Holistic Approaches
to Pain Management and Treatment
of Substance Use Disorders
including Opioids
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Dealing with the Opioid Epidemic -
A Training Resource
By Jim Messina, Ph.D., CCMHC, NCC, DCMHS-T
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Prologue
There are a number of Holistic approaches to treatment of substance use disorders including Opioid and Heroin Addiction. What follows is not an exhaustive list but a comprehensive summary of known Holistic Approaches being used at the current time in conjunction with Residential Treatment, 12 Step Programming, Evidence Based Psychotherapy and other long term interventions to address the overwhelming epidemic of the abuse of opioids, heroin and related substances.
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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
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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
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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).
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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).
References
Johnson, M. (2012). Bibliotherapy and journaling as a recovery tool with African Americans with substance use disorders. Alcoholism Treatment Quarterly, 30(3), 367-370. DOI:10.1080/07347324.2012.691042
Young, C.M., Rodriguez, L.M. & Neighbors, C. (2013). Expressive writing as a brief intervention for reducing drinking intentions. Addictive Behaviors, 38(12), 2913-2917. DOI:10.1016/j.addbeh.2013.08.025
Videos
Journaling for Depression at: https://www.youtube.com/watch?v=RLPTkbBjwO4
Battling Bipolar Disorder: Journaling for Mental Health at: https://www.youtube.com/watch?v=zTHk1F-a7Cw
Massage and Bodywork
Massage and bodywork address the mind/body/spirit, offering the possibility of healing and change on many levels. On a physical level, it can facilitate the release of tension and holding and improve energy balance and flow. It also offers the opportunity to explore deeper levels of relaxation and peace, greater self-acceptance and awareness, and a deeper connection to self and others. Management of non-specific neck pain disorders often include massage therapy as well as exercise therapy intervention or promotion which have been found to be effective non-pharmaceutical treatments (Skillgate et al., 2015). Patients with severe pain were found after massage therapy, to report highly significant improvement in their levels of distress, pain, tension, discomfort, and mood compared with their premassage ratings (Suresh et al, 2008).
References
Skillgate, E., Bill, A.S., Cote, P., Viklund, P., Peterson, A. & Holm, L.W. (2015). The effect of massage therapy and/or exercise therapy on subacute or long-lasting neck pain - the Stockholm neck trial (STONE): Study protocol for a randomized controlled trial. Trials, 16, 414. DOI 10.1186/s13063-015-0926-4
Suresh, S., Wang, S., Porfyris, S., Kamansinski-Sol, R. & Steinhorn, D.M. (2008). Massage therapy in outpatient pediatric chronic pain patients: do they facilitate significant reductions in levels of distress, pain, tension, discomfort, and mood alterations? Pediatric Anathesia, 18.884-887. doi:10.1111/j.1460-9592.2008.02638.x
Video
What's The Difference Between A Massage & Bodywork at: https://www.youtube.com/watch?v=s0U2pBCsC0I
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Meditation
Meditation has roots in many spiritual traditions, including Hinduism, Buddhism, Islam, Judaism, and Christianity. Meditation emerged in each case as a spiritual practice to discipline the mind and deepen spiritual awareness. There is an ongoing call for the incorporation of spirituality into the world of substance abuse treatment and the use of meditation seems to be responsive to this call (Horton & Naelys, 2016). Today meditation is also practiced for stress management, personal growth, general wellness, and its therapeutic effects for medical and emotional difficulties. The most recent boost to meditation comes from the mindfulness meditation movement, derived from Vipassana in Buddhism but presented in Western form by Jon Kabat-Zinn and others (Moss, 2011). An abundance of empirical research studies has now emerged documenting specific benefits from mindfulness meditation and meditation in general. There are many different types of meditation which all work to slow down the chatter of the mind and promote relaxation and mental clarity. Benefits of these age-old techniques of healthy living have been shown to persuasively to promote resilience and better mental health (Hazri & Sakar, 2014).
