Using a substance in increasing amounts or for longer than you'd anticipated?

Not being able to reduce your use of a substance or stop using it even though you really want to?

Thinking about the substance, and how, where, and when you're going to use it?

Using the substance even though you are experiencing difficulty or loss in relationships, your job, or your physical health?

Using the substance NOT to feel good, but just NOT to feel bad?

These are some of the presenting signs of a substance use disorder (SUD). When you are experiencing these feelings, thoughts, or urges it may be very difficult for you to "just quit".

Substances affect the brain in very specific ways that make it very hard to control their use without coordinated medical and therapeutic interventions and support.

These interventions can include care delivered in a hospital, for the management of withdrawal symptoms, a residential treatment program, or various outpatient settings.

The first step in your healing process is having a thorough evaluation by an experienced provider, whether that is a physician or a behavioral health specialist, like a social worker, counselor, or psychologist.

This evaluation includes defining the severity of your use disorder and establishing the level of care you will need. The level of care is called the American Society of Addiction Medicine (ASAM) Criteria. Once this level of care needs is determined, you can begin to make decisions about what treatment options may work for you, based on your resources and life circumstances. Sometimes we cannot always match individuals to the level of care they might need due to financial, family, or work restrictions.

If you have never had an initial substance use evaluation or ASAM criteria evaluation, you can start your process here at Heron Wellness. I am able to meet with the family system, or other support system to better understand the context of the use disorder, and together, we can develop a plan that addresses both your needs and your abilities to engage in care at the most appropriate level for you. My network of providers at both the outpatient and inpatient levels of care allows me to connect you with experienced and thoughtful care.

Whether you meet the criteria for outpatient care you choose this option based on your current life circumstances, or you are looking for outpatient care as part of the continuum of your care as you transition from a higher-level program, I am here to develop a treatment plan to help you on your recovery journey.

I provide care for individuals who are struggling with substance use and who fit into four different categories. 

1. Individuals who are engaging in risky substance use, or who feel uncomfortable with their use but do not meet criteria for a use disorder. 
2. Individuals with SUD who meet the criteria for an outpatient clinic level of care.
3. Individuals with SUD who meet the criteria for a higher level of care but for any number of reasons are not able to access a higher level of care than an outpatient clinic level. 
4. Individuals transitioning from a higher level of outpatient or residential level of care. 

Patients and families seeking care can engage in a trial of outpatient care management at Heron Wellness. 

I am able, for appropriate patients, to provide outpatient withdrawal management for alcohol, benzodiazepine, or opioid use. This involves appropriate evaluation of use, physical and emotional health, age, social support and safety, and ability to comply with the withdrawal protocol and return for follow-up evaluation, sometimes daily.  

If outpatient withdrawal management is a safe option, this is the first step for some patients. Many patients will undergo medically supervised withdrawal in an inpatient setting and then present for outpatient care based on placement criteria.

Once a patient is safely through the acute withdrawal process we can move forward to creating an outpatient treatment plan. 

My approach differs from traditional conventional treatment because I am committed to addressing the whole person: physical, emotional, and spiritual. Treatment will include a discussion about the utilization of evidence-based medications to support recovery. Medications for Opioid Use Disorder (MOUD) include oral (Suboxone/Subutex) or long-acting injectable (Sublocade) buprenorphine and long-acting injectable naltrexone (Vivitrol). Medications for Alcohol Use Disorder (MAUD) include oral naltrexone and Vivitrol, gabapentin, acamprosate, disulfiram (Antabuse), and topiramate.

There are medications that have evidence, although less robust, for stimulant use disorders, cannabis use disorders, and dissociative substances which are offered as well. I also help patients who use tobacco and nicotine products with medications to support cessation. Tobacco and nicotine use during treatment for other substance use disorders reduces the efficacy of other treatments and increases the risk for return to use in abstinent patients, making efforts to stop using these substances imperative in the recovery process. Medication management for co-occurring mood and anxiety concerns can be utilized as well. If at any time I do not feel that management of co-occurring behavioral conditions is within my scope, I will refer you to a psychiatrist within my network of colleagues. 

