#and like. ive engaged in some RISKY behavior

[wwwyzzerdd420]

I really just do not get women At All

[checkoutmybookshelf]

Ok, it's no surprise that I deeply enjoy Much Ado About Nothing as a play (and there are some truly delightful film and filmed staged productions), and there's a lot of talk about the scene between Beatrice and Benedick after Hero and Claudio's aborted wedding (Act IV, scene i).

What I don't see a lot of though, is how Benedick literally accidentally talks Beatrice into asking him to kill Claudio.

Yeah, Beatrice didn't walk into that scene ready to ask BENEDICK to make this right. Let's walk through the lesser-quoted lines from this scene.

We all know the iconic, "Lady Beatrice, have you wept all this while," but then we get this little exchange:

Benedick. Surely I do believe your fair cousin is wronged. Beatrice. Ah, how much might the man deserve of me that would right her! Benedick. Is there any way to show such friendship? Beatrice. A very even way, but no such friend. Benedick. May a man do it? Beatrice. It is a man's office, but not yours.

Benedick asking if a man may do "it" is a blatant offer to try to fix things, but it's pretty damn clear at this point in the text that he has big-ass heart eyes and hasn't thought this offer through, because the way to right Hero is to either get Claudio to recant--which he's not going to do because that is going to make him look like an absolute dingus and it will embarrass Don Pedro--or else to kill him in a duel. To ask a man to kill his best friend--even if that best friend is a complete and utter chungus--is cruel. It is one thing to call a friend out for being a dick to Hero, but to ask for Benedick's to be the hand that kills Claudio is a whole other level that Beatrice is going out of her way to excuse him from.

She is explicitly--and correctly, frankly, given the chains of command and power dynamics involved--excusing Benedick from being responsible for Claudio's behavior and correction. And while yes, part of dismantling the patriarchy is men holding each other accountable, murder is not accountability, it's the beginning of a goddamn blood feud. So Beatrice is over here very subtly going "You have clearly not thought this offer through, and I'm not going to ask you to kill your best friend." It is not his office.

And rather than hearing what Beatrice is saying, Benedick goes and MAKES IT HIS OFFICE by declaring his love for Beatrice. Which like...aside from this being not the moment, it just makes it even clearer that Benedick is not actually listening to Beatrice here. His focus is on her, but Beatrice is razor-focused on Hero and the fact that Claudio just more or less ended Hero's life. But here's the other thing.

I subscribe to the "Beatrice and Benedick had a prior relationship before the play and it ended badly" theory, because I think it explains a lot about their dynamics. But that also makes this scene a little bit risky and pointed. Because yeah, while Beatrice warns him not to swear he loves her and then eat his words, if they have a history, then her "Kill Claudio" is not just a request. It's a test.

He already didn't choose her once, presumably for way lower-stakes reasons. So to ask him to choose her, to be on her side, with all of what that means, is a test of a possible new relationship. And it's one Benedict comes perilously close to failing, because of course he's not going to kill his best friend and brother-in-arms.

And just like that, Beatrice is out, because Benedick "dare easier be friends with [her] than fight with [her] enemy." His choice is not her, and she will not be anyone's second choice. Especially given that choosing Claudio means that Benedick is engaging in the infuriating mental gymnastics where Hero can have been done badly wrong, but Claudio somehow isn't Hero and Beatrice's enemy.

This is not a complicated situation; Claudio was absolutely in the wrong, caused harm, and needs to be called on the goddamn carpet for it, and Benedick is over here trying to "both sides" it. I'd have been out too, and then he has the nerve to insist that he and Beatrice be friends before she's allowed to leave the stage! I adore that she then full-on goes off on him, and every single time Benedick tries to get a word in edgewise, Beatrice comes up with another argument and just cuts his ass off. There is no "letting him explain," there is no "I'm just playing devil's advocate," there is no "trust me, I know Claudio." There is only the facts of what happened, and Beatrice hammering them directly into Benedick's head. Lots of productions cut out the attempted interruptions by Benedick in favor of letting Beatrice run with a monologue, but if you look at the text, he tries FOUR SEPARATE TIMES to interrupt her.

But Beatrice just steamrolls on, and the thing is, it works.

Beatrice hits and refutes key arguments that we can just imagine Benedick bringing up. The bullshit logic of him being in a romantic relationship with Beatrice while supporting Claudio's actions. The undeniable public slander of Hero. The bullshit that is slut-shaming and measuring a woman's worth by her virginity. The divide between an "ideal" manhood and the reality of men's behavior. The nonsense that is how easily men are valorized for slandering women. Every point brought up and thrown in Benedick's face until he is left with only one final question; the only possible question that could matter at the end of this scene:

Benedick. Think you in your soul the Count Claudio hath wronged Hero?

And Beatrice is very, very sure. Which ultimately is enough for Benedick to choose her, and agree that yeah, Claudio needs to be called out and corrected, and he is now on board with taking that responsibility.

It is kind of wild to me that this scene begins with Beatrice trying to protect Benedick from the reality of the situation, and insisting that if he wants to be in love with her, if he wants to be in her life again, then this time he has to choose her for all that that means. And as Beatrice makes clear, what that means is a disruption--if brief--of the patriarchy and the status quo. Being with Beatrice means that Benedick has to stop being the prince's jester and stand against toxic masculinity and harmful patriarchy in a real, concrete way.

It's Shakespeare, so that doesn't stick beyond the happy ending, but it is here, and Beatrice really said "if you want to be with me, you have to stand with and for me and the women around me" when it was clear Benedick wasn't taking no for an answer.

[mazzystargirl]

ok living up to pinned post w some true confessions/dark secrets… so basically after i tried to kms in 2021 fall and went to the hospital i entered a really intense slut era and like started impulsively spending money and stuff too and i didnt have a job so i was like oh omg having a sugar daddy would work out really well for me and also i wanted to do things that would be like damaging or whatever idk why i did it rly. but anyway i engaged in some sugar baby behaviors. and then that winter break i went home from school and met up w some of my friends who ive known since i was a kid. now i have to give a little bit of context here cuz its important. so i have these 3 friends, one of whom ive known since i was 3 years old (N) and the other two since i was like 7 (S and J). and we all live in a very tight knit neighborhood/cultural community where mostly everyone knows everyone. and so my 3 friends parents know my parents. i guess you can see where this is going… but anyway i told them i had a sugar daddy or like it came up in conversation idk. and that was that. then literally the following AUGUSTTTT my mom comes to me and is like oh so some people in the neighborhood have been saying that you’ve been engaging in risky behaviors with older men and that youve been meeting them in hotels. so obviously i denied it very emphatically and tried to pry out who tf she heard that from and honestly i was like what like who could have even spread that and she said J’s mom told her and was lowkey rly cagey about it bc she didnt want to “break her daughter’s trust” and had asked other aunties about the situation like wtfff… and then i remembered i had mentioned to them over winter break so she must have fucking told her mommmm. i decided to assume best intent and chose to believe she was worried abt me and thats why she told her mom so i messaged her like hi did u tell ur mom abt this and i appreciate ur concern but i would have appreciated it if maybe u came to me directly and checked on me it would have been better and u lowkey hurt my feelings cuz now im stressed and anxious and don’t know whos saying what abt me etc etc. and then…

she fucking LIEDDDDD she said she didnt say anything to her mom AND that her mom didnt say anything to my mom!?? which i know is fucking bullshitttt 😭 like it makes 0 sense like if no one said anything is my mom just pulling shit out of the air and if she was how would she land straight on the money like that it just doesnt add up. so i was like um ok ?? uh have a good day. and decided to let it go and i lowkey don’t speak to her anymore and i told N and S that im not speaking to her but they can hang out w her if they want. and i forgot abt it.

but now i just moved back home after finishing school and its lowkey been eating away at me. it hurts me that she was my friend for 13 years and its all up in flames and i never got any closure or an apology or even her to admit or acknowledge the situation?? it hurts me to be at home worried abt what people are saying or thinking about me. i know i shouldnt care but what other people think of me bothers me. im not ashamed of myself and my choices but i don’t want other people to think less of me. i don’t want to reach out to her bc what if she doesn’t care at all about the situation ??? i don’t want to be like this has been eating at me forever and it really hurt me and her to be like what r u talking about i don’t think about you at all. she also just got into med school and im happy for her for real like glad shes doing well its just like. she hurt my feelings really bad :(

anyway if you read this far… what should i do 🥲 is the only path forward trying to let go… tbh i think i just need someone to validate my feelings like am i right to be hurt or is it all my fault and should i beg for forgiveness 😭 like my friend N got coffee w her a couple weeks ago and brought it up to me twice what does that even meannnn

[upsidedowngrass]

reading your and jaspers posts about bryce with silent admiration because im too scared to contribute but i really love bryce so much hes my girlfriend and my husband and i like hearing u guys talk about him because youre Right. especially as someone who struggled from grief and trauma and being abused i think bryce's case interests me more than any of the other characters (even though liam is my favorite, and it says a lot because i find all of them interesting) because there is so much to him. i doubt he has processed a single thing about what happened. i think stellas death was recent too honestly, within the last few years at least, and he copes by... not coping. burying himself in work and drinking in the hopes to forget about it. not even to mention the fact that in episode 7 it showed him driving home drunk personally i feel he was past the point of caring to the point of engaging in risky/dangerous behaviors (this speaks for itself, i dont think i need to say why). i think that the plane impacted him so much that within those 7 months after leaving he got his shit together. i cant speak for if hes totally sober or not but at the very least he doesn't drink as much as he used to and i doubt he's putting himself in danger anymore. to be honest i think bryce is one of the characters who has changed the most because of the plane, which makes him being rejoined all the more interesting to me. im probably just making shit up but i like to read into it a little more than "bryce and liam were getting along but now theyre separated and liam has to fix it oh no". sorry this ask is kind of word vomit im not in the headspace to tidy it up but i hope you get what i mean

i think if one had continued for longer than it did it would have been interesting to explore bryce finally accepting and coming to terms with his past (him not seeing his childhood home in the wr anymore kind of representing this). i love bryce and he deserves to heal

TY!!!!!!! im glad my thoughts warrant admiration to you :D!!!!!!!!!!! (i will say tho that every time uve ever posted YOURE thoughts i am like ohhhhh.... ur SO RIGHT. i think u have some of the BEST interpretations of the one characters ive seen!!!!!)

(talked SOOO so much .so there is a readmore :) )

brcye really IS such an interesting character???? ik ive said it before but i AM biased towards protagonists so i usually focus on liam but like ...... bryce really IS probably one of the more. indepth ? characters in one in terms of like. background and how he Acts. i think ALL of teh characters are written really incredibly but i think, given how much of his bg is clarified (esp in contrast with how little is shown of the other characters lives pre-one) his motives, personality, emotions all end up being SUPER super elaborate and i REALLY love how he was written ??

(that said i think the reason he IS elaborated on sm is bc like. one doesnt elaborate on character backgrounds like MOST of the time. even charlotte is mostly left up to interpretation, bc one is more about the HOW people respond rather than WHAT made them respond that way. but charlotte and bryce are both outliers, and bryce ESPECIALLY so. because both obviously have Things they havent worked through properly, but bryce is directly just. Living in it. its the fact that he WONT acknowledge the actual Things that hapepned enough to heal that warrants the elaboration. while the other characters stop acknowledging ANYTHING about their lives , save for charlotte, who gradually works out her issues themselves, because THATS whats effecting her, bryce is CONSTANTLY just. he Needs to go back, but his problems ARE about what happened, and the fact that his life outside of the plane was what MATTERED to him, but that even then, he just Wouldnt acknowledge that life when he Needed to. idk if that makes sense but ohhh i think about the decision to elaborate on some characters and to not on others bc it feels Important)

hes so. he mirrors all of the contestants in some ways, but he mirrors amelia a LOT in that both of them respond to trauma by Setting It Aside. like That Trauma Cant Affect Me If I Dont Look At It. like. ur right bryce has NOT processed ANY of his trauma. which like it makes SENSE bc. it prob feels so much easier to him to not think about it by drinking instead, because its a Lot to think about. its a Lot to come to terms with. but bc he WONT acknowledge it but its still AFFECTING him he just gets More and More miserable (the detail about him driving home drunk and not even caring is so. :( )

what IS one of the most. compelling? aspects of his character to me is the way he responded to Everything after getting eliminated. bc it just feels So Real. because he IS healing, not completely, and not in the best way, but he clearly like. started putting SO much work into improving his life??? (the detail of him finally getting an end table for his bed instead of just... using a cardboard box ALWAYS gets to me. and that + the fact that the photo of stella is put up makes it seem like. THATS what was in that box. he LITERALLY started Unpacking thigns. its like poetry to me.) because it IS hard, and i think hes still putting things to the side, shoving the trauma from the plane to the side now instead of all his other grief and trauma. and the removal of the cans from his room yknow?? that hes getting up for work on time now?? its like. yeah i agree idk if hes necessarily SOBER yet but he really does seem like hes working really hard

its not perfect, but its BETTER and it feels. correct?? (and tbh? trying to brush off the plane as a dream isnt even teh worst thing he couldve done with that, i think, bc reasonably what WAS he supposed to do w that experience?? i dont think there WAS a good answer) bc the plane was a whole new kind of trauma. and i think surface level, one would THINK hed get WORSE after further trauma but like. i think he DID in some ways but in the ways that actually affected how he acknowledged and responded to his pre-existing trauma DID get better bc, as he puts it, hed Thrown his life away before, and didnt want to do it again. bc this time, he very well couldve died. and while he was on the plane, being home, on earth was SO much better than the plane, and it recontextualized Everything. hell, maybe after that, the earth finally felt Less daunting, like somewhere he Wanted to be, because for once, he WANTED to be back, and rationalizing That and the fact that he got Lucky, that something Worse couldve just full on Killed Him Forever really DID mean he didnt WANT the worse to come, at least not as much as before. but that meant he HAD to start actually Working on improving things, and i think he may not have Intended to acknowledge Worse things, but simply because the things he had to do to improve his life, like drinking less, making his house more Livable, they all Forced him to think about things More. hes still certainly not thinking about them as much as he Should, hes still not Processing things, but hes Heading in the right direction . he really was SO changed by ONE

and then liam showing up forces him, once again, to think about something he tried to push to the side. aaaaaaaandd then he rejoins and its so. it feels thematically fitting and IS so so SO interessting. because for once in his life hes REALLY facing his trauma head on. but then is brought straight back into it. and i need to think about that aspect more bc those thoughts are a bit less Focused than my other thoughts but given how complex his writing is after he gets OUT, its. SO interesting to think about how being BACK affects him

esp bc like. him starting ep 18 Pissed Off- which historically his responses to trauma are to either just Be Shocked, as depicted a LOT in ep 14, or to get Very Vocally pissed, as shown through the first half of s1, esp ep 6, and ep 11, and ep 13, and ep 18. ive seen it written as 'he doesnt have anywhere to direct the sheer amnt of STRESS and fear so he just. ends up yelling at people bc what else CAN he do' and i think thats?? probably fairly accurate. i dont think hes as Constantly Irritable and Irrationally Angry as fanon presents him , bc it tends to be. excessive. but he DOES get reasonably angry in response to stress !!! i always think abt how his body language in the 'credits' scene of ep 6 look like hes yelling at airy. and im. lays on the ground. i dont even know if thats ever as much 'just anger' as it is Fear and it FUCKS ME UP

but the way i see it, that ties to ep 18 a LOT. because he was really Getting better. hell, what he thought was the WORST that could happen HAPPENED (dying) but he. came out OKAY? its like he was being forced to think about and work through his trauma and he survived and was ok. but being sent back is like. 'oh god i did that all for nothing.' but i think it also sort of?? serves as the Last Push for him to really, REALLY acknowledge the plane (which is why it makes sense so thematically for him to be the rejoiner. he WAS the only contestant whod Chosen to ignore it all. but that has nothing to do with the plane, he cant choose if the plane ignores Him.) past talking about its affects, how its affected people. because after everything hed worked toward, hes Back. hes back, and everyone else is STILL HERE. liam had said they were all still There but seeing them there is a whole other thing. hed SEEN the effects of making it out after 7 months. but he never saw what it was like to still BE there after all that time. and bryce CARES about them (fanon sometimes treats him as if he is a bit. coldhearted? but i think people misattribute him being unhappy with liam as him not caring. i think the problem is that he maybe cares too much, and was affected a LOT, but didnt and doesnt know how to handle that. so he WANTS to ignore it, because it was all he could do, and haaving to backtrack on his haphazard healing from the plane is. highly daunting and uncommfortable and terrifying. thats not being cold though, thats VERY different) and now he HAS to acknowledge Everything, has to be a part of it Again. and i think its a combination of 'liam was here for 7 months after we all thought itd only be a few weeks. Anything could happen. who knows how long ill be here for?' and 'liam didnt have anything when he came back. will I have anything when i come back?? will i have worked so, so hard to heal and fix my life for Nothing?' and 'i dont WANT to be here again.' and 'oh my god all of them Really Really Are Here. Theyve been here the whole time.' and i think all that culminates in an appropriate amount of horror, and that prompts him to do what hes STARTED doing, which was All He Can. and hes pissed off cus hes terrified, so he spurs everyone into pulling out the plug. and then. it doesnt work. it doesnt work and thats the LAST of what he had, and i think iirc hes the LAST one to close his eyes afterwards. because hed BEEN off the plane, hes the one of them who had any hope to give them anymore. and it didnt work

(i also think a lot about how it mustve felt seeing the contestants all so. resigned. because bryce was like that before all this, but ever since one began he was stubborn, and didnt WANT to give up. and i think finding out that these people youd seen try so, so hard just to Handle Any Of This be SO resigned would be. so fucked up. he knew amelia when she was so determined to leave, and while charlotte seems a bit saddened by her resignation, bryce was there BEFORE that happened. he wasnt there like liam or charlotte was to see it gradually develop, and to develop that despair alongside them. all hes seen is that amelia was so determined. and that he may not have known her THAT well before, he knows shes different. he knows she Gave Up and like. GOD. and also i think abt how he mustve Felt seeing the plug for the first time because ehs the only one of them who hadnt seen it before (given its likely all the other characters had, since they casually refer to it). and given the short time frame between him getting there, and the contestants trying to pull the plug? it almost seems that that was like. the last straw. and ive never posted it but i once drew stuff abt it bc. the damage to it is noticable. and i think hes already aware liam was fucked up, but this is like. a tangible, permanent record of that on the plane. and he cares about liam, and has been grappling with all the things liams told him, but thats. thats something he can See. And i think it all of it culminates in him deciding that what hes been avoiding is doing Soemthing about all this, because before he couldnt, and then it was. an awful idea to, and then he didnt have many choices BUT to help. but now theres hardly anything to do, but he has to try. he doesnt want to give up. and it makes me soooooooooooooooooo. head in hands.)

anyway that was a LONG tangent the point is. YEAH. i think rejoining would be. very very significant for his character i dont think youre making shit up its DEFINENTLY a topic w a lot of things to discuss about it

but god. yeah it wouldve been SO nice to see him come to terms with everything hed been through before one. i think the show purposefully included what it did and ended when it did because it makes more sense thematically for it to go unresolved, because the point was that NOTHING was able to be resolved nicely because unfortunately, many things are Out Of Their Control. things COULDVE resolved almost perfect but enough things went wrong at just the right (or more fitting, wrong) time for all of that to not work. i think him no longer seeing the suburbs may have signalled more that maybe, just maybe, he could Do something to help the other contestants even if HE was Dead, that now he finally HAS a goal, if that makes sense (though i think even in the timeline of the series it still wouldve taken way longer for him to process everything Fully, they WERE only in the waiting room for probably about a day) but the idea of finally seeing the waiting room as it is bc hed finally worked through everything .... man.............. man

ik ive already said it though but i DO think it is sooooo so possible for him to heal post canon. im a firm believer that no matter what, at LEAST bryce and ameliaa get home (liam and charlotte have more room for error but i DO generally interpret the ending as them both getting home too, theres just less room for things to go wrong w amelia and bryce). and i think after everything? hed be able to heal. it would SUCK but i think hes, shockingly, in a better place Logistically for things to improve, because he has a support system, he has what hed already worked on in those 7 months, he has so much to aim for. it would be rough and take long but i think ultimately? hed be able to heal :) and its what he deserves

[bad-advice-its-very-bad]

tw general mentions of mental health

so i have this friend. let's call them emily. i've known emily for two years now, and they've grown to be one of my closest friends. mostly because we both really struggle with mental health stuff and at that point in my life no one else knew about those struggles. we helped each other through a lot of really crappy stuff and times. the difference is, in those two years, i've gone to, and am still in therapy, and have learned coping skills, have a support system etc etc etc ive tried convincing emily (on numerous occasions) to do the same, but they consistently refuse to do so, and they still pretty much only have me. there's also a ton of other stuff, but i could write a ten page essay about that. pretty much, our friendship, even though it's great feels kind of one-sided where im reaching out and they take weeks or months to respond (if they do at all) and dont really talk to me when we see each other in person and it's just getting really draining emotionally. so a few days ago, i finally make the decision to, well, not cut them off but pretty much tell them i'd had enough and im going to take a break for a while. they responded and pretty much just went straight to the self-deprecation (pretty much im sorry im so worthless and can't even maintain a friendship). and while im just so relieved that i've cut them off, more or less, to some degree, im just so worried since im all they have and if im gone who knows what will happen. so what should i do?

sorry for the long message

hum, that’s a tricky one.