Mindfulness – Helps one to tap into the present moment – for relaxation and reduction of stress in any situation: at home, at the office or school, while driving, and while shopping. Mindfulness has been found to reduce opioid cue-reactivity while restructuring natural reward processing and provides preliminary support for the hypothesis that behavioral interventions may ameliorate craving by enhancing reward responsiveness (Garland, Froeliger, & Howard, 2014). Also recent study has demonstrates preliminary feasibility and efficacy of Mindfullness Meditation as a treatment for co-occurring prescription opioid misuse and chronic pain (Garland, Manusov, Froeliger, Kelly, Williams & Howard, 2014). Providing training and promoting mindfulness as an effective factor for the treatment and reduction of detrimental impacts of addiction can be a major step toward treatment of dependency on drugs and its individual and social impacts. Through providing adequate trainings to patients, the addiction intensifying factors can be harnessed, preventive measures can be strengthened, and the forthcoming detrimental outcomes can be prevented (Imani, et al, 2016).
Transcendental Meditation - The long-term positive effects of Transcendental Meditation seems to be correlated with a reduced relapse rate. Transcendental Meditation may not only reduce tension and anxiety, but also enhance a sense of control in anxiety-provoking situations that strengthens the long-term resistance to stress. Transcendental Meditation (TM) program has been recommended for improving soldier resilience, and as a viable adjunctive treatment option for PTSD and Anxiety (Barnes, Monto, Williams & Rigg, 2016).
References
Barnes, V.A., Monto, A., Williams, J.J., & Rigg J.L. (2016). Impact of transcendental meditation on psychotropic medication use among active duty military service members with anxiety and PTSD. Military Medicine,181(1), 56-63. doi:10.7205/MILMED-D-14-00333
Garland, E.L., Froeliger, B. & Howard, M.O. (2014). Effects of mindfulness-oriented recovery enhancement on reward responsiveness and opioid cue-reactivity. Psychopharmacology, 231, 3229–3238. DOI 10.1007/s00213-014-3504-7
Garland, E.L., Manusov, E.G., Froeliger, B. Kelly, A., Williams, J.M., & Howard, M.O (2014). Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: Results from an early-stage randomized controlled trial. Journal of Consulting and Clinical Psychology, 82(3), 448–459. DOI: 10.1037/a0035798
Hazari, N. & Sakar, S. (2014) A Review of yoga and meditation neuroimaging studies in healthy subjects. Alternative and Complementary Therapies, 20(1), 16-26.
DOI: 10.1089/act.2014.20109
Horton, E.G. & Naelys, L. (2016) Spirituality in the treatment of substance use disorders: Proposing the Three-legged Stool as a model for intervention. Journal of Religion & Spirituality in Social Work, 35(3), 179-199. DOI:10.1080/15426432.2015.1067585
Imani, S., Vahid, M.K.A., Gharraee, B., Noroozi, A., Habibi, M. & Bowen, S. (2016). Effectiveness of mindfulness-based group therapy compared to the usual opioid dependence treatment. Iranian Journal of Psychiatry,10(3), 175-184
Moss, D. (2011). Special issue: Yoga, meditation, and applied psychophysiology Biofeedback, 39, (2), 43–44. DOI: 10.5298/1081-5937-39.2.11
Videos
How can mindfulness change your life - Jon Kabat Zinn at: https://www.youtube.com/watch?v=EJjyrzqkXrE
9 Attitudes - Jon Kabat Zinn at: https://www.youtube.com/watch?v=2n7FOBFMvXg&feature=em-subs_digest-vrecs
Jon Kabat-Zinn: Body Scan at: https://www.youtube.com/watch?v=D8oKWQiEWYs
Mindfulness for Beginners by Jon Kabat Zinn Audiobook at: https://www.youtube.com/watch?v=eaL24Ppn_fM&feature=em-subs_digest-vrecs
The Science And Spirituality Of Meditation – Documentary at: https://www.youtube.com/watch?v=s7TrfTuD9Q4
