Support for Medication-Assisted Treatment (MAT) has continued to grow in recent years as the opioid epidemic in America has put a mounting strain on the country. While the numbers of overdoses and opioid-related deaths have steadily climbed to devastating heights there has been more effort to explore treatment options. A better understanding of the medical and mental health aspects of addiction has become a priority. Stigma has slowly begun to carry less weight while advocates push for more effective and supportive routes to care for recovering addicts. One thing people have turned to heavily is medications like Suboxone of Methadone in attempts to steer away from more illicit and dangerous substances like heroin or fentanyl.
The application of medication in treatment can be very useful. It is a strategy that can help with the preservation of life by helping people stay off more unpredictable and life-threatening substances. However, some would say that if used for long-term this form of treatment is still relying on the idea of substitution. Often times these drugs have their own very harsh withdrawal symptoms, especially with extended use.
Taking a look at the more popular drugs used for medication-assisted treatment, one may ask- can you quit medication-assisted treatment with no withdrawals?
Understanding Medication-Assisted Treatment
Medication Assisted Treatment is the use of anti-craving medications to try and help address issues related to drug dependence, withdrawal, and relapse. The more common medications used in MAT include:
But MAT is also utilized alongside comprehensive therapy and other forms of support. Experts and advocates for addiction recovery, including the Substance Abuse and Mental Health Services Administration (SAMHSA), insist that maintenance medications alone are not sufficient enough treatment.
Advocates for medication-assisted treatment will compare MAT to someone taking medication for diabetes or asthma, with the belief that maintenance drugs are an essential part of staying healthy. However, others in the world of addiction recovery still believe it is possible to be healthy in recovery without the prolonged use of powerful medications.
The truth is the answer may not be the same for everybody. Different treatments may be more useful for different people. No one should be ashamed of the method they use to get help. But we also want to look at how some drugs used in medication-assisted treatment might make things more complicated for certain people.
Looking at the most popular maintenance drugs for opioid addiction, of course, we find Suboxone. To better understand Suboxone withdrawals, we first have to know what it is. This popular brand name is used to identify a prescription medication that contains active ingredients:
- Buprenorphine- a narcotic opioid medication
- Naloxone– an opioid blocker that impedes the effect of opioid medications
This medication functions as a partial opioid agonist and diminishes cravings as well as prevents other opioids from reacting to the brain’s opioid receptors. Taken in low doses for short periods of time, the drug can be helpful in curbing opioid withdrawal symptoms while tapering off without too many residual effects.
The tricky part comes when someone uses Suboxone for an extended amount of time as a replacement for heroin or other opioids.
Sometimes this can lead to its own form of recreational use and physical dependence. Even the U.S. Drug Enforcement Administration reports that Suboxone is commonly susceptible to abuse. It is still a powerful drug.
Suboxone Withdrawal Symptoms
While Suboxone and other maintenance drugs may be a preferred tactic for going ‘cold turkey’ off of heroin or other opioids, the drug itself still has the power to cause its own set of withdrawal symptoms. These symptoms can include:
- Irritability or agitation
- Difficulty sleeping
- Profuse sweating
- Runny nose
- Frequent yawning
- Stomach pain or cramping
- Dilated pupils
- Nausea and vomiting
- Changes in mood
Not to mention precipitated withdrawal, when the ingredients in this medication can actually induce the onset of unpleasant symptoms rapidly, if not immediately, for someone actively engaged in opioid use.
Methadone is a long-acting opioid medication utilized since the 1970s to try and help people get off of heroin. It is typically used today under strict medical supervision because the drug is very potent and has a high risk of addiction. In fact, a 2012 National Survey on Drug Use and Health found that approximately 2.46 million people reported to using methadone for a non-prescribed purpose at least once.
According to another study, in 2009 methadone was responsible for 1 out of every 3 opioid overdose deaths.
Because of the risks, a gradual taper should be utilized to wean someone off of methadone. Often times doctors will prescribe another detox medication to help with this process, with the tapering to be done under medical supervision.
