Holistic Approaches

to Pain Management andTreatment 

of Substance Use Disorders

including Opioids & Heroin

Acupuncture

Acupuncture is a part of East Asian medicine developed in China over 2,500 years ago and currently practiced throughout Asia, Europe and the United States. Acupuncture is the insertion of fine needles into specific points on the surface of the body for the purpose of stimulating healing. Acupuncture may be a safe and feasible treatment to assist mothers to reduce their dosage of methadone (Janssen et al, 2012). Acupuncture was found to be as effective as relaxation training techniques for problems with anxiety, sleep or substance use or in reducing the need for further addiction treatment in patients with substance use problems and comorbid psychiatric disorders (Ahlberg, Skarberg, Brus & Kjellin, 2016).

References

Ahlberg, R. Skårberg, K., Brus, O., & Kjellin, L. (2016). Auricular acupuncture for substance use: A randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services. Substance Abuse Treatment, Prevention, and Policy, 11(24), DOI 10.1186/s13011-016-0068-z

Janssen, P.A., Lou Demorest, L.C., Kelly, A., Thiessen, P. & Abrahams, R. (2012). Auricular acupuncture for chemically dependent pregnant women: A randomized controlled trial of the NADA protocol. Substance Abuse Treatment, Prevention, and Policy 7:48

Videos

Acupuncture - Back Pain Treatment - Full Version at: https://www.youtube.com/watch?v=fqUuPkaHFDI

Acupuncture Therapy to Relieve Stress and Sinus Issues | ASMR Triggers at: https://www.youtube.com/watch?v=TC4l0EmNkyY

Aromatherapy

Aromatherapy uses essential oils extracted from plants and herbs that can be inhaled or applied through the skin. Aromas derived from these natural plant sources have been shown in clinical studies to have positive effects on the mind and the body. These essential oils, which are composed of naturally occurring chemicals, can help to support emotional balance, a sense of calm, stress relief, and feelings of well-being. It is known that thinkin about the scent can be as powerful as the scent itself. Mentioning certain scents can bring about a deeper discussion of feelings and emotions, allowing the patient to tune into the experience more intimately, to feel it more directly, and to connect to it on a fuller level (LaTorre, 2003). Aromatherapy provides a potentially effective treatment for a range of psychiatric disorders appears to be without the adverse effects of many conventional psychotropic drugs (Perry & Perry, 2006).

References

Perry, N. & Perry E. (2006). Aromatherapy in the management of psychiatric disorders: Clinical and neuropharmacological perspective. CNS Drugs, 20(4), 257-280.

LaTorre, M.A. (2003). Aromatherapy and the use of scent in psychotherapy. Perspectives in Psychiatric Care, 39(1), 35-37.

Video

What is Aromatherapy? At: https://www.youtube.com/watch?v=Qtd2CuGgaD4

Biofeedback

Biofeedback is a scientific way of learning how to reduce tension. Biofeedback practitioners use instruments to give a person immediate feedback about the level of tension in their body. People practicing biofeedback often say they gain psychological confidence when they learn that they can control their physical reactions. Biofeedback has been found effective in several aspects of addiction treatment (Sokhadze, Cannon & Trudeau, 2008). Heart rate variability biofeedback (HRV BFB) is a clinical intervention that is gaining growing empirical support for the treatment of a number of psychological disorders, several of which are highly comorbid with substance use disorders (SUDs). The autonomic nervous system is the bases of two key processes implicated in the formation and maintenance of addictive pathology—affect dysregulation and craving—and it appears that HRV BFB may be an effective intervention to ameliorate autonomic nervous system dysregulation in these processes, and as such, prove to be an effective intervention for SUDs (Eddie et al, 2015 and Eddie et al 2014).