First things first, I’d shove a WHOLE lotta resources on mental health in their messages. I know it may seem like your annoying them, but if it’s that bad they deserve to know there’s helplines and chats and groups that they can turn to. (I suggest vet them before you send them)

Secondly, sometimes it’s hard for people to realize they are allowed to reach out for help. Even if they only think it’s minor or it will take valuable space for others that “ are worst than them” But they have every right to reach out for help, their allowed to go to people with minor issues or major issues. And if you can somehow get that through their head you’ll probably see some improvement.

thirdly, I don’t think they can access traditional in person therapy as it seems. You can never know why, personally for me it’s a whole BIG awful talk about my mental health that I never want to tell my family. And it might be a similar situation with your friend, so unorthodox ways to get that same therapy experience might benefit them alot.

fourthly, you can’t help everyone. Sometimes it’s on them to figure out how to cope and understand how to get better, and even though you love them and care deeply it’s hard to get them to understand that. If you’re worried your friend might be engaging in risky behaviors (S/H, alcoholism, drugs, suicidal behavior, taking too many risks for no apparent reason.)

I suggest trying to talk to them about harm reduction.

fifthly, you being emotionally drained and exhausted by being their therapist friend is totally valid. your friend saying self deprecating things is just a symptom of a bigger problem they have, it's not your fault or anything you need a break from them. if they were in the same situation they would do the same thing, it's hard to manage both your mental health and your friends. I don't blame you for being exhausted, the reason I do this stuff is because I'm exhausted by my own problems and this is a healthy and constructive way to help both you and me. your helping your friend out of love, but also obligation.

I think a good plan to do is.

give your friend a pep talk and show them tons of alternate ways to access therapy that is not in person.

give them helpline information and tell the "I've known you for so long, I'd never try to hurt you. I just want you to know there's options if life gets hard and I'm not around

tell them about harm reduction, and CURB any and all negative connotations about addiction and self harm. if they are suffering the best thing you can do is be accepting and show them ways to safely and also reduce the harm of the addictions/self harm.

tell them if they are being abused. in anyway period, they can trust you to not victim blame or something without knowing the full story. we don't know what's happening with them, but we have to be kind and caring if that's the reason for her mental health. tell them "it was never your fault, you didn't know." or "you were just a kid, it was never you that was the problem but how you were treated. it's okay to be upset or angry, or grieve the life you should have had. that's normal. trust me I'm here for you."

also if the whole abuse thing is a yes, give them tons of abuse helplines. you and I don't know how to go forward with that knowledge but the helplines know how to.

support them and tell them truely why you feel drained (if you Hadn't already.) and tell them you actually care alot about them and this is not an attack or that your mad at them or anything. your overwhelmed too, and you both should feel not overwhelmed. (VERY IMPORTANT, YOU HAVE TO SAY YOUR NOT ANGRY OR ANYTHING. mentally ill people tend to think the worst if you don't say it. be kind and caring, and they should not feel so bad.)

if that doesn't work, I think you yourself should call a helpline and ask about strategies to help your friend. they should know a lot more than both you and me.

thank you for sending an ask in, this has been interesting!

I hope you can figure out a way to help your friend.

if worst comes to worse, I suggest you give your friend character.ai's psychologist's link to your friend. it's better than nothing, and it's surprisingly helped me too. so it might help your friend open up.

here's the link LINK

I hope I was able to provide a push in the right direction, remember this is the BAD advice blog. not everything will work, sometimes we both have to fail a bit to figure out the best way to help people.

[theperplexityoftheunknown]

What is a relationship to be continued

You may ask yourself why this is Important yet it is very important! We will discuss Why they are important to your well being and what type of person you are in a relationship? I think if you take the time to read this post in its entirety and intense complexity you will have a better understanding of where you are in life and what more you can become by understanding the perplexity of every relation to man or relationship because trust me THIS BABY is going to get TOUGH.

Lets start of with the first question what is a relationship

the way in which two or more people, groups, countries, etc., talk to, behave toward, and deal with each other. : a romantic or sexual friendship between two people. : the way in which two or more people or things are connected.

Please go ahead and read one more time because that may or may not be the closest thing of a relationship to that you have a mutual relation  and understanding of but its way, way more complex just keep reading.

Each relationship we have encountered has been determined by how we were raised Im going to refer to some quick psycho-social information coming from a study introduced during world war 2 by British psychoanalyst john bowbly, whose lonely childhood gave him a lifelong interest in the power of parenthood.

In the 1970s a test was conducted by Bowlby’s student Mary Ainsworth. She performed the strange situation test where children that's age ranged from 12-18 months were put  in a toy-filled room with their mother and given a chance to play. A stranger enters and interacts with the parent and child,then mom exited the room-- leaving behind a confused and alarmed little kid. A few minutes later mom returned and comforted her toddler. Needless to say being separated from the person who feeds, protects, and tends to you is frighting for any toddler, but the test showed definite categories of reaction to that fear.

Why is this important ?

Early Attachment.

As seen above you can see that a study was conducted concerning attachment styles. It's important because it is with this information that you find out what type of relationships You are going to be compatible with. Some types absolutely do not collide but if you think this is all about “how do i form a relationship” well keep reading because its not possible for everyone.

1 Secure, when it is evident to have a secure attachment style when the parenting style was: Warm, attentive,relatively consistent, and quick to respond based on that approach the child's Baseline Emotional Status (BES) would have been happy, confident, and curious which would have subconsciously continues into adulthood with the Child’s expectation of life being: My need will be met

2. Anxious -Ambivalent/resistant, it is evident to have an anxious attachment style when the parenting style was: Inconsistent: sometimes responsive and sometimes not. The Child's BES would have been Insecure, anxious, and intensely emotional which in return would have subconsciously continued into adulthood with the child's expectation of life being: “IF i act in the right ways, I might earn love and my needs may be met”

3. Avioident- ,it is evident to have a avoidant attachment style when the parenting style was: Distant and Cold, or harsh and critical. The child's BES would have been Emotionally shut down which in return would have subconsciously continued into adulthood with the child's expectation of life being: “I can't trust anyone to meet my needs. I must meet my own needs.

Im sure your getting the idea of why this is now important

Lets looks at three statements

1 I find it relatively easy to get close to others and am comfortable depending on them. I don't often worry about being abandoned or about someone getting too close to me.

2. I find that others are reluctant to get as close as I would like. I often worry that my partner doesn't really love me or doesn't want to stay with me. I want to get very close to my partner, and this sometimes scares people away.

3 i am somewhat uncomfortable being close to others:  i find it difficult to trust them completely, difficult to allow myself to depend on them. I am nervous when anyone gets too close, and often, love partners want me to be more intimate than i feel comfortable being

In 1987 psychologist cindy hazan and philip shaver reported the results of the statements above  they called it the ‘love quiz’

56% of adults respondents had identified themselves as secure, 19% as anxious and 25% as avoidant

The perfect combination

Secure people tend to have the most secure relationships, and a relationship needs only ONE secure partner to get that stability. With a partner who is happy to give reassurance and isn't threatened by the idea of being needed, an anxious person can relax, and is often loyal and loving. With someone who doesn't take it personally when their partner wants time alone,avoidant people can worry less about being tied down- however, most of the compromises in the relationship will likely be made by the secure partner. The real problem comes when two insecure types get together. If relationships often get messy for you, learning to recognize attachment styles and understanding how they clash can give you a path through the conflict

But then again Here comes perhaps the most perlex question i can ask? What happens in adult hood when you experience the pain and turama of a heartbreak?

What particularly does that do to each individual and how do they cope?

Do some people perhaps just shut down! Absolutely not! One subconsciously gains the ability to cope with their losses how? Lets start with:

Sexual compulsion – Relationship with sex, attachment and sexual orientation

I know your wondering What the Fuck where did this just turn to but trust me, or dont but you may or may not want to hear this or perhaps your brain craves the knowledge to understand and you ask yourself why your life is working in the way it is; remembemer its all in you!

I believe the first coping skill for some may be Hypersexuallity which I will refer to later.

2. I believe a conduct Disorder  DSM-IV-TR 314.9 Is primary consistent with feelings of Emotional shock from a previous ‘heartbreaking’ or traumatic event.

I will explain. I'm going to refer to the diagnostic features of conduct disorder which manifest itself  as a repetitive and persistent pattern in  which the basic rights of others or major age-appropriate societal norms or rules are violated. These behaviours fall into four main groupings” Criteria A1-A7 aggressive conduct that causes or threatens physical harm to other people or animals .

Or see criteria A8-A9 nonaggressive conduct that causes property loss or damage Or see A9 - A13, DECEITFULNESS OR THEFT

It is definite that promiscuous behavior is dangerous therefore someone engaging in Criteria a1-a7 w/o aggression and associated with parts or in hole with A8-9

Furthermore  the prevalence of conduct disorder appears to have increased over the last decades and may be higher in urban than in rural settings.

Course.

Individuals with conduct disorder are at risk for later mood disorders, anxiety disorders, somatoform disorders, and substance related disorders.

Sexual addiction, also known as hypersexual disorder, is associated with serious psychosocial problems for many people.

Sexual addiction, which is also known as hypersexual disorder, has been associated with serious psychosocial problems for many people although it has not been recognized as a disorder that merits inclusion in the DSM (Quadland, 1985) – see Karila et al. (2014) for review. Originally, Carnes (1983)published a book titled Out of the shadows: Understanding sexual addiction, which has raised interest in the area and facilitated a discussion on the best way to define and diagnose the disorder. Despite different views about pathological characteristics of sexual addiction there is an agreement that this is a progressive relapsing condition which does not merely refer to a pathological diagnosis of sexual lifestyle that is socially deviant (Edger, 2010).

Sexual addiction involves compulsive behaviors such as constantly seeking new sexual partners, having frequent sexual encounters, engaging in compulsive masturbation and frequently using pornography. Despite efforts to reduce or stop excessive sexual behaviors individuals find it difficult to stop and they engage in risky sexual activities, pay for sexual services and resist behavioral changes to avert HIV risk (Carnes, 1991; Coleman-Kennedy & Pendley, 2002; Coleman, Raymond & McBean, 2003; Kalichman & Rompa, 1995). Sexual compulsivity has been associated with the number of unprotected vaginal sex acts with female sexual workers, lower self-efficacy for condom use, greater use of illicit drugs, and more financial need (Semple et al., 2010).

Cognitive and emotional symptoms include obsessive thoughts of sex, feelings of guilt about excessive sexual behavior, the desire to escape from or suppress unpleasant emotions, loneliness, boredom, low self-esteem, shame, secrecy regarding sexual behaviors, rationalization about the continuation of sexual behaviors, indifference toward a regular sexual partner, a preference for anonymous sex, a tendency to disconnect intimacy from sex, and an absence of control in many aspects of life (Carnes, 2000, 2001; Carnes & Schneider, 2000; Coleman et al., 2003; Coleman-Kennedy & Pendley, 2002). Finally, some studies find that sexual addiction is associated with or in response to dysphoric affects (Black, Kehrberg, Flumerfelt & Schlosser, 1997; Raymond, Coleman & Miner, 2003; Reid, 2007; Reid, Carpenter, Spackman & Willes, 2008; Reid & Carpenter, 2009) or stressful life events (Miner et al., 2007).

Attachment theory (Bowlby, 1979, 1982) argued that early attachment experiences affect personal and social life, professional relationships, dealing with stress, mental and physical health and cognitive development. According to recent developments in attachment theory, those who developed a safe attachment style which is not anxious or avoidant during infancy can form healthy relationships in adolescence and adulthood and handle life problems (Uytun, Oztop, Esel & Mdusunen, 2013). Individuals with secure attachment are expected to have low chances of becoming addicted to sex since they regulate and limit their sexual activity more than those with insecure attachment (Zapf, Greiner & Carroll, 2008). Furthermore, individuals who are addicted to sex are looking for sexual activity without the need for emotional relationships and they are more likely to be characterized by avoidant or anxious attachment (Gentzler & Kerns, 2004).

Gay men are diverse with respect to the sexual behaviors they both desire and enact (Moskowitz & Roloff, 2010; Sanderson, 1994). Moreover, gay men differ from other groups in their sexual behavior. Research shows that, on average, gay men have more partners, engage in more risky sexual behavior, and are more likely to seek sexual sensation than other groups, such as heterosexual men, women and lesbians (Bailey, Gaulin, Agyei & Gladue, 1994; Ekstrand, Stall, Paul, Osmond & Coates, 1999; Thompson, Yager & Martin, 1993). But among homosexual men there is variability in the propensity to engage in compulsive unprotected sex. Meyer and Dean (1995) have reported that about 6% of their 149 young New York City gay men (aged 18–24 years) engaged in very high risk behavior, defined as unprotected receptive anal intercourse with multiple partners. It appears that very high risk takers are qualitatively different from other risk takers: they reported more mental health problems, including more drug use and higher levels of internalized homophobia and AIDS-related traumatic stress response. Furthermore, there are moderators of sexual behavior among gay men such as being in monogamous relationships. Also sexual health and sexual health behaviors for example sexually transmitted diseases (STDs) were most influential over the enactment of sexual behavior or desires (Moskowitz & Roloff, 2010).

Few studies investigated sexual compulsivity among heterosexual and homosexual men. Furthermore, to the best of our knowledge, the relationships between compulsive sexual behavior and attachment and sexual preference or orientation have not been investigated before. We have therefore investigated sexual compulsivity and attachment style among populations of heterosexual and homosexual men and women. We hypothesized that secure attachment would be associated with lower rates of sex compulsion. Secondly, that homosexual men and women would show higher levels of sexual compulsivity than heterosexual men and women. Thirdly, we hypothesized that attachment style might mediate between sexual orientation and sexual compulsion.

[erineverly]

𝐄𝐑𝐈𝐍 + 𝐆𝐎𝐈𝐍𝐆 𝐁𝐑𝐀𝐋𝐄𝐒𝐒 !

i.⠀⠀⠀ it’s all because of her chronic hunger for attention — so-called histrionic personality disorder. thanks to her overprotective, controlling mother, erin has been sheltered and pampered every step of the way since she was a little child. spoiled completely rotten, she’s become accustomed to being in the spotlight as well as receiving endless praises and compliments for even the tiniest accomplishments, which leads to her developing an unhealthy sense of entitlement. now, no longer a child but a grown woman, erin can’t live without constant attention. with a high tendency to exaggerate and overdramatize, she feels unappreciated, taken for granted, left out and flat out ignored when people ( whether her loved ones or friends ) don’t focus solely on her. she can’t help but seek reassurance and approval, having a very strong desire to be seen. unfortunately, she doesn’t seem to possess the ability to differentiate between the positive and negative kind of attention that her actions may attract. when she desires to turn a few heads while walking into a room, nothing can stop her from achieving her goal. this is where her aversion to bras begins…

⠀⠀⠀ unaware of her exquisite beauty ( that already attracts a lot of attention on its own ), she’s found a way to make sure that no one will ever pass by her without stealing a glance — ditching her bra. gifted with a perky cleavage, whenever she steps out with nothing underneath her clothes, men eye her up and down quite shamelessly, approach her more often with bold offers and are more eager to engage in small talks. a lot of times, it does make her feel very uncomfortable and unsafe, exposed and vulnerable, and she’ll blush excessively or lower her head. unfortunately, her need to be noticed is stronger than her fears — bad attention is still way better than NO attention at all, isn’t it ? male cashiers at grocery stores, baristas at coffee shops and waiters at restaurants always smile at her and treat her with kindness, often randomly compliment her looks which serves to boost her ego. she’d be lying if she said that she wasn’t enjoying it. after all, attention is what she craves most and simply can’t live without, she’s willing to engage in risky and impulsive behaviors to receive it.

ii.⠀⠀⠀ it also originates from her need to be constantly taken care of and protected. when in a relationship, erin quickly develops an extreme dependence on her partner. she goes to him, seeking emotional comfort, unconditional love and acceptance. the more submissive role is the one that suits her best ( because of her personality ) but it can also cause a variety of problems — one of them being the unhealthy need to always be reminded of how important she is to the other person, how much he cares about her. when she refuses to put on a bra while going out with her significant other, it’s because she hopes that it will bring out the possessiveness in him. she believes that the mere thought of other men giving her attention, salivating the second they lay their hungry eyes on her, will make him hold her hand a little tighter, wrap his arm around her more eagerly, publicly display his affection for her to let everyone around know that she’s his.

iii.⠀⠀⠀ a silent rebellion. as someone who always obeys the rules and behaves in a way that’s socially acceptable / praised, deep down erin feels the urge to rebel — if girls have to wear bras because that’s what everyone considers appropriate, it only encourages her to do the opposite and toss her lingerie out the window. she wants to finally break some rules, show people that she’s more than just this sweet little girl who’s always following someone else’s orders, prove that she can be independent and do as she pleases. she’s never had much control over her own life ( when she was a child / teenager, her mother was the one in charge ), she eventually comes to the point where she’s beyond determined to be able to have a say. she expresses her disobedience in a quiet way — by not wearing a bra.

iv.⠀⠀⠀ shyness and excessive purity. sexuality ( and everything related to it ) has always been a huge taboo for erin, whether growing up or in her adult life — she views her desires and needs as something shameful, dirty and evil. walking into a lingerie store alone has her stomach flipping upside down, her face resembling a ripe tomato, her heart pounding harder and faster than ever. no matter how old she is, her reaction never changes. to spare herself embarrassment, she usually grabs a bunch of bras that seem to be her size, pays for them as quickly as possible, without maintaining eye-contact with anyone, and runs to her car. that’s why a lot of bras that she owns are simply uncomfortable, either too small or too big, with underwire that cuts into her ribs and leaves her skin irritated. she chooses to wear no bra because she doesn’t want to suffer or have to constantly adjust it while in public.

v.⠀⠀⠀ a combination of jealousy, low self-esteem and abandonment issues that has become a driving force in erin’s adult life. growing up without her father, blaming herself for her parents’ divorce, she’s developed an incredible fear of being left behind and forgotten. she’s felt easily replaceable and unimportant all her life. it’s one of the reasons why, when she meets axl and he offers her all his kindness and love, he immediately becomes her whole world — the mere thought of losing him is simply unbearable. with women constantly surrounding him, following him everywhere he goes ( especially during and after the appetite for destruction tour ), erin worries herself sick and feels the need to step up her game in order not to lose him. if groupies don’t wear bras and are willing to lift their mini-skirts without him having to ask, how can she possibly be enough for him ? she illogically believes that by changing her innocent looks to something more obscene, she’ll keep the singer interested, prove him that she can be just like those other girls if that’s what he wants, if he’s tired of her being a prude.

vi.⠀⠀⠀ the fear of growing old and becoming unattractive / the need to be reminded of how beautiful she is. as much as erin tries to deny it, her looks are obviously very important to her ( especially these days when she’s no longer twenty years old ). seeing that her exposed cleavage can still attract attention is what helps her forget about the inevitable — she will be old one day. as long as she’s turning heads, she doesn’t have to think about it.

[my-thoughts-my-views]

Some Common Questions about Sexually Transmitted Disease (STD)

Here we are going to answer some common questions about Sexually Transmitted Disease (STD) or STD testing. STD may also be called a Sexually Transmitted Infection (STI) or Venereal Disease (VD).

 What are STDs?

 As the name implies, these are the diseases that are typically transmitted through sexual contact, but not exclusively through sexual contact.

 It is really through transmission of semen, blood or other body fluids. And in addition to sexual contact, transmission could happen through IV or blood transfusion, IV use, needle use, shared needle use of course.

 How common are STDs?

 STDs are very common, in fact STDs are one of the diseases that are on the rise throughout the world. Despite the fact that we have got adequate testing and despite the fact that we have got good treatments, the lookout for STDs is important.

 What would be some of the signs or symptoms of STDs?

 Lot of STDs are in fact asymptomatic, meaning you may not have any symptoms at all. But there are some more common symptoms that can occur; things like burning with urination, this could be in men or women, in a male drip or discharge from the penis happening even weeks after a new sexual contact could be an early sign that an STD is present. Other things like lesions on the penis or in and around the vaginal area, pain with intercourse, fever, any of these things could also be a sign that perhaps an STD is present.

 Symptoms of STDs in men:

 It’s possible to contract an STD without developing symptoms. But some STDs cause obvious symptoms. Specific symptoms can vary, depending on the STD. 

 In men, common symptoms include:

 -         Pain or discomfort during sex or urination

-         Sores, bumps, or rashes on or around the penis, testicles, anus, buttocks, thighs, or mouth

-         Unusual discharge or bleeding from the penis

-         Painful or swollen testicles

 Symptoms of STDs in women:

 In many cases, STDs don’t cause noticeable symptoms. The specific symptoms can vary from one STD to another. 

 Common symptoms in women include:

 -         Pain or discomfort during sex or urination

-         Sores, bumps, or rashes on or around the vagina, anus, buttocks, thighs, or mouth

-         Unusual discharge or bleeding from the vagina

-         Itchiness in or around the vagina

  Are there different types of STDs?

 There are. Some of them can be bacterial, some of them could be viral or some of them could be parasitic.

 What are the ones that are more common?

 The ones that you may have heard of would be things like…

 - Herpes (HSV-1 and HSV-2)

- Syphilis

- HPV (human papillomavirus)

- Chlamydia

- Gonorrhoea

- Trichomoniasis (Trich)

- HIV which if left undetected and untreated can lead to AIDS. It's for these reasons and the fact that STD is so prevalent that we need to be aware of them.

 Less common STDs:

 -         Chancroid

-         Lymphogranuloma venereum

-         Granuloma inguinale

-         Molluscum contagiosum

-         Scabies

   Are the things that put you at risk to get STDs?

 There are many things that may be put you at the risk to get STDs.

 First and foremost unprotected intercourse meaning not using a condom and particularly if it's with a new sexual contact. Increase in other types of activities like IV drug use where needles are shared could put you at risk for an STD. Blood transfusions while in very rare causes of an STD could cause contraction of some type of an infection.

 Who should consider getting STD testing?

