On average, 44 people in the United States die every day from an overdose of opioid prescription painkillers. These drugs — such as Vicodin, Percocet, codeine, and morphine — reduce the brain’s recognition of pain by binding to certain receptors in the body. With continued use, a person can develop a physical dependence on these drugs, such that withdrawal symptoms occur if the drug is stopped. These drugs can also cause a “high.” Both of these effects contribute to addiction — that is, the loss of control around the use of a drug, even though it causes harm to the person. Addiction to opioid painkillers is the biggest risk factor for heroin addiction.
Due to the high demand and significant wait times for substance use treatment, Counseling Services of Greater Boston is now accepting urgent, outpatient telehealth appointments for addiction treatment!!
Rapid Response Appointment times are available daily!!
Here is the appointment link for anyone in need of immediate services!!!∞
I am now Accepting New Telehealth Patients in the Greater Boston Area and New Hampshire through Counseling Services of Greater Boston!!
SUBSTANCE USE COUNSELING
SUBSTANCE USE EVALUATIONS
Please share with those in need of services!!
Contact Info Below!!
Main Office: 781-328-1904
Or contact me direct 617-729-9111
I am a Licensed Independent Psychotherapist and educator. I believe in creating positive change through Social Interpersonal Growth Psychotherapy, a humanistic approach to growth and self-acceptance. My areas of expertise include opioid/substance dependence, substance use education, medication assisted treatment education, and crisis intervention.
I have worked with substance use and opioid use disorders for many years in direct treatment, teaching, and curriculum development of addiction-related training materials and resources. I have experience working with adolescents, adults, and elder populations. I continue to work extensively with co-occurring psychiatric disorders such as Schizophrenia, Bipolar, Anxiety/Depression, and Post Traumatic Stress Disorders (PTSD).
My training includes Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Trauma Informed Care, Person Centered Therapy, Mindfulness, and Solution Focused Therapies.
I have a Ph.D. in Psychology, a M.Ed. in Counseling Psychology, and a MA in Behavioral Psychology. Post-Doctoral studies included understanding addiction as a chronic disease, treating addictions, and the Neuroscience of Addiction.
Dr. Veronica E. Nuzzolo∞
A Personal Story by Roberta Dignan Robinson
I grew up in West Roxbury, married, had children, and relocated to Pelham, New Hampshire. I was a Paralegal and commuted to Boston for 11 years.
Meanwhile my mother was aging in place, and as her health began to fail, her needs began to increase. So I managed her home care 60 miles away, making frequent trips to West Roxbury to ensure everything was going smoothly and she was getting what she needed. One day I had an epiphany that in order to be available the way she needed I might need to actually be in her home full time.
And that was exactly what happened.
I found it necessary to move back to West Roxbury, however, not yet into her home as I wanted her to stay as independent as possible. Then the inevitable – in one week, we had four emergencies…the last finding her upside down on the couch with her feet on the back of the couch and her head hanging to the floor. It was then apparent that I needed to take the next step and move in with her.
At this time, I had a full-time job with the City of Boston Commission on the Affairs of the Elderly. My mother was, apparently, in her death process (who knew? There was no one to guide me through this journey) and my daughter was in her marriage process in New Hampshire. I was so stressed that I thought I would pass before my mother did. Hers was a slow, subtle 5 year decline. Every year she had an incident which brought her to the hospital, rehab, and then home. In the first year the case manager at the local hospital told me it was the beginning of the end. And so I was on guard…for four more years. It was the 5th year that she never made it home. I called her the Energizer Bunny.
At the end, it was like a switch had been flipped; she was incontinent, and couldn’t care for herself. I had to clean up day and night and then go to work the next day. I was doing it all.
Caregiving is such a responsibility!! Nobody knows what it’s like until they’ve done it themselves. Kind of like walking a mile in someone else’s shoes…as the expression goes.
I had aides (certified nursing assistants) to help – I called them my angels. I cooked for them all, and gave them gifts for Christmas. I so appreciated them and couldn’t have done it without them!
The world of elder services is an incredible maze. I was trying to figure out her health, trying to educate myself on available services, and trying to get the best support for her that I could. There was not one person to outline this information for me . I felt like a bumper car, getting bashed around.
