Recovery – What to Expect

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What to Expect

There are several important items that people who are new to Methadone Maintenance Treatment (MMT) should know. Often times, psychoeducation is necessary at the onset of treatment. Many people lose interest or become discouraged in the initial phase of their program because they are not well educated as to the process of recovery. The first step is the most difficult, so congratulations on making the decision to experience recovery and begin a new life! Welcome to the Duke City Recovery  Family, we will do our best to ensure that you have a successful experience.

  • Most people are unaware that during the induction phase, you will experience temporary and moderate sickness until a therapeutic level is reached. It is important to meet with your clinician to move through this challenging process as often as possible. Our new participants will visit with their counselor several times during the first two weeks to experience a “check-in.” This process is to ensure that you are doing well and feeling better day-to-day until your therapeutic level is achieved. Remember, this is temporary, so hang in there! A couple of weeks of adjustment is nothing compared to the rest of your life in happiness!
  • We often get concerns from participants that their family, friends, employers, etc. express discontent for this medication and should not be on this “type” of road to recovery. Most have a false perception that opiate addiction is something that can be stopped “cold turkey;” however, this is not the reality. In situations such as this, we invite the concerned individual to attend a session to discuss apprehensions and educate them on the value of this process. In most cases, and after an understanding is gained, the participant has a new level of support in their recovery. In short, many people lack understanding! It’s okay, let’s talk!!
  • In your first month at DCRT you can expect to meet with your therapist to complete a person-centered Comprehensive Treatment Plan. This means that you can use your voice and establish realistic goals to plan for your recovery and a resilient lifestyle! You can address spirituality; relapse prevention; family therapy; relationship problems; marital issues; parenting; employment; education; or, anything else that you need assistance with. Our Master’s Level and LADAC clinical team has a wealth of skills so we’re prepared for anything, to include advocacy! Come on in and let’s start your new journey! You have so much to look forward to…whew…what a relief!! God Bless You!

With a welcome heart,

Therese M. Duran, MA, LPCC, LADAC

Clinical Director/Forensic Evaluator

What Makes Duke City Recovery Different

whatmakesDCRTdifferent What Makes Duke City Recovery DifferentDuke City Recovery Toolbox (DCRT) is not your typical outpatient treatment center because we offer our clients full behavioral health services. When our clients receive treatment for opioid and drug dependency at DCRT they can also receive treatment for underlying or coinciding behavioral issues, such as; Post Traumatic Stress Disorder (PTSD), depression, anxiety and more.

Offering behavioral health services in-house makes a big difference because a majority of our participants do not have transportation, may experience anxiety about entering new environments, or have trust issues with meeting new people or just simply entering a new building.

Our clients have the option of choosing faith based recovery services, however, if not, DCRT offers many types of recovery groups. There are over twenty different recovery groups meeting at DCRT each week.  Some of these groups are anger management, relapse prevention, bible study group, and parenting just to name a few.  Our groups help individuals stay focused on recovery and offers hope from peer-to-peer support which is valuable to an addict.

There are many roads to recovery. It is the hope of Duke City Recovery Toolbox that every addict finds a road that leads them to a place of freedom from heroin and opioid addiction.

If you or someone you know is suffering from the affliction of addiction please contact us. Duke City Recovery has a way to get better, be better and to live.

Combining Sedatives with Methadone

The Dangers of Combining Sedatives with Methadonepills 300x218 Combining Sedatives with Methadone

Benzodiazepine and Alcohol are commonly used sedatives that combined with Methadone can have deadly consequences.

Benzodiazepines are usually prescribed for treating sleep disorders or anxiety. Some of the most commonly used/abused benzodiazepines are:  Xanax, valium, diazepam, lorazepam, and Klonopin to name a few.  Although these drugs work well to relieve symptoms of anxiety, such as panic attacks, there is an increased danger when used with methadone.

Benzodiazepines and alcohol are central nervous system (CNS) depressants, meaning they naturally slow down the heart and respiratory rate.  When combined with methadone (another CNS depressant), these effects are increased, which could cause a person to go to sleep, stop breathing, and never wake up again.

