Prescription Medication Dependency or Substance Use

First things first: nobody grows dependent on a substance because they're bad.

Society almost invariably sees substance use and dependency as moral shortfalls on account of the patient; and the medical approach towards these issues is usually paved with judgement,

Seriously, does the smoker already experiencing lung cancer or emphysema need to be interrogated with criticism about the habit that has played a role in their unfortunate disease? Does the patient with an opioid dependency need to be reminded that what they are doing is "bad"? I am pretty sure the internal language of their minds is abrasive enough by now, and internal punishment is the order of the day.

How about approaching substance and prescription dependency with kindness and compassion? Risk reduction strategies start to happen almost naturally and overall use decreases as we make an effort to understand why the client's internal system has decided a substance is the mandatory way to cope.

Prescription Medications:

Working in the highly prescriptive arena of palliative care has gifted me with significant knowledge on medications and substances that work on the brain. The ability to "down-taper" a patient off from a medication is -absurdly- a nuanced talent not taught in medical school nor specialty training. It seems the medical industry has wanted providers to learn how to add medications to the patient's roster, but not how to remove them.

If your intention is to decrease your reliance on a painkiller, a sleeping medication, an antidepressant or any other medication that works on the brain; we could work on this goal together. if previous attempts at decreasing your dependency on these pharmaceuticals have been challenging, this is an arena of care where I could be of help. Nuanced titration of psychotropics, management of withdrawal symptoms and consideration of replacing higher risk prescription medications (e.g. benzodiazepines for sleep, excessive amount of opioid pain medications for pain, etc.) with lower risk alternatives; are all issues that I could help you with.

Substance Use:

The approach that IFS (Internal Family Systems Therapy) has towards substance use is truly radical. If we think about our internal worlds as a cornucopia of parts each with a particular role, and many of them galvanized in a particular direction as a consequence of trauma; it's easy to think about parts of us that have decided outside sources (e.g. substances) are the only way to decrease emotional pain in the system. The complexity of the issue grows as reactive critic parts -understandably so- take over in succession and shame the behavior abrasively. Just like two independent agents, the part that uses the substance and the critic engage in an intense escalation; each pulling harder into their corner. An effective IFS session adds much needed perspective to this escalation, offers appreciation and understanding to the most polarized of parts, and slowly allows for de-escalation of behavior.

In this way, IFS is a systematic way to offer compassion to the conundrum of substance use.

The 'War on Drugs' that has failed immensely at a continental scale, has -unsurprisingly- given us poor results at the individual level as well, and allowed very little space for healing.

I am a certified Suboxone prescriber -a replacement agent for opioid dependency- and have experience with prescribing other agents helpful in allowing the system to slowly and safely decrease reliance on illegal and legal substances. But the journey of doing this through compassion and understanding is beyond valuable, in this world where judgement has been the order of the day.