 Well certainly if you have any symptoms that suggested things that we talked about earlier like burning with urination, drip or discharge, pain with intercourse, a new lesion vaginally or on the penis. You should consider STD testing in those settings, or if you engage and perhaps some risky behavior; unprotected intercourse particularly if you're not in a monogamous relationship

Or have shared and other risky behaviors like sharing needles with IV drug use, getting tested would be a wise idea.

 There are Home Testing Kits available in the market for some STDs. These Home testing kits may not always be reliable. Use them with caution. Check to see if the U.S. Food and Drug Administration has approved the testing kit before buying it.

 Is there any Laboratory Tests available for STDs?

 If your sexual history and current symptoms suggest that you have a sexually transmitted disease (STD) or a sexually transmitted infection (STI), laboratory tests can identify the cause and detect infections you might also have.

 Blood tests:

 Blood tests can confirm the diagnosis of HIV or later stages of syphilis.

 Urine samples:

 Some STIs or STD can be confirmed with a urine sample.

 Fluid samples:

 If you have open genital sores, your doctor may test fluid and samples from the sores to diagnose the type of infection.

  What are the Treatments available for STDs?

 The recommended treatment for STDs varies, depending on what type of STD you have. It’s very important that you and also your sexual partner be successfully treated for STDs before resuming sexual activity. Otherwise, you may pass an infection back and forth between you.

 Bacterial STD:

 Usually, antibiotics can easily treat bacterial infections.

 It is important that you should take antibiotics as per prescription. Continue taking them even if you feel better before you finish taking all of them. Let your doctor know if your symptoms don’t go away or return after you’ve taken all of your prescribed medication.

 Viral STD:

 Antibiotics can’t treat viral STDs. While most viral infections have no cure, some can clear on their own. And in many cases, treatment options are available to relieve symptoms and reduce the risk of transmission.

 For example, medications are available to reduce the frequency and severity of herpes outbreaks. Likewise, treatment can help stop the progression of HIV. Furthermore, antiviral drugs can lower your risk of transmitting HIV to someone else.

  How can we prevent ourselves from STDs?

 The only fool proof way to prevent yourself from STDs is to avoiding sexual contact. But when having vaginal, anal, or oral sex, there are ways to make it safer.

Use of Condom:

 Condoms are generally effective at preventing STDs that spread through fluids, such as semen or blood. But they can’t fully protect against STDs that pass from skin to skin. If a condom doesn’t cover the area of skin with the infection, a person can still contract an STD or pass it to their partner.

 Regular STD screening:

 It is a good idea for anyone who’s sexually active. It’s particularly important for those with a new partner or multiple partners. Early diagnosis and treatment can help stop the transmission of infections.

  Check-up of your Partner:

 Before having sex with a new partner, it’s important to discuss sexual history. Partners should also be screened for STDs by a healthcare professional. Since STDs often have no symptoms, testing is the only way to know for sure if someone has one.

 If you’re eligible, you and your partner should also consider getting vaccinated for HPV and hepatitis B.

 By following these strategies a person can lower their chances of contracting STDs and passing them to others. 

   Thank you very much for reading this article. Please share this article to your friends and family to prevent them from STDs. Please also visit Herpes Guide to get more details about Herpes.

[lupine-publishers-sjpbs]

Lupine Publishers | Counseling Case Report: Smoking Cigarette

Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences

Abstract

This paper is a counseling case report of 15 sessions on a client who has been diagnosed with smoking cigarette from Kelem Worq Preparatory School. CO6 was an 18 -year-old grade 12th social stream student in Keleme Worq Preparatory School. CO6 was the second of the four children in his family. Assessment tools included a detailed interview and behavioral records. CO6 has been smoking cigarette since grade eight. At the time of counseling CO6 smoked five per day. CO6 drunk 4-6 glasses of beer occasionally, has done this for several years. Other than these drugs no other drug use reported. Many factors identified during the assessment were considered critical in accounting for the cause and persistence of CO6’s cigarette smoking [1,2]. Cognitive behavioral counseling was the theoretical framework that informed the case formulation. The counselor used self-reports of the client as outcome measures. SQ3R study method, the five Ds and cognitive behavioral therapy technique were applied to solve the client’s major problems of academic, smoking and alcohol drinking problems, respectively. Progress was evident by improved class attendance, more sustained focus on her academic studies, and continued improvement in sleep. The client has minimized his cigarette smoking and stopped his alcohol drinking.

Introduction

This paper is a counseling case report on a client who has been diagnosed with smoking cigarette from Kelem Worq Preparatory School. The assessment part has included the necessary identifying information with appropriate changes to shield the client’s real identity [3]. As part of the treatment plan the presenting problems will be identified and matched to the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV-TR) multi-axial diagnosis( its new version is also available, DSM-V).

Nicotine or Tobacco Use Disorders

Tobacco Use Disorder according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), diagnosis assigned to individuals who are dependent on the drug nicotine due to use of tobacco products. Tobacco contains the psychoactive drug nicotine, which is a central nervous system stimulant. The immediate effects of nicotine administration are tachycardia, hypertension, increased respiration, hyperglycemia, enhanced memory storage, improved concentration, and appetite suppression. Nicotine can be taken through several routes, including inhalation (smoking cigarettes, cigars, or pipes), chewing tobacco and snuff [4-8]. Nicotine produces dependence and withdrawal symptoms upon cessation of use, the onset of which occurs about one hour after the last dose. Withdrawal symptoms include irritability, annoyance, anxiety, and cravings for nicotine. Substance abuse disorders have high comorbidity with tobacco use disorder. People in early recovery from other drugs or alcohol tend to smoke heavily or chew tobacco. Features of tobacco products that enhance their addictive potential include the rewarding properties of nicotine, the behavioral reinforcement of the hand- to -to mouth habit, lack of social support to cease smoking, the ease of access of tobacco products, and the cultural acceptance of tobacco products. Another factor which enhances nicotine’s addictive qualities is bioengineering by tobacco companies, which add ammonia to nicotine to facilitate absorption and bioavailability (Figure 1). The Diagnostic and Statistical Manual of Mental Disorders indicates that risk factors for Tobacco Use Disorder include low-income levels, low level of Education, and diagnosis of the following disorders: conduct disorder, depressive disorder, anxiety disorders, personality disorders, psychotic disorders, and other substance use disorders. There is also a genetic component to Tobacco Use Disorder (American Psychiatric Association, 2013).

Case Description

CO6, code name of the client, was an 18-year-old grade 12th social stream student in Keleme Worq Preparatory School. He was the second child among the four children. His father was 55 years old and lives outside Addis Ababa due to his workplace, but he visits his family in every weekend day. C06 had smooth communication with his father. His mother was housewife and learned up to grade 12. C06’s mother was a smart for him, and she communicates friendly. His oldest sister in the family was 22 years old, and she was indulgent, reluctant to take great care of others. The rest younger sister and brother are 14 and 8 years old, respectively, and both of them have good communications with him. C06 described his parents’ parenting style as democratic. C06’s birth and childhood time were normal. He grew up in a close and loving family and recalls a happy childhood, and uneventful adolescence. As he reported that his parents were supportive and sensitive to his needs and encouraged his to be independent and responsible. CO6 describes himself as a “good boy” who excelled socially and involved in many extracurricular activities. But he described himself as not good boy in academic performance as he was socially. He had a healthy self-esteem growing up and never engaged in risky behaviors or got into trouble other than smoking cigarette and drinking alcohol. CO6’s peer relationships during childhood and adolescence were good and he remains close with several high school friends and he was remembered by his jocks. CO6 had also developed good peer relationships with neighborhood children and enjoyed with them sometimes. CO6 dated during elementary school and had a few casual relationships while he was high school students. Still he has not serious romantic relationship with anyone. CO6 struggled to get out of bed in the morning, sometimes missing his morning classes. He stays up until 8:00 or 10:00 pm for eating and watching TV but he did not have much involvement during super time. And he had good self-esteem towards himself and had not suicidal ideation and never attempted suicide. Until this professional contact CO6 had not seen by any other professionals for a serious physical or mental problem.

Clinical Assessment

I would like to inform you that I have had 15 sessions in person with this client. The clinical assessment included a clinical interview and behavioral observation. CO6 has been smoking cigarette since grade eight. At the time of counseling the client smoked five per day. He started smoking again after awaking the first cigarette smoked was within the first 30 minutes. CO6 drunk 4-6 glasses of beer occasionally, has done this for several years. He didn’t see alcohol drinking as a problem. CO6 always smokes while drinking alcohol and CO6 used coffee sometimes. Other than these drugs no other drug use reported. When CO6 became depressed he wants to smoke. In addition to his depression, head ace, watching his friends while they smoked or handed cigarette, drinking alcohols and sometimes his low performance in academic were the most triggering factors for his desire to smoke. CO6 had no past successes with behavior change: Quit smoking twice when he was grade nine for 2 months but relapsed. He, at the time of counseling, wanted to quit smoking to prevent the medical and social consequences of smoking. Even if CO6 was ready to quit at this time, CO6 was worried about his ability to succeed in his quitting. His limited time for self-care, peer pressures, his low selfconfidences to quitting, absences of social supports from his schools and families and his alcohol consumptions were his potential barriers to quitting. However, his strong motivation, strong health reasons, one previous quit attempt with some duration (2 months), his high self–esteem towards himself and, friends who want to quit with him were the assets of the client.

Diagnostic Formulation

Based on the assessment findings in the initial interviews, the following diagnosis was formulated. Axis I: Substance abuse (cigarette smoking and alcohol drinking). Axis II: No Axis III: No Axis IV: Problems related to the social environment (inadequate social support), and Educational Problems (academic problems and inadequate school environment) Axis V: Moderate functioning

Case Conceptualization

Several factors identified during the assessment were considered critical in accounting for the etiology and persistence of CO6’s cigarette smoking. Cognitive behavioral model was the theoretical framework that informed the case formulation. The emphasis placed on developing a case formulation leads to treatment goal-setting and planning. CO6 was an eighteen-year-old boy who came from a medium class family. His chief complaint when he met the counselor was that he smoked cigarette accompanied by symptoms such as withdrawal and tolerance symptoms. CO6 said that he can’t concentrate in attending classes every day, which was why CO6 said he left school to smoke cigarette after break time. As the clinical interview revealed that the client had not exposed his smoking for his parents. CO6’s most serious problem was his cigarette smoking. From a behavioral perspective, these impulse control difficulties may have developed because of faulty learning experiences, including pressures from his close friends in school and neighboring, his modeling of his significant others’ behavior and lack of guidance from parents. For CO6’s problem behaviors, precipitating factors included alcohol drinking, holding of cigarette by his friends and watching of theses friends while smoking , going to toilet with friends at break time and his thought of ‘’I am poor in education”. Client’s perpetuating factors included his poor quit attempts, no support at school, withdrawal symptoms associated with cigarette smoking and his low self-confidence in succeeding in quitting cigarette smoking. CO6’S strengths include his sociable behaviors with school and neighboring friends. CO6 has a strong desire to quit smoking as CO6 believed that health and social consequences of cigarette smoking was inevitable. The counselor selected cognitive behavioral therapy for this client to solve his problems of cigarette smoking and its associated symptoms. It has been shown that cognitive-behavioral therapy, combined with a smoking cessation medication (such as the nicotine patch, nicotine gum, for example), is quite effective for smokers who are motivated to quit. Cognitive-behavioral counseling is an evidenced-based psychological treatment that focuses on identifying and changing maladaptive thoughts, emotions, and behaviors that trigger, worsen, and/or maintain a range of problems (such as depression, anxiety, addiction, etc.). Because changing your smoking-related behaviors-and restructuring your thoughts related to smoking urges- is essential to quitting, cognitivebehavioral counseling can effectively be applied to smoking cessation. An intensive cognitive-behavioral therapy program is typically composed of three phases: preparation, quitting, and maintenance (or relapse prevention).

Treatment Plan and Course of Treatment

Based on the case formulation, CO6 and the counselor collaborated in the development of the following prioritized list of problems and treatment goals. The order and relative importance placed on these goals was largely determined by the client, although there was input from the counselor in directing treatment efforts to goals that would have the most impact on CO6’s cigarette smoking and its associated symptoms, and had the greatest likelihood of success. The treatment plan followed the problem format, a format that presents the target problems with its major goal and objectives and intervention methods in structured form.

Problem-1: low academic performance a) As evidenced by: low results grade to grade. b) As evidenced by: poor class attendance. c) As evidenced by: lack of study skills. d) As evidenced by: absent from schools. e) As evidenced by: late in the morning to go to school.

Goal-1: to improve academic performance Objectives and Interventions.

Objective-1: teaching study skills

Interventions: The SQ3R study method was employed to target co6’s poor study skills and to improve his academic performance.

Objective -2: Increase class attendances

Interventions: To improve class attendance, a behavioral contingency was developed to ensure CO6’s woke up by 7:00 am so he could attend all his scheduled classes for that day. In addition, CO6 would shower, eat a light breakfast, and walk to school. If he completed this schedule 3/5 days, CO6 would reward himself by going pool houses for the weekend or to the movies with classmate.

Objective -3: work on sleep difficulty

Intervention: Poor class attendance and an inability to study were major contributors to poor academic performance. It was decided to target CO6’s sleep difficulties that were a major cause of missing classes and daily fatigue that made it difficult to study. Maladaptive sleep-related behaviors were identified, and corrective homework assigned. The client and the counselor set up a sleep log and agreed to keep the sleep log, maintain regular sleep hours, eliminate daytime naps, to make sure the bedroom has oxygen, and restrict bedroom activities to sleep.

Problem 2: Cigarette Smoking a) As evidenced by: smoked for five years. b) As evidenced by: nicotine dependence withdrawal. c) As evidenced by: fugue out of school for smoking. d) As evidenced by: slum physical appearances.

Goal-2: Cigarette Smoking Cessation Objectives and Interventions.

Objective 1: To confront with the urge to smoke

Intervention

To achieve this objective the client and counselor applied the five Ds

a) Delay, even for a short while. b) Drink water. c) Deep breathing. d) Do something different and, e) Discuss the craving with another person.

Objective 2: Teaching different behavioral tips to quit smoking cigarette

Intervention tips

a) Write out a list of reasons to quit and display it prominently e.g. on wall. b) Get rid of all tobacco products, ashtrays, lighters, matches, etc. from all areas which you inhabit. c) Clean all clothes in order to remove cigarette smell. d) Enlist the support of non-smoking friends, relatives, and workmates. e) Change the environmental cues, e.g. the telephone often causes a reflex action to smoke, move the telephone to another place to change the cue. f) Keep hands busy e.g. knitting, gardening, drawing, origami. g) Sit in non-smoking areas. h) Positive self-talk. i) Try to avoid stressful situations in the immediate period after stopping. j) Set aside the money normally spent on cigarettes to buy something as a reward do not drink alcoholic beverages because these are associated with relapse. k) Avoid, even temporarily, social situations normally associated with smoking. practice saying, “No thank you, I don’t smoke. l) Ask other smokers not to give cigarettes, offer to buy cigarettes or smoke in the patient’s presence. m) Think positive and remember your reasons for quitting in the first place. n) View quitting as a day-at-a-time process rather than an immediate lifelong commitment.

Problem 3: alcohol drinking

Goal 3: To stop drinking alcohol: The psychologist also offered cognitive behavioral therapy techniques for his alcohol abuse and some behavioral tips.

Progresses

The counselor used self-reports as outcome measures. The therapist reviewed co6’s sleep log and daily activity record to evaluate the success of these interventions at modifying sleep behavior and class attendance. Progress was evident by improved class attendance and a more consistent bedtime routine. CO6 reported better class attendance; more sustained focus on her academic studies, and continued improvement in sleep. The client has minimized his cigarette smoking and stopped his alcohol drinking. The treatment is still under supervision.

Strengths and Weakness

Use of the core conditions of (empathy, genuine and unconditional positive regard) as relationship building throughout the whole counseling processes helped me to express my values, reactions, and feelings as they became appropriate to what was happening in the therapy sessions. It helped me to create a trusting working relationship with my client. The process helped the counselor to understand the value of supervision. The supervision helped the counselor to identify themes that had not been obvious to the counselor. It helped the counselor articulate the counselor role as a counselor. Supervision helped the counselor to identify areas where the counselor was not challenging my client enough and to be conscious of any manipulative signs by client and how to handle them. Supervision also helped the counselor to identify strengths in empathizing, listening, summarizing, and paraphrasing. Sometimes client would tend to talk very little and at such times the counselor would tend talk more and to give advice to my client may consider as weakness.

 https://lupinepublishers.com/psychology-behavioral-science-journal/pdf/SJPBS.MS.ID.000188.pdf

https://lupinepublishers.com/psychology-behavioral-science-journal/fulltext/counseling-case-report-smoking-cigarette.ID.000188.php

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[117--087]

Two Hundred And Four Reasons

Spartan-117 & Spartan-087

[Preface] // [Part 1] // [Part 2] // [Part 3] // [Part 4] // [Part 5] // [Part 6] // [Part 7]

With this past month marking the 4-year anniversary of this blog, I was somewhat at a loss as to what to do to commemorate the occasion...until I remembered there was one more thing I could post as an addendum to my essay series chronicling the development of John-117 and Kelly-087′s relationship throughout Halo canon. There were a few additional pieces of media featuring SPARTAN-II Blue Team that were released in the wake of 2015′s ‘Halo 5: Guardians’ that I think are worth taking a quick look at in regards to how they carry on the tradition of highlighting the bond between a certain Blue-One and Blue-Two.

Through All These Years

The first of the two is an animated miniseries (though more akin to a motion-comic) that loosely adapts the content of both the novel ‘The Fall of Reach’ and its comic book counterpart (which I’ve previously discussed). Like the comic before it though, this miniseries includes a few minor details that differ from the original source text in interesting ways.

The second is a short story from the comic anthology ‘Tales From Slipspace’, called “On The Brink”, and features some panels and dialogue that I feel are very relevant to the content I’ve analyzed so far in regards to Kelly-087′s character and her dynamic with John-117.

We’ll start with the ‘Fall of Reach’ miniseries. Most notably, the animation is bookended by a rather touching scene involving Blue Team returning to the glassed surface of the planet Reach (some time in between late-2557 and mid-2558) in order to hold a private memorial for Samuel-034. But I’ll get back to this after looking at the body of the animation’s content.

To preface: it is worth noting that the animation includes Fred-104 and Linda-058 in events at which they are not canonically present - mainly the “ring the bell” exercise as part of John-117′s team, and as participants in the assault on the Unrelenting in 2525. This was done in order to better familiarize a general audience with them as characters and the roles on Blue Team they would eventually come to fill in the years after the Spartan-IIs’ training in actual Halo canon.

Unlike the comic book version of ‘The Fall of Reach’s events, this miniseries does make sure to include the crucial lesson that John-117 learns from Chief Mendez after putting himself first during the trainees’ initial obstacle course exercise.

“You don’t win unless your team wins.”

Much like in the novelization though, Kelly in particular takes a stand against John’s selfish behavior before he proves he is willing to make amends for his mistake and commit to being a team player.

After the young members of Blue Team reconcile, we are then shown the Spartan-IIs’ wilderness training exercise that takes place two years later. And, in a new addition to this part of the story, we see Sam make a pit-stop to carve the symbol of an eagle and a lightning bolt (which would later become Blue Team’s insignia) into a tree in commemoration of the group’s friendship as John and Kelly look on and consider their next move. As described in ‘The Fall of Reach’, Kelly is noticeably taller than John as a child, which is a small detail I appreciate being included in the animation.

From here things follow the comic adaption pretty closely through the augmentation procedures and the Spartans’ first official mission to Eridanus Secundus to capture insurrectionist Colonel Robert Watts. A few nice asides are made throughout the entire animation where the members of Blue Team casually converse like normal teenagers (making jokes, encouraging one another, offering advice, invitations to do activities, etc.) when not directly engaged in mission-relevant dialogue. So it is good to see this kind of additional humanization of the S-IIs based off of what has long been established about them in Eric Nylund’s books.

Finally the last section of the miniseries is narrated by Kelly-087 herself in flashback (with Michelle Lukes reprising her role from ‘Halo 5: Guardians’), which covers the Spartan-IIs receiving their first sets of MJOLNIR Armor and Sam’s death at the hands of the revealed alien Covenant.

Without quoting every line she says, I will simply say this portion of the animation is well worth watching just for Kelly’s commentary. After Blue Team is outfitted with their suits of Mk. IV armor on Chi Ceti, we come to the Spartans’ infiltration of the Covenant ship Unrelenting. In a small departure from the novel and the comic book, Kelly is actually pulled aboard the vessel by John just as she is about to fly off into space - and though I doubt it was intentional, I find it is an interesting reverse-parallel to what we see in the ‘Halo Legends’ animated short “The Package” all the same.

From here events proceed in general accordance with canon, with Sam’s armor eventually breached by a plasma bolt after being shot while pushing John out of the line of fire. Once Blue Team makes it to the ship’s reactor, they hold off a few waves of Covenant while reading the bomb they brought with them to destroy it. John and Kelly work in tandem as Blue-One and Blue-Two; and in an amusing exchange of roles at one point, we see Kelly take charge of the situation and sprint across the bridge to shut the doors leading to the reactor room while ordering John to complete the work on the nuke.

“I’ll seal the door. John, finish arming that warhead!”

“I remember thinking that no matter how dark the future, we could face it as a team.”

However, as we all know, things reach a breaking point when Sam admits that he has to stay behind on the ship due to the irreparable damage to his armor. This part of Nylund’s book always struck me right in the heart, and the scene here is no exception. This moment is then bolstered by Kelly’s reflection on how this first loss in battle deeply affected not only her and John, but all of Blue Team.

