Considering the Marvels of Alternative Therapies as Holistic Addiction Treatment

Welcome to another episode of Recovery Dialogues and Sober Stories, where we aim to continually explore the many facets of the substance misuse and dual diagnosis landscape. Today's episode is brought to you by Wish Recovery, a leading luxury drug and alcohol treatment center focused on helping people heal from addiction each day of the year. Today, we will look at alternative therapies and their role in holistic treatment for whole self-recovery. Addiction is a complex issue. That cannot be addressed solely by addressing its physical or psychological symptoms. Holistic addiction treatment, which focuses on the mental, emotional, and spiritual aspects of an individual's life, aims to heal individuals on multiple levels by addressing underlying issues that contribute to addiction. This approach recognizes that addiction is often a symptom of deeper problems such as past trauma, mental health disorders, or a lack of spiritual connection. Unlike traditional treatment methods that focus solely on abstinence and behavioral change, holistic addiction treatment recognizes that each individual's journey to recovery is unique. It provides an individualized approach that fosters personal growth and self-discovery, one of its key strengths. The benefits of holistic addiction treatment are numerous. It treats the whole person, not just the addiction, providing individualized treatment plans that cater to each person's unique needs. It incorporates complementary therapies such as yoga, mindfulness, art therapy, acupuncture, and nutrition counseling, focusing on self-care and self-discovery. Yoga and mindfulness practices promote self-awareness, stress reduction, and emotional balance. Art therapy offers a creative outlet for individuals to express their thoughts, emotions, and experiences in a nonverbal way, which is particularly beneficial for those who have difficulty verbalizing their feelings or have experienced trauma. Acupuncture has been shown to reduce cravings, alleviate withdrawal symptoms, and support overall well-being. Nutrition counseling educates individuals about healthy eating habits and addresses nutritional deficiencies contributing to addiction or affecting recovery. These are just a few examples of the types of alternative therapies that are available that assist with addiction treatment. Holistic addiction treatment offers a comprehensive approach to recovery that addresses physical, mental, emotional, and spiritual aspects of addiction, offering a more sustainable and fulfilling recovery outcome. Today, we have two remarkable guests joining us on the show. I am honored to introduce Dr. Joseph Valpacieli, an esteemed addiction treatment researcher, and Dr. Tom Ingegno, a doctor of acupuncture and Chinese medicine. Dr. Valpacieli holds a double doctorate in medicine and psychology and has over 40 years of experience in the field with numerous noteworthy contributions. Dr. Ingino is the visionary behind Charm City Integrative Health and has 23 years of experience in integrative and functional medicine. Thank you both for joining us today. Let's start with you, Dr. Valpacieli. Could you talk about the role of alternative therapies in addiction recovery? How do they differ from traditional approaches? And what are their benefits in addressing the underlying causes of substance use disorder?

Thank you for giving me the opportunity to talk about alternative therapies. First, I'd like to give an overview of the standard approach to treating addictions. At its core, addictions involve a vicious cycle in which drug use creates the need to use more of the drug. This leads to impaired control of the drug and over time psychosocial consequences and biological adaptation in the form of drug tolerance drug withdrawal. The standard approach to treating addictions is to remove the person from the environment and to place them in a safe, secure space where drugs and alcohol are not available. Presumably, that breaks the person of the cycle of using drugs, creating the need to use more drugs. With time, The desire to use drugs and alcohol often decreases. Together with drug counseling, group therapy, and peer support, a person gradually learns strategies to avoid situations that put you at risk for relapse and learns to develop healthy relationships with other people that do not involve drug and alcohol use. This process of recovery is typically very intensive at first, It may involve a month or so away from home, followed by a period that's less intense, but still involves at least daily peer support for several months. An addiction is thought to be a chronic condition. It's not curable, and a person needs to pay constant attention and vigilance to avoid any drug or alcohol use Recovery is a lifelong process. Alternative therapies can also help with addiction, but they typically take a more holistic approach to treatment. They are concerned with the whole body. Behavioral practices such as yoga, meditation, and breathing exercises generally focus on the overall well-being of the person. Reductions in addictive behavior are thought to be a natural consequence of restoring a balance between one's mind and body. Alternative models assume that by addressing the basic underlying causes of addiction, a full recovery is possible and one can be free to live a full and productive life. The main benefit in addressing the underlying mechanism is that one can be free of the addiction and therefore devote more time to focus on the pursuit of joy and a productive, happy, healthy life.

