Methadone can be used to treat persons with an opiate use disorder. Methadone works by occupying areas of the brain that opiates target to prevent withdrawal symptoms or make them less severe for those that have stopped using opiates. Methadone also helps with eliminating cravings for opiates. Withdrawal symptoms include:

• Sweating
• Aches and pains
• Restlessness
• Tremor
• Diarrhea
• Nausea
• Vomiting
• Stomach cramps
• Runny eyes and nose
• Feeling hot and cold

 
Many people stay on methadone long-term and some people gradually reduce their dose to completely stop taking methadone. Methadone should not be taken with any other illicit substances and alcohol. The impact of mixing benzodiazepines (Xanax, Klonopin, Valium, etc.) and methadone can be deadly. There is an increased risk of overdose when benzodiazepines are taken with Methadone. Since Methadone is a depressant that slows the central nervous system, which includes heart rate and breathing, so does benzodiazepines. As a result, the combination of taking the two can slow the heart rate, risking the heart for cardiac arrest and stopping one from breathing.
 
Methadone can be prescribed and lasts longer in the body to help those with an opiate use disorder once someone stops using. Most persons are referred to a community treatment center for assessment. Most treatment facilities have a general practitioner on site that can complete the assessment. The assessment usually includes taking details of the person’s health, social circumstances, past and current drug taking, identifying if methadone is needed or appropriate, an examination, urine analysis to confirm any illicit substances being used and assessment of what the person needs are at this time. In addition, to those that may have been using heroin intravenously, a blood test for HIV, liver function and Hepatitis A, B and C are conducted.
 
After the assessment, an initial low dose is prescribed. The low dose is prescribed out of safety and can be adjusted frequently. This stage is very important because this is the phase where a regular maintenance dose is identified over a few week period. The maximum effect can vary person to person as it takes 2-4 hours for Methadone to reach its peak effect level.  
 
Once the correct dose is identified, the person is now in what is called Methadone maintenance. Methadone is a once-daily liquid dose taken under supervision of a nurse or pharmacist who dispenses it. Methadone must be taken regularly and if three or more doses are missed, the body may lose its ability to break down the drug. If three or more doses are missed, persons can return to taking Methadone, but at a lower dose. Some people that have been on Methadone for a while will want to detox. This often takes years as it is safer to stay on Methadone than to detox before the person is ready.
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People that use Methadone are more likely to stay off heroin if they are supported by friends and family. Too often, family and friends do not support persons with opiate use disorders because of their lack of knowledge regarding Methadone. Methadone is a drug used to help those persons with an opiate use disorder so they no longer use opiates. It can be viewed as taking medication for high blood pressure or insulin for type 2 diabetes. The way people can change their diet to reverse type 2 diabetes while taking medication is the same as those using Methadone to reverse their opiate use disorder. Support from loved ones goes a long way for a person using Methadone. Persons with opiate use disorders also do well when attending outpatient treatment coupled with group and individualized therapy. It is much harder to do it alone.
 
Please educate a friend, coworker and loved one on the benefits of supporting a person with opiate use disorder when they have made the choice to use Methadone in their recovery efforts. There are plenty of successful people around us, you may never know, that have or currently use Methadone. As America is going through the opioid epidemic, being educated on the various ways Methadone can help just might save your loved one’s life.

People who are critical of others point out others perceived flaws. Many of us have grown up with painful criticism. Painful criticism can be toxic to anyone’s well-being. Being criticized as an adult can trigger suppressed pain and as a result, one either withdraw themselves or lashes out on others. Either action is counterproductive to one’s well-being.

Sometimes, painful criticism can trigger shame causing one to revert back to the hurt child who could never do anything right. Shame can be an extremely painful emotion. When shame is triggered, some people find ways to not feel such as cutting, overeating, or using illicit substances. Shame can feel very threatening as it dysregulates the nervous system. Practice mindfulness by noticing it, allowing it some space and realizing when it has arisen. Understand that you are not the shame.

You have no control over how others perceive you. You do have control over how you hold and view yourself. Find your inner strength and accept your lovely, unique human flaws. The key to doing this is building mental strength by what you do and don’t do.

1. Say “NO” – One of the best words spoken! Know when to say it and don’t feel shame or guilt about it.
   
   
2. People-Pleasing – Accept someone telling you “no” as it works both ways. Embrace the fact that social rejection is unavoidable. Most importantly, you will live!
   
   
3. Relationships – Cultivate healthy relationships with yourself first. This relationship speaks volumes and sets the tone for how others should treat you. Be in the business of reevaluating your relationships with yourself and others on a regular basis.
   
