Is your loved one headed for relapse?

Getting sober and committing to a life free of drugs, alcohol and all other mood altering substances comes with many different challenges.  Relapse is a harsh reality that many people going through recovery will face. The best way that you could help your loved one is to be mindful of the different warning signs that may arise when your loved once is nearing a relapse or has recently gone through a relapse. Being aware of the signs is key to ensuring that your loved one can receive assistance during this difficult time. Some of the signs that someone is heading towards a relapse are subtle, while some of the signs can easily be missed. 

Typically, a relapse happens mentally before the person actually gets to the point of picking up their substance of choice. The mental relapse can happen when a person begins to think about and glorify some of their past habits or goes back to spending time with some of their old friends, ultimately thinking about the positives from their time spent doing drugs and forgetting the pain and turmoil that their substance use had caused. Following the internal struggle of a mental relapse comes the physical relapse. 

The physical relapse is what we think of most when we hear the term “relapse”. A physical relapse is when the person consumes a substance, ultimately breaking their sobriety. Once the relapse happens a person can quickly fall back into old, dangerous habits and put their own lives at risk.


There are behaviors to watch out for that may be an indicator that your loved one is heading towards or has reached a relapse:

  • Changes in the persons behavior

    • Depressed mood, impulsive behavior, easily agitated, forgetfulness, becoming defiant, sudden mood swings

  • Changes in appearance

    • When abusing a substance, a persons physical appearance as well as their living environment becomes a secondary priority. 

  • Asking to borrow money or taking items that do not belong to them

    • Financial problems or irresponsible financial planning can be a sign of relapse because people often prioritize purchasing their substance over purchasing what is necessary for their daily living. 

  • Missing treatment days, therapy appointments and/or support meetings 

    • Distancing yourself from your support system and those who are holding you accountable is a common behavior that helps the person avoid conversations surrounding their substance use. 

  • Reconnecting with old friends or contacts 

  • Participating in old habits 

    • This could range from lying, to not attending work and/or school, coming home at late hours or not coming home at all, staying awake or sleeping for long periods of time. 

These key behaviors are important to watch out for when you are questioning if your loved one is heading towards or has reached a substance relapse. As much as it is important to be aware of these relapse signs, it is also important to know that help is here and recovery is possible.  

What is Buprenorphine?

Buprenorphine is a prescription opioid used to treat opiate addiction, and prescribed under its brand name, Subutex or Suboxone, among others. This drug is an opioid partial antagonist, meaning that it produces an effect similar to narcotic opioids without getting the user high. Buprenorphine essentially tricks the brain into thinking that addictive chemical substances like heroin are being introduced into the bloodstream; it does this by binding to certain receptors within the brain. Some might take excessive amounts of buprenorphine in attempts to get high – this will not work for several reasons. The reasons are as follows:

  • Buprenorphine has a much lower potential for abuse than addictive chemical substances like heroin and prescription painkillers. 

  • This prescription medication affects the way opiates interact with the brain and body by putting a ceiling on the effects of opiates. This means that no matter how much of an addictive substance an individual takes while on buprenorphine, he or she will not experience a high past a certain point. 

  • It is much harder to become physically dependent on buprenorphine, and those who take this medication in excessive amounts will not experience the side effects they would experience when taking an addictive opiate like heroin, such as euphoria or central nervous system repression. 

  • Those who take this medication will experience less intense symptoms of withdrawal upon ceased use.


When taken as prescribed, buprenorphine will result in the following:

  • Reduced withdrawal symptoms, including physical symptoms like muscle cramping, stomach issues, profuse sweating, and sleep-related issues such as insomnia. 

  • Decreased opiate cravings. When an individual is undergoing heroin withdrawal, buprenorphine may be used to prevent relapse that would otherwise result from unmanageable and intense psychological cravings. 

  • A reduced propensity for illicit opiate abuse, usually based on a reduction of cravings. 

  • Increased propensity to stay engaged and active in addiction treatment. 

Taking Opiates While on Buprenorphine

Some individuals may attempt to take opiates like heroin or prescription painkillers while they are actively taking buprenorphine or a similar opioid antagonist. They may do so thinking that the prescription medication will enhance the effects of the opiate they are ingesting. The drug is taken sublingually (meaning it is placed under the tongue and dissolved), so an individual may assume that taking another opiate via a different method of consumption (such as intravenous injection) will lead to a more intense high.