Dr. Ingino, based on your experience, what are the most effective alternative therapies for addiction recovery, and how do they promote self-discovery and personal growth. Can you provide examples of how these therapies have helped individuals on their journey to recovery?

So the expression is never ask a barber if you need a haircut. Now, I'm an acupuncturist. I'm going to tell you that acupuncture is amazing for it. And I do have some data and historical use to back that up. So one of the things that occurred right here in the States, specifically the Bronx, New York, In the 1970s, we had a big heroin epidemic, and it, as most things do, hit poor and impoverished areas in the Bronx harder than it did other areas. Now, believe it or not, there was a development in the 1970s with the Black Panthers to make an acupuncture protocol consisting of 5 points in the ear that has been outperforming methadone clinics who are seeking to do the same thing, it was a combination of these points in a community setting with licensed therapists on staff if people wanted to talk about their addiction. And we have plenty of studies, and we have from the '70s till today clinical use of this treatment, and we are doing great with it. And it's a great alternative medicine. It's a great pathway for people to look as a complementary route to, say, their traditional therapy or intensive inpatient treatments, whatever that person particularly needs.

Dr. Valpichelli, how do alternative therapies like art therapy, equine-assisted therapy, yoga, and meditation offer new tools for coping and self-care in addiction recovery? What specific techniques or practices within these therapies have shown promising results.