My advice for people who care for seniors in poor health: Coordinate their health care and plug them into life. Get them connected to a community, whether it’s faith-based, an adult day health center, the housing community, or something else. It doesn’t matter what – we need each other! Isolation is the worst enemy for seniors.
Also, look into senior health programs, like PACE (Program of All-Inclusive Care for the Elderly) (there are 8 programs in Massachusetts), Senior Care Options, or services through the local elder services agency. These services can make a major difference for everyone involved.
Don’t forget to take care of the caregiver. My colleague, Dr. Anne Fabiny, has some excellent tips on caring for the caregiver, and here is what she says:
- Find support. Nobody can do it alone. A combination of caring families, friends, neighbors, and professional services often helps.
- Make time for yourself. Try your local Council on Aging or Benefits-Checkup to see what options are available for respite care and other services. Organizations like the American Cancer Society may be able to link you with low-cost or free programs and services to help people of any age. AARP and government publications can guide you to caregiver services and long-term care options.
- Ask for help. It’s OK to tell friends and family the job is too much for you alone. Ask them to help brainstorm solutions. Always accept help when it’s offered. Sometimes getting a few things in place, like transportation, food, or medical appointments, can make a big difference.
- Lean on friends. Ask friends if you can use them as a sounding board. If just one person in your circle can do this, try not to burden him or her. Consider other ways of seeking support as well. A religious community can also be a source of comfort and emotional support for many.
- Join a support group. Many organizations, hospitals, health organizations, and religious groups offer support groups for caregivers. These groups are a good place to blow off steam and share ideas with people facing similar situations. Some support groups are online, which can be easier for homebound caregivers.
- Consider therapy. Sometimes the best support you can seek is therapy if you’re among the many who find caregiving emotionally stressful. If you feel depressed or overwhelmed, get help from a psychiatrist or therapist. If you don’t know where to turn, ask your doctor for a referral.
Most importantly, don’t forget YOU. Make some time to have dinner with friends, go to a movie, take a walk, laugh a little. You must keep your battery charged or you will not be able to be there for your loved one.
I hope you find these resources and tips useful to help improve your loved one’s life as well as your own.
Roberta Dignan Robinson∞
Dr. Veronica Nuzzolo presents Opioid Prescribing Policy Changes and the Impact on Chronic Pain Patients. Hosted by Middlesex District Attorney Marian Ryan, Eastern Middlesex Opioid Task Force Meeting (December, 2019).
In the early 1990’s when it was determined that Americans were under-treated for pain, pharmaceutical companies began producing stronger and longer-acting medications. More than 191 million opioid prescriptions were dispensed to American Patients in 2017. Recent data from the Center of Disease Control and Prevention suggests that illegally manufactured fentanyl, its analogs, and heroin are responsible for well over half of all overdose deaths. The most common drugs involved in prescription opioid overdose deaths include: Oxycodone, Oxycontin, and Vicodin. Noteworthy is that many who died from prescribed opioid medications were not the medically approved patient. In addition, most deaths involve multiple substances that are used in combination, often including alcohol. Research futher indicates that approximately 65 percent of adults in the United States have used alcohol. Furthermore, almost 6 percent of adults used both alcohol and drugs, representing approximately 12.6 million adults in the U.S. population. (more…)
Society gives short shrift to older age. This distinct phase of life doesn’t get the same attention that’s devoted to childhood. And the special characteristics of people in their 60s, 70s, 80s and beyond are poorly understood.
Medicine reflects this narrow-mindedness. (more…)
You ARE My Hero!
Substance use disorders affect millions of Americans, and overdose is now the leading cause of accidental death in the United States. The need for treatment and recovery services has never been greater. This increasing demand has led to rapid growth in the number of detox and treatment service providers, which has burgeoned into a $35 billion a year industry. Most of these service providers work hard to provide honest, quality care to save lives.
As we watch the devastation of the opioid crisis escalate in a rising tide of deaths, a lesser known substance is frequently mentioned: fentanyl. Fentanyl’s relative obscurity was shattered with the well-publicized overdose death of pop star Prince. Previously used only as a pharmaceutical painkiller for crippling pain at the end of life or for surgical procedures, fentanyl is now making headlines as the drug responsible for a growing proportion of overdose deaths.