   
4. Be Kind – Be considerate and helpful without any obligations.
   
   
5. Acceptance – Differentiate what you can and cannot control so you can feel your best, discover new options, opportunities and happiness.
   
   
6. Adaptability – Adapt to change with haste and stay reasonable in challenging or unforeseen situations.
   
   
7. Emotional Acumen – You can effectively resolve your past trauma and grow as a human being because of your ability to recognize what exactly you feel, why and what it means to your existence. Express empathy and compassion for yourself first and others.
   
   
8. Present State of Mind – Live in reality in order to maintain a high level of awareness. Accept the situation as is without compromising your emotions, being stuck in the past or constantly worrying about the future. Use reason, logic, observation and common sense to conceptualize reality.
   
   
9. Being Proactive – When there is a problem, weigh your options and make a practical decision taking in your emotions, thoughts and motives so you can enjoy life even through the ups and downs.
   
   
10. Sense of Self - Know yourself and how to deal with your emotions. Don’t take your emotions out on people or allow people to take theirs out on you.
    
    

Don’t take what people do, feel, think or say personal because you are wonderful regardless of their opinions. As humans, we are all dealing with our own shit – feelings, perceptions and opinions. Other people’s judgments are not superior. They are simply expressing their own subjective standard as it relates to their experiences. You’d be foolish to argue someone’s taste or preferences.

Don’t allow a compliment or criticism to affect you. Instead, trust your own judgment and know what is best for you. You don’t need other’s approval because you know your strengths and limitations so again, accept your perfect imperfections and mistakes. Acknowledge and reward your successes despite anyone’s recognition. People are going to have their own opinions no matter what.

​In the end, yours is the only one that matters!

 Every day without using can be uncomfortable especially when trying to practice and implement new recovery skills. This alone makes the first 90 days of recovery very critical. The first 90 days has been known as where most relapses occur.

When in recovery, you give up more than a substance, but also behaviors. If you are returning home from treatment, everything you left (friends, job, family, etc.) can be overwhelming. Recovery can be difficult to manage without structure, a routine and consistency. Without these things, recovery can collapse. Below are 12 critical tools for surviving the first 90 days of recovery. 

1. Create a recovery environment – get rid of anything in your home that’s related to using (alcohol, pills, or any other addictive substances or objects) that is easily accessible. Don’t think twice and if it seems difficult, ask for help from a loved one, another sober support or sponsor.
   
   
2. Create a daily routine – it has to be one you can keep to avoid being idle and leaving time open for your thoughts to wander back to using again. Your schedule can include going to 12-step meetings, doctor or therapy appointments, spending time with family, sleeping, work, exercising, etc. In addition, make appointments for any past annual check-ups or dental visits.
   
   
3. Give thanks for each day – express gratitude for your successes, lessons learned and accomplishments. Thank yourself, God or a higher power. Try to practice this daily by putting your feelings of gratefulness out there. Even the most stressful or frustrating day deserves acknowledgement because you made it through and faced its challenges making you better equipped to face another day.
   
   
4. Learn your triggers – identify what can push you towards relapse. This is extremely important because initially, your triggers can be hard to manage, especially without the proper tools to help you fend off cravings to use. If it helps, write your triggers down so you know what to do when you experience a trigger.
   
   
5. Identify and practice healthy coping skills – cleaning, calling your sponsor, going to several meetings throughout the day or week, completing crossword puzzles, reading a book,  etc. Most cravings and urges usually last about 20 minute so if you apply any of your coping skills, you will begin to set the tone for various ways you can help yourself to stay sober.
   
   
6. Attend meetings – there is value in attending 12-step meetings. They are highly recommended and often a necessity for your recovery. Attending meetings can help you in troubling times or when you feel triggered. It is encouraged to attend 90 meetings in 90 days in your first 90 days of recovery.
   
   
7. Find a sponsor – finding a sponsor should be a high priority if you attend 12-step meetings. A sponsor will be your go-to person in times of crisis.
   
   
8. Sleep and diet – recovery also involves taking care of your physical needs (proper nutrition and rest). Consult with your primary care physician on what proper nutrition means for you. This is important because you may be recovering from the effects of your addiction or complications related to using (type 2 diabetes, compromised immune system, anemia, etc.). Addiction disrupts your body’s circadian rhythms making it difficult to fall or say asleep without using so try to get seven to nine hours of solid sleep per night.
   
   
9. Exercise - exercise does not necessarily mean going to the gym, but can include taking brisk walks, jogging, riding a bike, taking a hike or going to your local recreation center. 
   
   
10. Limit social engagements – the first 90 days is not the time to revamp your social life. Save this for when you are more confident in your ability to maintain your recovery in all situations (people, places and things) and are feeling strong as well as healthy.
    
