you get well or they can’t treat you; or 2, they say it’s all about the underlying trauma and psychiatric issues and once they treat that you’ll be OK.

That’s wrong. You need both issues addressed simultaneously, with a variety of more subtle approaches. Fortunately, that’s exactly what we do well. Dr. Green wrote an article on some of this read here but some principles include:

  • Treat both conditions at the same time.
  • Understand WHY someone is using, what it does for them.
  • Prioritize according to safety concerns, and client interest and willingness.
  • Use medications that help both conditions and don’t exacerbate one or the other.
  • Understand and educate how instability of one will trigger the other.
  • Treat in phases, as things will look different in a few weeks. In other words, don’t rush to diagnose. Stabilize, treat, review.
  • Be pragmatic; teach the basics of self-care and governance.
  • Go gently but bravely into emotions – positive or painful, as things feel very different, much better, on the other side.
  • Work with an extended network of family and supportive people.