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PostPosted: Thu Jan 15, 2015 12:46 pm 
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I am in Houston, and earlier this year, I completed my courses to start on my path of becoming an LCDC (Licensed Chemical Dependency Counselor). I am on Suboxone, the only solution I have found that works for me to give me back a normal life. I have completed about half my practicum hours, but am in a bit of a personal quandary. I have been to multiple rehabs, and was in AA/NA on and off for a couple years, but haven't been to a meeting in over 4 years. Since being on suboxone, I haven't relapsed in 14 months (opiates/somas/benzos DOC). I have read a lot about MAT (medical assisted treatment), but it was never discussed in any of my LCDC classes. I get the impression, that a lot of people in the substance abuse field look down on suboxone as a "recovery tool", and I believe in therapy in conjunction with suboxone. I guess I'm just looking for some advice on my career choice, I want to be an LCDC, and help others, but I'm not sure that people will accept my agreement with MAT, and using suboxone to help addicts. The out patient rehab center where I'm doing my practicum has never brought up any kind of medically assisted treatment plans, and they are not 12-step driven either, but rather focus on individual counseling, group therapy, and client education. I think I'm asking because, my goal is to work in a residential rehab, and I'm not sure that any would agree with my positive viewpoint about suboxone as a lifetime maintenance recovery tool.


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PostPosted: Thu Jan 15, 2015 2:35 pm 
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Hey Todd,
Let me be the first to say that the recovery field Needs people like you . The fact is there are many ways to recover.
Problem is this country has done it the same way over and over again with mixed results. Your clean today because of tbe work you have done to help yourself and most importantly others as well.
Suboxone saves lives. Period. It is not for everybody but neither are other programs. I feel the best thing we can do is to be openminded enough to do whatever we have to for a new life without the drugs that bring us down.
Suboxone is a great tool, wish everyone thought so too. You may be on the cutting edge of recovery in the future.
I do know how you feel somewhat. I have 4 years cleanEnough as of yday. Sub is a big part of that, but had a ruff time in the 12 step rooms because of it. Im not there today. But I do miss the peer support of it. We can all work togather,but do we have to keep our sub a secret? Idk...time will tell..

Best of luck Todd an congrats on 14 months Clean Enough!!


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PostPosted: Thu Jan 15, 2015 7:32 pm 
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Todd, you bring up some really interesting questions. I am looking into a masters program in Addiction Studies, which would include elements of counseling as well. I had also taken a couple of the required courses to get my CAC I (Colorado Addiction Counselor-entry level) before I decided to work on a masters degree instead. In Colorado a masters degree in the field gets you to a CAC level III with a few extras to complete. I bring this up because in the two classes I have taken, Principles of Addiction and Pharmacology, MAT was definitely part of the curriculum. So I have a couple of questions. Is your LCDC through the state of TX? I assume you've been required to take some classes. You're saying that none of the classes even mention MAT as possible drug abuse treatment? Or is the lincensure you are seeking through a specific drug treatment instituation?

Both of the preliminary classes that I took for a level 1 CAC mentioned the most current research on addiction, and that included information on methadone, buprenorphine, and several other drugs that are being testing for various addictions. I don't understand how a state could consider education in addiction counseling that didn't include the latest scientific research!!! Makes no sense to me. Would you please tell me the classes that you were required to take? Colorado has a list of 7 or 8 classes that are required for a CAC Level I.

I understand why you would be concerned about your addiction recovery tool not being represented in the places you may work. Since so many recovered addicts are in the field, I would be concerned that drug testing would be part of the job with zero tolerance for any opiate. Frankly, I'd also be concerned that I wasn't receiving the latest scientific evidence based information about addiction! Surely you learned the latest connections between addiction and the brain!?

I don't know how much programs vary state to state, and maybe I'm not surprised that TX isn't at the forefront of current evidence based best practices, but I don't think there should be that much variation between state education models. I'm very interested in what you have to say.

Amy

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PostPosted: Fri Jan 16, 2015 12:40 pm 
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Amy, Texas requires you have an associates degree (which I have), and then 540 classroom hours of chemical dependency studies, counseling, etc. Houston has a school (ICDS- Institute of Chemical Dependency Studies), that gets you the hours, so I went there. The article that was really long that someone posted about the choice theory or disease theory was one of the videos we watched. Yes, they gave us the info on brain function and how chemicals impact it (dopamine levels, and others). The class had like 6 sections, chemicals, counseling, ethics, relapse prevention...I'm at work now, so don't have the full list. So I have my required hours by the state, and I need 300 practicum hours, which I have around half. I just remember watching a video made by some LCDC's in Austin, and they were all basically making light of using suboxone as a "recovery" tool. I just don't see much difference than using antabuse (spelling?) for alcoholics...it's a medication to dissuade them harshly from drinking alcohol.