But as with trying to quit heroin or other powerful opioids ‘cold turkey’, trying to abruptly discontinue methadone can bring on intense withdrawal. This includes physical and psychological symptoms such as:
- Runny nose
- Tearing or watery eyes
- Muscle aches
- Joint pain
- Abdominal cramps
Many of these symptoms are similar to the symptoms of withdrawing from heroin or other opioids. So in a sense, this drug can create similar withdrawal symptoms as the drugs it is supposed to be used to treat.
Quitting Medication Assisted Treatment
Is it possible to quit medication-assisted treatment- yes, there are always other options for getting comprehensive care and lasting recovery without the prolonged use of these medications. Even relapse prevention is possible without relying on medications to fight cravings.
Can you quit medication-assisted treatment with no withdrawals? Well, that may be a process. It depends on a number of factors, such as the specific maintenance medication and the length of time using it. For example, someone who has been using methadone for years could probably have a much harder time getting off methadone than someone who used another medication for a month or so to help get off opioids.
Safety is crucial when deciding to quit MAT. Quitting medication-assisted treatment without a taper or other forms of medication can cause intense withdrawals. It is not suggested that someone try to quit MAT ‘cold turkey’ or without consulting a doctor for help with changing the dosage and slowly tapering off the drugs.
Again, just because it isn’t heroin or fentanyl doesn’t make it harmless.
MAT or Detox?
Medication-assisted treatment holds a lot of value, but the question becomes whether or not it is the kind of sustainable solution you want. Recovery isn’t one-size-fits-all. Medication-assisted treatment can be helpful in saving someone’s life who cannot stop using drugs. But is it something that will completely eliminate cravings and withdrawals, or will it just postpone these symptoms?
Remember, these are still powerful narcotic drugs that have a high risk for abuse. Some people end up using medication maintenance for life. Others will use it for a short period of time, with a detox period afterward. Either way, it is your choice; how long do you want to rely on substances, and to what extent?
Other models believe in providing holistic treatment and personalized therapy after a detox period, helping to reduce and remove chemical dependence and build a foundation for personal recovery.
Using medication to help with the painful and often overwhelming symptoms of withdrawal from opioids and other drugs can be essential to a smooth and healthy transition. In fact, with a safe medical detox, each individual is given an initial assessment to see what medications will be helpful in making this phase of treatment comfortable and safe. This can include medications for anxiety, mood disorders, physical pains and various other side-effects of substance abuse.
And when it comes to some of these medications, it can sometimes be necessary to continue using them.
The biggest difference is whether narcotic maintenance medications like Suboxone or methadone become a long-term prerequisite to recovery, or if they are used to help someone who is sick get better so that the real healing can happen.
Palm Healthcare Company believes in providing a safe medical detox to allow for a comfortable and healthy transition from active drug or alcohol use. Our facilities utilize an experienced and professional medical staff who help to monitor each individual’s progress and provide effective medical support for lasting recovery. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now. We want to help.
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For some of us, the holidays can be hard. Whether you are new to sobriety, in long-term recovery, or just a human being who just happens to live in a world with holidays, certain times of year can bring on a lot more stress than you would prefer to deal with. Thanksgiving can be one of these difficult times of the year. Some of us find it overwhelming to be surrounded by so many relatives and close friends because it can lead to high-stress social situations. Like when that one uncle brings up politics or that one aunt talks about their much more successful child. Or like when the parents bring up that time you pawned all their jewelry and crashed their car running from the cops.
No? Okay so maybe that is a very specific example.
Either way, Thanksgiving can be tough. Some of us in recovery from drug or alcohol addiction might not be able to spend this holiday with our families. We might feel isolated or even left out if our addiction has placed us in a situation where we cannot be directly present with our loved ones. Or we may find it a challenging situation simply because it is usually a day we remember drinking.
But still, there is always a great deal to be thankful for.
This week, as the holiday season comes in full force, we wanted to share 4 ways to get through Thanksgiving in sobriety for those who might be having a little more trouble than others.
Too often people forget that holiday gatherings aren’t so much about the food or the partying. They are about the quality of time being spent together. Being present and in the moment will help you to actually enjoy the holiday instead of stressing over it. Even if you are not physically present with your family, being more available to those you are able to be with can make Thanksgiving in sobriety more enjoyable.
And you can still be available for your family and friends that aren’t around by reaching out over the phone and giving them some of your time as well.
