This is the third and final part of a series on addiction-related topics from an October 2nd presentation by Aimee Techau, a Denver area nurse practitioner who specializes in psychiatric medicine. The Colorado Nurses Association District 6, SLV AHEC and the Women’s Citizenship Club of Alamosa hosted the presentation.
ALAMOSA — Drug addiction does not have to be a death sentence.
During a presentation Tuesday night in Alamosa, Nurse Practitioner Aimee Techau offered hope for addicts and those who love them.
She described many avenues to assist with recovery for addicts, ranging from support groups to medications. Most people need a combination of remedies, she said, adding that abrupt cessation without support of any kind will almost invariably lead to relapse.
She recommended a holistic approach to recovery that deals with the whole person, spiritually, physically, mentally, emotionally, socially and intellectually.
Recovery can take the form of inpatient or outpatient treatment, therapy, support groups such as AA and medication, Techau explained. She has even used alternative means such as acupuncture, she said.
She said other treatment avenues include exercise, nutritional changes, yoga, spiritual support, individual and/or group therapy including cognitive behavioral therapy and support groups of some kind. Techau said a 12-step group like AA might not be the best suited for everyone, but there are other peer support groups as well.
“Some type of therapy and peer support” is very important to recovery, she said.
Just making sure a person’s basic needs are met is also important, she added. For example, if someone is not getting enough sleep he or she will be more prone to relapsing. She recommends non-addictive sleep medication for addicts who are recovering. Sufficient sleep is very important in recovery, she stressed.
She referred to the HALT triggers (hungry, angry, lonely, tired), but said sometimes even a happy experience will trigger a relapse as a celebratory event, so addicts must be aware of what might trigger a relapse for them.
“Recovery is not a straight line,” Techau said. People may and often do relapse, but each time can take them closer to the end goal, she said.
Techau described medication-assisted treatments for various drug addictions. She said there are medications available for opioids, alcohol, tobacco and benzodiazepines. There are not for cocaine, methamphetamines and hallucinogens.
However, she said there are early-stage efforts underway to create vaccines for cocaine and methamphetamines. “There’s very exciting research right now,” she said.
Some of the medications available for various drug addictions include:
• For tobacco — pills, patches, gum and similar treatments
• For alcohol and benzodiazepines — Naltrexone can be helpful with these and other substances, as it reduces the desire to drink and the craving. Antabuse has fallen out of favor with treatment providers, as it causes those who use it to get sick if they drink. Naltrexone, on the other hand, just reduces the desire to drink, Techau explained. It also has few side effects aside from possible stomachache or more vivid dreams.
She said unlike the withdrawal from other drugs, people could die during withdrawal from alcohol and benzodiazepines due to seizures. It is important for medical help to be available during withdrawal from those substances, she said.
People withdrawing from opioids will experience vomiting, diarrhea, running nose (pretty much all the “faucets” running, Techau said) but will not experience the life-threatening withdrawal symptoms that alcohol and benzodiazepines create.
• For opioids — Suboxone® can be given in an outpatient situation and methadone in a more controlled situation. Suboxone can be administered now in a shot that lasts for three months or an implant in the arm.
“We’ve got options now,” Techau said.
Naltrexone is another option here, Techau said.
“We have all of those here available in the San Luis Valley,” said Charlotte LeDonne, RN, nursing coordinator for the SLV Area Health Education Center as well as a member of the presentation’s other sponsoring groups, The Colorado Nurses Association District 6 and Women’s Citizenship Club of Alamosa.
Techau said even though Naltrexone would be an “off label” use for meth and cocaine, it could be used for those addictions as well.
• Stimulants — Wellbutrin, Mirtazapine, sometimes Naltrexone and NAC (N-acetylcysteine)
Techau said while people may talk about addicts as uncooperative, they can actually be more compliant and desirous of getting well than some other folks with chronic conditions such as COPD or diabetes.
“Folks with substance use disorder are far more compliant,” she said. “They actually get well. They recover. There’s hope there.”