I'm doing my practicum at the Phoenix House in Houston, they are an out-patient recovery center. We work with youth, specialized females (victims of domestic abuse, assault, drugs), and we have a mixed adult group.

I was in rehab at a few places (fortunately/unfortunately...you know what I mean), and I stayed 45 days at Memorial Hermann, this was in 2009, and my second day they gave me 1 tab of suboxone, then stopped. While I was there 6 people that had finished or got kicked out b/c insurance wouldn't cover all committed suicide. They were all opiate addicts, and I think in my POV that if more people had access to suboxone we could save lives. I strongly believe that it is not the only answer, but should be combined with individual, and group therapy. I just know that 99% of the people in AA/CA/NA groups that I went to didn't consider you "clean" if you were on suboxone. I think the point needs to be SCREAMED that as LCDC's we are trying to save lives, and if suboxone can do that (which of course I do), than why not embrace it fully, along with counseling to work out our issues.

Sorry, it's so long, I'm just struggling with what I believe can help people, and what it seems the professionals are doing. If I had been on this medication 5 years ago, it may have saved my marriage, a couple cars, and thousands of dollars.


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PostPosted: Fri Jan 16, 2015 3:43 pm 
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Thanks for explaining, Todd. From what you are saying, your schooling introduced the idea of addiction as a disease of the brain, but they don't make the connection that sub and the like are tools of recovery that address the dysfunction of the brain? Weird.

It's not like I don't see this here in Colorado. There is a program that houses and treats pregnant addicts/addicts with small children, and the girls can be on methadone while they're pregnant but have to come off after they have their babies. Suboxone and methadone aren't seen as treatment tools in this program run by the University of Colorado ARTS department. Yet the same department has programs which include MAT as well. I can't tell why there is not more integration of scientific evidence based practice throughout all of their many programs. And I don't know if people who are hired choose a certain job because they have a bias toward one program or the other.

The best treatment practices seem to be multifaceted. But I'm sure there are professionals in the field and who run treatment programs that hold onto outdated practices. There must also be some treatment facilities in Houston that integrate newer practices though, right? Perhaps there is a suboxone clinic that includes counseling as a component that you could work for. Are you concerned about working at a place that does require counselors to be drug-free? Have you started to look for a job in the field or is that premature right now?

I would love it if you could share what you discover as you move from being a student to working in the field. It would be good to know what I may encounter professionally as I move forward as a sub patient myself.

Amy

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PostPosted: Fri Jan 16, 2015 4:06 pm 
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Yes, I am concerned that my employer in this field will require me to be drug-free (but drug-free to me ((semantics really)) is being off illegal substances, and not abusing any legal substances. I abused norcos and somas mainly, but I do not abuse suboxone. I did have to take a drug test at the Phoenix House where I worked on my practicum, and the test came back negative as I expected. I've been on suboxone for 14 months now, and have passed other drug tests for employment. From what I understand, the drug test would have to specifically test for this medication. I also think that suboxone gets a bad rap, because people in general refer to it as a "drug", and not medication. I mean you never hear people taking blood pressure pills, or cholesterol pills as "drugs". I know the substance abuse field is relatively small, and word is that your reputation is very important. I just don't want to end up failing a drug test when I'm trying to get a job, when in my viewpoint failing a drug test would mean that I was using illegal drugs, or abusing legal ones.

The people who run the school, will help you look for work, but I don't want to embarrass them by failing a drug test, IF, again IF testing positive for suboxone would be considered a positive (failed) drug test.


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PostPosted: Fri Jan 16, 2015 5:09 pm 
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You're absolutely right and I totally agree with you. There are many words that are loaded in this field: clean, sober, drug-free, etc. The state of active abuse and the state of utilizing suboxone correctly are totally different. The behaviors and choices of a person on sub is completely different than active addiction. It is a travesty that certain people in the profession equate them.

But we are the future, Todd! The more people like us who enter this field, the more that will change. I hope you find the perfect job for you and I commend you for entering the fight!

Amy

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PostPosted: Fri Jan 16, 2015 10:04 pm 
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Hi to Both of You

I have been following this thread and find it very interesting. First i am going way off base LOL The drug court judge in my area insists everyone be totally "drug" free. He does give the people time to go to rehab and taper off their DOC. Sounds good...well sounds good but isn't. We have had so many young people die that two of the family's that lost their sons within 2 weeks of each other, started a Drug education, referral's & bi-weekly meetings group. One of the mothers agree's 100% with the judge and is now friendly with him. The other mother feels like i do. One size does NOT fit all. The reason she changed her mind was i asked her to pay attention to the people in his drug court - sort of follow them. His true recover rate is 7 out of 100. 4 young people (ages 22-28) died in one weekend. This was after completing his drug court. Intense 3 month rehab with sober house for 3 months. He (well his staff actually) follows them for 24 months with meetings & UA's. 2 Years is nothing as far as i am concerned....maybe a beginning.