Meditation Music for Positive Energy - Relax Mind Body | Spiritual Awakening Music at: https://www.youtube.com/watch?v=URWss3EzpVQ
Meditation Music for Positive Energy l Clearing Subconscious Negativity l Relax Mind Body at: https://www.youtube.com/watch?v=-1bl9H9bNPA
Music Therapy
Music can have a powerful effect on emotions and mood. It can be a vehicle for self-expression and can help create peaceful and calm feelings. As such, it can be a valuable tool for people working to overcome an addiction. Music therapy can help people process emotions and supports personal growth important to overcoming addictions. Research into the effect of group improvisational music therapy on depression in adolescents and adults with substance abuse was investigated music therapy relieved their depressive symptoms (Albornoz, 2011). Use of Music therapy with postoperative patients resulted in them experiencing enhanced pain management and environmental noise satisfaction (Commeaux & Steele-Moses, 2013). But even just listening to music on your own or creating music can have some important benefits. It can help: (1) Release or calm the emotional highs and lows people often feel when they first become sober, (2) Manage stress levels - listening to or creating music can be a wonderful way to de-stress, (3) Relieve a sense of boredom that is often felt in early recovery and (4) Increase enjoyment and reduce feelings of loneliness which can lessen the stress of recovery
References
Albornoz, Y. (2011). The effects of group improvisational music therapy on depression
in adolescents and adults with substance abuse: A randomized control trail. Nordic Journal of Music Therapy, 20(3), 208-224. doi.org/10.1080/08098131.2010.522717
Comeaux, T. & Steele-Moses, S. (2013). The effect of complementary music therapy on the patient's postoperative state anxiety, pain control, and environmental noise satisfaction. Medical Surgical Nursing, 22(3), 313-318.
Videos
Music Therapy & Emotions for Depression, Stress & Mental Health Issues at: https://www.youtube.com/watch?v=I1R-r-VBySY
Music Therapy to Relax Before Sleep: Let go of Stress, tension, anxiety relief at: https://www.youtube.com/watch?v=HjDkQfSPBkA
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Neurofeedback
Neurofeedback (also called Brain wave biofeedback) is a therapy in which patients learn to change their brain wave patterns. Changing brainwaves can have a beneficial effect on relaxation and reduce stress and its unhealthy impact on the brain and nervous system. In one type of neurofeedback the training involves normalization of alpha and theta brain waves which are disturbed by long term substance abuse. Neurofeedback has shown dramatic success in several studies in preventing relapses from drug and alcohol addiction. Neurofeedback is considered an excellent therapeutic tool for treating substance abuse conditions and for treating eating disorders. Although it has been used primarily in treating attention deficit disorders, neurofeedback is seen as beneficial in the treatment of many conditions affecting thought processes (ADAW, 2010). The Flexyx Neurotherapy System (FNS), a novel variant of EEG biofeedback, was adapted for intervention with seven treatment-refractory Afghanistan/Iraq war veterans, and brought about significant decreases in bothersome neurobehavioral and posttraumatic stress symptoms. FNS may help ameliorate mixed trauma spectrum syndromes Nelso & Esty, 2012).
References
ADAW (2010). Neurofeedback: Fact or fiction. Alcoholism & Drug Abuse Weekly. 22, DOI: 10.1002/adaw
Nelson, D.V. & Esty, M.L. (2012). Neurotherapy of traumatic brain injury/posttraumatic stress symptoms in OEF/OIF veterans. The Journal of Neuropsychiatry and Clinical Neurosciences, 24(2), 237–240.