“I know Spartans don't cry...but for once, I was glad for the helmet.”

“We thought training, augmentation, armor made us untouchable, invulnerable, immortal. Blue Team. But we were wrong - we were children. This was the only thing John was ever afraid of: losing one of us. And we knew we weren’t finishing this fight, we were just getting started.”

The animation then ends with the Spartan-IIs visiting the same place Sam originally “carved their mark into the world”. They take a moment to remember their fallen friend and reflect on the meaning of his heroic sacrifice, as the Chief sincerely asks his remaining comrades if they will continue to have faith in him to lead them through whatever lies ahead.

“Last time we were here, I asked Sam to trust me to take us home, to follow me. Will you trust me now? Will you follow me?”

...which plays perfectly into the next section of this write-up.

"On the Brink” is a short comic featuring Blue Team that was relased as part of the ‘Tales From Slipspace’ anthology book in the fall of last year. It takes place in 2558 and is a fairly self-contained story about one of the Spartans’ many exploits after their reunion in 2557. Specifically, they are looking to stop a Mammoth that has been hijacked by some splinter-Covenant from running into a UNSC nuclear reactor. Once again the events are overlayed with a narration by Kelly-087.

The 12-page comic can be viewed in its entirety here. And while it is brief and rather straightforward in terms of the story’s content, there are a few panels that I would like to take a closer look at. Most prominently, this section where Kelly muses on the steadfastness of the Chief’s leadership.

I love How Kelly notes that even though she’s dog-tired and in the middle of a violent firefight, hearing the voice of her best friend is all it takes to renew her focus, confidence, and determination to complete the mission - in a way nothing else can. For his part, John continues to rely Kelly to back him up and talks to her throughout the operation even as her discovery of some civilian scientists aboard the Mammoth forces him to make a risky evasive maneuver in order to save them. And honestly I don’t know what could speak more for the strength of the bond that these two characters have and the kind of trust they have in each other.

After the massive vehicle finally comes to a complete stop, the reactor remains intact and some extensive property damage to the surrounding area is the only fallout of the Covenant attack on the UNSC base. This does not appease the site’s foreman however, and he confronts Blue Team. John keeps his cool while Fred reacts angrily in turn to the man’s disrespect and thankless attitude. Kelly looks on, and can’t help but wonder when John will finally grow weary of the tumultuous and unsure environment the Spartan-IIs have found themselves mired in in the wake of the Human-Covenant War.

The end of this story presents us with quite the conundrum from Kelly’s point of view. Because while she will always support John and believe wholeheartedly in his ability to triumph over adversity, her final thoughts reveal that she does indeed recognize that for all the ways he’s remained stalwart he still has limits too. Just like the rest of them. Which once again works to emphasize how human these characters still are.

These pieces of media continue to paint the same picture of these characters that we have gotten for the last 15+ years: two people who have grown together over a lifetime of experiencing all manner of hardships and yet they maintain a healthy mutual relationship based in respect and honest care. How this may come into play later in the series after the events of ‘Halo 5: Guardians’ remains to be seen, but for now it is good to at least have a few more moments to add to John-117 and Kelly-087′s catalog of positive representation.

[finalproblem]

Picking up from where we left off...

John and Mycroft helped Mary fake her death. Sherlock wasn’t in on the plan.

John got hooked up to TD 12 to make him forget about the fake death--that’s why he was acting like Mary was truly dead in The Lying Detective.

Before John’s memory was erased though, he wrote a note to Sherlock and asked Molly to deliver it.

Whether by accident or design, something about John’s note gave away the fake death to Sherlock.

Sherlock Holmes needed his memory to be erased now, too.

Mary and Mycroft knew Sherlock wouldn’t be likely to agree to a memory wipe on his own, so they set their own plan in motion.

Mary left a video message for Sherlock encouraging him to engage in risky behavior in a bid to reconcile with John.

Mycroft and Mary then sought out Wiggins. The whole fake death plan was going down because they were trying to go up against bad guys known as the Scowrers (or that’s their name is in canon, they may well end up with a different one here). Wiggins used to be a Scowrer, and Mary knew it. So they were able to either convince or blackmail Wiggins into helping them out.

When Sherlock predictably went back on drugs as a way to mess himself up to the point of John not being able to resist helping, Wiggins was there to provide.

Remember Sherlock’s own words from His Last Vow,��though: “Wiggins is an excellent chemist.”

See the “coffee” he’s pointing at? That’s an IV bag full of some brownish fluid.

Sherlock flashed to the same stuff briefly while he was throwing “Faith’s” gun into the Thames, because that moment reminded him of what he knew about the fake death. What the TD 12 had made him forget.

Wiggins mixed up some kind of drug cocktail with TD 12. Sherlock (knowingly) gets high and (unknowingly) gets his memory erased simultaneously, thinking it was his own idea the whole time.

(Another option for this is that the effects of TD 12 had proved too weak for Sherlock’s unusual mind, and Sherlock was instead upgraded to the stronger TD 13. In which case, that’s what the post-it on Mycroft’s fridge was referring to. But I’m going to keep calling it TD 12 until someone in the show acknowledges the existence of another version.)

The connection between the drugs and TD 12 was also foreshadowed when John checked Sherlock for signs he’d been using again by pulling up Sherlock’s right sleeve.

Sound familiar?

Eventually, Sherlock went so far off the deep end that Wiggins bolted from 221B.

Mycroft then brought a team of agents into the flat, claiming that he was trying to figure out “what drove Sherlock off the rails.”

The reality was Mycroft already knew exactly what had done it. But he did use the opportunity to feel out whether John had caught on yet.

Mycroft also had his agents “collect evidence,” which was really just an excuse to get the incriminating TD 12 / drug cocktail remains taken away.

Like it never even happened.

[payment-providers]

New Post has been published on Payment-Providers.com

New Post has been published on https://payment-providers.com/primer-on-merchant-accounts-part-2-providers-isos-how-to-choose/

Primer on Merchant Accounts, Part 2: Providers, ISOs, How to Choose

The digital payments industry is notoriously confusing. This post is the final installment of a 2-part series on merchant accounts, which are required for all businesses that accept credit cards. “Part 1” described the purpose of such accounts.

I’ll address in this article merchant account providers and the role of independent sales organizations. I’ll also offer tips for selecting the best provider for your business.

All of this follows my 3-part “Credit Card Processing FAQs” series, in which I explained industry jargon, pricing models, and fees.

Card Brands

Recall from “Part 1” that “acquirer,” “merchant account provider,” “merchant acquirer,” and “acquiring bank” refer to the same thing: a financial institution that has been registered and approved by one or more of the card brands (Visa, Mastercard, Discover, American Express) to accept card payments on behalf of a merchant.

Cards brands govern the business of acquiring. Their role is enormous. Acquirers must comply with the brands’ rules and regulations. Thankfully, the brands compete to register and retain acquirers.

Card brands — American Express, Mastercard, Visa, and Discover — set rules and regulations for providers of merchant accounts.

The card brands charge licensing, application, and membership fees. Other merchant account roles of brands include:

Rules and regulations. The brands create, modify, and publish the rules for the acquiring industry.

Security. The industry depends on protecting sensitive card data and personal information. Many of the rules for acquirers concern security. Among other measures, acquirers, including their partners and subcontractors, must comply with PCI-DSS.

Technology. Card brands have created electronic systems that allow acquirers to receive, route, and secure payment transactions. This includes, for example, services that encrypt and securely store card data. Other services include fraud prevention, transaction routing, data storage, and business intelligence (data and analytics).

Compliance. The brands police their own acquiring networks, with frequent audits to ensure compliance with the rules. Offenders can lose their acquiring licenses, although it’s much more common for the card brand to levy a fine and help the acquirer become compliant. I’ve seen a card brand waive, usually temporarily, one or more of its rules for an acquirer. This typically occurs when an acquirer needs more time to implement a new procedure, such as PCI.

Third Parties

Understanding the merchant account needs of every type of business is a near-impossible task, even for the largest banks, who do not typically have specialized expertise. As a result, acquiring banks rely on third-party providers.

What follows are common third-parties.

Independent sales organization. An ISO is a company that markets acquiring services to merchants on behalf of an acquiring bank. An ISO is similar to an independent insurance agency. The ISO will tailor a range of payment-acceptance services for merchants and will receive a commission — usually a one-time fee or a percentage of the revenue generated — from the acquiring bank and payment processor. ISOs can sell the services of many different acquirers, picking and choosing the best fit for the merchant. Less reputable ISOs sell the services that offer the highest commissions or fees instead of the best option for the merchant. ISOs are typically experts in a particular industry. Some payment processors also operate as ISOs — the processor sells on behalf of an acquiring bank. Some ISOs call themselves acquirers.

Member service provider. MSP is Mastercard’s name for ISO.

Third-party agent. TPA is Visa’s name for ISO.

Value-added reseller. A VAR integrates the technology of third-parties into a single product or offer. An example is integrating payment gateways into point-of-sale equipment. VARs are not acquirers, but they may operate like ISOs or own ISO businesses.

Referral agents. Some acquirers and ISOs offer referral fees to agents, who can be ISOs but are usually unrelated to payment processing, such as accounting firms. Unlike ISOs, referral agents do not have to register with the card brands. Thus referral agents cannot call themselves acquirers or use Visa or Mastercard’s branding. They also cannot perform the functions of an acquirer.

Monitoring ISOs

The card brands have strict rules for ISOs. An ISO must register with each card brand and with each acquirer that it represents. ISOs pay sign-up and annual fees to the card brands, who audit ISOs annually for branding and other compliance rules.

The card brands have strict rules for ISOs.

The card brands hold acquirers responsible for the behavior of ISOs. If an ISO brings a fraudulent merchant into the payment network, the acquirer is responsible. If a merchant signed by an ISO incurs chargebacks, the acquirer refunds the issuer. If an ISO’s merchant accepts payments but does not fulfill orders, the acquirer remediates. Thus acquirers select, underwrite, audit, and monitor their ISOs carefully.

Merchant acquiring can be a risky business for the following reasons.

Chargebacks. A chargeback is a transaction reversal when a cardholder claims that he did not make a purchase. The issuing bank will return the cardholder’s money almost immediately and file a claim against the merchant’s acquirer.

According to the rules, the acquirer must first refund the issuer (which has already refunded the cardholder). Only after the refund occurs can the merchant and its acquirer dispute the process. Regardless, the acquirer will remove the funds from the merchant’s merchant account — no questions asked — plus a hefty chargeback fee. When a merchant is unable to refund chargebacks, the acquirer must cover the charges. In short, acquirers (not merchants) control merchant accounts.

Fund reversals. A fund reversal is a refund (or partial refund) granted to the customer by the merchant. Because the acquiring bank deposits funds in the merchant’s merchant account, often before the expiration of product warranties and guarantees, acquirers are exposed to the risk that a merchant will refuse to refund customers (resulting in chargebacks) or the risk that a merchant will go out of business before refunding its customers. In both cases, the acquirer is responsible for chargebacks if the merchant cannot perform.

Merchant solvency. Merchants that go out of business (i) cannot pay their merchant account fees, (ii) cannot cover chargebacks, and (iii) could fail to return an acquirer’s point-of-sale equipment.

Merchant fraud. Merchants that engage in fraud expose acquirers to (i) chargebacks, as explained above, (ii) fines and other penalties levied by the card brands, and (iii) reputational damage to the acquirer and the brands.

How Acquirers Make Money

The primary source of revenue for acquirers are merchant account fees, fines, and miscellaneous revenue from payment processors and other value-added providers. Acquirers do not receive interchange fees, which is revenue for the issuing banks.

Revenue from merchants includes fees for:

Registration,

Account setup, maintenance, and closure,

Support and service,

Currency conversion,

Chargebacks and chargeback disputes,

Audits,

PCI compliance,

Settlement, also known as batch or daily batch,

Monthly minimums.

Acquiring banks can generate additional revenue by partnering with processors to offer both merchant accounts and payment processing solutions. Some acquirers, usually the largest banks (e.g., Chase, Citi), have internal departments for acquiring, issuing, and processing.

Selecting a Merchant Account Provider

Merchant acquiring is highly competitive. Pricing and contractual terms differ among providers. Consider these tips to find the best provider for your business.

Know the details. Make sure the salesperson is disclosing all of the costs and restrictions, such as (i) all fees and penalties, (ii) the company’s policy for holds and reserves, (iii) when to transfer funds out of the merchant account, (iv) procedures if you’re not satisfied, (v) monthly minimum fees or other hidden fees, and (vi) the length of the contract and the early termination fees.

Understand your processing volume (daily, monthly, yearly) before negotiating. Knowing your transaction volume will help determine whether you need a dedicated merchant account or an aggregate account, such as Stripe, Square, PayPal. The type of account will dictate your payment processing fees as dedicated accounts allow less expensive interchange-plus pricing.

Understand your business’s risk profile. Take steps to reduce chargebacks. Acquirers don’t like risk. If you operate in a high-risk industry, help your acquirer understand how you plan to reduce its exposure. High-risk businesses can expect to pay higher fees or incur larger holds. Ask the acquirer if it can help avoid fraudulent payments.

Ask about discounts from potential acquirers if you use their payment processing services or their partners’ services.

Integration. Confirm that a potential acquirer can integrate with your business’s customer and accounting systems. Inquire as to the difficulty and the cost. Sometimes acquirers will absorb that cost.

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[pressroom-yahoohk]

Yahoo Hong Kong debuts the list of top pandemic-related keyword searches

Surgical masks top the list of pandemic-prevention supplies Yoga is the choice of physical & mental exercise for Hong Kongers Air Fryers & air purifiers are must-haves for home quarantine HKTVMALL gains big points for investing 200k into a mask factory Webinars takes the throne in key tools to keep learning at home Netflix & TVB streaming shows claim Top 3 in popular Home Entertainment The Dow Jones & Financial Secretary’s 10k cash handout are the working class’ most frequent searches

As the COVID-19 pandemic prevails, technology has become an essential part of life for health-conscious Hong Kongers, whose digital consumption behavior has seen a drastic change whether in searching for pandemic-prevention supplies, daily essentials or online learning tools. Large populations working from home also resulted in immense demand for streaming services and entertainment, opening up commercial opportunities for businesses big or small. Verizon Media has always prioritized COVID-19 prevention by offering a plethora of trusted online content for everyone to enjoy at home. As a media and search company that amplifies what matters to users most with trust and empathy, Verizon Media’s subsidiary brand Yahoo Hong Kong (www.yahoo.com.hk) has partnered with top-notch service providers to serve Hong Kongers’ needs.  Yahoo Hong Kong has charted the list of top pandemic-related keyword searches to review the topics and entertainment that Hong Kongers are most concerned about.

Yahoo’s keyword search during COVID-19: Top-10 anti-pandemic supplies 1. Surgical masks 2. mask 3. toilet paper 4. bleach 5. hand sanitizer 6, two boxes, thanks 7. ethanol 8. rice 9. hand sanitizer formula 10. sanitizing cotton

Masks in short supply; overnight queues a common sight COVID-19 strikes panic in all of us. Hong Kongers who had experienced the painful lessons of SARS in 2003 were aware of the importance of wearing masks for health protection. Yet their single-use means consumption and demand are massive, urging citizens to spare no effort to queue overnight just to get a box of masks.  Businesses are also sourcing masks from around the world and selling them on social media. As such the comment of "two boxes of masks, thanks" messages flooded the online world, crowning it second place in the list of popular pandemic-prevention supplies.

Toilet paper panic-buy due to rumours of depletion At the beginning of the COVID-19 outbreak, a rumour spread online about toilet paper manufacturers switching to producing masks, igniting a wave of panic-buys in the town. Toilet rolls, boxed tissues, kitchen paper, and even sanitary pads were wiped out. Subsequently, the supermarkets clarified that their supply is sufficient and limited purchases to stop panic buys. As such, “snapping up toilet paper” also became one of the top-10 pandemic-prevention search words.

Yahoo’s keyword search during COVID-19: Top 10 products and people for mental and physical well being

1. Yoga 2. Hiking trails 3. Elva Ni 4. Hiking shoes 5. Nintendo Switch Ring Fit 6. Fitness bike 7. Fitness equipment 8. Country Parks 9. Fitness Centres 10. Hiking Gear

Home exercises and yoga gain popularity Self-protection is important, but so is boosting our immune systems against the virus, thus giving birth to the trend of home exercises. Yoga can regulate the entire body, improve blood circulation, promote endocrine balance and release stress. It is easy to get started and can be easily practiced at home, making it the first choice of workout for Hong Kongers! Viewers can also live-stream a yoga or fitness session with KOLs to achieve results while saving big bucks. Yoga KOLs like Elva Ni, as such, have gained popularity.

Suns out and masks off: country parks and hiking trails become new stomping grounds The city is packed with people and has poor air circulation, making nature the next best thing for Hong Kongers to, literally, get a breather sans mask. Therefore, search words like “hiking trails”, “country parks”, “outlying islands” and “hiking gear” gained much traction. Taking to nature is, of course, a healthy option, but please keep the mask on if the trails are crowded.  

Yahoo’s keyword search during COVID-19: Top 10 home appliances 1. Air Fryer 2. Air Purifier 3. Air Cleaner 4. Dehumidifier 5. 5G Mobile Phones 6. Washing Machine 7. PlayStation 5 8. Combination Ovens 9. Bread Maker 10. Ovens

Home-cooked meals go up, as does creativity in the kitchen Eating out is risky so Hong Kongers are inclined to stay home for meals, thus boosting the search for kitchen appliances and tools. Topping the list is the air fryer, which can achieve the same crispy results but with less oil – surely a treat for everyone in the family. Ovens and halogen ovens share the spotlight among couples who’re into making candle-lit dinners or parents wishing to surprise their kids with homemade cakes. After the pandemic, everyone's cooking skills will definitely improve a lot!

Home Appliances go head-to-head with one another & air purifiers claim top 3 Spring humidity is upon us, and dehumidifiers have long been the top-three in years prior; but due to COVID-19, air purifiers became the new winner. Aside from air purifiers for the home, wearable air purifiers are equally popular: this thumb-size device is easy to carry and blocks pollen and PM2.5 pollutants by generation ions. Yet the virus is ubiquitous: aside from air purifiers, we must still beware of personal hygiene, keep our hands clean and wear masks.

Yahoo’s keyword search during COVID-19: Top 10 online shopping platforms 1. HKTVMALL 2. Watsons 3. ParknShop 4. Bonjour 5. Wellcome 6. SaSa 7. Ztore 8. Aeon 9. Carousell 10. Yata

HKTVMALL gains brownie points for investing 200k to make masks   In the beginning of month, HKTVMALL announced the establishment of its mask factory and expects to start selling month-end. Its company’s value climbed to 4.6 billion. Prior to the pandemic, HKTVMALL dispatched two teams to source masks around the world and materials for masks production around Southeast Asia. Its USD 200k investment to build a mask factory has sparked heated discussions online. As the leading online retailer, HKTVMALL has been the go-to for searching daily staples, bleach, rice, toilet paper; it even hired more delivery people when orders started piling up. There is no doubt that HKTVMALL is at first place in the most-searched online shopping platform.

Watsons sells masks online; mascot “WatsBag” rises to fame When Watsons sold masks at its brick and mortar shops, queues piled up at the door. Yet, high demand means lining up overnight may not always be met with success. Some citizens even started arguments with Watsons staff and fellow mask-seekers. As such, the pharmacy moved the reservation process online: at its peak, the system saw 1.49 million people queuing up. During the wait, mascot WatsBag (a green shopping bag) entertains those in the queue with comical expressions and dialogue that soon became inspiration to derivative work and Whatsapp stickers designed by creative netizens. Soon after, Watsons released WatsBag’s life story and other family members in a series of peripheral products for sale. Some WatsBag’s nicknames have also made it to Yahoo’s top-three searches.

ParknShop shines during Home Quarantine As the plague of COVID-19 drags on, the majority of the public remains indoors, but daily staples and foods still need to be replenished. And for that, Hong Kongers prefer heading to CK Hutchison Holdings’ ParknShop headed by tycoon Li Ka-shing. Many supermarkets’ online platforms are, too, grasping onto this business opportunity as they see overwhelming orders. While we enjoy the convenience of deliveries, we should also be thankful for the people who are braving the pandemic to bring these goods to our doorsteps.

Yahoo’s keyword search during COVID-19: Top 10 learning-at-home tools 1. Zoom 2. eClass 3. iPad 4. Kindle 5. pagamo 6. Phonics 7. eLearning 8. happypama 9. TEDEd 10. Lego Steam

Learning Online is Packed with Fun Though schools are under suspension, learning never stops but has instead shifted to online education. Online conference platforms feature screen-sharing functions so lecturers can share learning materials while teaching, offering a much more engaging experience than rote learning. Conferences are two-ways, and incidents of students accidently leaving on the microphone have caused a raucous. Zoom – a platform more common among students – topped the list of 10 most popular searches in the “learning at home” category.

Learn at home with the help of Technology For parents, school suspensions and executing classes at home are big headaches. Fortunately, a number of schools are using the eClass learning platform to share electronic learning materials. Students need only log into the eClass system to access their assignments so as to learn at their own pace and time at home even under class-suspension. As such, PaGamO, Happy PAMA, and other target-oriented, online self-learning platforms stand out from the crowd and made it to the Top 10 most popular searches in the “learning at home” category.