This is not true – as previously mentioned, buprenorphine reduces the effects of other opiates. If the two are taken in conjunction, an overdose is possible, seeing as the individual will take the addictive opiate and greater amounts in an attempt to combat the lack of a high. It is extremely dangerous to take this medication other than as prescribed or to take it in conjunction with an opioid narcotic. 

What is tramadol?

Potent and Fast-Acting

Tramadol is considered a fast-acting painkiller, meaning the effects take hold rather quickly – generally within 30 minutes to an hour. This is part of the reason why the medication is used to treat short-term pain, like the pain that results from a surgical procedure or the pain that sets in after an injury (an injury that will quickly heal). When it comes to prescribing this specific medication, physicians will determine an appropriate dosage. The dosage will vary on a person-to-person basis. Prescribing physicians should conduct an in-depth assessment before administering a drug as strong as Tramadol, taking things like genetic propensity for addiction and all underlying disorders into account. However, because the drug is so addictive, it is impossible to determine who will develop a substance abuse disorder and who will not.

There are simply certain factors that make the development of a serious issue more likely. If you or someone you love has been struggling with a Tramadol addiction, seeking professional help at your earliest possible convenience will be necessary. At Relevance, we have extensive experience treating those who have developed physical and psychological dependencies to Tramadol and all other potent painkillers. Simply give us a call to learn more about our comprehensive Tramadol addiction recovery program. 


Call Us Today: 732-702-2242

Tramadol Addiction Recovery

If the signs of Tramadol abuse are recognized and treated early on, the development of physician dependency will be less likely. Some of the more common symptoms of Tramadol abuse include changes in appetite that often lead to weight loss, drowsiness, slurred speech, and an inability to focus the eyes/loss of vision, nausea and vomiting, intense headaches, and impaired coordination. Some of the more common symptoms of Tramadol addiction include extreme gastrointestinal issues, high fever, profuse sweating, dizziness, muscle spasms, anxiety, and depression.

As previously mentioned, the highest dosage that should be consumed in one day is 400mg. Those who take this specific drug in higher doses are likely to experience serious and often life-threatening health-related complications, such as seizures, strokes, and coma. In short – Tramadol is strong. It is a potent painkiller, and those that take it for an extended period will generally experience some degree of consequences – whether those consequences have to do with severe side effects or the ultimate development of a Tramadol addiction disorder. If you or someone you love has been struggling with painkiller addiction and is looking for a way out, give us a call today to learn more about our comprehensive and effective addiction treatment programs at Relevance.

Know the Danger

Drug addiction has existed since mankind discovered psycho-active substances. Addiction has been a major health concern in the United States for quite a long time. There are many different kinds of drugs available throughout the country, and whether or not an individual becomes addicted is very subjective depending on what kind of drugs he or she uses, the frequency of use, and any potential underlying risk factors. The National Institute on Drug Abuse reports that alcohol is the most commonly abused chemical substance, closely followed by tobacco, marijuana, and illicit drugs (which can range from stimulants like cocaine or methamphetamine to opioid narcotics like heroin).

Not everyone who picks up a chemical substance will become addicted. Most people who experiment with drugs will not develop a serious, life-threatening substance abuse problem. When it comes to who gets addicted and who does not, the method of ingestion will play a significant role. Some drugs come in pill form, and they are taken orally, or swallowed (like prescription painkillers or prescription stimulants). Some come in a powder form, and they are ingested nasally, or snorted (like cocaine). Some drugs are smoked (like marijuana or crack cocaine) and some are injected intravenously (like heroin).

When it comes to enhancing addictiveness, taking drugs nasally or intravenously poses the highest risk. Take a look at both of these methods of drug abuse more in-depth, and reach out to us with any additional questions that you may have. If you or someone you love has been struggling with an addiction of any type or severity, we are available to help. 


Dangers of Snorting Drugs

Certain illicit substances are traditionally ingested nasally, such as cocaine or heroin in powder form. Nowadays, those who are struggling with drug abuse will often snort other substances, like certain medications, to achieve a faster and more intense “high.” For example, it is now common practice to crush and snort prescription medications like Adderall, Ritalin, oxycodone, and hydrocodone. Some mistakenly believe that snorting prescription medications is safer than snorting street drugs like cocaine.