If you go into the holiday with the head-space of being a drag, you will probably follow through with that. But if you chose to be actively engaged in you can easily give new meaning and feeling to the experience.
Decide how to talk about it
Sometimes the fact that you are in recovery will come up, so you should decide how you want to talk about it… if you want to talk about it. The great thing is you aren’t required to tell anyone who doesn’t know. You don’t have to explain yourself. Just let people know you don’t drink.
When it comes to family or friends who do know about you issues with substances, decide how comfortable you feel with this conversation. Be willing to address concerns, but also set boundaries. You still have to take care of yourself, especially in early recovery.
Try to focus the conversation on the good side, like the fact that you are enjoying a Thanksgiving in sobriety with them. Some people will want to focus on the bad, but you can still decide how you are going to talk about it. To stay in the spirit and be present, talk about the solution you have now, not the problem you were facing.
Include your support system
Having a strong support system is a vital part of long-term recovery. Whether it is relatives, close personal friends or people from the recovery community, having people to have your back definitely helps. Holidays are all about connection, so stay connected to those who share your experience. Let your family members know you’re going to be leaning on them for support if things get hectic.
Also, have people outside of the family to reach out to. If you are involved in a recovery fellowship or support group, connect with your peers to learn how they handle similar situations. Don’t be afraid to ask for help. Include people who know what you are going through and who can help keep you on track.
Get in the Thanksgiving Spirit
One way to enjoy Thanksgiving in sobriety is to actually commit to the idea of Thanksgiving. This is a holiday all about being grateful for what you have and giving thanks and love to those closest to you.
If you are grateful this Thanksgiving, be sure to give some of yourself. You can help the family with making food or setting up, or you can go beyond that and give in other ways. Sometimes people in recovery find ways to volunteer for the holidays. Participate in some form of community activity that gives back and helps those in need.
Being enthusiastic about the opportunity to share this time with your loved ones and give to others can help you overcome the hang-ups you might encounter. If you can try to get in the spirit of the holiday, it won’t be so much about drinking or stressing over everything and more about spending the time with the people you love.
The spirit of the holiday is to celebrate what you have. If you are sober you have something pretty significant to be celebrating, right? Thanksgiving in sobriety lets us reconnect with those we love and show gratitude for the second chance at life. It shouldn’t be all that hard to get into the spirit of being grateful. The real good feeling comes from loving and giving back.
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Always remember during the holidays to take care of yourself. For Thanksgiving in sobriety be grateful for how far you have come. If you are still struggling with an addiction, now is the time to get help, so that you can give your loved ones the peace of mind they deserve so you can have even more to be thankful for. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
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The Big Pharma industry is still in the hot seat, and this week another lawmaker is adding a new name to the roster of drug makers to be investigated for shady marketing practices. Alkermes, the company behind the opioid treatment implant Vivitrol, is now being investigated for how they market their product.
Background on Vivitrol
Vivitrol is another name given to the generic drug Naltrexone. Originally approved by the U.S. Food and Drug Administration (FDA) for the treatment of alcohol dependence in 1994, Naltrexone eventually became approved for the treatment of opioid dependence. The medications primary use appears to be blocking the opiate receptors in the brain. It’s intended so that someone using heroin or other opiate-based drugs cannot experience the drugs high.
The Vivitrol shot is made by Boston-based biotech Alkermes. This medication stood out from other Naltrexone medications because Vivitrol is an injection given every 4 weeks with a monthly doctor visit. It is time released for longer lasting relief, instead of being a pill taken once a day.
Supposedly Vivitrol is intended to further help by reducing cravings for opioids. However, Naltrexone and Vivitrol have been refuted by many for having any notable effect on opioid cravings.
Enter Senator Harris
Kamala Harris is a Democratic California Senator who has announced she will be part of launching a new investigation into the sales and marketing practices of the makers of Vivitrol. According to the senator, Alkermes allegedly worked to increase sales of their opioid treatment medication through two questionable strategies:
“Aggressively” marketing Vivitrol to officials in the criminal justice system
Senator Harris says that Alkermes pushes for judges and lawmakers to use their product. The company even provided free samples, which resulted in Vivitrol being actively implemented in 450 treatment programs across 39 states.