Sometimes individuals do not wish to utilize medications for the treatment of SUD or other behavioral health concerns. There are a number of nutraceutical-based options to help reduce cravings for individuals who desire a non-medication intervention.

Medication management is always available if alternative treatment protocols prove unsuccessful. Complementary use of nutraceuticals with medications can further support the recovery process and is offered to all patients who are interested and meet the criteria. 

In addition to medications and nutraceuticals, I provide coordination of care with behavioral health specialists if patients are not already engaged in individual or group therapeutic treatment. Behavioral therapeutic treatment is critical to addressing the root causes of substance use, healing from trauma, learning new coping skills, learning relapse prevention strategies, and building resilience. Patients who are interested in 12-step or other mutual self-help programs will be provided with referrals to explore and access these groups.

I work closely with Utah Support Advocates for Recovery Awareness (USARA), which can link individuals with peer support, a wide variety of mutual self-help groups, community acudetox (ear acupuncture), and other important resources for recovery. 

I provide addiction-focused primary care, making sure that people are healthy and safe from a physical health standpoint. Laboratory evaluation including screening for infectious diseases associated with use (HIV, Hepatitis B and C), sexually transmitted diseases, liver dysfunction, nutritional deficiencies, and thyroid and sex hormone imbalances is an important part of the initial evaluation process. Treatment for Hepatitis C and sexually transmitted diseases, excluding HIV, are available here. Screening for ongoing risk for HIV and subsequent pre-exposure prophylaxis (PReP) is also available. Preventative wellness screening including pap smears, contraceptive management, and IUD placement is available.  Treatment of metabolic, nutritional, and hormone imbalances are critical pieces of the recovery process and will be provided as indicated. 

The overwhelming majority of treatment for SUD really ends with the management of acute withdrawal and stabilization with medications and behavioral therapies. I believe that recovery and healing of the mind, body, and spirit can only happen when we address the modifiable lifestyle factors that drive the underlying process of all chronic illnesses. SUD is a chronic, relapsing process that affects the neural circuitry and neurotransmitters of the brain. The brain is an organ, just like the heart, and is affected by the foods we eat, the amount of movement our bodies get, how much we sleep, the way we deal with stress, and how connected we are to other humans. These are the modifiable lifestyle factors of functional medicine. Positive behavioral changes of these factors are imperative to recovery and may be just what you have been missing if you've been working to heal from addiction but have not yet found success. 

Addressing modifiable lifestyle factors and creating positive change has three components that we will work through together. This will involve individual and group visits and I will coordinate with your therapeutic provider to support this aspect of your care. 

1. Education - How we feed our bodies, move and exercise, sleep, manage stress, and connect to others is not intuitive, especially if you have been struggling with your mental health and substances. Education is power and you will receive it with abundance. 
2. Engagement - People only engage to the extent that they are capable. We will work together to create realistic, specific, measurable lifestyle goals that work with your life circumstances and your recovery process. Small, positive changes increase motivation and most importantly...
3. Empowerment - You can heal yourself. This is the truth. I am here to guide you.  

As part of your treatment, you may be interested in complementary healing modalities. Some of these modalities include physical therapy, massage, therapeutic yoga, personal training,  acupuncture, energy healing, and traditional healing work. I work with a diverse network of experienced healers in our community and will connect you with these talented individuals to support your recovery. 

I provide the 5 Needle Protocol (5NP) in my practice. The 5NP is an effective, evidence-based ear acupuncture protocol that reduces symptoms of withdrawal, craving, anxiety, insomnia, stress, and trauma. This is provided in individual and group settings and I think you will find it incredibly useful. If you would like more information about the 5NP and its utility in treatment, please visit our website: utahacudetox.com. 

My approach to the treatment of substance use and substance use disorders is different from that which you may have experienced in the past. I believe strongly that you must be at the center of your own treatment. I believe that treatment must include medications for recovery as needed, behavioral therapeutic interventions, addiction-focused primary care, lifestyle modification, and complementary therapies in order to address the physical, emotional, and spiritual components of your recovery process.

Healing IS possible. 

There IS hope in recovery. 

If you are interested in approaching Hormonal changes, Behavioral Issues, and Wellness with an Integrative Approach, please reach out to Schedule a Discovery Call