Unfortunately, those that choose this method of ingestion will almost always do short and long-term damage. Not only will the respiratory system suffer (after being repeatedly exposed to chemicals and toxins), but the nasal passages will suffer as well. In some cases, they may entirely collapse. Some begin to experience chronic nosebleeds, some permanently lose their sense of smell, and some will experience a chronic runny nose and issues with the esophagus. Snorting drugs can lead to throat cancer, a deteriorated nose, heart attack, seizures, coma, and death. 

Dangers of Injecting Drugs

Of all ingestion methods, injecting drugs is the most dangerous by far. Not only are those who inject drugs at a significantly greater risk of overdose-related death, but they will also:

  • Become addicted far more quickly 

  • Put themselves at risk of certain contractible diseases, like HIV and Hepatitis 

  • Suffer from skin rashes, infections, and abscesses 

  • Experience collapsed veins 

  • Do severe damage to their respiratory and cardiovascular organs

  • Suffer from psychological disorders

If you know someone who has been engaging in intravenous drug abuse, seeking help immediately will be necessary.

Is Marijuana Addictive?

Marijuana is the second most widely used drug in the United States and arguably the most common used substance amongst teens and adolescents. As a counselor in the field of addiction and mental health, a commonly asked question is whether marijuana is addictive or not. Can marijuana lead to dependence? In short yes. 

Per the Office of National Drug Control Policy, marijuana is significantly more harmful and mind-altering than most people think, especially today due to the potency of THC. Compared to the 1960’s and early 70s’, weed today, can be six to ten times more potent, which comes with many side effects. Furthermore, teens and adolescents naively believe that they are consuming pure weed, however, that is rarely the case. Marijuana is being mixed or ‘laced’ with many other substances, from Oregon to PCP to fentanyl. 

According to multiple research studies, marijuana meets the DSM-V criteria for substance dependence and individuals who are trying to quit marijuana use, experience withdrawal symptoms such as nausea, sweating, shakey body movements (tremors), depressed mood, disrupted sleep patterns and behavioral and mood changes. In addition, a study conducted in 2002 found that teens and adolescents are three times more likely to become dependent on marijuana as compared to adults. This early use increases their likelihood of experimenting with and becoming dependent on other illicit drugs in the future. 

Another false assumption, is that marijuana is not harmful to the body. Marijuana significantly effects many parts of the human body. For example, persistent use of marijuana alters the hippocampus, which is the part of the brain that creates memories. In short, abusing marijuana leads to a decrease/ loss of hippocampal neurons and thus memory impairment occurs. Furthermore, chronic use of marijuana significantly damages the respiratory system. Research shows that the same chemicals found in tobacco, that lead to cancer and other debilitating conditions such as Asthma and chronic wheezing, are also found in marijuana.

Resources:

United States. (2020, July). Is marijuana a gateway drug? National Institute on Drug Abuse. Retrieved,  https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-gateway-drug

United States. (n/d). Myths and current research. Student Well-being Center Notre Dame. Retrieved from, https://mcwell.nd.edu/your-well-being/physical-well-being/drugs/marijuana-or-cannabis-sativa/quitting-marijuana-a-30-day-self-help-guide/myths-and-current-research/


In short, marijuana use can be dangerous and lead to short-term and long-term physical and mental health problems. Below are some of warning signs and symptoms correlated with marijuana use and/or abuse: 