Lobbying efforts by federal and state lawmakers
In her statement, Harris also alleges that the company has spent millions of dollars in direct appeals to government officials. Meanwhile, they were contributing to numerous congressional campaigns.
Due to the drug companies marketing, Vivitrol raked in well over $69 million dollars in the third quarter of 2017.
In her statement Senator Harris says,
“We are at the height of a crisis, and companies are taking advantage of pain in order to profit”
“We must hold these companies accountable for their deliberate actions that magnify the opioid epidemic and drive up the cost of drugs for Americans.”
The senator even quoted the chief of addiction medicine at Stanford University School of Medicine, Dr. Anna Lembke, who said,
“Alkermes has taken unethical drug promotion to new depths by enlisting judges, law enforcement personnel, and legislators to favor Vivitrol over proven treatments. Alkermes’ actions undermine public health.”
Which seems like some pretty strong words. In the midst of the opioid crisis, it might be fair to say we should use every resource we can get. However, the Big Pharma enterprises still need to be put in check when it comes to overlooking more effective treatments.
In fact, a 2011 review of studies suggested that Naltrexone was not significantly superior to placebo, and the authors believed there was no sufficient evidence to support Naltrexone therapy for opioid dependence.
One reason Senator Harris seems to have Vivitrol in the crosshairs seems to be that the pharmaceutical company made a habit out of promoting Vivitrol as a more effective treatment than other maintenance drugs, such as Suboxone or Methadone, even though there is no substantive data to support this claim.
As part of the investigation, Harris contacted Richard Pops, the Alkermes Chairman, requesting the company provide data and communication. At the moment Alkermes is disputing the allegations. Senator Harris appears to be calling their bluff, as she was requested that Alkermes submit:
Alkermes has also been asked to turn over any materials provided to participants or speakers for Alkermes since 2010. They’re being asked to disclose amounts paid to the company by various associations, including:
American Society of Addiction Medicine
National Institute on Drug Abuse (NIDA)
Partnership for Drug-Free Kids
Any studies presented to these groups are also to be turned in.
In their own statement, Alkermes states they are “focused on ensuring that patients, healthcare professionals, and criminal justice officials are educated on Vivitrol, and believes that patients should have access to all medications.”
There is no telling whether or not this investigation is going to turn into a witch hunt or if it will blow the lid off of even more bad behavior from Big Pharma. While other drug companies that can be connected to the opioid crisis are already facing lawsuits and others even criminal cases for racketeering and fraud, the Vivitrol producers might find themselves on the chopping block sooner rather than later.
There is already much disagreement about whether or not the Vivitrol treatment is really effective in the first place. Some say the medication helped save their life. Many others have horror stories of uncomfortable side-effects made worse by cravings. Either way, pharmaceutical companies still need to be held accountable for their marketing methods, especially when they seem a little suspect.
For now, this is all a request. Only Republican Senator Ron Johnson has the power to issue subpoenas on behalf of the Homeland and Governmental Affairs Committee.
When talking about the most effective treatment programs for addiction, we should also remember that maintenance drugs like Suboxone, Vivitrol and others are not exactly a solution. While they can be effective in keeping people alive and helping to overcome their sickness, the real healing does not come from magic pills or implants. The real transformation comes with developing the understand and the tools to take care of yourself. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-888-922-5398
While the opioid crisis in America has reached public health emergency proportions, we still have to remember that there are a lot of other extremely dangerous drugs out there. Cocaine is a drug that has been around for a very long time, but with the rise in heroin and prescription drug abuse, people may have this idea that cocaine is no longer a real threat.
However, cocaine is still very dangerous and very prevalent around the world and here in the United States.
So how well do you know this drug? What do you know about its history? Do you know about the most common health risks?
Here are 25 facts about cocaine you probably don’t know.
Karl Koller (1857-1944)
This Austrian ophthalmologist experimented with cocaine as an anesthetic. The most infamous accounts are of Koller applying the drug to his own eye and then pricking it with needles.
Cocaine is the most powerful central nervous stimulant found in nature. The drug often gives users feelings of alertness, energy and even power.
In 1885, a U.S. manufacturer sold cocaine commercially. They advertised that cocaine would “make the coward brave, the silent eloquent, and render the sufferer insensitive to pain.”