Duke City Recovery Toolbox has protocols in place to decrease the potential for overdoses related to the combination of these substances.

In medication assisted treatment programs, it is common to see patients with benzodiazepine prescriptions because people who suffer from addiction often suffer from anxiety and sleep disorders.

Methadone can only be prescribed by pain clinics (for pain) and medication assisted treatment programs (for addiction).  This means that many physicians do not have methadone experience and often do not know the contraindications either. Duke City Recovery Toolbox works with these prescribing physicians to provide education and guidance in order to offer patients safer alternative medications allowing someone to continue their treatment while treating their anxiety as well.

Self-medicating using alcohol or benzodiazepines should never be an option.  Often times when someone is suffering with symptoms of anxiety or an already established dependence to either of these substance, self-medicating becomes their only option. 

Benzodiazepines and alcohol work to sedate, calm anxiety and allow for sleep. However, there are other options and when these substances are used with methadone the combination can be deadly.  The best option is to find an anxiety medication that is safe in combination with opioid replacement therapy so all of the patient’s needs can be met.

If you have questions about medication, and/or opioid replacement therapy, contact us at Duke City Recovery Toolbox.

The Stigma of Methadone

methadoneImage 300x129 The Stigma of MethadoneThe stigma associated with methadone treatment is mostly associated by opinions and misinformed people or family members that do not have a good adherence to treatment. Below are some of the myths and facts about methadone treatment:

Myth: Methadone rots your teeth and gets in your bones.
Fact: Methadone is metabolized primary by the live but has a long half-life because it is also stored in various body tissues. The gradual release of methadone from these body tissues is one of the benefits of methadone for maintenance purposes. It does not rot teeth (addicted person often neglect dental care during the course of their active addiction), nor is it stored in the bones.
Myth: Methadone is harder to “kick” than heroin.
Fact: Because of its long half-life, withdrawal from methadone takes longer than withdrawal from heroin, but because methadone withdrawal is medically supervised; the process is far less uncomfortable than withdrawal from heroin.
Myth: Methadone treatment providers are just “legal dope dealers.”
Fact: Methadone is the most highly regulated and monitored form of addiction treatment. Persons participating in medication assisted treatment are not getting “high” from their dose, nor do they need to engage in other activities often associated with addiction. “Dope dealers” do not offer counseling and help people regain a quality of living loss to addiction.
Myth: Methadone gets into your bones and weakens them.
Fact: Methadone does not “get into the bones” or in any other way cause harm to the skeletal system. Although some methadone participants report having aches in their arms and legs, the discomfort is probably a mild withdrawal symptom and may be eased by adjusting the dose of methadone.
Also, some substances can cause more rapid metabolism of methadone. If you are taking another substance that is affecting the metabolism of your methadone, your doctor may need to adjust your methadone dose.
Myth: It is harder to kick methadone than it is to kick a dope habit.
Fact: Stopping methadone use is different from kicking a heroin habit. Some people find it harder because the withdrawal lasts longer. Others say that although it lasts longer, it is milder than heroin withdrawal.
Myth: Taking methadone damages your body.
Fact: People have been taking methadone for more than 30 years, and there has been no evidence that long-term use causes any physical damage. Some people do suffer some side effects from methadone – such as constipation, increased sweating, and dry mouth – but these usually go away over time or with dose adjustments. Other effects, such as menstrual abnormalities and decreased sexual desire, have been reported by some participants but have not been clearly linked to methadone use.
Myth: Methadone is worse for your body than heroin.
Fact: Methadone is not worse for your body than heroin. Both heroin and methadone are nontoxic, yet both can be dangerous if taken in excess – but this is true of everything, from aspirin to food. Methadone is safer than street heroin because it is a legally prescribed medication and it is taken orally. Unregulated street drugs often contain many harmful additives that are used to “cut” the drug.
Myth: Methadone harms your liver.
Fact: The liver metabolizes (breaks down and processes) methadone, but methadone does not “harm” the liver. Methadone is actually much easier for the liver to metabolize than many other types of medications. People with hepatitis or with severe liver disease can take methadone safely.
Myth: Methadone is harmful to your immune system.
Fact: Methadone does not damage the immune system. In fact, several studies suggest that HIV-positive participants who are taking methadone are healthier and live longer than those drug users who are not on methadone.
Myth: Methadone causes people to use cocaine.
Fact: Methadone does not cause people to use cocaine. Many people who use cocaine. Many people who use cocaine started taking it before they started methadone maintenance treatment – and many stop using cocaine while they are on maintenance.
Myth: The lower the dose of methadone, the better.
Fact: Low doses will reduce withdrawal symptoms, but higher doses are needed to block the effect of heroin and – most important – to cut the craving for heroin. Most participants will need between 60 and 120 milligrams of methadone a day to stop using heroin. A few participants, however, will feel well with 5 to 10 milligrams; others will need hundreds of milligrams a day in order to feel comfortable. Ideally, participants should decide on their dose with the help of their physician, and without outside interference or limits.
Myth: Methadone causes drowsiness and sedation.
Fact: All people sometimes feel drowsy or tired. Participants on a stabilized dose of methadone will not feel any more drowsy or sedated than is normal.