    
11. Develop Goals - this could be your personal treatment plan to yourself as to what you want to achieve short and long-term. These goals could be obtaining your GED, gaining employment or any other ideas you identify to help you get close to your long-term goals.  
    
    
12. Continue to see a therapist – it is common to experience periods of sadness or feeling blue especially in your first 90 days. If you are taking prescribed medications to ease cravings, withdrawals and/or mental health issues, do not stop any treatment regimen on your own; please consult with your therapist and/or physician first.
    
    

​Take your time and be gentle with yourself to avoid the pressure of trying to achieve all you want or believe you need to do. Recovery is a lifestyle, a lifelong journey and not a race. 

​Is your body living in the present, but your mind is in the past or future? Do you have resentments, guilt, or shame from your past? Are you afraid of current circumstances causing you displeasure continuing in your future?

The voice of the ego-mind makes us believe we can only achieve internal peace based on what happens in the world around us.

The philosopher Wittgenstein stated, “The eternal life belongs to those who live in the present.” When you do not allow yourself to experience any moment for itself, you stop time.

The past is said and done. What remains to be seen is what you can bring to your present and future. You always have the power to decide that any poor decision you made in the past does not have to be repeated in the present.

Be motivated by having been treated unfairly in the past to treat yourself fairly in the present. You have better things to do than rake yourself over the coals because of your past. What you tell yourself today is way more important than what others have told you in your past.

Shift your thinking to understand how past experiences do not represent you. Instead, your past experiences represent things you have experienced. Your past does not make you a better or worse person nor is it your enemy. The enemy is your way of thinking about your past. Use your past to make you emotionally strong in your present.
​
Let’s face it; the past is not going to get any better! 

Growing up, the parent-child relationship is the first social relationship we experience. Children who grow up in a household where their feelings are not acknowledged, validated or responded to sufficiently learn their emotions are not valid, unacceptable to others, or don't matter and they must ignore, neutralize, devalue or push away their emotions. The child now knows how to disconnect from their own feelings.

Some children grow up with parents or caretakers that treat them as though they are not lovable. They then develop the idea that they are the problem or something is wrong with them. The truth is that the child received uncaring treatment by an unhappy and/or emotionally limited parent.

As an adult, the feelings of emptiness from childhood become a vital part of ones being. Emptiness can be described as something missing inside of you; a disconnection from yourself and others caused by absence of feeling. Physically, your body could feel as though there is an empty space in your belly, chest or other parts of your body.

As an adult, people who have emptiness often care for others better than they care for themselves. They can put a smile on their face, never giving away their emptiness. Adults that do not feel worthwhile may suffer from depression and lack confidence.

If this resonates with you, please know you can begin to give yourself the emotional attention you did not get as a child. You can begin to accept your own feelings as an expression of your true self without feeling or believing you are weak. Pay attention to what you want and need while using your voice to ask for them.

Take time to practice positive self-talk to eliminate your inner critic. Start showering yourself with self-acceptance and self-love by appreciating the good qualities you have.

Take great care of yourself. This can include forgiving yourself for your past mistakes and eliminating any guilt or shame associated with feeling empty or worthless. Relationships that are toxic, find a way to end them so you can treat yourself with the self-compassion you deserve.

Engage with others in a meaningful way to take a step towards healing your emptiness. Others may feel the same thing, but do not express it, so you could be offering a gift that helps them. Every human being has value.

Work on your inner child to give your adult you a better life. You can heal!

Growing up, you may have discovered ways to make yourself feel better when you had been hurt or felt bad. Some self-soothing ways could have included playing with your dog, favorite doll or toy truck. As an adult, when you felt uncomfortable, upset, anxious or irritated, you may have turned to negative self-soothing techniques to make yourself feel better as quickly as possible. Some of these things included:

​

1. Drinking alcohol or using illicit substances - Excessive use of alcohol and illicit substances to self-sooth can lead to an addiction or losing self-control to the point you are being taken advantage. Substance use can also lead to brain damage and death.
   
   
2. Overeating – Eating to self-sooth can cause weight gain, poor body image and poor health.
   
   
3. Self-Cutting – Cutting to self-sooth creates permanent scars, possible infection, pain and embarrassment.

These things may have made you feel better at first, but later worsened your situation. If you are using any of these negative self-harm techniques now, there are safer ways that can work for you.  Try any of these 10 self-soothing techniques to feel better about yourself or any situation.

1. Relaxation exercises – download a relaxation app and listen to relaxing sounds from nature (waterfalls, bird calls, whales, etc.) or take a walk.
   
