equichem

Why is change so hard?

Mon, 04 Oct 2021 18:26:43 GMT

Whether you are trying to cut back on your drinking, leave your job, or exercise more, the mere thought of making a change is fear-inducing. Even when we are fully aware that our current situation or behavior is unhealthy (e.g., a toxic work environment, an unhealthy relationship, drinking), making a change is still challenging.

For example, take John who currently has a job in a toxic work environment. John has recognized for months that he is unhappy despite having tried many approaches to improve his situation. His mental, emotional, and physical health continue to deteriorate, and his drinking has increased.

However, John still finds it difficult to leave his current company and accept a new job offer. Why?

One reason: There is a lot of comfort in doing something familiar even when we are fully aware that it is unhealthy. And change, even when likely to improve our situation, means taking a risk and moving away from the comfort of familiarity. The fear of the unknown and the uncertainty of change keep us stuck in unhealthy situations.

The FDH treatment program recognizes that making positive life changes requires more than just reducing drinking and drug use; it involves assessing a wide range of habits and behaviors that may be contributing to unhealthy patterns.

Call us today for a free consultation at 773-747-5500.

I don't know if I want to stop drinking

Sun, 26 Sep 2021 18:26:43 GMT

If you have noticed that you are drinking more during the pandemic, you are not alone. Recent research has demonstrated that alcohol consumption has increased significantly – folks are drinking more alcohol, more often, with stress, boredom, and easy access to alcohol as the main drivers of this behavior (Grossman et al., 2020).

You may have started to pay more attention to your drinking patterns and considered cutting back or not drinking at all. Do not worry about being unsure that you want to abstain from alcohol indefinitely. At FDH, when appropriate, we introduce you to harm reduction - an approach that can be used to decrease drinking to safe levels – and then help you to implement a harm reduction plan to be assessed at regular intervals.

You don’t have to be certain that you want to quit drinking forever to start making positive changes. Call us today at 773-747-5500 for a free consultation.

Reference

Grossman, E. R., Benjamin-Neelon, S. E., & Sonnenschein, S. (2020). Alcohol Consumption during the COVID-19 Pandemic: A Cross-Sectional Survey of US Adults. International journal of environmental research and public health, 17(24), 9189.

MD infusions provider spotlight: Dr. Jonathan Adelstein, Front Door Health

Thu, 13 May 2021 18:26:43 GMT

Jonathan Adelstein, MD, is a board-certified general and addiction psychiatrist. He trained at NYU and the University of Washington and has worked in a variety of treatment settings. This experience has left him frustrated because the majority of substance use treatment just doesn’t work. Largely as a result of this, 90% of those who are struggling with substance use disorders don’t seek any treatment at all. To address this need, Dr. Adelstein founded Front Door Health, an innovative home-based substance use treatment program.

Why can’t I sleep?

Sun, 09 May 2021 18:45:48 GMT

Quick Information About How Cell Phone Usage Interferes with Sleep – Part I

Getting quality sleep on a consistent basis is essential to a strong recovery yet challenging for many of us, partially because of our cell phone usage. From the moment we wake up to the minutes before we doze off, we are inundated with information and stimulation. Using our phones directly before bedtime is especially problematic for getting adequate rest. Here are a couple reasons why:

1. Melatonin is a hormone that signals the body to prepare for sleep. Light to the eyes inhibits the production of melatonin and delays sleep, while darkness facilitates the release of melatonin and induces sleepiness. When we use our phone before bedtime, screen light gets absorbed by our eyes, which fools our body into thinking that it is time to be awake and alert. A specific type of light, blue light, has been identified as the main culprit. In response, some technology companies have added a blue light filter feature to their devices. However, keep in mind that while blue light does inhibit melatonin production, there are many other types of light emitted by our devices that do the same. As such, the usefulness of the blue light filter is limited.

2. Cortisol and adrenaline (epinephrine when originating in the brain) are hormones which are released in the body during times of stress. For many reasons, technology use at bedtime can increase levels of these hormones and interfere with our ability to relax and fall asleep. First, the content we consume on our devices before bedtime can induce stress and uncertainty, which increase cortisol levels and delay sleep onset. Reading news stories about COVID, for example, can make us feel helpless and anxious. Second, the apps we use may be stimulating. For example, playing a game on an app that involves strategic thinking and frequent interaction is probably more stimulating than reading about the benefits of controlled breathing on a meditation app. Third, the short distance between our face and the device increases cortisol levels, as our mind is wired to perceive something close to our eyes as a threat, even if it is non-threatening.

Ideally, we would put our phone away at least 60 minutes before we go to bed to avoid any kind of interference. However, for those of us who prefer not to do this, we can at least educate ourselves to minimize the harm caused by this behavior.

Call us today at 773-747-5500 so we can help you assess the impact of your behaviors and habits on your goals and values.

Triggers

Sun, 18 Apr 2021 18:47:50 GMT

Quick Facts About Triggers

What is a Trigger?

One important part of recovery is to identify your triggers. A trigger is a cue or experience that gives rise to a craving or urge to use a substance.