So what is fentanyl and why is it so dangerous?
Fentanyl is a synthetic opioid, meaning it is made in a laboratory but acts on the same receptors in the brain that painkillers, like oxycodone or morphine, and heroin, do. Fentanyl, however, is far more powerful. It’s 50-100 times stronger than heroin or morphine, meaning even a small dosage can be deadly.
There are many good reasons to emphasize the biological underpinnings of substance use disorders. Perhaps most important, the biologic basis of this chronic disease is a strong argument for parity: that is, treating (and funding treatment for) addiction on par with other “biologic” diseases.
The stigma and shame of addiction has much to do with the perception that people with substance use disorders are weak, immoral, or simply out for a good time at society’s expense. Understanding that addiction impairs the brain in many important ways may reduce such stigma. What’s more, the specific type of brain dysfunction may help identify a range of effective interventions and preventions. For example, during adolescence, the brain is at its most plastic — and vulnerable. This is a time when caution and intervention may prove most valuable. The earlier the drug exposure or trauma to the brain, the greater the damage.
Women usually welcome news that the gender gap in pay or leadership positions is closing. But lately we’ve been learning that women are also gaining parity in another respect: alcohol consumption. A new study from researchers at the National Institutes of Health indicates that the rate of drinking in general, and binge drinking in particular, is rising faster among women ages 60 or older than among their male contemporaries.
When the researchers analyzed data from National Health Interview Surveys from 1997 through 2014, they found that the proportion of older women drinkers increased at a rate of 1.6% a year, compared with 0.7% for older men. Binge drinking (defined as imbibing four or more drinks within two hours) increased by 3.7% annually among older women, but held steady among older men. The results were reported online March 24, 2017, by Alcoholism: Clinical and Experimental Research.
By one of the later relapses, Sheff, a journalist, had already begun researching a book about addiction and had interviewed some of the world’s leading experts on the biology of addiction and treatment.
“I was frantic,” he says. “I called the guy who knows more about meth than anyone in the world, and I asked him ‘Where can I send my son?’ And he had no idea. He was stunned. He asked colleagues, other researchers, and they didn’t know either.”
Sheff did find a treatment program for his son, but not through his scientist contacts — he found it through a friend, another father with an addicted child.
What is Suboxone and how does it work?
Suboxone, a combination medication containing buprenorphine and naloxone, is one of the main medications used for medication-assisted therapy (MAT) for opiate addiction. Use of MATs has been shown to lower the risk of fatal overdoses by approximately 50%. Suboxone works by tightly binding to the same receptors in the brain as other opiates, such as heroin, morphine, and oxycodone. By doing so, it blunts intoxication with these other drugs, it prevents cravings, and it allows many people to transition back from a life of addiction to a life of relative normalcy and safety.
A key goal of many advocates is to make access to Suboxone much more widely available, so that people who are addicted to opiates can readily access it. Good places to start are in the emergency department and in the primary care doctor’s office. More doctors need to become “waivered” to prescribe this medication, which requires some training and a special license. The vast majority of physicians, addiction experts, and advocates agree: Suboxone saves lives.
Common myths about using Suboxone to treat addiction
Unfortunately, within the addiction community and among the public at large, certain myths about Suboxone persist, and these myths add a further barrier to treatment for people suffering from opiate addiction.
Recently, Massachusetts Governor Charlie Baker introduced “An Act Relative to Combatting Addiction, Accessing Treatment, Reducing Prescriptions, and Enhancing Prevention” (CARE Act) as part of a larger legislative package to tackle the state’s opioid crisis. The proposal would expand on the state’s existing involuntary commitment law, building on an already deeply-troubled system. Baker’s proposal is part of a misguided national trend to use involuntary commitment or other coercive treatment mechanisms to address the country’s opioid crisis.
The CARE Act and involuntary hold
Right now, Section 35 of Massachusetts General Law chapter 123 authorizes the state to involuntarily commit someone with an alcohol or substance use disorder for up to 90 days. The legal standards and procedures for commitment are broad; a police officer, physician, or family member of an individual whose substance use presents the “likelihood of serious harm” can petition the court.