-bloodshot eyes

-weight gain

-loss of interest in once desired activities or events

-memory impairment 

-sleepiness

-slowed reaction time

-nervous or paranoid behavior 

-impaired judgement

-lack of motivation 

TIPP Skills with DBT

By Danielle Goldberg

With many people in addiction , a major issue is the inability to regulate their emotions effectively.  When we do not know how to manage what we are feeling, we tend to search for an escape or a " quick fix". Those " quick fixes" usually lead us down a round of rebellious behaviors with negative consequences. 
At, Relevance we utilize a dialectical approach to treatment using Dialectical Behavior Therapy.  DBT helps balance the synthesis of acceptance and change and helps individuals to learn how to regulate their emotions more effectively, and reduce the urges to use . Many times people in active addiction find themselves in distress often . DBT therapy teaches clients to learn to identify distress and use skills to decrease that level of distress to a more manageable level. 
A popular distress tolerance skill from DBT is TIPP skills. TIPP skills helps provided the client a intense sensation to shift the focus of their brain to something else, which allows the level of distress to come down. The TIPP skills are ; change of temperature, intense exercise, progressive muscle relaxation , and paced breathing . These skills can be used alone, one skill for 5 minutes,  or  as a group of skills working your way down the list over a 20 minute period , based on your level of distress.


Contact us today to learn more. 732-702-2242

The change in temperature skill is anything that provides a shocking change of temperature, some examples are taking a very cold or very hot quick shower, splashing cold water on your face, dipping your head in a bowl of water, blasting the air conditioning with the vents on you, or holding ice in your hands.  

The intense exercise skill is a short interval of an exercise, not a workout at the gym, some examples are a quick sprint around the block, setting of 20 jumping jacks, push ups, or a short rep of an exercise at your max weight . This helps us focus on the pain or discomfort from the exercise rather what is causing you distress, and allows the emotions or urges to come down . 

The progressive muscle relaxation skill is where you tense each muscle up in the body, working from your head down to your toes tensing each muscle and then letting go of the tension as a way to let go of the distress and the physical sensations of distress . You can also use visualization and imagery to use this skill, by putting whatever is causing you distress on a conveyor belt and letting it fall off , as way to let go. You can also do yoga poses or a stretching  to do this skill. 

The paced breathing skill is to have some method to your breathing in order to keep you focused. You may use square breathing where you breath in for  four seconds , hold for four seconds, and breath out for four seconds. This way you are focusing on your breathing rather then your distress. 

These skills are intense and work rather quickly , which is why they are helpful to manage your distress. They put the clients in control of their emotions which tends to empower them. DBT has proven effects to help clients with substance abuse and mood disorders. I have been intensively trained as a DBT therapist , and implement the DBT curriculum as a basis for treatment to provide clients with coping skills that will help to manage urges to use and negative emotions . I have seen this treatment work first hand and I have seen the impact it has on the therapeutic process. 

PTSD & Addiction

June is PTSD Awareness Month

Remember, you are not alone in your journey. This month, take the time to reach out to the people in your life who might be affected by PTSD, and be the advocate for them, or take that first step for yourself.


Do you know how to recognize signs and symptoms of PTSD? A traumatic event – combat, natural disaster, sexual assault, or an accident – can take over the way you experience life. After going through this type of trauma, it may be impossible to stop thinking about it. Whether you are active duty, a veteran or a military family member, you can learn more about how to recognize and get treatment for PTSD symptoms.

People who live with PTSD can find it hard to feel safe. Nightmares and trouble sleeping are more known signs, while feeling on edge, unsettled, and displeased with things you used to enjoy are other more subtle ones. Maybe you feel it’s just easier to be alone. Feelings like these are common after a traumatic event.

Symptoms of PTSD fall into four categories:

  1. Reliving or re-experiencing the event

  2. Avoiding things or places that remind you of the event

  3. Negative changes in beliefs and feelings

  4. Consistently being on guard.

    For someone to be diagnosed with PTSD, symptoms must fall within all four categories.

PTSD symptoms can happen at any age, and they come and go. Only a mental health care provider can diagnose PTSD, which is the first step to getting effective treatment. If you or someone you know is experiencing these symptoms, whether they are recent or have been present for years, it is important to talk with a doctor.

Among people seeking treatment for PTSD are 14 times more likely to also be diagnosed with a substance abuse disorder (SUD).

Military and Veterans with PTSD

One of the highest risk groups for both PTSD and addiction is the veteran population. According to the U.S. Department of Veteran Affairs, veterans who seek out treatment for a SUD are often diagnosed with PTSD. This is most likely due to the emotional stress, physical demand, and mental strain of combat. Service members that were deployed overseas to Iraq and Afghanistan are at a higher risk of developing PTSD.