Yahoo’s keyword search during COVID-19: Top 10 home entertainments 1. Crash Landing on You 2. Joy of Life 3. Forensic Heroes IV 4. Three Lives, Three Worlds, The Pillow Book 5. Itaewon Class 6. The Dripping Sauce 7. Kingdom 8. Someday Or One Day 9. Parasite 10. Running Man

When it comes to binge-watching at home, Korean dramas are the go-to Until a cure is available for COVID-19, medical staff highly recommend the public to stay home, and the best way to kill time? Binge-watching shows. “Crash Landing on You” by Netflix tells of a girl from an upper-class family and her adventures in North Korea after she accidentally paraglided into the country. During her stay, she falls in love with the captain of the North Korean Special Forces in a romantic tale that has mesmerized the young generation, making it the most-searched show. Second and third places are TVB’s primetime shows, “Joy of Life” and “Forensic Heroes IV”. The binge-worthy “Joy of Life”, produced in Mainland China, illustrates a mysterious, good-looking man who makes a legend out of himself. “Forensic Heroes IV”, on the other hand, is the brainchild of esteemed producer Mui Siu-Ching and has reached new heights in viewership of 40-plus points.

Yahoo’s keyword search during COVID-19: Top 10 finance-related keywords 1. Dow Jones Industrial Average 2. Financial Secretary Budget 3. 10k cash handout 4. RMB exchange rate 5. Yen to HKD 6. Anti-epidemic Fund 7. Australian Dollar 8. Hong Kong Dollar Fixed Deposit 9. Community Care Fund 10. Pounds to HKD

US Stock market plummets, worst performance in 30 years No country is free from the wrath of COVID-19. As situations worsen in the United States, businesses and corporations have been forced to come to a halt. Three major stock indexes plummeted, of which the Dow recorded the largest quarterly decline since 1987, hovering at 15293 points, making this the headline search item.  

Financial Secretary’s 10K cash handout encourage spending Financial Secretary Paul Chan Mo-Po announced in February the 2020-21 Budget composed of a number of bailout features, of which the 10k cash handout to all Hong Kong permanent citizens aged 18 or above has received the most attention. This scheme is believed to benefit more than 7 million Hong Kongers both living in the city and overseas. In such economic turmoil, the cash handout will surely lessen citizens’ financial pressure and encourage spending. Hong Kongers can apply for the 10K cash hand out scheme in July via online and paper forms and receive the money as early as August.

Co-head of APAC, Verizon Media Mr. Rico Chan says, “As a trusted media partner of Hong Kongers, Yahoo has been walking alongside people of this city for the past 20 years. Under the plague of COVID-19 and daily surges of news and updates on the pandemic, we are on an information overload. Yahoo Hong Kong continues to stand with Hong Kong with a Combating COVID-19 live log and website featuring unbiased, accurate and real-time information. Aside from trusted sources of information, Yahoo Hong Kong also lends a helping hand during these challenging times to source masks and sanitizing supplies from around the world and making them available to our members via the Yahoo App.  In lieu of school closure, we also launch an all-new online learning hub (Yahoo Kids Up) that amalgamates reputable self-learning channels to offer students at home premium content and support within the confines of their homes.  With faith, Yahoo will stand strong with Hong Kongers to overcome this pandemic.”

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A Future Without HIV: Are We There Yet?

Jennifer Waugh

The findings of a major eight-year-long HIV study known as the PARTNER2 study have shown that so long as HIV+ partners are being fully treated, there is no chance of passing on HIV to a sexual partner, even with unprotected sex. What does that mean, and where do we stand now that we know this?

Last weekend was huge for HIV research. Literally epic.

The Guardian, CNN and other major news sources reported on the findings of a major eight-year-long HIV study known as the PARTNER2 study. This landmark study followed 1000 male couples where one partner was HIV positive and on antiretroviral (ARV) medication, and one partner was negative for the disease, across fourteen different countries in the United Kingdom.

The study findings showed that when men were adherent to their ARVs (when they took their meds daily and as directed), they became virally suppressed, and had no chance of passing on HIV to their sexual partner, even with unprotected sex. These couples reported engaging in unprotected sex more than 77,000 times collectively without any transmission of the virus.

You heard that right: so long as the HIV+ partners were being fully treated, it was found that there was no chance - zero — of passing on HIV to their sexual partner, even with unprotected sex.

The findings of this study were published in 2018, but the CDC recognized the fact that undetectable viral loads lead to zero HIV transmission in 2017, showing support of the Prevention Access Campaign’s “Undetectable = Untransmittable,” or “U=U." More than eight hundred organizations across one hundred countries have now joined together in support of the U=U campaign. HIV/AIDS has claimed the lives of millions since it was first discovered in 1983, but it seems things may finally be looking up.

This is obviously amazing news. This is also a lot to unpack, though, so let’s talk basics, filling in gaps you might have about HIV or AIDS, treatment, and their history, then let's take a look at the view from here.

What are HIV and AIDS, anyway?

HIV (Human Immunodeficiency Virus) is a disease that attacks the immune system, and which makes anyone who has it more susceptible to other infections that can then cause AIDS (Acquired Immune Deficiency Syndrome). A person living with HIV is considered to have AIDS when their CD4 count — the amount of white blood cells in the body — drops below 200 (the normal range is 500-1,500), and they have been diagnosed with what's called an opportunistic infection. Some of the most common opportunistic infections are recurrent pneumonia, toxoplasmosis, hepatitis B and C, and candidiasis (yeast infections or thrush) - though there are many. Basically, because HIV attacks the immune system, which makes it easier to fall seriously ill by another serious infection, and greatly inhibits the body’s ability to fight back. Good CD4 cells are destroyed, and HIV begins creating new copies of the virus.

One big misconception that still exists, thanks in part to stigma and lack of accurate education, is that HIV = AIDS, or even that HIV always leads to AIDS. That’s not true. With advances in research and treatment options, many people with HIV in developed nations now never experience AIDS.

HIV was initially found in 1981 and first called GRID -- Gay-Related Immunodeficiency -- because it was first seen in gay men. This framing unfortunately perpetuated stigma (negative, oftentimes shameful, perception) that still surrounds both gay men and HIV to this day. HIV isn’t just about gay men. It can be transmitted (passed from one person to another) through bodily fluids including blood, semen, vaginal fluids, and breastmilk. Though the virus passes most easily during anal sex (due to the ease with which anal tissue tears, making the act more “risky” for the receptive, or bottom, partner) HIV does not discriminate based on sexuality, gender, or skin color. Contrary to historical stereotypes, statistics show that globally heterosexual women are who experience the highest rates of HIV infection.

In the 1980s and 1990s when treatments were not yet readily available or affordable, hundreds of thousands of gay men had died from AIDS, largely due to homophobia.  In the USA alone, "By 1995, one gay man in nine had been diagnosed with AIDS, one in fifteen had died, and 10% of the 1,600,000 men aged 25-44 who identified as gay had died." Gay men have accounted for more than half (55 percent) of all AIDS deaths since the epidemic’s beginning.

Sensationalized news articles and headlines across the world played a great part in this by demonizing gay men, using terms like “gay plague,” “gay cancer,” and displayed images of tombstones and the Grim Reaper. Heartlessly, HIV and AIDS were viewed by many as a punishment for what they or others considered “amoral behavior,” like sex between men, IV drug use, or sex work. This, combined with existing intense bias against these groups, led to a mass amount of fear, and tremendous silence surrounding the disease. At the height of the AIDS epidemic in the US and beyond, gay men led activist movements criticizing the government’s blind eye and lack of action at such a crucial time, fighting for the Reagan administration to pay attention and to fund research and treatment. It wasn’t until 1986 that President Reagan even mentioned the word AIDS publicly. During this time, HIV was still considered by many to be a death sentence, as affected populations continued to be further marginalized.

Ian Green, Chief Executive of Terrence Higgins Trust, a British charity that provides services relating to sexual health and HIV, was diagnosed with HIV 23 years ago. In a recent interview, Ian, now undetectable, disclosed fears he had when he was diagnosed that many still have today when they test positive for HIV. “The most significant [emotion] at that point in time was how long did I have to live. The other thing that really concerned me for a very long time is am I a risk to other people?” I can only imagine the immense relief that might now be felt by a person living with HIV to learn they are unable to pass it on to anyone else – to not feel as though they are any sort of danger to other people, so contrary to perceptions and experiences of the past.

In the United States, specifically, the population most affected by HIV is still men who have sex with men, accounting for 26,000 new infections each year. Worldwide, though, women represent the majority — 52% — of all adults living with HIV. Though we know anal sex poses the greatest risk of transmission, penis-vaginal intercourse is also a leading cause of transmission worldwide. Similar to the anus, it's easy for the vaginal wall to experience small (usually unnoticeable) tears during intercourse, providing a route for HIV transmission. Vaginal tissue is highly susceptible to any type of infection. Beyond basic physiology, women (including those who don't have vaginas) also remain disproportionately affected by the virus due to vulnerabilities created by social, economic, and cultural status. Gender inequality, as well as intimate partner violence, reinforce harmful power dynamics, both on a personal and systemic scale. In many countries, women face significant barriers to education and healthcare, contributing to a known lack of understanding around pregnancy and HIV.

What about treatment?

HIV treatment medications (ARVs) became available in the late 1980s, starting with the first licensed drug, AZT (of the drug class Nucleoside Analogs), which was initially highly toxic.

Fast forward to the 1990s and a new era of ARVs. Researchers began to realize that one class of drugs was not enough to control CD4 counts, and eventually introduced HAARTs – highly active antiretroviral therapies – made up of combinations of Nucleotide Reverse Transcriptase Inhibitors (NRTIs), Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs), Protease Inhibitors, Fusion Inhibitors, CCR5 Antagonists, and Integrase Inhibitors. Not only were these treatments (called “cocktails” in early years) numerous - sometimes 20 or more pills a day - but many doctors refused to even treat people living with HIV. Then there’s the fact that even seeing a doctor and paying for these incredibly costly meds meant having health insurance (something many, many people didn’t have), and a plan that would potentially pay thousands upon thousands monthly for treatment.

Through years of advocacy and research, ARVs became more effective in treating the virus, and HIV resource agencies began growing around the world, making it easier for more people to access these medications. Drug trials continued, and researchers found the right combination of these different classes of drugs.

Today, people living with HIV who are connected to treatment can now take as little as one single pill per day as their full treatment. (That one pill contains at least three types of medications, though.) By finding these effective combinations, remaining adherent to one’s ARVs has become much easier than not only remembering to take, but having to swallow, handfuls of pills per day.

This brings us back to the results of the PARTNER2 study and what life looks like for people who receive HIV treatment today.

UNAIDS data from 2018 reported that 21.7 million of the 36.9 million people living with HIV worldwide were receiving treatment in 2017. Their current initiative and goal is 90/90/90: that 90% of people living with HIV will know their status, 90% of those people will be on treatment, and 90% will be virally suppressed. Adherence to treatment is key to suppression of the virus.

Current standards of treatment include taking daily medication and having lab work done every six months prior to checking up with a healthcare provider. Today there are many ARV medications, and doctors choose the best regimen for each individual patient. Typically, after a few months of taking medication (and depending on how long they have been living with the disease untreated), people diagnosed with HIV will have such a small amount of copies of HIV in their blood that they are considered “undetectable.” People achieve viral suppression (a controlled, lowered amount of the virus) when the copies of HIV are less than 200 per milliliter (mL) of blood. This doesn’t mean that a person with an undetectable viral load will test negative for HIV, but during routine labs (which check the CD4 – the level of good white blood cells, and the amount of HIV copies in the blood) their amount is so small that it will not show up on that particular test.

It’s important to note that just because a person achieves undetectable status does not mean they can stop taking medication. If a person begins missing more than 3-4 doses of their ARV per month regularly, their viral load can climb to a detectable value, and they may need to switch medications to get that number back under control.

So, what does this news mean for everyone?

Obviously, the fact that HIV treatment has now been proven to prevent transmission when taken properly is incredible news, and is potentially momentous both for people living with HIV and those of us who have worked or are currently working to prevent it. Researchers have been working hard for decades on the science behind HIV and developing and administering effective treatment.

But what about the people who don’t have access to these medications? In developing nations, poor economy contributes to a lack of healthcare, and the availability of medication to fight HIV. UNAIDS estimates that more than $26.2 billion will be required to combat HIV/AIDS in the year 2020. Treatment is expensive.

Stigma plays — as it always has — another huge role in the ability to receive treatment. Even just being tested for HIV is scary because of fear of judgment and discrimination. In terms of HIV, however, ignorance is not bliss. It is crucial to know one’s status so that treatment can be initiated, and more people will not come in contact with the virus. 73 countries worldwide still consider homosexuality to be a prosecutable offense, sometimes punishable by death: these attitudes and policies obviously keep many people from even getting tested. A key proponent to HIV prevention is education and counseling, but for many, the idea still exists that HIV = gay, and it can be dangerous to discuss either.

There are many other barriers that exist that prevent people from receiving HIV treatment. People of color and those who are low-income are incredibly underserved. Many people do not have access to health insurance or appropriate healthcare. ARVs cost upwards of $3,000 per month without insurance. Even with insurance, lack of education often leads to the inability to understand a diagnosis and other parts of health, and makes it difficult for many marginalized people to communicate their needs with a doctor. What about transportation? Just getting to a doctor’s office or pharmacy is often a task on its own, especially in rural areas or healthcare deserts (areas with no clinics or hospitals). Additionally, housing and food security play their own roles in creating barriers to optimal HIV health. Without a safe place to live, many people lack a safe place to store their medications even if they can get them. Most ARVs need to be taken with food to be absorbed properly: not knowing where your next meal will come from adds another layer to the struggle with adherence.

Luckily, there are many HIV resource agencies to assist people with some of these barriers and help to make access to HIV healthcare easier. In the United States, the AIDS Drug Assistance Program (ADAP - though the name varies by state; for example, this resource is called MIDAP in Michigan) provides free HIV healthcare and HIV medications for people enrolled in the program. This organization even covers undocumented citizens. HIV resource agencies often provide testing, education, counseling, and HIV health management services (including social work, and food, housing, and insurance assistance) for people who are lucky enough to have an organization in their area.

There are also other recent HIV advancements to be excited about. Pre-Exposure Prophylaxis (PrEP) was initially approved by the FDA as a preventative medication from MeetPositives SM Feed 4 http://bit.ly/30bb2qr via IFTTT

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8 Benefits of Voluntary Mental Health Admission

When a mental health condition has deteriorated to the point of a severe psychiatric break, hospitalization is the appropriate level of care. When a loved one is in the midst of a psychiatric event or crisis it is presents difficult choices. Will your loved one voluntarily agree to be admitted to the hospital or is an involuntary admission necessary?

Understanding the options available and the differences between an involuntary and voluntary mental health admission can help smooth the way toward your loved one’s healing.

What Constitutes a Mental Health Crisis?

When living with a mental health disorder each day can present unpredictable developments. While one day the individual is feeling stable and optimistic, the following day might find them contemplating suicide. Mental illness is complex and does not progress in a straight line. Even the most closely monitored disorders can suddenly take an extreme turn for the worse.

Signs that a mental illness has become a psychiatric crisis revolve around impaired functioning and being a danger to oneself or others. When the individual’s symptoms appear to have deteriorated, the following signs would constitute grounds for hospitalization:

Becoming incommunicative, catatonic

Extreme mood swings

Cognitive impairment

Unable to function at even basic daily tasks

Aggressive or violent behaviors

Impulsive risky behaviors that endangers the individual or others

Psychotic symptoms, such as paranoia, hallucinations, or delusions

Neglecting personal hygiene

Not eating or sleeping normally

Threatening suicide

When some of these signs are present it is important to discuss a voluntary mental health admission with the individual.

Different Types of Mental Health Treatment Centers

Covering a wide spectrum of mental health disorders at varying levels of care, mental health programs come in a variety of formats. These include:

Outpatient private practice providers

Outpatient mental health treatment centers or day programs

Residential mental health centers

Dual diagnosis treatment programs

Psychiatric hospitals

The psychiatric hospital provides the highest level of care, with acute stabilization services, 24-hour monitoring, medical care, and intensive psychiatric treatment. These facilities may be a state psychiatric hospital, a private psychiatric hospital, or a general hospital with a designated psychiatric floor.

8 Benefits of Voluntary Mental Health Admission

When approaching a loved one about voluntarily admitting to a mental health center for more focused care you may be met with resistance. This is understandable, as no one likes the idea of needing this level of care for a mental health disorder. But it is helpful to convince them that by entering a program voluntarily there are several benefits, versus involuntary admission. These benefits include:

Self-admitting into a psychiatric hospital or residential mental health program with acute stabilization services is the most efficient option for getting the necessary psychiatric help quickly.

There is reduced stigma attached to a voluntary hospitalization versus an involuntary admission.

It gives the patient a feeling of control over their desire and need for treatment, versus being taken against their will.

It allows the patient to voluntarily leave the facility.

The individual will feel a sense of ownership about their treatment, leading to higher levels of involvement in the treatment interventions and activities.

Patients who enter treatment voluntarily are more inclined to experience improvement than those admitted involuntarily.

Voluntary admissions are often shorter than involuntary admissions, often because the patient is engaged in his or her treatment and more cooperative.

The relationship between the patient and the doctors assigned to them is less adversarial with voluntary admissions.

What to Expect in a Psychiatric Hospitalization

Someone who is admitted into a psychiatric hospital, either voluntarily or involuntarily, will likely require acute stabilization. This involves continual monitoring, medication analysis, adjustment, and prescription of psychotropic drugs, IV fluids, and the initial evaluation and preliminary diagnosis of the admitting psychiatrist. Patient medical history and psychiatric history will be reviewed, as well as current symptoms. Until stabilized the patient will remain in a secured area of the hospital.

Ongoing treatment during the hospital stay will involve an integrated approach using evidence-based therapies, medication, and adjunctive therapies. Holistic therapies may also be included in the treatment program, as these are conducive to stress management and relaxation.

Individual and group therapy sessions will be provided daily. These enable the patient to work through underlying psychological issues that may be contributing to the enhanced psychiatric break. In addition to examining past traumas or other painful events in their life, the patient will also likely have to process feelings of shame or guilt related to their mental condition. Many patients feel as if they are a burden to loved ones and fear abandonment or rejection.

Once the patient has achieved a stabilized status they may request to leave the hospital setting and step down to either a residential or outpatient mental health program. Only patients who are admitted voluntarily can make such requests.

Stepping Down After Psychiatric Hospital Stay

When it is appropriate for the individual to leave the hospital setting and transition to either residential or outpatient care, they will experience more freedom and autonomy. A residential program will likely offer many of the same treatment elements, but may have a more relaxed setting compared to the hospital. A residential stay can be as short as a couple of weeks up to several months, depending on the unique mental health needs of the patient.

Outpatient programs are available once the individual is ready to return either home or to reside in transitional living for a period of time. The outpatient program can be minimal, such as one or two therapy sessions per week, to more intensive such as a day program.

The Treatment Specialist is An Online Resource For Mental Health Information

The Treatment Specialist offers help for individuals or loved ones experiencing psychological distress. Our trained specialists provide free information about the mental health disorder and can guide individuals toward appropriate treatment options for the specific disorder or dual diagnosis. If you need more information about a voluntary mental health admission, please connect with The Treatment Specialist today at (866) 644-7911 for a free confidential assessment.

  The post 8 Benefits of Voluntary Mental Health Admission appeared first on The Treatment Specialist.

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Ambien Abuse Treatment

New Post has been published on https://www.therecover.com/ambien-abuse-treatment/

Ambien Abuse Treatment

What is Ambien?

Ambien is a brand name for Zolpidem and it’s a powerful sedative to help people with sleep problems. One characteristic of this pharmaceutical is its efficiency as the patient is likely to fall asleep around 30 minutes or less after ingesting it orally. The half-life of this drug is at least two hours. Ambien is also highly addictive so it’s not to be prescribed lightly, and only if all other avenues have been exploited.

Since 2013, doctors have recommended cutting the dosage because patterns of driving accidents were traced to the drug. Apparently, those who took Ambien the night before are seriously at risk when they get behind the wheel the morning after.

Even before it came to America’s shores in 1993 after getting approval for restricted medical use the year before, Ambien was already widely popular in Europe for about five years. In 2007, a generic equivalent became commercially available, which resulted in savings for patients.

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A research conducted by a team led by University of Washington’s School of Pharmacy, and published in the American Journal of Public Health, concluded that sleeping pills such as Ambien will double the risk of accident for motorists. They collated data from 400,000 cases from the state’s health plan for a period of five years.

Those who took Ambien and Tradzodone (Eleptro) doubled the risk of figuring into an accident compared to non-users. Those who took Restoril had a 27% likelihood of crashing.

The study confirmed the Federal Drugs Administration’s warning on cutting the dose for sleeping pills for people who drive the next day.

Basically, taking Ambien the night before is like driving with blood alcohol levels of between 0.6 and 0.11 percent.

What is the recommended dosage of the FDA?

For men, Ambien dose should not be more than 5 milligrams for immediate-release and 6.25 milligrams for longer-acting brands.

For women, the recommended dose should not be more than 5 milligrams for immediate-release brands and 6.25 for longer-acting brands.

Prior to the recommendation, the dose was 10 milligrams for women and 12.5 milligrams for men

Not all who take Ambien is aware that they already developed dependence on the drug. They really think that they are just trying to manage their insomnia. However, one good way to know is if their lives are already revolving around the sleeping pills then it’s highly likely that they are already addicted.

Are there Any Other Uses for Ambien?

Ambien is not recommended for long-term use. It’s to be prescribed for extreme cases, when the lack of sleep is already threatening the patient’s health.

While it’s principally designed as a sedative-hypnotic, clinical trials have been conducted as a possible treatment for Parkinson’s disease. A 2012 Taiwanese research found that taking controlled dosage made a patient better as she could talk intelligibly with her caregiver and was able to walk around without any kind of assistance.

However, there’s really not test to prove its long-term efficacy to treat Parkinson’s. Psychologists also warned that taking more than 10 milligrams of Ambien per day will only increase the risk without necessarily amplifying its effectiveness.