Triggers may be internal or external. Internal triggers could be feelings, thoughts, or memories. External triggers could be places, people, or events. Here are some examples:

Internal Triggers

1. Feelings (example: Sadness) – Feeling sad is a common trigger for those struggling with substance abuse because substances provide quick and predictable relief from uncomfortable emotions.

2. Thoughts (example: Catastrophizing) – Certain thoughts and thought patterns can be triggering. Catastrophizing is a distorted way of thinking in which an individual dwells only on worst case scenarios. In this example, substance use could be an appealing option to calm down the mind.

3. Memories (example: ex-partner) – An individual may feel triggered upon recalling memories of a previous relationship that they grieve over.

External Triggers

1. Places (example: bar) – Walking by the bar an individual used to frequent is triggering because it surfaces memories of a variety of drinking experiences the individual had there.

2. People (example: drinking buddy) – Speaking with a “friend” with whom an individual used to drink can bring back unpleasant and conflicting memories.

3. Events (example: work party) – Work social events can be triggering because they involve alcohol consumption and pressure to drink.

External triggers can cause internal triggers. For example, when an individual walks by their old bar (external trigger) they may feel jealous (internal trigger) of people inside who are drinking.

This post captures a small fraction of what your triggers could look like. Not only can FDH help you identify your triggers, but we can also assess your home environment for anything that may have a negative impact on your recovery. In future posts, we will discuss evidenced-based techniques to cope with triggers.

Call us today for your free consultation: 773-747-5500.

Front Door Health: prioritizing people over things

Thu, 25 Mar 2021 18:52:28 GMT

Traditional substance abuse treatment centers or “rehabs” invest in real estate, buildings and ever-more luxury amenities in an effort to acquire patients. Google “rehab” and you might think you searched, instead, for vacation packages or high-end “wellness” retreats. Unfortunately for consumers, medical treatment is not a destination or five-star chef-prepared meals or beach volleyball. Effective treatment is working with physicians and therapists delivering the best care science has to offer.

The single most important factor in determining the success of therapy is the quality of the relationship between the patient and therapist. So, while warm weather, kayaking and equine therapy sure sound nice, we’re not sure how relevant these things are to the task at hand – treating the medical problem of substance abuse.

Front Door Health has different priorities, we invest in people, not “things.” We provide a team of experts, led by a Board-Certified Addiction Psychiatrist, whose sole focus is on the individual patient. We focus exclusively on delivering care, we are not concerned with “filling beds” to service real estate debt, paying for facility upkeep or enticing patients to travel to what amount to luxury spas, only to return home days later to face the very problems they just left.

Front Door Health cannot promise ocean views, surfing, golf or massage. We will, though, treat your substance-related problems with the seriousness they deserve. We will deliver a team of medical and behavioral experts, to your home, and provide personalized care using only what science has shown to be effective – one-on-one therapy, medication-assisted treatment, trauma-informed care and psychiatry.

Quick facts about stress - part I

Thu, 25 Mar 2021 18:50:41 GMT

Stress is universal, but there are many misconceptions about it. Here are 3 quick facts about stress:

1. Stress is not always "bad" - there are situations when stress could be beneficial. For example, being moderately stressed before an athletic competition could actually improve performance. When stress is helpful, it is called eustress and when stress is harmful, it is called distress.

2. The stress response is also known as the fight-or-flight response - this response is activated when we identify something to be dangerous or threatening. This quick and automatic physiological response prepares our body to manage the threat.

3. The stress response is a survival mechanism - being able to quickly prepare for imminent physical dangers was and still is (but perhaps to a lesser extent) important for our survival. When finding ways to manage your own stress, keep in mind that our bodies are wired for survival, not peace of mind.

Our stress response is environmentally driven. The FDH program can help you identify stressors and manage stress in your different environments. Call us today for your free consultation: 773-747-5500.

Context-dependent learning: why WHERE you learn to stay sober really matters

Sun, 07 Mar 2021 19:58:13 GMT

From learning to dribble a basketball to mastering parallel parking to studying for an important exam, humans acquire high-level skills and complex habits of mind through strong associations with the contexts in which we encounter and use them. Context-dependent learning refers to the concept that individuals do better at recalling and applying information when the context present at encoding (or acquiring) and retrieval (recall and application of the encoded information) are the same. Simply put, we do better when we learn and apply what we learned within the same context or environment.

For example, in one study scuba divers were asked to memorize lists of words on land and underwater. The lists that were learned underwater were best recalled underwater. Those learned on land were best recalled on land. The group with the worst recall was the one where the learning and testing environments were misaligned – learning underwater and testing on land. Similarly, in another study, it was shown that chewing gum while studying and again when taking a test produced the highest recall and best scores, far superior to the group who chewed gum to study but did not chew gum during the test.

It’s no wonder, then, that once rehab patients return home they are unlikely to retain and apply the lessons and habits acquired in rehab – the contexts are misaligned. Might this explain, at least in part, the disappointing success and high relapse rates produced by treatment-as-usual?