There are many types of alternative therapies, and I'm going to give an example of 4 therapies that have promising results. First is art therapy, and art therapy has a long tradition in addiction treatment. And the theory behind art therapy is that by allowing people to express themselves through art, People can explore issues that may be difficult in traditional face-to-face therapy. There are many ways someone can express themselves artistically, such as through painting, drawing, sculpting, poetry, journaling, acting, or music. And with the help of a supportive therapist, the person can express and better understand unpleasant feelings such as shame, anger, and guilt. The art helps to bring into conscious awareness feelings that have been buried. Over time, art can be a wonderful way to lose oneself, to be creative, and to have fun. And while few people would say that art therapy by itself is an effective treatment for drug and alcohol addiction, There's some observations that suggest that when combined with traditional therapy, art therapy can be useful to help people, especially people with anxiety, depression, and for people dealing with trauma. And there are quite a few people with addictions, with alcohol and drug addictions, who have these issues Art therapy can be an important part of treatment for these folks. The second popular alternative therapy is equine therapy. This therapy involves horses in treatment and allows a person to feed, pet, or even ride a horse as part of treatment. Equine therapy has been used in a variety of disorders, including post-traumatic stress disorder, other anxiety disorders, and depression. Now, it's not clear how interactions with horses can be helpful for addictions, but it's thought that the physical connection with such a large animal is likely to help focus attention, and in this way can help soothe feelings and help a person develop a sense of trust with another living organism. While there are many anecdotal reports that equine therapy is effective, there's little experimental clinical research that supports this. Some people say if being around horses is fun and helps people stay in treatment, that by itself is worth keeping, or keeping equine therapy around. Yoga is the third type. Of alternative therapy, and its overall health benefits are well documented. Yoga involves various postures and mental concentration, creating a mind-body connection that many users find relaxing. In fact, research shows that yoga can affect brain biochemistry and even reduce nicotine withdrawal symptoms. A recent meta-analysis of 8 randomized clinical trials with addiction showed that yoga was beneficial in 7 of the 8 studies. Yoga even showed positive effects when used with standard medical treatments such as methadone for opioid use disorder. And the fourth technique I'm going to talk about is the use of meditation. Meditation and breathing techniques. These techniques have a long history in connection to addiction treatment, and there's a growing body of scientific research to show effectiveness for a variety of emotional disorders, including addictive disorders. Meditation involves focusing the mind on a specific thought, image, or physical sensation such as breathing or muscle tension. A recent review of research studies showed that more than 50 randomized clinical trials involving a variety of addictions, including alcohol addiction, opioid addiction, and nicotine addiction, showed that meditation and breathing techniques can be helpful. The meditation can reduce stress and anxiety. And these feelings are often associated with craving for drugs and alcohol. Meditation can also reduce sympathetic hyperactivity, which is often associated with drug withdrawal. And so the meditation can reduce the physical symptoms of withdrawal. But most interesting is that by teaching someone meditation, you can help improve one's conscious focus. And since people with addictions often have neurological changes in which behavior is regulated more by unconscious impulsive brain activity than conscious rational thinking, it's thought that consistent use of meditation can help a patient have more cognitive control over their impulsive habits, and this can prevent relapse in high-risk situations. A common theme that runs through alternative treatments is this notion of mindfulness. To become mindful is to focus non-judgmentally on the here and now, paying conscious attention to present thoughts, perceptions, and feelings. Techniques to Maintain a mindful state including the breathing exercises, meditation, or movements such as yoga, or focus on physical sensations such as sensations of touch, smell, taste, hearing, or art cues. I find that different techniques work well for different people. Some people can get into a mindful state state simply by focusing on preparing a cup of tea. Others find that deep breathing exercises are the best way to become mindful. I even have some people who tell me that prayer is a great way to get into a mindful state. But regardless of the technique to get there, mindfulness involves non-judgmental, conscious, focused awareness. While the exact mechanism of how mindfulness works for drug and alcohol addiction, there's increasing data to show that a mindful state reduces stress, anxiety, depression, anger, pain, insomnia, and even high blood pressure. These states are often associated with cravings for drugs and alcohol, so it's not surprising that mindfulness training can reduce craving and relapse. And people who practice mindfulness consistently, the attitude associated with mindfulness becomes a way of life in which people learn healthy traits such as accepting oneself and others, focusing on the here and now, and acting with conscious awareness rather than unconscious impulsivity helps people avoid relapse to drug use. And these traits serve one well, not only for a program of recovery, but as a general way of life.

Dr. Ingino, can you provide research or evidence supporting the effectiveness of alternative therapies in addiction recovery? For example, how do these therapies align with the principles of trauma-informed care and holistic healing.

Okay, rather than me doing something bland like pulling up studies on PubMed and reciting those to you, I would encourage people listening to this or anybody interested in acupuncture specifically for addiction, check out NADA. That's National Acupuncture Detoxification Association online. They've got plenty of white papers, plenty of studies on this topic. There is also a great documentary about addiction, and specifically in the '70s, like I mentioned before, this ear acupuncture protocol that NADA is sponsoring and doing around the world now. And it talks about the history of it and how it became a prominent source in America to treat addiction. This all comes from, believe it or not, Tupac, Shakur's stepfather. He was a Black Panther and an advocate for his community, and he was also a doctor in East Asian medicine. And he developed this protocol to help a suffering population, and he should be honored for that. It is quite an accomplishment to put your mark on something that's already several thousand years old and do that in a time that, honestly, the '70s for some of us wasn't that long ago.

Dr. Valpicieli, what should individuals and healthcare providers consider when choosing and implementing alternative therapies for addiction recovery? How can these therapies be customized to meet each individual's unique needs and preferences?