Ambien is also used for catatonic patients. A Clinical Review of the Treatment of Catatonia published in the National Institutes of Health in 2014 found patterns of success in giving Ambien to catatonic individuals. They seemed to have roused from their stupor on doses between 7.5 mg and as much as 40 milligrams per day. It was recommended that clinicians instead use this drug as an alternative to benzodiazepines.

Another way for Ambien to be used is its administration to individuals with restless leg syndrome. The urge to move their legs because of the discomfort, and sometimes pain, makes it impossible for the patients to sleep. This is where Zolpidem will come in. Treatment may also include regular massage, hot packs, exercise, and steering clear of coffee and alcohol.

What are the Drugs that Will Interact with Ambien?

Ambien by itself is quite safe on the condition that you follow the doctor’s prescription to the letter. It’s also important that you should be honest with your doctor when you want to be prescribed sleeping pills.

There are other drugs that will counteract and interact with Zolpidem. They could either enhance the effects or adulterate the efficacy.

You should tell your doctor if you are already taking the following medications:

Phenothiazine antipsychotics, which includes Chlorpromazine. This medicine is being used for patients suffering from schizophrenia, bipolar disorder, and other psychotic episodes.

Tuberculosis medicines such as Rifampim. This drug is also used to treat the fatal disease called meningitis.

Itraconazole is an anti-fungal antibiotic that is used to treat a variety of diseases. Among the side effects are drowsiness, nausea and vomiting, diarrhea, and rashes.

Anti-depressants, which may counteract the effects of Ambien.

As long as you are honest with your doctor, there’s no danger of taking Ambien to treat your sleeping disorder.

  Drug addiction is a growing threat to the economic security of the US, along with the peace and order of the communities. According to the 2014 Behavioral Health Trends in the United States commissioned by the Substance Abuse and Mental Health Services Administration or SAMHSA, more than 21.5 million of Americans who are 12 years old and older are struggling with addiction.

Of the total, around 8 million are struggling with a co-occurring mental issue apart from their substance addiction. This makes the treatment process quite complicated because the rehab center will also try to address the mental illness.

You might think that drug addiction is a personal choice, and has nothing to do with you. But drugs affect the economy in a variety of ways. The Office of the National Drug Control Policy under the White House, however, reported that drugs cost the US economy about $200 billion in 2007.  This was in 2007 so the figures should have gone up by now.

  Can I Spot Someone Addicted to Ambien?

If you know that your loved one is struggling with addiction, you would be doing everything to get them help.

One of the major hurdles, however, is that we tend to look at our loved ones through rose-colored lenses. This gives us with a major blind spot that they can exploit to lie about their problems. However, there are ways for you to spot if someone is hooked to sleeping pills or any drug in general:

They are acting very strange

There’s a drastic change in their behavior

They are always sleeping or on the flip side, they are not sleeping at all (a symptom of severe addiction)

They appear very calm and relaxed then suddenly become irritable or angry

They are prone to engage in unnecessary risky behaviors

They always run out of money and ask you for more (theft is the natural progression if you stop giving them money)

They skip work, school, or any other activities or hobbies that they used to take pleasure in doing

They lock themselves in their room for days

Depression and guilt are common offshoots of Ambien addiction. Unfortunately, these don’t translate to actions. Even if they wanted to change for the better, they just have no faculty to do it unless they seek professional help.

Is Ambien Addictive?

Short answer, yes, Ambien is addictive. It’s the reason why it’s not recommended for long-term use because the individual will develop a dependence on the drug. Although it’s classified as non-benzodiazepine, which hints that tolerance is not as bad as benzodiazepines like Xanax, it can still habit-forming.

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How to know if you are already dependent?

Spot these symptoms and seek help immediately:

Being secretive about your intake

Upping the dosage over and above the doctor’s recommendation

Trying to find creative ways to refill the prescription

Craving for the drug

Spending too much money on the drug

Taking unnecessary risks to acquire Ambien

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In fact, dependence on Ambien can take as little as two weeks. Unfortunately, most people don’t realize that they already developed an affinity until their doctor takes them out of the medicine. That’s when they get the cravings. They also develop withdrawal symptoms for the drug, which will be discussed later in this article.

Although taken orally, some individuals will pound it to powder until they can snort it. This is supposed to give them a high and the effects are instantaneous, instead of waiting about 30 minutes for Ambien to hit them.

We should make a distinction here between dependence and addiction, however.

Dependence, also called tolerance, is when your body has already adapted to the effects of the drug. You will develop some withdrawal symptoms once you stop taking Ambien. In order to achieve the same effect, the patient needs to increase the dose.

You can be dependent without being addicted, although there’s a very thin line that separates the two.

Addiction sets in when there are already some changes in the brain’s chemical characteristics, which result in changes in behavior. In this case, they are already acting irrationally and thinking illogically because the main goal is to get their fix.

Is Ambien Classified as a Narcotic?

Zolpidem is classified under Schedule IV Substance by the US Drug Enforcement Agency. As you know, this is part of the Controlled Substances Act, which sorts drugs according to their uses and risks.

Under Schedule IV, Ambien is not supposed to be used for recreational purposes. Its distribution is highly regulated, which means you can’t buy it over the counter without a prescription from the doctor. Schedule IV drugs are classified due to their “low potential for abuse,” as well as a little risk of developing dependence.

Going back to the question, it’s not classified as a narcotic in the medical sense. However, buying one outside of its purpose—and without a doctor’s prescription—is considered an illicit act. You may be charged criminally for that action.

Also, the law makes a distinction on when it can become a narcotic. Even if you do have a doctor’s prescription for a medical issue, if you ingest it other than how it’s prescribed, then you can also face legal consequences.

And what are these illicit acts?

You peddle Ambien to your family and friends for profit

You crush it to powder before snorting or injecting it

You go beyond the doctor’s recommendation to achieve a high

Does Ambien Trigger Blackouts?

Ambien does trigger blackouts and it’s an effect that it shares with alcohol. There are too many documented cases of people who complained that they remember nothing of the events that transpired the night before, right after they took the drug.

Unfortunately, they just found out the morning after that they actually engaged in high-risk behaviors without any recollection of what happened. Sex with strangers without protection is not uncommon. They also drove home even when they were intoxicated. They also exposed themselves to danger several times. All these are very disconcerting when they thought that they were sleeping the whole time.

There’s a term for this and it’s called parasomnia—it’s a state where the patient has engaged in activities when he has already gone to bed. Of course, parasomnia is not exclusive to Ambien users. There are others who sleep-walk but if you already have the tendency, the drug will only heighten the risks.

  What are the Risks Associated with Ambien?

Despite being classified as Schedule IV Substance, there are still risks associated with taking Ambien. The recommended prescription would be for two weeks. You are also told to take it just before going to bed so it works as intended.

However, extended-release drugs may be ingested for four weeks, provided that the patient will be reassessed after a month’s time to determine the efficacy of the drugs and to minimize the risks.

The drug is not recommended for kids below 14 years old. Pediatricians don’t usually prescribe this to their patients.

The FDA warned that taking Ambien for a long-term and beyond the prescribed period will expose the individual to more risks. The last thing you should do, however, is to mix a potent cocktail of alcohol and Ambien because it will exponentially magnify the risks.

For one, the drug already takes down your defenses and inhibition. That’s precisely what alcohol will do to you. You will become more aggressive and more prone to make risky choices—such as taking on a dare that will seriously endanger your life.

Ambien affects your central nervous system so temporary lapses in memory are not uncommon. Alcohol will also have the same effect, characterized by blackouts. Again, you are exposing yourself to unnecessary risks such as driving while impaired or worse, being molested in the case of women.

Of course, if you are working in construction sites or any hazardous environments, refrain from taking Ambien. We already demonstrated the danger of taking the drug the night before when you are behind the wheel in the morning. Better inform your doctor right away. He may give you another prescription for your sleeping problem.

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HOW TO MINIMIZE THE RISKS

In order to cut down the risks, the FDA recommends that individuals should take the lowest dose for Ambien, just enough so they can get some sleep.

They should not take Ambien if there are only about eight hours left before they wake up to work

They should also follow the instructions of their doctors on how to take Ambien

They should not go near heavy equipment or a motor vehicle the morning after

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The problem is that you will still feel lightheaded, drowsy, dizzy, and loss of balance about eight hours after taking your last pill. This is why it can contribute to impaired driving.

DANGERS OF UNPROTECTED SEX

People with Ambien blackouts have reported having sex with a total stranger. This is very dangerous because they might contract a sexually transmitted disease. Because they are not really conscious of their actions, it’s unlikely that they will use protection during the sexual act, unless their partner insists.

This will expose them to HIV infection and that can be very devastating for the patient. Those who take Ambien will typically combine the drug with alcohol—another depressant that can trigger blackouts—which only increases their parasomnia.

Can You Overdose on Ambien?

Ambien alone will probably not result in fatal overdose. There’s simply no statistics to extrapolate the frequency because Ambien overdose deaths are extremely rare. For instance, even if you take 200 milligrams of Ambien—which is far more than the recommended dosage of 5 mg—you will likely not die.

With that said, Ambien that is taken in combination with other drugs or alcohol can be fatal. For instance, snorting the drug in conjunction with another anti-depressant, such as liquor, has been linked to coma.

Some people also use Ambien after they crash from cocaine abuse. Those who are already taking anti-depressants or psychoactive drugs should make sure to tell their doctors about the state of their mental health to avoid endangering themselves with Ambien use.

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Take these Steps to Prevent Drug Overdose

Avoid combining Ambien with other opioids, illicit drugs, anti-depressants and psychoactive drugs

Follow the doctor’s prescription and the FDA recommendation for males and females

Inform your doctor if you have a liver disease

Do not crush the pill to snort it or dissolve it in water to inject it into your bloodstream

Tell your doctor if you have problems with alcohol and other illicit drugs

Talk to a therapist to sift through the underlying issues that may have contributed to your sleeping disorder

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What happens when somebody overdoses on drugs?

Naloxone has been found to be effective in saving the patient’s life in case of an overdose. This is why the federal government is making this drug available to most pharmacies throughout the US, and you can buy this even without prescription.

This drug is only designed as a first response. You still need to call in paramedics to rush the individual to the emergency room. For the most part, the stomach will be pumped to take out the toxins. For Ambien, the doctor may administer the drug Flumazenil to prevent the patient from going into a coma.

During this critical period, the patient may go into a seizure, which is one of the symptoms of Ambien withdrawal. In this case, the patient will be monitored closely at the hospital to prevent cardiac and respiratory events that may threaten his life.

Will Ambien Show Up in Traditional Urine Tests?

Those who are addicted to Ambien may still pass the traditional urine test in their workplace if their employer will check for drug use.

With that said, there’s a specialized urine test specifically designed to test for Ambien and other non-benzos. It will show up on the test around 2-5 days after your last dose. Screening using hair samples are also more accurate as they can verify how long you have been abusing the drug and the frequency in which you take it.

This can still show up in the test even months after you last took Ambien. Of course, it will depend on how addicted the individual is.  For instance, just a single dose beyond the recommended prescription will show up in your hair sample even after six weeks.

Another method is the saliva screening, which can be administered almost immediately after use. However, the short-window makes this method unreliable. The screening should take place within eight hours after the last pill or you would already have bypassed that chance to detect abuse.

However, we should clarify that even if you are subjected to hair samples and specialized urine tests, you will still test negative as long as you follow the recommended dose of the doctor. So you don’t have to worry about that.

How Long Does it Stay in Our System?

The half-life for Ambien is around 1.5-2 hours. For senior citizens, the half-life will stay from 2-4 hours. But there are several variables that will allow the drug to stay in our system longer.

These factors are:

The age of the patient – Your metabolism will play a large part in flushing the drug from your system. Naturally, older people will take longer to get rid of Ambien from the bodies so they tend to be affected more, hence the double half-life.

Person’s weight —  Ambien is quickly dissolved in the blood because of its water-soluble properties. Those who are on the heavy side will get rid of the drug more quickly compared to those who are on the thinner side. On the flip side, people who are overweight need to ingest more dosage for the drug to be effective.

The food and fluid you take – Those who love their midnight snack before turning in for bed will have a more difficult time flushing Ambien from their system. The logic behind this is that our body will simultaneously break down the drug and the food, which means the process will take it a much longer time.  Meanwhile, drinking a lot of fluids after taking Ambien will speed up the process.

Dosage and tolerance – You always want to follow the doctor’s prescription and directions. Those who take more than the recommended dose will have Ambien in their system longer. Meanwhile, if you’ve already developed a tolerance for the drug, it’s highly unlikely that you are already abusing the sleeping pill. The chemical will build up in your system, which means it will likely turn up in various screenings.

What are the Side Effects of Ambien?

Ambien has both immediate and long-term side effects. As already mentioned, it may result in drowsiness and dizziness which will impair your ability to function the day after. We recommend that you wait at least 5 hours after you wake up in the morning before doing some tasks that take concentration and focus.

The immediate side effects include:

Rashes and hives

Swelling, particularly on the tongue, face, and lips

Difficulty breathing

Chest pain

Unconsciousness

Extreme diarrhea

If you experience these side effects, stop taking Ambien immediately to avoid endangering yourself further.

However, you can expect the following side effects when you take Ambien:

Drowsiness

Loss of coordination

Headache

Cramps and muscle pain

Stuffy nose

Cotton mouth

Irritation to the throat

Light-headedness

Inability to focus

Confusion

Nightmares

A memory gap is not uncommon. However, if you have no recollection of major events after taking this drug such as having sex or driving your car on the way to work, tell your doctor immediately. You are potentially in danger if you continue to ignore this side effect.

Also, make sure to inform your doctor beforehand if you have the following conditions:

Kidney and liver disease

Asthma or bronchitis

Sleep apnea

Chronic obstructive pulmonary disease

If you have a family history of mental illness of drug and alcohol abuse, taking Ambien may be risky for you.

Long-term side-effects of Ambien:

Hallucination

Periods of memory lapses

Aggression

Delayed reflex and motor responses

Disorientation

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AMBIEN AND DEMENTIA

What’s more disconcerting is the link between the prolonged use of Ambien and dementia later on in the patient’s life.

A 2015 case-control study found a connection between Zolpidem abuse and Alzheimer’s disease. The research made this conclusion after studying almost 17,000 subjects in Taiwanese healthcare system between 2006 and 2010. The risk is amplified for those who are dealing with diseases such as diabetes, hypertension, and stroke while taking sleeping pills.

Clinical trials also found out that senior citizens exposed to Ambien for prolonged periods are 2% more prone to dementia.

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What are the Withdrawal Symptoms for Ambien?

You know that you are abusing Ambien when you are already taking it even if you have no objective of getting some shuteye. Those who developed a tolerance are also likely to combine the drug with alcohol or other opioids to magnify the effects.

Dependence can develop as early as two weeks of taking Ambien. Those who developed an addiction will find it very difficult to quit without outside help as they are already physically and mentally dependent on the drug.

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PHYSICAL AND MENTAL DEPENDENCE: WHAT’S THE DIFFERENCE?

Physical dependence occurs when the patient already manifests some physiological reaction to the drug. When your body resists the prolonged divorce from Ambience, then you have probably developed a dependence on the sleeping pill. The gravity of the reaction will depend on the level of addiction.

Literally, you will feel sick just being away from the source of dependence.

Mental or psychological dependence is the condition when your body craves the drugs even if there’s no physiological manifestation that occurs from not taking it. However, it will drastically impair the way the patient lives his life because the main focus is obtaining the drug at the expense of the family, work, and society at large.

In most cases, the two are not mutually exclusive.

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It’s not recommended that you stop cold-turkey once you already developed an addiction to Ambien because this could be dangerous.

The symptoms you can expect from Ambien withdrawal are:

Anxiety

Difficulty breathing

Panic attacks

Seizure

Mood swings

Anger or irritability

Tremors

Sweating

Lethargy

Depression

Suicidal thoughts

Stomach cramps

Erratic heart rate

Nausea and vomiting

Flushing

These symptoms will typically manifest themselves about two days after your last dose. Oftentimes, they can be very uncomfortable that the patient has no choice but to get his fix.

The patient will not experience all the symptoms simultaneously. In fact, they might just experience four or five of those symptoms. For instance, seizures and suicidal thoughts only occur in very rare cases. The symptoms will wane or totally disappear around a week.

There are also several factors that will affect the treatment for withdrawal

How long you have been using the drugs

The amount of dose you take over and above the doctor’s recommendation

What other drugs you are taking part from Ambien

If you are overweight or not

How old you are

In essence, if you are a heavy user and has been abusing Ambien for a long time, in more probability and symptoms are going to be more intense—which borders on pain—for you.

Do I Need to Undergo Detox?

Yes, you do have to undergo medical detox to get rid of Ambien from your system. There’s such a thing called “rebound insomnia.” And this is what happens when you’ve developed an addiction to Ambien and suddenly stops using it. What happens is that your insomnia is amplified. It’s even worse off than before.

Detox is simply the process of managing your withdrawal symptoms. The goal is two-fold:

To make sure to lessen the discomfort caused by the withdrawal

To monitor the patient in a controlled environment to guarantee that he is safe all the time

With some drugs, you can get away without any substitute medication while undergoing detox. However, the physician does have to manage the rebound insomnia that will ensue as a result of quitting Ambien.

You may talk to some of the residents in inpatient care about their experiences with the detox and you will get a different answer every time. That’s because there are too many variables that are involved in the process so no two encounters are the same.

DETOXING FROM AMBIEN

It’s never a good idea to self-detox. Some people may have the constitution to stop cold turkey but this could also be dangerous without a medical supervision. As you can see from the symptoms, erratic breathing and heartbeat are among the physical manifestations. The patient with an unknown cardiovascular disease can be at risk.

In contrast, you will be given a battery of laboratory tests to determine prior illness, which will put you at risk during the withdrawal process. Safety is the primary goal of the detox.

Also, you will find yourself among your peers who have similar experience than you. This means they can empathize with what you are feeling and provide emotional support. The doctor will craft a treatment plan according to your own unique needs.

For some patients who have not developed a severe addiction to the drug, the doctor may recommend stopping cold turkey. For others, substitute medications may be involved.

Because Ambien is water-soluble, it goes straight out of your system quickly, with a week the maximum ceiling of detox. With that said, don’t be surprised if some patients will stay under detox for two weeks or more.

Again, each individual is different.

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ESTIMATED TIMELINE OF WITHDRAWAL

Within 8 hours: The half-life of Ambien is short when you compare it to the other opioids and sedatives. Those who are severely addicted to the drug will notice the symptoms within four hours after their last dose. For others, the symptoms will manifest themselves from 4-8 hours.

Within 48 yours: You will feel most of the withdrawal symptoms within a couple of days after your last dose. Rebound insomnia probably has set in so it’s likely that you haven’t had a wink for the past two days.

Within 120 hours: The fifth day is the turning point for most users. This is when the withdrawal symptoms have peaked. Panic attacks, anxieties, rapid heart rate, and mood swings are just among the symptoms you will feel. With no medication, you will likely not be sleeping at this point.

Within 2 weeks: After the peak, the after-effects will taper off. By the second week, your body has already adjusted to the fact that there are already no foreign chemicals in your system.

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Is Detoxing Really Necessary?

Unless you get rid of all the chemicals in your system, your body is always going to seek it. People sometimes equate the lack of capacity by the addicted individual to get rid of his addiction with a weakness in character.

It’s not about willpower.

In fact, we can argue that this thinking is more dangerous compared to somebody who knows his limitations and asks for help from experts.

Those who think they can do it through the sheer will are likely to detox at home. It’s going to be such a burden for your loved ones to have to always understand your situation. Chances are that you are going to lash out at them because of the mood swings and irritability symptoms.

They may take it personally, especially if they don’t understand what you are going through. Also, this would be extremely unfair on their part when they are subjected to mental and sometimes physical abuse over something that’s not their fault in the first place.

The feeling of guilt—along with the suicidal thoughts—can have grave consequences for the individual.

Flushing all that toxins from your body will greatly help you in your path toward staying sober.

Detoxing allows the doctor to monitor all the other associated medical issues while you try to manage the withdrawal symptoms.

For instance, if you have difficulty sleeping while the effects taper off, the doctor can prescribe a substitute drug. A common medication is Valium, which mimics the effects of Ambien. If the doctor feels that you are already dehydrated, he may inject you with some fluids to minimize the health risks.

If the anxiety or panic attacks prove too much, the doctor will also prescribe other medicine to calm your nerves.

What Can You Expect in Drug Detox?

There’s a lot of misconception about drug detox in the way it is depicted in movies. For the most part, you will not be chained to the bed (although this happens in extreme cases and only for your own protection) with padded walls. You will not scream in the middle of the night while doctors will look at you through a small glass hole in the door.

The drug rehab center will make sure you are comfortable throughout the whole process. Most residential facilities are designed like a spa rather than imbibe the clinical atmosphere of hospitals.

First, you will go through what is known as an intake process. Simply put, this is when the therapist or counselor will interview you to get a feel of your own situation.

It’s important that you should be honest with your answers here. The results of the interview will form the basis for the detox treatment plan that will be administered for you.

You will also be subjected to a series of laboratory tests to get a baseline of your health status. You will be placed in a room where the detox process will take place. You may be alone in the room or you will be with several others.

At this point, expect little or no contact with your family. This is to ensure that you will focus on your treatment than being distracted by the emotional connection.

Again, you will not be chained to the bed. After your program for the day, you will be allowed to get out of the room and mingle with the other patients. The detox will only be successful if all the other supporting treatments are present.

In the inpatient rehab, you will also attend one-on-one counseling sessions and group therapy sessions apart from detox. Your food and fluid intake will be closely monitored. Nutrition will be tailor-fitted to give you the nourishment necessary to go on with the detox process.