Side note- The manufacturer even included a syringe in the packaging.
Drugged on the Job
According to some historians, white business owners in the early 1900s would encourage their African-American employees to use cocaine in order to boost their productivity.
First Addicted Physician
In 1884, famous American physician William Stewart Halsted performed the first surgery using cocaine as an anesthetic.
Side note- he shortly afterward became the first cocaine-addicted physician on record. Surprising?
According to one study, trace amounts of cocaine can be found on 4 out of every 5 dollar bills. However, cocaine is a fine powder and is easily spread around, meaning the bill wasn’t necessarily used as a snorting straw.
Historians say that Hitler was addicted to cocaine, among many other drugs including methamphetamines. Nazis often used drugs as a means of stimulation. Many believe all those stimulants helped ignite his ranting paranoia.
Second Most Popular
Cocaine is the second most commonly used illicit drug in the United States. The first is marijuana.
In 2004-2007 cocaine overdose caused 31% of visits to the emergency room.
Every day, 2,500 Americans try cocaine for the first time.
Over 200 million people use illegal drugs worldwide. 21 million of those people use cocaine.
Even though the United States only makes up less than 5% of the world’s population, the country consumes approximately 37% of the world’s cocaine.
The illicit cocaine industry earns between $100 and $500 billion each year.
Scotland has the highest cocaine use out of any other country in the world. One out of every 40 Scots uses cocaine, which is approximately 2.4% of the population.
Babies Born Addicts
Every year in the United States more than 400,000 babies are born already addicted to cocaine.
An estimated 10% of all people who begin using cocaine will immediately progress to serious, heavy.
Sharing is Hurting
Sharing straws to sniff cocaine can actually spread several blood-borne diseases, including hepatitis C.
Cocaine users tend to have higher rates of certain mental health conditions, including:
When compared to the general population.
Perfect for Heart Attacks
Come describe cocaine as the “perfect heart attack drug” because it causes so many harmful effects, including:
- Increased blood pressure
- Stiff arteries
- Thickening of heart muscle walls
Even worse is that these irregularities persist long after the effects of cocaine have worn off, even for those who aren’t chronic users.
Chronic cocaine use can cause a condition called bruxism, which is grinding of the teeth involuntarily.
Cocaine frequently causes dehydration and dry mouth. This leads to many users having less saliva in their mouth, which can then lead to tooth decay.
The Nose No’s
Cocaine can also destroy the cartilage separating a person’s nostrils after continued use.
The direct pharmacological effects of the cocaine are often only credited with 1/3 of the deaths associated with cocaine use. The majority of deaths in connection with cocaine are by:
- Motor vehicle collisions
Meaning a lot of people die as a result of the mind-altering properties of cocaine and risk behaviors associated with the drug.
Consuming cocaine with alcohol is one of the deadliest drug combinations there is.
Now you may be wondering… what is the last fact going to be? You might get through this list knowing less than you expect about the powerful illegal stimulant…
You can quit because there is help for you. Cocaine addiction can be crippling and feel impossible to overcome. But with safe medical detox, followed by effective and holistic treatment options, you can build a lasting foundation for recovery from cocaine addiction.
Palm Healthcare Company takes pride in offering comprehensive and innovative treatment options to help individuals create a personalized recovery plan. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-888-922-5398
While the nation is still struggling to find the right strategy to climb out of the opioid crisis in U.S. it seems many are holding onto the idea that Big Pharma is going to save us from the destruction they helped create. While we can agree that evidence-based medical assistance in recovery is a useful tool, some seem to think that the only fix for a pill problem is more pills, or in this case, more needles.
Just recently, after President Trump declared the opioid crisis a “National Health Emergency”, the advisory committee to the U.S. Food and Drug Administration (FDA) voted 18-1 that a new injectable drug called RBP-6000 could benefit addicts and the lower of two doses studied had an “acceptable” safety profile.
So what does this mean for the opioid epidemic efforts? Is Indivior a miracle injection that is going to make the epidemic more manageable, or is it another kind of Methadone or Suboxone that is just keeping people hooked?
What is RBP-6000?