We at Front Door Health believe so, and suggest the contextual differences between rehab and a “real world” environment, in particular, exacerbate this discrepancy and contribute to the revolving door of treatment-relapse-more treatment. Rehab bears no resemblance to the real world – there is no access to drugs and alcohol, the environmental triggers to use drugs or alcohol are absent – none of our problematic relationships are present, we are not working, or studying, or seeing friends. Instead, you are isolated, told when to wake up, given a program schedule and cocooned in a supportive, 24/7 environment designed to keep you sober.

This works quite well, in rehab. The challenge becomes sustaining progress once back home and confronted with all the contextual triggers that await – access to drugs and alcohol, work pressure, family dynamics, “using” friends, etc.

Front Door Health solves this problem by aligning the learning and practicing contexts – we come to you, you do not “check out” of life and move in with us. As a result, our patients master the skills and habits of sobriety and healthful living at home, interacting with their environment and their families. Unlike skills learned in rehab, those learned and practiced in the “real world” will be retained, tested and made part of each patient’s personal recovery “program.” We believe this is one of the many advantages to the Front Door Health approach.

The “Front Door” difference: briefly examining what’s wrong with addiction treatment and why Front Door Health is a better alternative

Sun, 07 Mar 2021 19:55:53 GMT

No one, in good conscience, can argue that addiction treatment in this country actually works. Of course, it works “for some,” but does that excuse a failure rate approaching 90%? This is not a criticism of those providing care – front-line treatment professionals (like us) are some of the most hardworking, caring and committed people in healthcare. Instead, this is an indictment of the “tools” these professionals are forced to work with, tools designed, it seems, to have little or no effect on addictive problems.

When viewed in the context of what we know about addiction, the tools we use to treat it are revealed to be largely useless and in some cases to do more harm than good. Let’s consider some “truths” about addiction and compare the approaches taken by treatment-as-usual versus Front Door Health:

1. Addiction is a chronic and recurring disease

It is understood that addiction is a “chronic” condition, meaning it is persistent, long-lasting and frequently subject to periods of remission and reoccurrence or “relapse.” Conventional or treatment-as-usual (your typical “rehab”) responds to this chronic condition by providing brief and expensive episodes of care, typically 30 days or less. Front Door Health provides one-year of uninterrupted treatment in the patient’s home.

2. Addiction is a primary disease of the brain

Treatment-as-usual responds to this complicated brain disorder largely with 12-step (AA, NA) philosophy and “step work,” treating addiction not as a medical problem, but as a “spiritual malady.” Front Door Health delivers a physician-led team of medical and behavioral experts employing evidence-based solutions.

3. Addiction and mental illness overlap

Despite digital advertising claims to the contrary, treatment-as-usual largely ignores co-occurring mental illness or offers superficial (and fleeting) treatment options. Front Door Health provides integrated and long-term therapy and psychiatric services, including medication management.

4. Trauma is often a root cause of addiction

Standard rehab facilities typically ignore trauma, treat it superficially, or retraumatize patients by addressing trauma within group settings. Front Door Health delivers one-on-one therapy with trained, trauma-informed therapists.

5. Environment and relationships play key roles in addiction and recovery

By their very nature, rehabs remove patients from home and supportive relationships, place patients in peer groups of other addicts (in varying stages of change), and isolate them from the “real world.” Front Door Health assesses and improves the patient’s home environment and intrafamilial relationships, while teaching and practicing skills in the “real world.”

6. Medication-Assisted Treatment (MAT) is proven to save lives and improve outcomes

Most rehabs don’t offer MAT and those that do typically provide only quick tapers proven not to work. Front Door Health provides Suboxone, Sublocade, Vivitrol, and other medications in the patient’s home for as long as medically-appropriate for each individual.

Again, this is not meant as an indictment of the treatment industry, which is (for the most part) well-intentioned and caring. It very much is, though, an indictment of how this industry practices, using tools and lengths-of-stay that are literally designed not to work. Front Door Health was created to offer a different path, one that understands the nature of addiction and offers solutions based on that understanding. This is the “Front Door difference.”

Stress, isolation, and boredom: the other effects of the pandemic

Sun, 21 Feb 2021 20:02:56 GMT

With significantly limited social interaction, lack of access to supportive resources, and few emotional outlets, the relentless pandemic and response has left many of us feeling consistently high levels of stress, boredom, and isolation. These feelings make substance use an especially appealing option, as drugs and alcohol provide quick and predictable relief. Unsurprisingly, new research has shown sharp increases in alcohol consumption and illicit drug use during the pandemic.

While virtual therapy has filled some gaps, it is nowhere near a perfect substitute for face-to-face interaction, and it comes with a slew of new issues and challenges that reduce the quality of care that can be provided.

Our At-Home treatment program not only provides you with enhanced access to treatment, additional helpful resources, and in-person support from your designated Care Team, but also delivers a more personalized treatment experience for improved chances of recovery.

While we can't change the Pandemic, we can change our response to it. Call us today to get started: 773-747-5500.