References

Eddie, D., Vaschillo, E., Vaschillo, B. & Lehrer, P. (2015). Heart rate variability biofeedback: Theoretical basis, delivery, and its potential for the treatment of substance use disorders. Addiction Research & Theory, 23(4): 266–272. DOI:10.3109/16066359.2015.1011625

Eddie, D., Kim, C., Lehrer, P., Deneke, E. & Bates, M.E. (2014). A pilot study of brief heart rate variability biofeedback to reduce craving in young adult men receiving inpatient treatment for substance use disorders. Applied Psychophysiological Biofeedback, 39, 181–192. DOI 10.1007/s10484-014-9251-z

Sokhadze, T.M., Cannon, R.L. & Trudeau, D.L. (2008). EEG biofeedback as a treatment for substance use disorders: Review, rating of efficacy, and recommendations for further research. Applied Psychophysiological Biofeedback, 33, 1–28 DOI 10.1007/s10484-007-9047-5

Video

What Is Biofeedback? Center for Brain Training's, Mike Cohen, Discusses Types of Biofeedback at: https://www.youtube.com/watch?v=4Sin4QR4cwo

Creative Arts Therapies 

Art Therapy – Dance Therapy – Drama Therapy – Poetry Therapy

These creative therapies can be very helpful in the process of recovery from addiction. They offer the opportunity to get in touch with their inner self and with their higher power. These creative therapies can provide a form of expression for feelings that cannot be easily identified or put into words. Through helping the people with an addiction connect with their more authentic self, the expressive therapies can help raise self-esteem and provide an opportunity to create new experiences beyond habitual and painful emotional patterns. The creative arts foster a renewed ability to relax without drugs or alcohol (Oklan & Henderson, 2014). Art therapy has been empirically assessed as an effective form of relapse prevention for substance abusers who are relatively treatment resistant, defensive and unexpressive (Tam, Shik & Lam, 2016)

References

Oklan, A.M. & Henderson, S.J. (2014). Treating inhalant abuse in adolescence: A recorded music expressive arts intervention. Psychomusicology: Music, Mind, and Brain, 24(3), 231–237. doi.org/10.1037/pmu0000058

Tam, H., Shik, A.W & Lam, S.S. (2016). Using expressive arts in relapse prevention of young psychotropic substance abusers in Hong Kong. Children & Youth Services Review. 60, 88-100. DOI:10.1016/j.childyouth.2015.11.022

Videos

Dance/Movement Therapy, Mindfulness & Substance Abuse Recovery at: https://www.youtube.com/watch?v=b1YryiseVWY

How Does Art Therapy Heal the Soul? | The Science of Happiness at: https://www.youtube.com/watch?v=BN2rTaFUlxs

Dance/Movement Therapy & Mental Illness at: https://www.youtube.com/watch?v=TIhpLsgQ1is

Dance/Movement Therapy at: https://www.youtube.com/watch?v=qy34LAXF-R0

An Insight Into Drama Therapy at: https://www.youtube.com/watch?v=uZc8VPEusKI

Geri Chavis - author of "Poetry and Story Therapy: The Healing Power of Creative Expression" at: https://www.youtube.com/watch?v=eTawF13BzGM

Welcome to Poetry Therapy at: https://www.youtube.com/watch?v=LzosdtW-QVA

Equine-Assisted Therapy in addiction treatment

Equine-Assisted Therapy has been around for a long time. It was originally started as a therapy for people with physical disabilities and developmental disorders. It has been successfully used as part of the treatment for various psychological issues such as depression, anxiety, and eating disorders as well. People recovering from addiction have also been found to benefit from interactions with horses. This type of outdoor therapy experience combines the power of nature with the benefit of forming a relationship with an animal to help build confidence, trust, patience, and self-esteem. Some addiction treatment programs have seen results from the use of horses in treatment, particularly for younger patients, although most research evidence on equine therapy’s benefits has taken place outside of the substance use treatment field (ADAW, 2015). It is believed that Patients riding a horse can become familiar with the tools needed to get the horse to respond effectively, and that can translate for the patients to an understanding of the tools they need to stay grounded in recovery, from support meetings to daily meditations. Also, the “herd” dynamics that patients observe in how the horses interact with one another teach lessons about leading and following in life, everything observed in working with the horses is a tie-in to something else (ADAW, 2015). Four interrelated aspects of equine therapy, namely “change of focus”, “activity”, “identity”, and “motivation,” suggest this therapy is more than just a break from usual SUD treatment. The stable environment is portrayed as a context where participants could construct a positive self: one which is useful, responsible, and accepted; more fundamentally, a different self from the “patient/self” receiving treatment for a problem (Kern-Godal et al., 2016).