For a little background, RBP-6000 is an experimental drug designed to help fight America’s growing opioid addiction crisis. It is described as a sustained-release buprenorphine. It is designed to be delivered once a month as a subcutaneous injection. The compound solidified once in contact with bodily fluids and releases buprenorphine over time.
If approved, it will be the first monthly injectable buprenorphine treatment. When creating the drug the manufacturers studied two dosing regimens.
In one, 300 milligrams were given once a month for six months.
In the other, two doses of 300 milligrams were followed by four doses of 100 milligrams.
According to reports, there was only a minute difference in effectiveness between the two doses, and they drug company acknowledge that the higher dose of RBP-6000 caused more side effects. Looking closely into some of the reports from the research, some side-effects include:
Injection site pruritus
Upper respiratory tract infection
While these side effects were not noted in an extremely high percentage of those tested, they are still relevant to consider until there is more extensive data available. So far, the report says the safety profile is consistent with that of Suboxone.
So RBP-6000 is like Suboxone using the delivery of Vivitrol; another injectable drug used to try and block the effects of opioids.
Big Pharma Making Big Moves
This is one sign of how Big Pharma is stepping in to make a buck off of the opioid epidemic yet again.
Indivior is the company behind RBP-6000. It was originally part of Reckitt Benckiser as the Buprenorphine division but has since split off to be a specialty pharmaceutical company. Indivior already sells Suboxone Film, a product which combines buprenorphine and naloxone. Suboxone is a maintenance drug widely used in America to try and curb the effects of opioid addiction and withdrawal, but Suboxone is known to have its own side-effects and withdrawals. Some even attest that Suboxone is itself addictive and very difficult to get off of.
Two months ago the share prices for Indivior took a deep hit after a U.S. court ruling clearing the way for a generic rival to Suboxone Film. So, with new competition on the way in the Suboxone market, Indivior put a renewed focus on another maintenance drug to bring to market.
Some analysts already expect that RBP-6000 could capture around 30% of the broader buprenorphine market. Some believe this new form of injectable buprenorphine could generate annual sales of around $700 million by 2021.
Jefferies sees potential sales of $1.3 billion by 2025.
So now the push for this new drug is boosting its sales prospects as competitors threaten revenues from Suboxone sales.
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Waiting for FDA Final Ruling
This endorsement on behalf of RBP-6000 comes less than a week after FDA Commissioner Scott Gottlieb announced the agency’s plans to promote extensive use among opioid addicts of less harmful opioids such as methadone and buprenorphine, the active ingredient in RBP-6000.
However, some of the FDA panelists still would like to see more data about which patients should be given the higher dose. Other panelists say they would like to have it available, even though they lack of data supporting any additional benefit of higher doses. So even though the drug is shown to have side-effects in higher doses, and there is limited information on how these side-effects impact the individual, the FDA is considering to let this drug pass the grade.
The FDA’s decision is set to be made by November 30th, although typically the agency follows the recommendations of its advisory panels. So it may very well already be a done deal.
Why It Matters
Again, with respect to the importance of offering alternatives to particularly dangerous opioids like heroin or fentanyl. It is important to have resources for the purpose of preserving of life. Keeping people alive long enough to get help is crucial. But we also have to see that this is not a miracle cure.
Methadone, Suboxone, and Vivitrol may serve a purpose for some in a certain capacity. However, these drugs are not an adequate substitute for comprehensive addiction treatment. Each one of these methods should be accompanied by a holistic treatment plan that addresses all aspect of addiction, including emotional and mental health.
Drugs like RBP-6000 may help subdue the more serious symptoms from the physical side of addiction, but they can also present their own risks.
It is important to offer safe medical assistance, but we have to remember that these Big Pharma companies are not selling us instant cures to opioid addiction. This isn’t even the first time we have seen a new drug come out to try and treat the opioid problem from companies that are closely related or directly responsible for narcotic medications that helped fuel the issue.
Remember, there is not a quick fix for this problem. We cannot prescribe our way out of the problem. It is going to take better treatment resources beyond more medications.
Drugs like RBP-6000 from Indivior are not necessarily a bad thing, but they also may not be the kind of treatment people should focus on. Instead, there are safe medical treatment options that offer holistic resources and mental health services. A lasting recovery begins with effective treatment. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-888-922-5398