In addition, PTSD has also been linked to veterans that have been sexually assaulted or harassed during their military service or experience.  Military service trauma can happen to any service member, of any gender, during their military service. Sexual trauma includes sexual assault, sexual abuse, or sexual harassment. About 1 in 5 female veterans have been diagnosed with military sexual trauma by Veteran Affairs (VA).

Get Help Today

If you or a loved one is wanting to learn more about addiction treatment with co-occurring PTSD, contact one of Relevance’s administration navigators by calling 732-702-2242 or learning more about Relevance’s admission process and insurance coverage options. With the help and support of our healthcare staff in our treatment facilities, achieving recovery is possible.

Mother’s Day for with a son in recovery

In the past, while my son was an active user, I would be in constant fear of not hearing from him, or hearing from someone else calling to tell me he overdosed.  That happened more than once.

It has been a VERY long road with him.  I have had many sleepless nights, many visits to the courts, jail, doctors, having him in and out of over 20 rehabs, not to mention the financial burden.

I can’t even begin to tell you how grateful I am that my son not only found but embraced CFC, just as they did him.  They saved his life.  They have guided him in ways that I couldn’t.  They introduced him to him, if that makes any sense.  They showed him all that he could do.  All he could accomplish.  They guided him with facing his fears, helping with not only his addiction but with his self esteem.  He has had to address his past, the good, bad and ugly.  

He is very dedicated to his recovery. He has goals that he reaches, and then makes new ones.    I no longer have the fear of getting that dreaded phone call.

I now look forward to him calling me.  We have serious and extremely funny conversations.  I am VERY proud of him and the man he has become.  

I appreciate my Mother’s Day more and more.

Diane Russo, Proud Mother


Diane and her son, Kevin, Business Development at Relevance Behavioral Health

Diane and her son, Kevin, Business Development at Relevance Behavioral Health

Advice for Mom’s in Recovery

Happy Mothers Day!

There is a reason they call it the hardest job in the world. Managing being a mother while maintaining recovery is possible using these tools!

Let Go of Resentment

Resentment can be a killer for those struggling with substance use disorder. Holding on to bitterness keeps us sick and holds us hostage and stuck in victim mode. Letting go of resentments and learning to deal with anger in healthy ways is a critical part of healing from this disease of addiction. Moms in long-term recovery have learned how to process anger. They don’t blame others or play the victim. Instead, they have learned how to be assertive without being aggressive. What I’ve learned and tell my clients is to pause when they’re angry or feeling uncomfortable. To step back, breathe, be mindful of their feelings and look at the role they may have played in the situation before reacting. Doing this helps them “respond” and not “react.” Learning to use these tools helped me tremendously.


Establish a Daily Spiritual Practice

Here’s what I know for sure: addiction darkens our spirit. Folks who are flourishing in recovery have some type of a daily spiritual practice. Spirituality means different things to different people. It is important to find a spiritual community, as well as what gives you joy, and do it! Here are some of the spiritual practices I have found extremely helpful in recovery.

  • Reflection: Unplug from the world. Put down the cell phone, pick up a pen and paper, and write down your feelings, emotions, goals, or what you’re grateful for.

  • Meditation: Take a moment to let your mind unwind from the stresses of every day life.

  • Prayer: Find your higher power. It does not have to be religion based. Your higher power can be anything that keeps you grounded, such as nature or your community. Feeling part of something greater allows you to stay connected to what is important.

  • Volunteer: Find opportunities to give back to others in your community. Helping others gives you a sense of purpose as well as increases feelings of self-worth and strengthens your sense of community.

Practice Self-Care

An important part of healing for moms is learning how to take care of themselves. In long-term recovery, I have learned to slow down and take time for myself. The acronym HALT – hungry, angry, lonely or tired – is always a reminder for me to check in with myself. I tell my clients to be vigilant if they are experiencing any of these signs and to be aware of how they are feeling and why. Remedies that worked for me include:

  • Taking a nap

  • Exercising

  • Going for a walk

  • Spending time in nature

  • Trying a new hobby

  • Binge-watching Netflix (I’ve done this a lot)