How Do You Treat Ambien?

Ambien treatment help is available in drug rehab centers through detox and counseling. There are two types of rehab: inpatient and outpatient.

We’ve already discussed the detox process but finishing the procedure is just the first step in recovery. There’s still a long road ahead in your path toward sobriety. It’s not recommended for the patient to go cold turkey, especially if the body has already developed dependence on the drug.

What are Inpatient and Outpatient Drug Rehab?

Residential and outpatient rehab differ in the way they treat the patient, although they have the same purpose, which is to help the individual lick his addiction and lead a life of sobriety.

Residential Rehab – As the term suggests, you will stay in the treatment facility during the duration of the treatment. Your outside contact is limited so you can focus on the issue at hand. While inside the facility, you are expected to follow all the rules and the strict schedule. Any violation will merit a corresponding sanction.

Outpatient rehab – For outpatient rehab, you don’t have to stay inside the facility. You can go home to your family and continue to go to work as long as you follow the regimen and also meet with your counselor at the appointment times.

The rehab center will recommend the type of treatment for the patient following the intake process. For those with severe addiction, it’s strongly encouraged that they stay in the facility because they are most vulnerable to temptations outside.

For patients whose dependence is not as severe, the outpatient rehab is recommended for them.

In terms of success rates, patients who go to inpatient rehab have a greater success in avoiding a relapse. Of course, this is a case-to-case basis.

PROS AND CONS OF INPATIENT REHAB

Pros:

You get 24/7 supervision and monitoring which gives peace of mind, especially in the early days of recovery while you are still adjusting

Trained support staff will be there to always help you

You will be with your peers who are undergoing the same struggles as you. They can also provide emotional and physical support

Medical detox to get rid of the toxins

You can focus on your treatment because outside distractions are minimal

Everything is structured in such a way to help the patient lick the addiction and prevent a relapse

Proven therapeutic techniques

Cons:

You have to sacrifice some of your liberties

Your activities and movements are regimented

You will leave behind your family during the treatment process, which can be hard for some

The cost may be steep

Insurance will not cover all the expenses

You will take an extended absence from work

PROS AND CONS OF OUTPATIENT REHAB

Pros:

You can still live your life with minimal disruption

You don’t have to take a leave of absence from work

The cost is more affordable compared to inpatient rehab

The cost can be covered by insurance with little out-of-pocket costs

Cons:

You are exposed to the same temptations when you are outside

There’s no medical detox for this option

Less success rate compared to inpatient treatment

The treatment program is not as immersive

What Can You Expect in the Drug Rehab Process for Ambien?

Ambien treatment typically ranges from a low of 30 days, to a high of a 90 day inpatient drug rehab program on average. One characteristic of this drug is that even though it’s as not as addictive compared to opioids or benzos, it takes longer for the physician to cut the dose for the patients before totally taking them off the drug.

Historically, those who are addicted to Ambien typically have a polydrug problem. This means that they are also taking other drugs in combination with the sleeping pills. This makes the treatment process much more complicated.

As already mentioned, outpatient rehab is best for patients who only have a mild dependence on the drug. With advice and the patient’s cooperation, the doctor can taper off the dose until such time the body is clean. Ambien abusers may have to attend group counseling sessions or therapy groups outside of the facility several nights a week, as long as they don’t clash with your work schedule. The rehab center should have a list near your community.

For inpatient rehab, you will be told to leave behind your worldly possessions as you enter a place of refuge. You will be provided with a checklist of what and what not to bring. Besides, before you are escorted to your room, your belongings will be checked by the personnel. Prohibited items will be turned over to your family.

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PACKING FOR REHAB TREATMENT:

When you enter the rehab center, you are only advised to bring on what you need.

You can’t bring in your mobile phone but only a list of addresses and numbers to contact while you are inside

If you have maintenance medicine, you can bring that with you as long as it’s still in the bottle. You are also required to bring the prescription that authorizes you to carry that medicine around

Cash but only in small amounts. There should be vending machines inside the facility which you can use your loose change for.

Your checkbook, ATM, or debit and credit card

Identification cards (driver’s license, employee’s card, etc.)

Healthcare insurance policy

A journal

Your wedding ring or a watch but you can’t bring too many pieces of jewelry with you

Reading materials (rehab centers differ in their policy on what the patient can bring)

Personal hygiene kit

Clothes to bring:

Sexy clothes are prohibited so you have to be modest in the way you dress

Plunging necklines and short mini-skirts are not allowed

Don’t bring in your whole closet because you will have limited space inside the room

Tennis shoes or comfortable footwear

Sandals or flip-flops

Socks and undergarments

Jacket or sweater

Bathing suits (no bikini)

Pajamas

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Despite the misconceptions, inpatient rehab is not a prison house. With voluntary treatment, you can leave anytime you like. Of course, that’s seriously discouraged because it can set back your recovery. However, with committed rehab, you will be required to follow through with your treatment if you don’t want to face the full wrath of the US justice system.

In fact, rehab centers actually don’t have locks on the rooms of the patients so that personnel can check in on them from time to time. You are not detained inside.

  What is Dual Diagnosis?

A co-occurring mental health can also be a problem with Ambien and polydrug abuse. The National Alliance on Mental Health defines dual diagnosis as a condition where the patient is simultaneously dealing with both the substance abuse and mental illness.

This condition is much more common than you think. In fact, the 2014 survey by SAMHSA revealed that that nearly 8 million people are struggling with co-occurring diseases. There’s a wide range of effects resulting from the drug abuse. Sometimes they overlap with the mental illness, which makes it very hard to spot for an untrained professional.

In most cases, it’s almost impossible to determine where one begins and the other ends, or which is causing the other.

There are several red flags that you can watch if the patient is already suffering from mental illness:

When the patient no longer cares about his appearance or hygiene

The patient is irrationally anxious or scared

The patient is depressed or lethargic

When the behavior change is so extreme

The patient isolates himself from his family and friends

The patient skips work and school, and even family reunions and gatherings

Difficulty comprehending even the most simple of instructions

Can’t hold a conversation down for prolonged periods

The patient no longer sleeps or he’s always sleeping

The patient is losing or gaining massive weight

The patient is experiencing delusions and hallucinations

The patient is extremely aggressive

Suicidal thoughts

It’s not uncommon for people with mental illness to turn to drugs or alcohol. There are an estimated 17.5 million people who are 18 years old and older who suffer from a serious mental illness. Nearly a quarter of that total is struggling with dual diagnosis.

People struggling with a co-occurring disease hardly get treatment, with 4 in 10 of them getting intervention but only for one condition. Only about 5 percent of them are actually receiving treatment for dual diagnosis.

Also in most cases, dual diagnosis patients seem to be functioning well. They have good careers, good families, and a healthy social life. This is why everybody will act surprised when the patients start to unravel.

How Do You Treat Dual Diagnosis?

Dual diagnosis caused by Ambien polydrug abuse can be treated in several ways. The crucial thing is early intervention to ensure help is made available at the onset. The mental illness and substance abuse are treated simultaneously. However, in most instances, the patient has to be cleansed from drugs first before addressing the mental disease.

The treatment plan will depend upon several factors—the severity of the addiction and the co-occurring disease, response to treatment, and the unique circumstances of the individual concerned. However, the programs in mainstream drug rehab centers do follow a certain trajectory. Below are some of them:

Detox – As already mentioned, you need to get rid of the toxins inside your body first. Detox is the primary procedure to achieve this goal. You will be administered substitute drugs to taper off the effects of Ambien or other opioids. During this process, you will be monitored 24/7 to ensure your safety while you go through the withdrawal symptoms.

Counseling and therapy – After detox, you will have to undergo therapy to get through the underlying cause of addiction. It’s only rare that persons will develop a substance abuse without some motivating reason. The same goes for mental illness. Although genetics may play a part, there’s usually a triggering factor that precipitates the symptoms to manifest themselves. He will also be taught coping mechanisms to ensure he doesn’t relapse when he goes out of the facility.

Medication – Extreme anxiety may need some medication to be managed. But this will be done under the close supervision of the doctor. In some cases, however, the patient will have to take maintenance medicine for the rest of his life.

Support groups – Support and community self-help groups often operate outside of the purview of the treatment centers. However, you will be referred to a group near you. They serve as emotional supports as you try to navigate your way through life without the crutch of drugs or alcohol. The members often have the same experiences as you so they can relate and empathize with your experiences.

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PRINCIPLES OF TREATMENT

Not much has changed since the 1970s in terms of treatment programs for drug addiction. But there’s a reason for that, and the simple fact is that they work. What are these principles adopted by rehab centers for an effective treatment?

Addiction is a treatable condition, even if it’s a very complex disease

Addiction affects both the biochemicals in the brain and the person’s behavior

Treatment methods are not generic but are tailor-fitted for the individual’s needs

Access to treatment should be made available to everyone

Early intervention is a good determinant of success

Treatment program should address not just the drug dependence but also the underlying causes

Behavioral therapies and counseling are essential to treatment

Length of treatment will boost the chance of success

Medications may sometimes be necessary

Treatment plans should be assessed and reassessed in relation to the patient’s progress or lack thereof

Detox may be necessary

Treatment should also include co-occurring disorders

The patient doesn’t need to volunteer for the treatment to be effective. However, the full cooperation of the patient will greatly increase the success

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What are the Therapy Methods Used in Inpatient Treatment?

Rehab centers employ different psychotherapy models to fit the needs of the patient. Unfortunately, there’s no magic potion that will dramatically treat the patient. The doctors have to find out which therapy that the patient best respond to.

Here are just some of the examples:

Cognitive Behavioral Therapy (CBT) — This model employs behavior and cognitive paradigm. The main goal is to help the patient recognize the feelings, beliefs, and experiences that are clearly irrational for most people but are very real to them. The therapist will then try to determine how much of these feelings and belief is contributing to the dysfunction. By changing the cause of these irrational thoughts and feelings, the patient may be able to leave behind the addiction.

Dialectical Behavior Therapy (DBT) – DBT is still based on the principles of CBT. This is employed for patients who are dealing with several issues at once. Some of these issues are complex enough that other forms of therapy may prove to be ineffective. Apart from one-on-one sessions, group therapy is also recommended.

Gestalt Therapy – Developed by the husband and wife team of Fritz and Laura Perls, this type of therapy takes some of the principles of the humanistic model. The therapy is focused on the individual’s experiences at the time when he’s in therapy, as well as the social dynamics that impact on the behavior and actions. The individual should be made to realize that he’s ultimately responsible and accountable for his actions. Guilt should be taken out of the equation.

Eye Movement Desensitization and Reprocessing (EMDR) – Apart from the principles of CBT, the therapist will also integrate the neurobiological model. Just as the name suggests, the patient will follow motions with their eyes. In theory, these hand and eye movements will help improve the patient in therapy. They will also be exposed to triggers in order to confront the source of their anxieties.

Didactic Therapy – Those who will undergo didactic therapy will be surprised by the classroom-feel of the sessions. You will be with your peers to enhance interpersonal skills. Psychological treatment principles will be shared in a form of a lecture. Among the things you will learn are the damaging effects of substance abuse, relapse risks and prevention, coping mechanisms, anger management, and other experimental methods such as meditation, yoga, and relaxation.

Creative Arts Therapy – You will be asked to express yourself through various medium. This is experiential as you experience various stimuli for a specific purpose. Included in this umbrella therapy include music, dance, art, or garden therapy.

Contingency Management Interventions/Motivational Incentives (CMI) – The idea is to provide the patient with tangible incentives in order to effect a positive change. For instance, for every time that you pass a drug test, you get a free voucher. In another example, inpatient residents will have a chance to win a prize when they enter a raffle with their urine serving as the ticket.

Motivational Enhancement Therapy (MET) — This has a short window, usually around four sessions or so. Basically, the person is guided to have a self-motivation to effect change within himself. Historically, the patients who engage in self-harm benefit most from this type of therapy. Also, they will learn how to view a certain trigger more objectively rather than letting it affect him emotionally enough to cause stress.

Hynotherapy and Psychodrama – Hypnosis is utilized so the patient will enter into a heightened state of awareness. The therapist will then guide him to thresh out the issues that may have contributed to the addiction. The ultimate aim, of course, is to ultimately change their behavior and thoughts for the better.

Psychodrama, meanwhile, will give the patient an opportunity to explore their internal issues by acting out their feelings. For those with a stage fright, the scenes can be acted alone with the psychotherapist acting as the director. A variation of this is called the Narrative Therapy, which instead help come up with stories based on the personal experiences of the patient.

Traumatic Incident Reduction (TIR) — The patient is asked to relive and revisit the past traumatic event in the hope of changing the way he views these episodes that shape the individual that he has become. This is done under the supervision of an experienced therapist and always in a safe environment. Some events can leave very deep scars that it will take several sessions for the patient to even start talking about them.

Organized Recreation Therapy – Sports, games, and camping are just some of the events that will be organized by the rehab center in order to get the patients to develop a more positive outlook in life. They can develop friendships or bond with their peers. Hopefully, they will see that the world is not so bad, after all. This type of therapy is especially geared for younger patients.

Animal Therapy – You can’t deny the positive impact that pets have on the lives of their owners. This is the principle behind this therapy model.

The Matrix Model – Often used for intensive outpatient treatment, this integrative therapy program is often used for meth or cocaine abuse. It’s a mix-and-match of treatments such as the CBT, 12-step process, family therapy, and motivational therapy. However, only the most effective aspects of these therapy models are incorporated into the Matrix model.

Behavioral Couples Therapy – This is those for those who attend a couples drug rehab as a pair and want to receive treatment together. Behavioral Couples Therapy (BCT) purpose is to build support for abstinence and to improve relationship functioning among married or unmarried partners seeking help for alcoholism or drug abuse.

Sleeping Disorder Ambien

How Can You Manage Your Sleeping Disorder Without Ambien?

For people who are having trouble with their sleeping routine, there are some steps they can do in order to manage their snooze time. Hopefully, their situation is going to be better and they don’t have to go to the doctor to be prescribed with Ambien.

Don’t stress too much – Stress is a killer, literally. It’s been linked to so many preventable diseases that finding time to de-stress will save you a lot of heartache and money later on in life. Among the stress killers are meditation and yoga, exercise, massage, or getting away from the source of the stress. This may include your co-workers, acquaintances and even family members who are aggravating.

Program your internal clock – We all have our internal clock. Some people can have deep sleep in the morning and fitful slumber at night. Others work the other way around. However, we can actually condition our body to get ready for sleeping. But you have to stick with your schedule for bedtime. You can’t change it for any reason whatsoever.

Take out all the distractions – Get the TV out of the room. Turn off your mobile phone and your laptop. Blacken out the room by hanging dark and thick curtains to block out any kind of light outside. Experiment with music if that will get you drowsy.

Eliminate caffeine and sugar from your diet – Stop drinking coffee or soda as they will affect your sleeping pattern.

Don’t drink alcohol – Unless you get stone drunk, alcohol will actually mess up your internal clock. If you don’t drink enough, you may even have trouble sleeping. The only alternative is to drink yourself to sleep but we all know that’s a very dangerous pursuit.

Get therapy – If you just notice a change in your sleeping pattern, there must be something that triggered it. Anxiety and stress are contributory factors to insomnia. If you can address those issues then maybe you will also resolve your sleeping disorder.

Can You Still Stay Sober After Ambien Addiction?

Ambien is not as devastating to your body compared to the other opioids and benzos out there. In fact, the worst of the withdrawal symptoms should taper off by the second week after you stopped taking the drug. However, your mental dependence will still continue even after completing the treatment program offered by the rehab center.

The good news is that there’s a high success rate for patients who underwent inpatient rehab for their Ambien addiction. That means rehab centers are not actually reinventing the wheel in terms of treating your problem.

Each person responds differently to treatment, of course, so the timeline may vary. The important thing is that the mode of treatment recommended for Ambien addiction is typically successful.

What are the Alternative Drugs to Ambien?

America is getting more and more dependent on sleeping pills. For Ambien, for example, as many as 38 million prescriptions were written for the drug between 2006 and 2011. According to estimates, about 9 million people in the US take sleeping pills before turning in for bed. Meanwhile, 1 in 10 of Americans is estimated to be suffering from a sleeping disorder.

There are several medications that are prescribed in lieu of Ambien. This is not to say that they are less effective but these are also medications that are also being prescribed for insomnia:

Restoril

Xanax

Lunesta

Sonata

Rozerem

Silenor

Both Lunesta and Sonata are similar to Ambien in the fact that they are also sedative-hypnotics. They also have the same side-effects along with the addictive risks. They are also prescribed for short-term use.

Both Xanax and Restoril are classified as benzodiazepine. They have a higher risk for abuse, however, compared to Ambien. They also have more side-effects.

Rozerem, meanwhile, is classified as a melatonin receptor agonist. It can leave you impaired the morning after, however, so be careful about driving. Silenor can cause short-term memory loss and blackouts.

For over-the-counter medicines, you can buy antihistamines even without a prescription and they can aid in getting you drowsy but only in moderate cases. The good thing is that you can’t abuse anti-histamines.

What Holistic Approaches that Can Substitute for Ambien?

In order to wean a whole generation of sleeping pill dependents, there are other alternative methods that can help you sleep. Below are just some of the proven methods that can help an individual get drowsy.

Melatonin — Supplements containing melatonin can help individuals fall asleep. Melatonin is actually a natural hormone produced by our body that will prepare us to bed. The supplements are available in capsule or liquid form. You can buy it over the counter even without prescription.

Unfortunately, our habits are hindering our brain from producing melatonin. These bad habits include watching TV before going to sleep, playing games, or tinkering with your phone. However, this is not recommended for long-term use.

Lavender oil – Lavender oil and patches will improve your sleeping habits. Just smelling lavender-scented products before going to sleep will result in a deep sleep. Even the elderly population has reported the beneficial effects of lavender. This is a trick that is actually embedded in the Eastern culture. Not only will it help you sleep better, it will also improve your blood pressure.

Valerian Root – Valerian is a plant that is native to Asia and Europe, although you can find it in North America, as well. Its root has been proven to have medicinal properties that can help people suffering from insomnia. However, it does have some side-effects as some people have reported of feeling slightly dizzy or sleepy in the morning.

Warm Glass of Milk – You probably heard this advice from your mom or grandmother, to drink a warm glass of milk to help you sleep better. Fortunately, it’s just not some fishwives’ tale. There’s actually a science behind drinking milk because it contains the tryptophan, which is a type of amino acid that promotes sleep. The chemical will trigger the production of serotonin, which is the brain’s natural sedative. For best results, pour some honey to the milk.

Exercise – Getting some sweat on may help get rid of all those stress, which can interfere with your sleeping routine. Also, an added benefit is that going to the gym may just tire you enough that you go straight to bed afterwards.

Soak in a tub – Getting a warm bath will relax your muscles and trick your brain into thinking that you are sleepy. The typical temperature for a warm bath is between 98 and 100 degrees Fahrenheit. However, you can crank it up to around 112 degrees for best results. You should soak for around one hour and thirty minutes to two hours before turning in for bed.

Noise machine – Instead of music, static noise and sounds depicting nature can improve the quality of sleep. For example, the sound of rustling leaves, or the waves lapping at the shore, or a brook with the chirping of birds in the background will provide a soothing environment. There’s also such a thing as a “pink noise,” which differs from a white noise. The pink noise has been proven to promote sleep.

Meditation – Meditation has been practiced for millennia with countless benefits to the mind and body. For this exercise, you should shut off your phone, TV, and other gadgets for around one hour before going to bed. Then you can start meditating. There are plenty of instructional videos on YouTube that you can follow early on. An alternative would be to take meditation and yoga classes and learn the moves so you can do them in the comfort of your own home.

Light Therapy – Light therapy has been helping insomniacs for years. Apparently, it will help reprogram your Circadian rhythm and help you get better sleep at night.

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WHAT IS THE CIRCADIAN RHYTHM?

Circadian rhythm refers to our body’s internal clock. To put it simply, this is your natural cycle of sleeping and waking times. For example, have you noticed that you are sleepy at certain times of the day? That’s your brain telling you about your Circadian Rhythm.

If you are a regular adult, you would feel sleepy between 12 to 2 p.m., which is your body informing you that you need a nap. Of course, for most of us, we get drowsy at night. This is why we say it’s way past our bedtime. Some people are nocturnal and some are a morning person so their Circadian Rhythm is the opposite of each other.

When you have enough sleep, you don’t really notice all these peaks and valleys of your internal body clock. It’s when you have insomnia when you really feel the difference.

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Of course, Cognitive Behavioral Therapy can also help the patient cure insomnia by identifying the sources of triggers that may have hindered their ability to sleep. Sometimes, Ambien has become a crutch. Even if you are not addicted, the mental block is so great that you really believe you couldn’t sleep without the sleeping pill. In effect, your mind has become conditioned to depend on the drug.

Should You Worry About Your Ambien Dependence?

If Ambien dependence already impairs your ability to function, then that is something to worry about. What’s more concerning is if you experience blackouts after taking the sleeping pills because you are exposing yourself to unnecessary risks.

You should always talk to your doctor regarding your apprehensions and experiences. Ambien and other sleeping pills are designed as a stop-gap measure. What you should do instead is to make sure you resolve all the underlying causes of your insomnia. This is the only way to address the problem permanently.

Can You Buy Ambien on the Streets?

Unfortunately, some of these sleeping pills do end up being trafficked on the streets. The scary thing is that they are accessible to kids who don’t know any better. All they think is that it’s cool to be doing drugs without really realizing the consequences of their actions. You have drugs mixed with alcohol and other illicit substances and that can create a deadly cocktail.

Ambien actually has some street names are Tic-Tacs, Zombie Pills, No-Go Pills, and Sleep-Easy, among others.