Video
What Is Neurofeedback? How Brain Training Can Benefit Kids, Families, and Adults at: https://www.youtube.com/watch?v=HxHR7InSQ1c
Nutrition
In dealing with the chemical imbalances that are both a cause of substance abuse and a result of long-term substance addiction, nutritional therapy can be helpful in several ways. It has been found that there is a strong relationship between sugar addiction and alcoholism. Eliminating certain substances such as sugars and simple starches and increasing protein intake can help to rebalance brain chemistry. Good nutrition can also help heal damage to the body caused by the depletion of nutrients common in substance abuse. Use of nutritional Supplements, Vitamins and Herbs helps restore the proper biochemical balance in the brain.Research has found that nutrition education is an essential component of substance abuse treatment programs and can enhance substance abuse treatment outcomes. For this reason, nutrition education, should be incorporated into substance abuse treatment programs (Grant, Haughton & Sachan, 2004). Supporting this point of view is that indications are that drug abuse may increase the risk of the metabolic syndrome because Drug-abusing patients have higher rates of diabetes complications and Substance abuse is a significant contributing factor for treatment noncompliance in diabetes and finally Nutrition education can enhance substance abuse treatment outcomes (Virman et al., 2007)
References
Grant, L.P., Haughton, B. & Sachan, D.S. (2004). Nutrition education is positively associated with substance abuse treatment program outcomes. Journal of the American Dietetic Association 104(4), 604-610. DOI:10.1016/j.jada.2004.01.008
Virmani, A. Binienda, Z.K., Ali, S.F. & Gaeani, F. (2007) Metabolic syndrome in drug abuse. New York Academy of Sciences, 1122, 50–68. doi: 10.1196/annals.1403.004
Videos
24 Anti Inflammatory Foods with Crazy Powerful Healings Benefits at: https://www.youtube.com/watch?v=qiiMWKTep2U
How to Avoid Inflammatory | 7 Foods You Should Avoid That Cause Inflammation at: https://www.youtube.com/watch?v=nxrBTAtsE1U
Pet Therapy
Animal-assisted therapy is being used in a wide variety of settings to help people with acute and chronic illnesses. This is based on the many physical and psychological benefits seen in patients when they interact with animals. These include lowered blood pressure and heart rate, increased beta-endorphin levels (a hormone produced by the brain and nervous system that reduces pain), decreased stress levels, reduced feelings of anger, hostility, tension and anxiety, improved social functioning, and increased feelings of empowerment, trust, patience and self-esteem. Animal therapy is looked upon as both a learning and healing experience. It has been demonstrated that simple presence of a dog was beneficial for reducing stress levels in stressed adults (Gonzalez-Ramierz et al, 2013). Literature has shown that animals’ presence, spontaneous behaviors and availability for interaction may facilitate therapy. It has been demonstrated that interactions with a friendly animal can result in reducing levels of cortisol and increasing oxytocin, dopamine, endorphins and phenethylamine (Abreau & Figueiredo, 2015).
References
Abreu, T.& Figueiredo, A.R. (2015). Paws for help – Animal-assisted therapy. European Psychiatry. Supplement 1, 30, 1651-1651. DOI:10.1016/S0924-9338(15)31274-8
González-Ramírez, M.T., Ortiz-Jiménez, X.A., & Landero-Hernández, R. (2013). Cognitive–behavioral therapy and animal-assisted therapy - Stress management for adults. Alternative and Complementary Therapies 19(5), 270-275. DOI:10.1089/act.2013.19505
Videos
Animal Assisted Therapy at: https://www.youtube.com/watch?v=J1yA_jPcjEo
Animal Assisted Therapy: How Pet Therapy Works at: https://www.youtube.com/watch?v=YW52mdoI-W8
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Tai chi and Qigong
There are many ways to achieve a meditative state of mind. For those who have trouble sitting quietly for periods of time, various movement practices and martial arts, such as tai chi, qigong, and karate, can focus and calm the mind and enhance feelings of self-confidence and self-worth.
Tai chi has been found in a recent study to be a promising exercise that improves quality of life for individuals with stimulant dependence (Dong et al., 2016).
Qigong - is a traditional Chinese health practice for mind and body wellness. It integrates slow movement, a relaxed posture, a focus on breathing, and a clear and calm state of mental awareness. It is considered a form of exercise called “moving meditation". Qigong meditation appears to contribute positively to addiction treatment outcomes, with results at least as good as those of an established stress management program. Results for those who meditate adequately are especially encouraging. Meditative therapy may be more effective or acceptable for female drug abusers than for males. (Chen, Comerford, Shinnick, & Ziedonis, 2010). A recent study showed that internal Qigong generated benefits on treating some chronic pain with significant differences (Bai et al, 2015).