References

ADAW (2015). Evidence grows for equine therapy as treatment engagement tool. Alcoholism & Drug Abuse Weekly, 27(41). DOI: 10.1002/adaw

Kern-Godal, A., Brenna, I.H., Arnevik, E.A. & Ravndal, E. (2016). More than just a break from treatment: How substance use disorder patients experience the stable environment in horse-assisted therapy. Substance Abuse Research and Treatment, 10, 99–108. doi: 10.4137/SART.S40475.

Videos

Horses Help Heal Veterans' Invisible Wounds | National Geographic at: https://www.youtube.com/watch?v=Z7EedCwJ4ww

Horse Therapy: Addiction, Depression, and Suicide Prevention at: https://www.youtube.com/watch?v=F8zlthz_tDU

Unexpected Miracles - Horses Healing Humans at: https://www.youtube.com/watch?v=UnOgqyR9kr8

Gardening

Being in nature is known, in and of itself, to have a healing effect on the mind and emotions. Gardening as a form of therapy has increasingly been used as an approach to addiction and mental health treatment. Healing gardens are often a part of addiction treatment centers, long term care facilities and other healthcare settings. Gardening can help to lower stress, boost self-confidence, build teamwork, and foster perseverance. The rewards are both immediate and long term as one sees the plants and garden develop and change with the seasons. This can be as simple as having some potted herbs or plants in one's home; becoming part of a community garden; or cultivating one's own vegetable or flower garden on one's roof if allowed or at one's home. Gardening promotes a new self-concept and gardening helps emotional and behavioral managemen (Twill, Purvis & Norris, 2011).  Research has shown that patients participating in gardening programs resulted in experiencing reduced stress and depression, in addition to improving the quality of their lives (Detweiler, et al., 2015).

References

Detweiler, M.B., Self, J.A., Lane, S. Spener, L., Lutgens, B., Kim, D.Y., Halling, M.H., Rudder, T.F., & Lehmann, L. (2015). Horticultural therapy: A pilot study on modulating cortisol levels and indices of substance Craving, posttraumatic stress disorder, depression, and quality of life in veterans. Alternative Therapies, 21(4), 36-41.

Twill, S.E., Purvis, T. & Norris, M. (2011). Weeds and seeds: Reflections from a gardening project for juvenile offenders. Journal of Therapeutic Horticulture, 21(1), 7-17.

Videos

Mental Health Center of Denver Horticulture Therapy Program at: https://www.youtube.com/watch?v=AA-7oWBZU6Y

Horticulture Therapy Heals the mind body and spirit at: https://www.youtube.com/watch?v=wWTZ7IckyTw

Guided Imagery

Guided Imagery involves the use of the imagination to achieve specific healing and life goals. It can be effective in helping people cope with stress and regain a sense of control and well-being. As with all other mind/body techniques, interest, motivation and practice are keys to the successful use of guided imagery for health and healing. Guided imagery is considered a nonpharmacologic modality as well as complementary and alternative medicine, and involves imagining scenes, pictures, or experiences to help the body heal from pain (Burhenn et al., 2014). It was found that incorporating guide imagery and other holistic therapies helped patients reduce opiate use. While some patients found other physicians to give them the opiates they desired, those who persisted in an environment of respect and acceptance significantly reduced opiate consumption compared with patients in conventional care. While resistant to complementary and alternative medicine therapies initially, the majority of patients came to accept and to appreciate their usefulness (Mehl-Madrona, Mainguy & Plummer, 2016). Stress Management techniques utilizing guide imagery were found to reduce pain for those suffering from chronic neck pain (Metikaridis et al., 2017).