So now i get to both of you...IMO, only someone that has been addicted and is clean or "clean enough" would really now how to counsel an active addict or recovering addict. My own addiction therapist is an addict. He really understands when i talk about something. I feel i can say things to him that i would not say to another therapist. Laws have to be changed and professionals have to really learn about suboxone treatment. It's so frustrating and scary to read here how doctors don't know how to treat a suboxone patient or the doctor knows nothing at all about it. Especially Emergency room doctors, they are often the first to treat a person.

Todd and Amy, you would be wonderful in the field. I hope things change enough so you don't have to worry about being on MAT.

No parent or judge or therapist truly understands that even though a person wants to stop they often fail because going from numb to awake is hard to do and the "go to" for stress etc is their DOC.

One last thought. The woman above was told sub treatment was trading one addiction for another. My son's first doctor was good, she said he needed at least 2 years and then if he did well they would taper him down over the next 2 years. My son is alive and has his own child, her son is gone forever. When ever i see her i feel guilty-crazy right? Her son got the "best" treatment money could buy but the one treatment that may have saved his life they didn't want.

So there is my 2 cents and a whole lot more LOL


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PostPosted: Mon Jan 19, 2015 12:46 pm 
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Thanks for the encouragement, yes, I think that it is easier for an addict to counsel another addict (AA's message basically, one addict giving hope to another). I also believe that there are many excellent counselors out there that aren't addicts that have a want, and compassion to help us. I know the first time I went into rehab (6 years ago), I was exposed to AA/CA/NA, and I think many of us use that belief system as a "benchmark" for recovery. That said, one of my first meetings (about 100 people in attendance), I remember the chairperson saying, out of the hundred or so of you here, only about 7 or 8 of you will still be sober in a year. At that time I thought that was crazy, I was clean a whole 5 days, and thought "finally I'm off drugs!!", 3 months later I relapsed.

I mention this, because from room to room that I've been in, the consensus seems to be that only a handful of people stay sober for an extended period of time, even some people who have 5 years, I've seen them come back in and say they slipped. LESS THAN 10% recovery from a FATAL illness should be unacceptable in the medical field. I love a lot of the principles of AA, I did work the steps, and sponsor a couple guys, but yet I relapsed. I needed another solution, my simple plan of recovery is suboxone, prayer, and fellowship with sober people. I haven't been to a meeting in about 4 years, and like I've said before, I have 14 months sober, 14 months no active addict behavior.

I want to get into counseling, and am working in that direction, but I hope the substance abuse field will move more toward saving lives by using suboxone. I read on posts in this forum that people have suffered while on this medication, but it WORKS FOR ME. Medical solutions and advances will continue to improve, many will say it is impossible to cure alcoholism/drug addiction, but ponder this...what if a medication is discovered that cures addiction, then what will these groups do.

Years ago, I'm sure no one ever thought we could cure cancer, but treatments evolved...thru medication, that has helped to put that disease in remission, and thankfully for some, 100% gone from their bodies. Other sickness have been cured, that many 100 years ago probably never thought could be cured, but technology and research for new medications have cured many diseases.

Is it impossible to fathom that our disease could one day be cured???


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PostPosted: Mon Jan 19, 2015 3:47 pm 
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In 1990 I received my certificate of completion as a Chemical Dependency Specialist. (CDS) The reason I wanted it was to be able to work in the EAP (Employee Assistance Program) that my company had. Right after I got into that department they out sourced it to a 3rd party. They also wanted degreed professionals administering it instead of a 24 unit specialist that was recovering also. So I lost that position within 2 months of getting it. But going to college is never wasted time.

What I learned was, 1) there is a large burn out rate. 2) They may want at least a B.A. to get the job. And last, I found out I wasn't very good at it, or should I say I didn't enjoy it the way I thought I would.

Now throw in Buprenorphine treatment where we have no idea on how employers are going to react to that. We are in the beginning stages of Buprenorphine being used as a drug replacement therapy. Who can predict the outcome? We can only hope that the public becomes aware of the success rate of this new treatment method. Old time addicts like myself are finally able to live life without cravings or even worrying about cravings. It is such a marvelous drug treatment program.

At least we say that Dr. Junig has done wonders in the field of addiction therapy. Just how we can get all medical personnel to understand the benefits of Bupe, well, we'll just have to do the wait and see approach.

Obviously, times have changed since I got my certification. They now issue a license for it in Texas? Go for it Todd! You'll be a pioneer in the field and can only do it good. Somebody has to start the change, it might as well be you, Todd.

Print out lots of documentation from our good doctor here. His blogs are a library of great information. I wish you the best of luck getting that door knocked down and saving some lives.

rule

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Fond Du Lac Psychiatry
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