  • Spending time with friends and famil

Spirituality

By: Joshua Ansley, Spiritual Advisor at Relevance

There is a somewhat famous quote ‘Religion is for people who are afraid of going to hell; spirituality is for those of us that have been there.’ When I present this quote, the people in the room that have experienced the most pain often times shake their heads ‘yes’ quite adamantly. They know that the suffering they have experienced was actually an integral part of the process of opening up spiritually. Some were even ‘religious’ before, but have now become ‘spiritual.’ So what does this word ‘spiritual’ mean and how does it differ from the traditional understanding of religion and, dare I say, ‘God?’ And how does it relate to suffering? From the moment we are born, we immediately use our senses to engage with the external world. Having an extremely limited understanding as burgeoning beings, we use the very visceral dualistic teaching of ‘pain and pleasure’ to dictate our choice of action. This built in survival mechanism is essential for us to stay alive and ultimately perpetuate the species. It is primal…It can also very easily run amuck leading to over-indulgence and ultimately, addiction (suffering). But it’s not the whole story.

Somewhere along the way some great sages understood that this ever-changing external world we live in will never bring us permanent stability. It simply cannot. Anything constantly changing cannot bring constant steadiness. There can be fleeting and even quite extended bouts of pleasure and ease, but an unending source cannot be found in this ephemeral world. Realizing that our understanding of happiness was directly related to our relationship to the external world through our senses- the sages turned away from the external world and journeyed inward.

This is spirituality.


Those sages discovered that if we live outward-in, the external world will define who we are. Name, fame, wealth and everything else external naturally becomes paramount. We are ruled by the opposites of success/failure, acceptance/rejection etc. that the mind has been conditioned to operate in. We become reactors, stuck in a fear based selfish need to survive this threatening, dualistic world of separation. This way of living ultimately leads to suffering. But- when the perspective is completely changed, the sages realized that everything else follows. Instead of reaching our mind into the world through our senses, we turn the mind inward to the deepest spaces within ourselves. It is there, through diligent work and searching, that we find the stability and the strength we need to shift from being reactors to actors in the world, leaving a powerful imprint of service and Love. One could possibly argue that moving inward would promote separation and isolation, but paradoxically we find that, as we move inward beyond the layers of conditioning, we find a deep connection to all- Love and understanding of ourselves and, thus, others.

These sages and saints from all different modalities realized that this mind which is immediately trained from birth to move outward needs some real Jedi training in order to detach itself from this world. Having found and personally experienced this ultimate source of eternal joy and connection to all, they felt compelled to teach others the way to re-connect with their deepest Self (AKA ‘God’ in the external duality of the mind). The sages began teaching principles and practices that could help people find their own personal experience with this ‘God,’ this unifying principle by which we are all connected. These sages and saints have such a powerful presence to them, so unaffected by the world and steady within themselves, that people want what they have. Unfortunately, people’s untrained minds are so firmly rooted in the external world of duality and its black and white ideas that they turn these practices that are intended to help people move along the path to freedom into a rigid shame based system of imprisonment and control. These dualistic followers are still conditioned to see God as they did their own parental or authority figures early on in Life instead of the very divine core of who they really are. These followers become the new teachers and thus, we have the birth of our understanding of oppressive religions and fear mongering gods. Often times, people are very turned off by the word ‘God’ when they initially start their recovery process. Understandably so, since they have had their own personal experience with some interpretation of the word- which could range from the often complete denial of the idea by the intellectual, anywhere through a neutral feeling and up to an extreme resentment at the concept (these resentments are often valid, for a number of reasons including a misunderstanding of spiritual teachings or abuse of power on the part of some preceptor). Couple that with an aggressive 76 year old man yelling at a 24 year old woman in an AA meeting that if she doesn’t find God she will never recover, one can completely understand why any rational person would run for the door and abandon all hope of ever returning. Unfortunately, when that happens we are ‘throwing the baby out with the bath water,’ as they say. Religion, itself, is not a bad thing (the word ‘religion’ is believed to be from the Latin root ‘religare’ meaning ‘to reconnect’ as yoga is ‘to yoke or join’); it’s the people who still operate under a strict dualistic, good/bad, right/wrong framework that completely misinterpret and distort beautiful divine teachings. In recovery we focus on ‘spirituality’- the very sap of religion- a beautiful process of moving inwards and understanding ourselves on deeper levels so that we can find the strength and stability to ultimately live the lives of beauty and joy that we were intended to.