Individuals must be SMART about choosing effective programs. When choosing alternative addiction treatment modalities. 20 years ago, I wrote a book titled Recovery Options, which I reviewed the many options available for people seeking addiction treatment. The main finding was that people are often unaware that there are many effective options for treatment and that no one approach works for everyone. I was also surprised to find that Often the most effective treatments were the ones that were used the least. People struggling with addictions are often desperate to find a treatment that works for them. It's so easy to be misled by programs that are better at marketing than in delivering quality care. It's important when evaluating a program to be careful to ask about the results of that treatment compared to other treatments. Ask about the cost and if the treatment fits your goals for recovery. Remember, marketing claims do not substitute for well-controlled studies. Anecdotal reports of success are easy to find but do not prove very much, particularly when the reports are presented by a treatment program that stands to profit from from your participation. Once you find a program that offers the right type of treatment, ensure that the program has well-trained staff to deliver quality treatment. If someone offers you a medication, be sure that medication has clinical research data to support its use. If you don't want If you can't review the clinical studies, find someone who can give you an unbiased assessment of the clinical data. For example, approval from the FDA is one objective measure of a medication's effectiveness. And just as you probably wouldn't pick a car based solely on a TV commercial, your health is well worth the effort to find and do the research to find what treatment option is best for you. For clinicians, choosing the right approach to work with your patient should be based on clinical research data as well. Comparisons among different approaches generally show little differences in treatment approaches, but there's large differences among treatment providers. And the best predictor of treatment, regardless of the type of treatment that you offer, is the relationship between the patient and the healthcare provider. And the relationship can be improved when a clinician takes a nonjudgmental, supportive stance in treatment. In our program, we train staff to use what I call the Brenda approach, which is designed to provide psychosocial support to enhance people's motivation to begin and stay in treatment. After completing a thorough biopsychosocial evaluation, the clinician reports back to the patient to give them an assessment of how their drug use is affecting their biopsychosocial functioning. As a clinician does that, they provide an empathetic understanding from the patient's perspective of how they feel about the report that they're hearing, and the clinician gathers a sense of what's important to the patient. What are the patient's needs for recovery? Only once the patient's needs are identified is the direct advice given to the patient to help meet their goals. And finally, after the direct advice is given, The results of that is assessed, and based on the results, changes are made to one's clinical advice. For example, if an intervention is working, it's important to stick with it and give people encouragement to stay with it. If a clinical intervention is not working, then try something else. The Brendt approach is based on the principle of Motivational interviewing, which has substantial research data showing its effectiveness in helping people engage in treatment, particularly people with addictions. There's one thing I've learned in the 20 years since I wrote the book, and it's that people's needs change throughout the recovery process. And so a treatment approach that's useful at one stage of recovery may not be so important at a later stage. So, our treatment approaches need to evolve as the patient's recovery evolves. For example, early in treatment, perhaps withdrawal symptoms are the things that are most upsetting to the patient. We need to address that, perhaps by giving a medication to reduce withdrawal. Over time, it may be relationship issues need to be addressed. Therefore, couples therapy is the best option for the patient. And later, the goal may be just to get a sense of connection with the world and a sense of peace and meaning. The point is the patient's techniques should match the clinician— the patient's goals should be matched to the right technique. We need to find the right treatment for the right patient at the right time.

Dr. Ingino, in what ways do alternative therapies empower individuals in their recovery journey? How do they enhance individuals' self-worth, resilience, and overall well-being?

This is another great concept that is not talked about too often, right? So even when you're getting acupuncture, we say, oh, that's passive, right? You're laying down, somebody's taking care of you. But within that, there are changes that are occurring that you can notice, right? And things with yoga therapy, meditation, equine therapy, art therapy, there is an active role in all of that for the patient, right? You have to do the work, as a lot of people say, right? Now you're going to be guided. You're going to have a practitioner there taking care of you. But even in acupuncture, we're going to have a conversation. What are your outcomes? What are your goals? What are you going to work on once we do this treatment? So all of it requires a little bit of patient empowerment because, hey, I'm going to show you the door. You're going to be the one to walk through it. And when people start to gain that success, and that's a critical time, right, when they start to see the change, Hey, I'm having a better day than I did yesterday. Or I've been able to string those days together, right? I've earned this new chip or something like that, right? Success begets success, we often say. So we want to keep that person there and empower them through being an active part in their therapy, right? It's not just going to be passive. It's not take this pill. It's not just show up to that meeting. It is, you are active in this, and that slowly builds confidence, that builds that empowerment that's so necessary, and that builds the momentum to help them recover.