   
2. Play – find time to play an old-school board game (Monopoly, Clue or Scrabble), charades, hangman, romp around in the grass with a dog or flag football with friends. You can also play tag, hide and seek or blow bubbles.
   
   
3. Be present in the moment – this is known as mindfulness. Try to not focus on the future or the past in order to fully experience the present. For example, engage 3 of your senses by taking a long and close look at a flower, touch and smell it.
   
   
4. Learn – are you interested in learning something new, but never explored it? Look for ways you can make this happen. Or, you may want to look at something in a new way such as reading a poem or scripture to find new meaning in it. Watch a TED talk about something you know nothing about.
   
   
5. Finish the little things – accomplishing even the smallest thing usually helps you feel better. If you have been putting off easy things you have been meaning to do for a while (cleaning out a drawer, dusting a bookcase, sending someone a thank you note). Do it!
   
   
6. Spiritual resources – prayer, meditation or reading affirmations, etc. Whatever feels right to you, try it and keep in mind, spiritual work does not necessarily occur within the bounds of an organized religion.
   
   
7. Be creative – make a sculpture, paint or draw. It does not matter if you have never done any of these things. Shifting your focus on one of these tasks can make you feel better.
   
   
8. Go to any kind of a museum – pick a piece to observe, stare at it and let it spark a story.
   
   
9. Write – journal about 5 things that make you smile or write a 5-line poem about your favorite song, food or a funny memory.
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10. Try a new food – pick a fruit, veggie or dessert you never tried before and do this once a week.

Remember, each day you can help yourself feel better by doing many good things that do not involve cutting, overeating or using alcohol or illicit substances. You are in control of your life. Do something fun, creative, uplifting, interesting and exciting when self-soothing routine. 

Every day the list expands to the things we can buy and do online. If you live in a rural area and want to go to therapy, but are afraid of running into someone you know, online therapy could be a great option. If you live in an urban area and are super busy from work demands, but want to go to therapy, online therapy could be just for you. Here are 5 pros to online therapy.

1. Online therapy is available to almost anyone as long as you have access to a computer.
   
   
2. You don’t have to leave the comfort of your home and have a session in your pajamas if you like; dress appropriately!
   
   
3. You don’t have to worry about transportation issues (parking, gas, traffic, etc.).
   
   
4. Online therapy can be a way to help you keep your appointments and minimize no-shows at face-to-face sessions.
   
   
5. Online therapy can be flexible with your life where you can a late night session when the children are sleep since you could not make it to a face-to-face session due to lack of childcare. This is a two for one!!!
   
   
6. Online therapy can be cheaper than face-to-face sessions.
   
   
7. There are a host of online therapy sites to help you choose the right therapist for you (Open Path Collective, Talk Space and Being Seen to name a few) taking away the stress of where to begin your online therapist search.

One con to online therapy would be if you are experiencing a crisis situation. Online therapists are at a distance making it difficult for them to respond fast enough. Therapists can respond, but their approach to the situation when communicating solely online may have to be changed.
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Whether you live in a rural or urban area, online therapy is not for everyone. Some people prefer the face-to-face session and that is totally fine! As long as you are getting the help you need, the delivery method does not matter. Only you can decide if online therapy works best for you and your situation. 

​One’s quality of life can be enhanced by having a positive attitude and sense of general well-being. Improving your mind and memory through mentally stimulating exercises can also help. Keep in mind, happiness takes work. The basic ingredients to being happy includes safety, satiation, perception and quietude.

Safety
Feeling unsafe can bring about fear. This fear creates uncertainty and tension within your body making it hard for you to experience happiness. Ask yourself, “How safe and secure do I feel in my everyday life?”

Satiation
No one has everything they want, but ask yourself, “At this moment, am I full?” Only you can answer this question. You know how much you need to be satiated however, if nothing is ever enough, your search for happiness will never end! You can be happy in this present moment without having everything you want, but you cannot be happy if your life is empty. How satiated are you with your finances, relationships, career, etc.?

Perception
Right now, take the time to reflect on the bigger picture of what your life is all about. Getting caught up in the minuscule details can be derailing you from enjoying the journey, the positive impact you are having on others and within your own life. How pleased are you with your general life situation? Are you grateful for the way your life is turning out?

Quietude
How often do you find yourself in a quiet place where you can have a true moment of reflection? If not every day, at least once a week, find a quiet place where you can get in touch with feeling safe, see how satiated you are and self-reflect for 20 mins. Take a break from your day of being busy and rest. Find the space where you can hear yourself think and have no responsibilities. How often do you have sense of peace of mind? How often do you feel content?

As you reflect on these questions, focus on the ones you struggled with or could not answer. These are the ones that need your attention the most. As you work on these, you move closer to being a happier person.