References
Bai, Z., Guan, Z., Fan, Y. Liu, C., Yang, K., Ma, B. & Wu, B. (2015).The effects of Qigong for adults with chronic Pain: Systematic review and meta-analysis. The American Journal of Chinese Medicine, 43(8), 1525–1539. DOI:10.1142/S0192415X15500871
Chen, K.W., Comerford, A., Shinnick, P. & Ziedonis, D.M. (2010). Introducing Qigong meditation into residential addiction treatment: A pilot study where gender makes a difference. The Journal of Alternative and Complementary Medicine,16(8), 875–882. DOI: 10.1089/acm.2009.0443
Dong, Z., Ding, X., Guobin, D., Fei, W., Xin, X., & Daoxin, Z. (2016). Beneficial effects of Tai Chi for amphetamine-type stimulant dependence: a pilot study. American Journal of Drug & Alcohol Abuse, 42 (4), 469-478. DOI:10.3109/00952990.2016.1153646
Videos
Daily Tai Chi - join in this 8-minute exercise at: https://www.youtube.com/watch?v=PNtWqDxwwMg
Tai Chi Secret: Increase mental clarity + relaxation at: https://www.youtube.com/watch?v=fhT178k0FhA
"Deep Meditation Music": Music for Qigong, Tai Chi, Massage, Meditation Music, Motivational ♫231 at: https://www.youtube.com/watch?v=0YgM0r5Mt6E
"Qigong-Ancient Chinese Healing for the 21st Century" at: https://www.youtube.com/watch?time_continue=5&v=Y7y_BMYaCGM
Yoga
Yoga emerged within the history of Hinduism in India and evolved as it spread across Asia and later into North America and Europe. Originally a comprehensive system for spiritual and personal awareness and discipline, integral to the Indian culture and to its spiritual heritage, today yoga is practiced for physical fitness, weight management,and general wellness and increasingly for its well documented therapeutic effects for medical and emotional problems (Moss, 2011). Yoga is a technique that uses physical postures and controlled breathing to lengthen and strengthen the spine, increase flexibility, calm the mind, improve concentration, and promote patience. Yoga can also contribute to a greater sense of control in more acute states when experiencing cravings, insomnia, agitation, etc. Regular practice is needed to fully experience these benefits. Benefits of these age-old techniques of healthy living have been shown to persuasively to promote resilience and better mental health (Hazri & Sakar, 2014). The utility of Yoga/Meditation as a simple, safe, and inexpensive format to improve the quality of life in a population that has many medical difficulties and extenuating stressors has been demonstrated (Agarwai, Kumar & Lewis, 2015). A recent study found that long-term practice of Sahaja Yoga Meditation is associated with larger grey matter volume overall, and with regional enlargement in several right hemispheric cortical and subcortical brain regions that are associated with sustained attention, self-control, compassion and interoceptive perception. The increased grey matter volume in these attention and self-control mediating regions suggests use-dependent enlargement with regular practice of this meditation (Hernandez et al, 2016).
References
Agarwal, R.P. Kumar, A. & Lewis, J.E. (2015). A pilot feasibility and acceptability study of yoga/meditation on the quality of life and markers of stress in persons living with HIV who also use crack cocaine. The Journal of Alternative and Complementary Medicine, 21(3), 152–158. DOI: 10.1089/acm.2014.0112
Hazari, N. & Sakar, S. (2014) A Review of yoga and meditation neuroimaging studies in healthy subjects. Alternative and Complementary Therapies, 20(1), 16-26.DOI: 10.1089/act.2014.20109
Hernández, S.E., Suero, J., Barros, A., González-Mora, J.L., & Rubia, K. (2016). Increased grey matter associated with long-term Sahaja yoga meditation: A voxel-based morphometry study. PLoS ONE 11(3): doi:10.1371/journal.pone.0150757
Moss, D. (2011). Special issue: Yoga, meditation, and applied psychophysiology Biofeedback, 39, (2), 43–44. DOI: 10.5298/1081-5937-39.2.11
Videos
Yoga and Mental Health: Happiness & Its Causes at: https://www.youtube.com/watch?v=mDm9urVY6IA
How Yoga Can Improve Our Mental Health at: https://www.youtube.com/watch?v=JAuFPraFz-c
What are the Benefits of Yoga? At: https://www.youtube.com/watch?v=CU3HuPNsyG4
Yoga and Mental Health at: https://www.youtube.com/watch?v=BMFvI2SLF60
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