References

Burhenn, P., Jill Olausson, J. Villegas, G. & Kravits, K. (2014). Guided imagery for pain control. Clinical Journal of Oncology Nursing, 18(5), 501-503. DOI:10.1188/14.CJON.501-503

Mehl-Madrona, L., Mainguy, B. & Plummer, J.(2016) Integration of complementary and alternative medicine therapies into primary-care pain management for opiate reduction in a rural setting. Journal of Alternative & Complementary Medicine, 22(8), 621-626. DOI:10.1089/acm.2015.0212

Metikaridis, D., Hadjipavlou, A., Artemiadis, A., Chrousos, G., & Darviri, C. (2017). Effect of a stress management program on subjects with neck pain: A pilot randomized controlled trial. Journal of Back & Musculoskeletal Rehabilitation, 30(1), 23-33. DOI:10.3233/BMR-160709

Videos

Guided Meditation For Anxiety & Stress, Beginning Meditation, Guided Imagery Visualization at: https://www.youtube.com/watch?v=6vO1wPAmiMQ

Calming our minds: Relaxing music & Affirmations for a Peaceful life & Relaxation at:   https://www.youtube.com/watch?v=tOQaVSX-N4c

Releasing Negative Thoughts Spoken Affirmations for a peaceful, calm positive mind at: https://www.youtube.com/watch?v=8mSJ4uKRBf0

Herbal Therapy

Herbs are natural plant substances that have a variety of effects on the body. Many herbs have long been used in detoxification. Kudzu has the potential for moderating alcohol abuse. Kava and valerian can be used to treat the insomnia that accompanies withdrawal. Milk thistle has been shown to improve liver function. The use of herbs in the recovery process may be most effective when combined with other strategies that support the whole person including nutrition, bodywork, acupuncture, relaxation and exercise (Behere, Muralidharan & Benegal, 2009). It has also been demonstrated that there is a link of the action of herbs or acupuncture to the neurotransmitters system  implicated in alcohol dependence (Liu, Lawrence & Liang, 2011).

References

Behere, R.V., Muralidharan, K. & Benegal, V. (2009). Complementary and alternative medicine in the treatment of substance use disorders—a review of the evidence. Drug and Alcohol Review, 28, 292–300. DOI:10.1111/j.1465-3362.2009.00028.x

Liu, Q, Lawrence, A.J. & Liang, J.H. (2011). Traditional Chinese medicine for treatment of alcoholism: From ancient to modern. The American Journal of Chinese Medicine, 39(1), 1–13. DOI: 10.1142/S0192415X11008609

Video

Top 10 Natural Pain Killers at: https://www.youtube.com/watch?v=gNXrRljjgW8

Homeopathy

Homeopathy is a non-toxic, gentle system of medicine that uses highly-diluted remedies to treat illness and relieve discomfort in a wide variety of health conditions. It is thought that homeopathic remedies are able to stimulate a person’s bodily systems to deal with stress and illness more efficiently. Research is currently being undertaken to understand how and why these remedies work on the mental and physical level. Specific homeopathic remedies may be helpful during the period of withdrawal from alcohol or drugs. Homeopathy is practiced by licensed physicians and other qualified prescribers in many parts of the world, including Europe, Asia, and the U.S. While self-care with homeopathy can be helpful for minor short-term illnesses and injuries, if an illness or condition is chronic or serious, it is best to consult an experienced prescriber for a remedy that more accurately meets an individual’s health needs. It has been difficult to research the effectiveness of Homeopathy with mental health and substance abuse disorders, but results of such studies support its use with these disorders (Adler et al., 2011). Alcoholism is one of the world's costly drug use problem. In addition, an alcoholic can develop multiple forms of addiction to alcohol simultaneously such as psychological, metabolic, and neurochemical. This behavior interferes with the alcoholic's normal personal, family, social, or work life. Here the best way of Homeopathic mode of treatment is to treat the patient by giving constitutional medicine along with moral support (Gupta & Shah, 2015). The therapeutic potential of perispinal injection for CNS disorders is highlighted by the rapid neurological improvement in patients with otherwise intractable neuroinflammatory disorders that may ensue following perispinal etanercept administration (Tobinick et al., 2012 & Tobnick et al., 2014, & Tobinick, 2016).