Dr. Valpicelli, could you share success stories or examples of individuals from your practice who have experienced transformative changes through alternative therapies in their recovery? What factors contributed to their success?

So, young woman came to me while a troubled teenager. At the time, she was using many drugs, but her main drug was heroin. Her mood was very unstable, and her parents were very angry with her. They wanted to kick her out of the house. They were burned out emotionally, and financially, they were drained. My patient was overweight and had very low self-esteem, and she often was involved in abusive relationships with men. One day, while she was high, she was stopped by police and resisted arrest, leading her to go to jail. And while in jail, She stopped using drugs. And when I saw her, when she was released from jail, I prescribed a long-acting version of naltrexone called Vivitrol. And so once a month she would receive an injection of Vivitrol, and that would block the effects of heroin and also reduce her craving for heroin. I also put her on medicines to help stabilize her mood. And she began the road to recovery. But for her, the road to recovery was not a straight one. Over time, she lost her desire to use drugs and she began to feel a little bit better about herself. She even went back to college, graduated. And while in treatment, in her recovery group, she found a man that she began to date. However, the fellow that she was dating began to use drugs again, but rather than relapsing with her new boyfriend, using drugs with her new boyfriend, she dragged his rear end to our treatment program and he entered treatment as well. So I saw them last week. He's been in recovery for 2 years now. She's been in recovery for Nearly a decade. She told me she was beginning clinical rotations in grad school that week in her road to become a drug counselor, and later that afternoon she was going to go out with her mom to shop for a wedding dress. Looking back at what contributed most to this success, I remember one event that occurred early in treatment. There was a day she was very anxious and demanded that I prescribe a medicine to relieve her anxiety. She had a history of misusing benzodiazepines, so I told her I could not write for a benzo. I didn't think it was in her long-term best interest. She became furious at me, screaming and pounding her fist into the desk, making a big scene. The office staff was upset with her because she was making a commotion in the Other patients were looking around wondering what was going on. And I talked to her in a plain, calm voice, and I said, I understand that you want something to take away the anxiety, but I care for you too much to write for a medicine that I think will do more harm than good in the long run. I said that it was okay to feel anxious. And I will not abandon you even though you're angry with me. We did some breathing exercises, and I remember telling her a stupid joke that made her smile. She began to feel a bit better and began to see that she could turn things around without having to use a benzodiazepine. This wasn't the last time she was frustrated with me or other people, but each time it became a little bit easier for her to bounce back. I even showed her parents some strategies for how to work with her, how to cope with her emotions, and rather than get frustrated with her temper tantrums, they used a similar strategy that I used in the office. Over time, the patient began to use more breathing and mindfulness techniques, and she used them on her own. Now she teaches other people mindfulness techniques as part of her work in helping them deal with their addictions. And I'm sure the naltrexone helped control her drug craving, and the other medicines I prescribed helped stabilize her mood. She was fortunate to have loving parents who supported her in recovery, and of course she deserves a lot of the credit for being a remarkable woman with a passion for achieving her goals. But I think the seeds of her recovery were planted that day that someone sat with her and without anger or judgment offered her hope that recovery was possible.

Dr. Angenio, What challenges or barriers exist in integrating alternative therapies into mainstream programs for substance use disorder treatments? How can these challenges be addressed to ensure wider accessibility and acceptance of these therapies?