With this information people can make an informed decision based on facts! Currently an estimated 9.2 million people who use heroin. The fortunate are the addicts who seek treatment. Please feel free to contact Duke City Recovery Toolbox if you or your loved ones have questions regarding methadone, or would like to talk to someone regarding methadone treatment.

What not to say to children…

 What Not to Say to Children


What not to say to children when recent events and tragic deaths bring up a conversation that is common in communities where addiction runs rampant.  Schools are not the havens we would like to believe. Substance abuse and violence are often first experienced there. We look for signs and symptoms but even when we find them what can be done? Here’s some suggestions of what not to do.




Are you card smart and drug smart. What do you know about drug abuse?  On the National Institute for Drug Addiction ( NIDA), website there are some challenging games.  It tests your knowledge about addiction, and the consequences of marijuana use on your memory. Challenge your friends, who think they know everything about substance abuse.

Danger, Danger the holidays are challenging times for the treatment of Substance Abuse

holidayDanger 300x225 Danger, Danger the holidays are challenging  times for the treatment of Substance AbuseHoliday seasons and the celebrations that come with them are difficult for people in recovery. Many things can happen to increase the risk of relapse. Addiction is considered a progressive-relapsing disease, and recovery from addiction is challenging to the most motivated of drug abuse individuals. Drug abuse is more prevelant this time of year and we are providing a tool to help you look for signs and symptoms that a relaps may be impending. It is adapted from the Substance Abuse and Mental Health Administration (SAMHSA) tool addressing the Holidays

Review the list below and check the items that might cause problems for you and your recovery program during the holidays. Then total up the number of checkmarks and assess your relapse risk below:

        More alcohol and drugs at parties

        Shortage of money because of travel or gift buying

        More stress caused by hectic pace (for example, traffic, crowds)

        Normal routine of life interrupted

        Stopping exercise

        Not going to AA or NA meetings

        Not going to therapy

        Party atmosphere

        More contact with family

        Increased emotions from holiday memories

        Increased anxiety regarding triggers and craving

        Frustration of not having time to meet responsibilities

        Coping with “New Year’s Eve” type occasions

        Extra free time with no structure


How did you do?

Mild: If you checked one to three items, the holidays produce only a slightly increased risk of relapse.

Moderate: If you checked four to six items, the holidays add a lot of stress to your life. Relapse risk is related to how well you cope with increased stress. Your score indicates that you need to plan carefully for your recovery during the holidays.

Severe: If you checked seven or more items, the holidays add a major amount of stress to your life. Relapse prevention means learning how to recognize added stress and taking extra care during dangerous periods. Your score indicates the holidays are one of these periods for you.


Take the NIDA Opiate Survey to Learn about this Viable Treatment Option

What do you know about opiate treatment?  This treatment helps prevent serious withdrawal symptoms as people try to overcome addiction.  The National Institute on Drug Abuse (NIDA) has developed a tutorial to educate you about this viable and often successful treatment program.

To take the tutorial and learn more about opiate treatment, please visit the NIDA wedsite.

To learn more about Duke City Recovery Toolbox and our opiate treatment program, please click here.