References

Adler,U.C., Kruger, S., Teut, M., Ludtke, R. Bartsch, I., Schutzler, L., Melcher, F., Wilich, S.N., Linde, K. & Witt, C.M. (2011). Homeopathy for depression - DEP-HOM: study protocol for a randomized, partially double-blind, placebo controlled, four armed study. Trials, 12, 43. doi:10.1186/1745-6215-12-43

Gupta, D.K. & Shah, P. (2015). Treating alcoholism in the global era by homeopathy. National Journal of Integrated Research in Medicine, 6(2), 117-120. 

Tobinick, E., Kim, N.M., Reyzin, G., Rodriguez-Romanacce, H. & DePuy, V. (2012). Selective TNF inhibition for chronic Stroke and traumatic brain injury: An observational study involving 629 consecutive patients treated with perispinal etanercept. CNS Drugs 26,1051-1070. DOI 10.1007/S40263-012-0013-2

Tobinick, E., Rodriguez-Romanacce, H., Levine, A., Ignatowski, T.A. & Spengler, R.N. (2014). Immediate Neurological Recovery Following Perispinal Etanercept Years After Brain Injury. Clinical Drug Investigations, 34, 361–366. DOI10.1007/s40261-014-0186-1

Tobinick, E. (2016). Perispinal delivery of CNS drugs. CNS Drugs, 30(6), 469-480. DOI:10.1007/s40263-016-0339-2

Videos

Homeopathic Remedies for Back Pain at: https://www.youtube.com/watch?v=f4sd2ks2d7w

Immediate relief after 2 years of severe constant pain 480p at: https://www.youtube.com/watch?v=vP6Nw1_OGIg (Tobinick et al., 2012 & Tobnick et al., 2014, Tobnick, 2016).

Hypnosis

Hypnosis is a calm natural state of focused attention which can be produced by one's self or with the help of a therapist. From that state, the mind is especially receptive to ideas and suggestions compatible with the person's goals. Some people have found hypnosis to be a useful part of a total recovery program. It has been used in dealing with patients who are wanting to stop drinking with some success (Jayasinghe, 2005). Hypnosis allows the patients reinvestment their senses, as well as a modification of their relationship with the outside world. This helps them to change and start a process of opening up and letting go of their addicting behaviors (Kammoun et al., 2009).

References

Jayasinghe, H.B. (2005). Hypnosis in the management of alcohol dependence. European Journal of Clinical Hypnosis, 6(3). 12-16.

Kammoun, M.F., Anastasiu, A., Dumoulin, T. & Garrigou, J.L.(2009). P03-54 Hypnosis and addictions: A two cases report. European Psychiatry. Supplement 1, 24, S1053-S1053.

Videos

Hypnotherapy Treatment for Anxiety (Mental Health Guru) at: https://www.youtube.com/watch?v=jvFtsXiVBoU

Hypnosis for Pain Control and Pain Relief at: https://www.youtube.com/watch?v=zlHhkGRthLE

The Truth Behind Hypnotherapy at: https://www.youtube.com/watch?v=l1Ciaa5zW78

Spiritual and Emotional Healing Hypnosis, Connect to the Universe, Receive Higher Self Meditation at: https://www.youtube.com/watch?v=SY1FX6ZU-YQ

Journaling

Writing in a personal journal is an excellent tool for self-reflection, charting your progress, recording your daily experiences and thoughts, and identifying your goals, habit patterns, conflicts and gratitude. It can help you express your thoughts and explore and clarify any issues you may be dealing with in a private way. The Tools for Coping Books on www.coping.usall utilized Journaling at the end of each of their chapters to encourage their readers to progress in their recovery efforts. Bibliotherapy and journaling have been identified as recovery tools with African Americans with substance use disorders (Johnson, 2012). In another research project, participants intended to drink significantly fewer drinks per week and engage in marginally fewer heavy drinking occasions after writing about a negative drinking occasion in their journal writing exercises (Young, Rodriguez & Neighbors, 2013).