This is the tricky one, right? A lot of these alternative therapies can't be billed to insurance. And when we get down to it, a lot of this comes down to money, right? We want to make money off of the people that are suffering. It is a horrible statement. It's a true fact. I don't think I'm throwing any mud here. I think everyone knows that our healthcare system is a for-profit system. And unfortunately, that leaves the biggest disparities with the most marginalized people. Addicts are traditionally marginalized, and even though we do have some research and documentation showing that a lot of these alternative therapies can be useful, they're often pushed to the side because they may not appear to be cost-effective to a healthcare system, right? What we need to do is radically reform, and I'm not starting to beat a drum here, but radically reform how we view healthcare. This is something that helps us all. This is not a political thing. But when my fellow brothers and sisters are healthy— goddammit, I'm preaching— I have a better society to live in. When we care about others, regardless of where they're from, how they got to that situation, their age, their sexual orientation, their gender identity, all that other BS, when we actually care about other human beings because they are other human beings, we will take better care of everyone. No one gets left behind, and we start to put people over profits. That's very preachy. I'm very sorry. That is a personal opinion of mine. But I do think that's where the discrepancy lies. If somebody can't make money off of something in this society, and we do it in healthcare, which is a horrible thing, we don't have the outcomes. We don't have the healthy society that we need to function.

Dr. Valpacieli, how can alternative therapies support long-term recovery and relapse prevention? What strategies or practices can individuals incorporate into their daily lives to sustain the benefits gained from these therapies.

As I mentioned previously, I believe long-term recovery is best accomplished with a combination of medication and psychosocial support. For example, following detoxification from alcohol or opiates, I typically prescribe naltrexone, which effectively reduces drug and alcohol craving and helps prevent relapse should the patient have a slip. Freed from craving for use of opiates or alcohol, a patient now has resources available to turn to getting their life together. And for me, that's what long-term recovery is all about, to help fill that void left by taking away the addiction. This typically includes repairing social relationships, learning to cope with stress and trauma, all without the use of drugs. I find mindful states can be particularly helpful to help people reduce anxiety and depression. And over time, getting in a mindful state can become the person's trait. That's a style of how they go through life, a style filled with non-judgmental ideas about themselves and others, less depression and anxiety, but also reduced shame and anger. And all these things help to improve one's relationship with others and oneself.

Lastly, Dr. Njinho, what message of hope and encouragement would you like to share with our listeners who may be considering or currently exploring alternative therapies for their addiction recovery? How can they find support and resources to embark on this healing journey?

You know, advice is rough because sometimes when you're caught up in everything, it's hard to hear. And part of that is due to feeling like you're the only one going through it, or you're the only one suffering. That can't be further from the truth. And while we can say the digital age makes us a little bit more of a loner, you do have literally resources at your fingertips. You can find support networks, whether it's NA or AA, whether it's something non-traditional, whether it's a website that just has free information. You can explore these alternative therapies, you can look into treatment centers, all for relatively little to no money, at least get the information. Remembering that you're not alone and you're part of a community that's all going through this can give you some support. Make sure you lean out, reach out to family, friends, and these support groups and use them during your recovery. Make them hold you accountable. Make them support you. Maybe make them isn't the right word. Ask them to support you. These are going to be the keys to success. And remember that I don't want to say anything trite or any kind of overused phrases. Healing is not a linear path. There's going to be some ups and downs. But as long as you keep going forward, eventually you get somewhere you want to be. And understand that there's plenty of people out there that care. Yeah, I think that's a big part of it. Just realize that even if you don't feel it, there are people out there that care.

Thank you, gentlemen, for your time. Insights and expertise. As we come to the end of this insightful episode, I would like to express my sincere gratitude to Wish Recovery for their unwavering support as the show's sponsor. Wish Recovery is a leading dual diagnosis treatment center dedicated to providing exceptional, holistic, and personalized care for those who are overcoming addiction and mental health challenges. I encourage you to subscribe to the show so that you don't miss any future episodes. There's more to come, so stay tuned for more from Recovery Dialogues and Sober Stories.