We are not going to say how much each pill costs on the streets. Suffice to say that they are more expensive than the tabled price on the pharmacy shelves. However, as illicit drugs go, Ambien should be the least of the worries for parents. There are more hard-core opioids out there such as heroin or fentanyl that can really wreak havoc on one’s life.

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How Do Prescription Drugs End Up on the Streets?

The question is that if doctors are highly regulated, how do these sleeping pills and other prescription drugs end up being peddled on the streets?

Indeed, part of the blame could be pointed at the physicians themselves. Some doctors are too lax in the way they prescribe the medicines. But the system itself is designed with a lot of loopholes that drug dealers take advantage of. For instance, doctors are swamped with patients on a  daily basis that they can sometimes make mistakes.

You can’t also deny that some doctors are blinded by the prospect of making money on the side by prescribing pills intended to be sold on the streets.

Drug dealers are also engaged in forum shopping. They fake the hospital results and get prescribed for their so-called pain. If one doctor will refuse, they just go to another doctor and so on and so forth.

Finally, the system in place is too slow to detect an anomaly. While the DEA is tasked to monitor the doctors, sometimes they come in too late.

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  Is Rehab for Ambien Expensive?

Going into rehab will cost you. That’s why just keep away from any type of addictive drugs. For instance, just for detox alone will set you back around $5,000 to $10,000. The expenses will accumulate the longer you stay under detox.

Outpatient rehab, meanwhile, is etimated to cost around $5,000 to $25,000 for the duration of the 90-day program. However, it can shoot up over $35,000 for luxury centers.

As you can imagine, inpatient treatment facilities will cost more. The 30-day program will cost around $20,000. Just multiply that by three if you are entered into the three-month program. Luxury centers may ask as much as $30,000 to $60,000 for a month-long program.

We are not even counting the maintenance substitute medications that may be prescribed to help taper off the effects of the chemical substance you are addicted to. For instance, if you are a heroin dependent, you will spend thousands of dollars for the first year of recovery alone.

If you have no extra money lying around, this will really hurt your household budget. That’s because you don’t just worry about paying for rehab, you also have to think about your basic necessities at home.

What is Obamacare and How Can it Help Your Drug Dependence Problem?

Fortunately, the laws have been changed to cover rehab and mental illness in health insurance. This was guaranteed by the Patient Protection and Affordable Care Act (ACA) signed by former President Barack Obama. Initially, it was designed to cover around 5 million people without insurance who need help with their addiction.

However, the government may also subsidize your treatment as long as you qualify. One of the main criteria is that your household income should fall below 400 percent of the poverty rate at the federal level.

There’s a FAQ website which explains further the benefits under the Obamacare in relation to substance abuse and mental illness. Among the treatments covered in insurance are counseling, psychotherapy, behaviorial therapy, inpatient and outpatient services, and treatment for drug and alcohol addiction.

What the Obamacare did was to lift the limits set by the insurance companies on addiction and mental health coverage. Basically, the discriminatory provision was struck out. Insurers may still set limits but the levels should be equal to the other medical and surgical services they are already offering.

Also, insurance companies are prohibited from slapping more charges on pre-existing conditions. This means occurring disorders like mental illnesses that come along with the substance abuse.

The insurance companies have already included in the insurance marketplace the five basic Obamacare-sponsored health plans.

Platinum Plan – The Platinum Plan will cover 90 percent of the expense with the rest coming from out of pocket

Gold Plan – The Gold Plan will cover 80 percent of the expense

Silver Plan – Silver Plan will pay 70 percent of the costs

Bronze Plan – The Bronze Plan will cover 60 percent of the total treatment cost

Can I Go Into Rehab Even Without Insurance?

Fewer than 10 percent of people with an addiction problem is actually seeking treatment. While denial that they have a problem in the first place is right up there in the list of reasons, we should add there the prohibitive cost of rehab.

There are around 44 million Americans without insurance coverage. That’s a very high number that should worry the healthcare system. However, it’s a discussion that should be set for another day. What’s important is that around 14% of Americans might not be able to afford rehab on their own. We are not even counting the other 38 million whose health insurance remains inadequate.

With that said, there are some creative ways you can still enroll in a treatment program even without coverage.

Here are some of them:

Financial Plans – Most rehab centers have their own built-in financial plans for patients who could not afford the steep payment. The fact is that most addicted individuals are strapped for cash because it’s highly unlikely that they lost their jobs and savings to feed their addiction.

Some partner financing institutions also offer financing programs. It’s basically a loan with a friendly repayment plan that will allow you to get treatment but still have the financial flexibility to repay the obligation later on. One example is that you don’t start the payments until after you have graduated from the drug rehab program.

Borrow Money from Relatives – If you have some rich relatives around and are willing to help, this is a good idea to avoid paying the interest rates incorporated in the loans. In some ways, the family member may even defer collection until you can hold down a job and received your salary. This is probably the best case scenario so count yourself lucky if this situation applies to you.

Government Subsidy – As already cited, you may be able to qualify for subsidized treatment from the government as long as you fall within the poverty level criteria. You can go to this federal website to determine if you are qualified.

Non-Profit and Charity Groups – Some Rotary organizations and charity groups have anti-drug programs which may cover the cost of treatment. Ask from the religious organization near you or from your city offices for some leads. Naturally, there’s going to be some competition for the privilege of being financially supported. You may also be required to pay back in terms of sweat equity or community service. For instance, the Salvation Army has a drug-rehab assistance program designed for the indigents.

Pass the hat – Colleagues and family members can pass the hat for donations in order to raise money for your treatment. Another option is to open a garage sale to raise money. You can also open a GoFundMe page, although your story needs to be gripping for people to actually part some of their cash to help your cause. Here’s an example of a GoFundMe page. Granted that it’s still far away from its goal, you get the idea.

Sweat Equity – If you have some special skills, you can offer them in exchange for cash to fund your treatment. If you know carpentry, for instance, or fix a car, these are tangible skills that you can use to raise money.

What Type of Treatment Facility Should I Choose?

There are three types of treatment facilities that you can choose from. These are the luxury, executive, and standard rehab.

Luxury rehab is an inpatient residential facility that will pamper the residents while at the same time help them manage their addiction. If you have money, this is exactly where you want to be. This is the option for celebrities and affluent individuals who can afford the lavish service. Among the amenities include swimming pools, saunas, fitness centers, room service, massage therapies, private rooms, personal butler, gourmet food, and 24/7 security. You will essentially get a personalized treatment for your money.

Executive rehab, meanwhile, is one-rung below luxury rehab. The amenities are also considered high-end. It’s especially designed for CEOs, professionals, and businessmen who are busy with their time and could not afford to leave behind their businesses or companies.

While the program is inpatient in nature, communication remains open for residents. The patient may leave the facility but with an escort. Meetings can be done in private via video-conferencing or messenger apps. Residents are also allowed to write and respond to email.

Finally, you have the standard rehab, which is a dime a dozen in the US. There are more than 14,500 rehab facilities in the country, which are not enough to accommodate the number of addicted individuals.

With standard rehab, you get what you pay for. The amenities and facilities are quite standard so don’t expect some special treatment. In some facilities, you will room with other residents instead of getting your own private quarters.

How to Choose a Rehab for Your Ambien Addiction?

Without taking into account the cost, there are some minimum yardsticks that will determine a good rehab center.

Trained and certified personnel – You will be entrusting your care to virtual strangers. At least they should know what they are talking about. All the staff, from the head counselor or physician down to the nursing assistant should have the necessary authority to dispense knowledge and expertise.

Dual Diagnosis treatment – You don’t want to be moving from one center to another because of inadequate proficiency to treat dual diagnosis. This should be clear even before you agree to avail of the treatment services.

Success rate – The drug rehab center should have a high success rate in terms of helping its patients toward sobriety. They center should also be willing to share any government rating or awards it may have garnered over the years which speak of the quality of their service.

Aftercare services – The rehab center should have available aftercare services of, if not, an extensive network of groups offering post-rehab support.

The location of the rehab can be crucial in your treatment. For some people, they are more comfortable about a new beginning so they choose a facility outside of their state, away from the sources of temptations and distractions. Others want to be closer to their family and although contact is limited, at least they know that their wife, children and parents are nearby.

  What is the Relapse Rate for Ambien?

Unfortunately, there is no study that establishes the relapse rate for Ambien. However, the risk of relapse is very high in the first year after finishing the rehab program in the treatment facility. The relapse rate for drugs in the US is around 40-60 percent. The rates do go down when you survive the first year. The turning point seems to be after the fifth year. If the patient remains sober for 60 months, then it’s almost a guarantee that he’s going to be sober for the rest of his life.

However, if you engage in binge drinking apart from your Ambien addiction, the rehab center will also make sure to clear your system of alcohol. The relapse rate for alcohol is much, much higher. According to the National Institute on Alcohol Abuse and Alcoholism, 9 in 10 of individuals with alcohol abuse disorder seem to fall off the wagon within four years after treatment.

If you are also combining other drugs with your Ambien abuse, those have to be addressed as well. You can relapse in many ways, which can complicate your situation.

It should be noted, however, that Ambien users who went through intensive outpatient or inpatient treatment programs experienced a high degree of success in terms of recovery. This could be due to the fact that as far as drugs go, Ambien has a low potential for abuse. In that case, it’s not hard to presume that the relapse rate for the drug is quite low, as well.

  Should You Travel Out of State for Drug Rehab?

Should You Travel Out of State for Drug Rehab?

Some people deliberately choose a rehab center out of state for their Ambien rehab treatment. Finding a rehab center that fits you is like looking for a house. While there are some boxes that need to be checked as far as standards go, you have to feel comfortable with the facilities and the staff. For residential treatment, you will be there for long periods. The success of the treatment will depend upon the cooperation of the patient and you can’t expect to entrust your recovery to people you are not comfortable with.

Traveling for rehab is actually an option that can speed up the recovery of the patient. Some rehab centers have branches from all over so they can refer the patient to any of those facilities for continuity’s sake.

Getting far away from home could be the best thing for your recovery. This is not for everybody, of course, because some people draw comfort from the fact that they are close to their family.

PROS AND CONS OF TRAVELING FOR REHAB

Advantages of traveling out of state:

You can focus on your recovery – Sometimes it’s a mental thing. It’s like cutting the cord that connects you to your home—and the psychological barrier that it represents—which then allows you to just focus on your treatment. You are also far away from the sources of temptations that might have contributed to your addiction in the first place.

  Your privacy is ensured – Let’s face it, the stigma of drug addiction still exists. Some families might consider it an embarrassing secret, which is why they try to hide it in order to keep their reputation and good standing in the community. With that said, more and more people are becoming more accepting of the fact that addiction is a disease and sometimes it’s not the individual’s choice.

  You will have safety – Drug trafficking is a nasty business and lives have been lost to ensure these traffickers can continue their trade. We are not saying that all individuals who took Ambien are involved in the illicit drug trade but the threat is real. These people will do anything to protect their identities and escape the long arm of the law.

  You have more time for introspection – Nobody ever claims that drug treatment is easy. The recovery is a very difficult process and it takes a lot out of the patient to look within himself, under the guidance of the therapist, on why he finds himself inside the facility. Being near home may result in too many distractions.

  Disadvantages of traveling out of state:

It’s more expensive – The obvious disadvantage is that it’s going to cost you more when you seek treatment from out of state. Your insurance won’t cover the associated costs. For outpatient programs, you need to rent a hotel room for the duration of the treatment. You need money to cover your food and other basic necessities.

You are far away from family – The biggest strength for traveling out of state is also its biggest weakness. Recovery is a lonely battle. Even if they are surrounded by the support system, the patients may still feel that they are battling the demons on their own. Drug rehab centers allow for limited contact after a few weeks so at least you can see your family when they are nearby. This may not be possible with out-of-town rehab, especially if you are already strapped for cash.

Is traveling out of state to seek treatment a worthy proposition? There’s no right answer because each person is different. This is a very personal decision, one that you should be talking with your family after weighing the pros and cons of traveling for rehab. If you recently searched “drug rehab near me” looking for an inpatient drug rehab call the addiction helpline and get help now.

How are Teaching Life Skills Crucial to Your Recovery?

While detox and counseling are an integral part of the Ambien treatment, one critical component of the drug rehab program is teaching life skills to prepare you for the life outside.

The elements may vary but the life skills you will learn inside the drug facility are broken down as follows:

Decision-making skills

Coping skills

Social skills

Mental and physical health

Anger management

Job application and retention

  Decision-making skills

Going down to the foundational theory of the program, the patient will learn to be responsible for his life and accountable for his actions. He will learn the daily tasks that most people have to perform just to get through the day. It’s more of reinforcement because they might have forgotten these daily tasks when their minds were clouded by the effects of drug addiction.

They have to understand that every decision will have corresponding consequences, and sometimes the results may not be always to their liking. The important thing is to roll with the punches because even the best-laid plans may go awry.

Personal Space

Even inside the facility, they will be responsible for their own personal space. They will make their bed in the morning, clean their rooms, and organize their belongings. What they will learn is the importance of a routine. While most people might find the routine to be boring, recovering patients need structure and routine as a distraction. This will help them withstand those low days when the cravings hit.

Job Application and Retention

Part of being responsible is being able to earn for yourself. A good number of drug dependents have lost their jobs because they were more concerned about feeding their addiction. They have to relearn financial responsibility. When they leave the facility, they are going to send applications as they make their way back to the real world. Fortunately, drug rehab centers have partner organizations and business chambers that will give recovering patients a second lease at life. City offices also have programs precisely for this purpose.

Coping skills and anger management

A good part of counseling and therapy is to teach the patient the necessary coping skills so they can handle stress the right way. Hopefully, with anger management lessons, they will be able to refrain from lashing out at the people surrounding them when the stress proves too much. The important thing is to make sure the patient will not go back to his old ways and stay clean for the rest of his life.

Mental and physical health

The patient will learn the importance of making sure the body is always healthy. One side-effect of drug addiction is that it takes away your body’s natural production of dopamine and endorphins. It takes time for your system to get back to normal. But you can accelerate the process through exercise, proper nutrition, and natural supplements. Also, securing that gym membership will be a good investment because not only will it will keep you fit, it will also give you something to do with your spare time.

Social skills

People with a substance abuse problem tend to isolate themselves mainly out of guilt. However, they also don’t want to be subjected to a lot of judgment or pity. This is a matter of perspective, of course. While they think that they are being judged unfairly by their families, they will realize later on that it comes from a place of concern and love. Before they go out to the real world, they will relearn social skills so they can develop newfound friendships that can help them on their path toward recovery. It’s not an option for them to link with old friends who have enabled their actions that contributed to their problems.

Is the Aftercare Program Really Important for Ambien Recovery?

The aftercare program should be discussed with your counselor. This will make the transition easier for you when you complete the inpatient drug program. One drawback of staying in the facility is the expected shift in the environment from the safe confines of the center and into the messy real world where there are plenty of emotional triggers that can push you back to your old habits.

The relapse rate for drug addiction is between 40-60 percent in the first year so the odds are stacked against the recovering patient. You need all the help you can get when you go out in the real world. This is where aftercare services will come in.

What are the major types of aftercare services?

12-Step Program – Developed from the concepts started by Alcoholics Anonymous, the principles of the 12-step program has hardly changed since it was first introduced in the 1939 book, “Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.” There are several community groups that offer this service for free. The important thing is your commitment and resolve to follow-through with the steps.

Family counseling – With drug addiction, the family is often overlooked as treatment is focused on the patient. But the family members also need to also address the trauma that they might have suffered. We always expect them to be there to provide emotional support for the patient without realizing that they, too, have to come to terms with their own feelings and issues.

Continuing counseling and therapy – Counseling and therapy don’t end when you leave the drug rehab facility. Relapse risk is very high in the first year, that’s why you need a lot of help to make sure it doesn’t happen to you. You can arrange with the drug rehab center for continuing counseling. However, there are also community and religious organizations that offer this service.

Sober Living – Sober living homes serve as a halfway house for recovering patients who might not feel ready enough to go back to the real world. In Sober living homes, they will earn life skills to ease the transition. The restrictions are not as strict compared to drug rehab facilities but they are also expected to be responsible for their personal space or the house. This means they have to do some chores. Meanwhile, residents are also encouraged to go to school or enroll in a vocational course to prepare for their lives outside.

Drawing Up Your Own Aftercare Program

With the help of your counselor, you need to draw up your personalized aftercare program based on the following principles:

Preventing a relapse. Each person is different and we all respond to different stimuli. The relapse prevention program should be laid out even before you leave the center’s doors

Linking up with support and self-help groups. Rehab centers have an extensive network of non-profit groups that can provide emotional support and advice to the recovering patient. Narcotics Anonymous is one such group but church-based organizations also adopt the same support principles to help you.

Following-up on appointments. You may be required to still see your counselor even after your Ambien treatment program is already finished.

Sober living house. But only if it’s necessary. This could be recommended by the counselor after assessing your progress or you can request to be sent to one if insecurities are present.

Random drug tests. Of course, you personally know that you are still using or not but this program will provide tangible goalposts because the tests could be done bi-monthly, monthly, quarterly, and bi-annually.

Constant monitoring. You will remain in constant communication with the staff and the counselor through Skype, email, and phone call. This is also important so you can be updated on the new technology or procedures in relation to treatment.

Where Can I Get Help for the Ambien Addiction?

The first step is recognizing that you need help in the first place. Your personal physician or the doctor who prescribed to you the Ambien may refer you to a treatment facility. Most doctors are comfortable providing advice on screening and possible treatment programs near you. The American Academy of Addiction Psychiatry website provides the information on where you can get help. The National Drug Helpline has a toll-free number that you can call. You can call the helpline 24/7 and be assured that somebody will pick up the phone.

The Recover also has a dedicated page to alcohol and drug dependent who want to get some help. You can visit their website here.

The best thing about it is that your privacy is protected. Nobody will share your information without your expressed permission.  Also, the counselor on the other line will not pressure you into going to the rehab right away. They are there to lend an ear if you want to talk about your issues or if you want to make some inquiries. You can hang up the phone anytime. It’s really up to you.

Even if it’s not you who has the problem, you can still call the helpline and ask for some guidance on what to do. Helping somebody struggling with a substance abuse is very difficult. Unfortunately, addicted individuals have learned to be very manipulative. They will find a way to make it your fault. They will lie and they will say anything to get you to back off.

We can understand why some people hesitate about seeking help. Getting sober takes an enormous amount of work and commitment. You can’t quit halfway because you are back to square one. What you need to understand is that you will always struggle with the cravings and be exposed always to temptations. The important thing is how you respond to those triggers. The drug rehab centers will not provide you with the magic bullet that will automatically eradicate the cravings. What they will do instead is to teach you how using proven methods and scientific techniques.

The good news is that help is available.

Contact your insurer to compute the co-pay, deductible, visit limits, and your out-of-pocket expenses. In this way, you can set aside a budget for the Ambien treatment. If you have no insurance, don’t give up hope just yet. There are some creative ways you can do to cover the costs. Veterans can link up with the US Department of Veterans Affairs for financial support programs to treat addiction. You can walk away from the treatment without paying a single centavo.

It’s a great misconception to think that only drug dependents who seek help out of their own accord would be the only ones who will have a successful rehab treatment. Even those who had to go through rehab due to an intervention from family members will also have a chance of recovery. The treatment programs today are miles better compared to just 10 years ago.

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Helping Someone Who Is Struggling with Ambien Addiction

We may hesitate to lend our assistance or advice to somebody if we think that our help is unsolicited. However, you must remember that this is not about you. Early intervention can be the difference between life and death.  We already touched about spotting someone who may be addicted so we are not going to repeat that information.

Educate yourself about the drug addiction – Fortunately, there are so many articles on the Internet that can provide you with the necessary information that you can build upon. Just make sure that you visit reputable websites so you don’t get the wrong information. By knowing the scope of the problem, you can better craft your strategy.

Plan your attack – Some people may need a more soft approach while others need a full intervention. It will depend upon how the individual will respond to the intercession. Sometimes guilt-tripping will do the trick, in other times, a full threat may prompt them to action. While you have your plan of attack, you also need to have a backup plan in case the first strategy doesn’t work.

Make yourself available – You don’t have to hold their hands all the way as they go through the treatment process. But they need to realize that they can turn to you anytime they need to. That’s the biggest support you can give. When you do talk to your loved ones about their addiction problem, try not to lecture them or admonish them regarding their actions. There’s plenty of opportunities to do that. You may even push them further away.

Leave something for yourself – We don’t discount the need to help your loved ones but don’t forget yourself, as well. In the practical sense, how can you help somebody when you are totally burned out. The important thing is to help yourself first before you can begin to offer your help to someone else. How can you help somebody when you also become sick because you are overexerting yourself?

Help manage finances – Money is one of the top reasons why people skip rehab treatment. You can help your loved ones manage their finances to make sure they have something extra to pay for treatment. If you have some extra money of your own, you can also help pay for the treatment. This will allow the patient to just focus on his recovery and not be stressed by how much he’s going to pay the rehab center.

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  With that said, the chance of getting sober does increase if the patient fully buys into the rehab program. It would also be easier on the counselors and the staff of the facility because the patient will not fight them all the way.

As far as addictions go, being dependent on Ambien is not the worst thing that can happen to you. Its effects are not as devastating as fentanyl, crack cocaine, and meth. There’s little chance of overdosing even if you take Ambien in large amounts. The only problem is if you mix it with the other drugs and alcohol.

Meanwhile, you will have a greater chance of moving past this ugly episode in your life as long as you seek help. You will have a hard road ahead of you but it’s certainly more well-paved compared to somebody addicted to harder opioids.  Call the nearest drug rehab facility now so you can finally overcome your Ambien addiction.