
SUN HEALTH MEDICAL CLINIC
, Inc.
Regardless of the weather, let's navigate together.
OPIOIDS

EFFICACY
Opioids: no study showed improved long-term outcome for non-malignant pain and likely worsens pain
Although exercise therapy (e.g., aerobic, aquatic, resistance exercises) and mind-body interventions (e.g., yoga, tai chi) can have great benefit to patients with chronic pain, behavioral health interventions, including CBT, may also be beneficial for reducing pain. Face-to-face psychotherapy has been shown to result in sustained improvement in chronic pain. A systematic review of 32 trials and 4,924 patients demonstrates that remotely delivered CBT may be effective for reducing pain and improving functional ability; however, it is unclear if these effects are sustained.
RISKS
Opioid Risk:
24% of all DEATH from Rx
(overdose, suicide)
Opioid Side Effects:
(usually from morphine or codeine)
- Nausea
- Constipation
- Hypotension mild
- Itching
​
The risks are higher for those with mental/substance disorders.
​
There is increased danger taking with benzodiazepine, alcohol, or other central nervous system depressants.
TAPER
Opioid Taper
If >=1 year, consider taper 10%/mo
OPIOIDS
SUBSTANCE USE DISORDER CRITERIA
CATEGORIES OF SYMPTOMS
mild: 2-3, moderate 4-5, severe 6+
IMPAIRED CONTROL
IMPAIRED CONTROL
Cravings and urges to use the substance
Spending substantial time getting, using, and/or recovering from the substance
Using more of a substance or more often than intended
Wanting to cut down or stop using, but not being able to
SOCIAL PROBLEMS
SOCIAL PROBLEMS
Neglecting responsibilities and relationships
Giving up important occupational, social, or recreational activities you used to care about because of substance use
Inability to complete tasks at home, school, or work
RISKY USE
RISKY USE
Using in risky settings
Continued use despite known problems
PHYSICAL DEPENDENCE
Needing more of the substance to get the same effect (tolerance)
Having withdrawal symptoms when the substance is not used

LAPSE
LAPSE
short slip into undesirable behaviors
RELAPSE
prolonged return to undesirable behavior

PLEASURE versus HAPPINESS
PLEASURE versus HAPPINESS
PLEASURE
PLEASURE
Short Lived
Physical
Distraction
Taking / Lack
Substances
Dependence
From Other
Ecstasy/Crash
Addictive
Instant Gratification
Misery
Boredom
Contrived
Dopamine
HAPPINESS
HAPPINESS
Long Lasting
Spiritual
Present Moment
Giving / Abundance
Not from Substances
Collaboration
From Within
Bliss/Rest
Not Addictive​
Fulfilling Investment
Joy
Creativity
Natural
Serotonin
SUPPORT
SUPPORT
TOBACCO
TOBACCO
Helpine: 1.800.NO.BUTTS
App: iCanQuit
SUBTANCE DEPENDENCE
SUBTANCE DEPENDENCE
Warmline: 855.300.3595
Access & Crisis Line: 888.724.7240 (trained counselors available 24/7 including additional treatment connection)
COGNITIVE BEHAVIORAL RESTRUCTURING
COGNITIVE BEHAVIORAL RESTRUCTURING
VITAL ABSORBING CREATIVE INTEREST: cultivated with Practice, Patience, Persistence
GOALS: Specific Measurable Actionable Realistic Time-bound
WORD EXCHANGE
must/should -> want/prefer/chose
can't -> choose not to
awful -> not great / undesirable
unbearable -> unpleasant
can't stand -> don't like
always -> often
all -> a lot