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  • Brain Circuitry Changes From Social Drinking

    Brain Circuitry Changes From Social Drinking

    When someone develops an addiction, they run the risk of not only seeing their personality and behavior change but also the way their brain functions. Scientists have seen a noticeable difference between an addicted brain and a non-addicted brain especially in terms of control mechanisms.

  • Is Alcohol Really Being Sold On Instagram?

    Is Alcohol Really Being Sold On Instagram?

    Unfortunately, recent advances in both alcohol sales and social media have proven to be a new way that teens may be at risk for finding and abusing dangerous alcoholic drinks.

  • How The Body Reacts To Long Term Heroin Addiction

    How The Body Reacts To Long Term Heroin Addiction

    Heroin is a very addictive drug that can be extremely challenging to withdraw from because of the fact that a person who is withdrawing from heroin addiction may experience extremely uncomfortable and unpleasant sensations.

  • Insurance Difficulties Heroin Addicts Have When Seeking Help

    Insurance Difficulties Heroin Addicts Have When Seeking Help

    Heroin addiction is one of the most difficult forms of substance abuse to quit and addicts need extensive treatment to experience a successful recovery. Unfortunately, many heroin addicts seeking help for their problem are finding it hard to get approval for their treatment from insurance companies.

  • The Sad Story Of Peaches Geldof Problems With Addiction

    The Sad Story Of Peaches Geldof Problems With Addiction

    Peaches Geldof, daughter of musician Bob Geldof and his late ex-wife Paula, was a beautiful young woman, a television presenter, a journalist, a model and a mother, who died at the age of only 25. What killed her was her addiction to heroin, the same thing that took her mothers life when Peaches was only 11 years old.

  • ‘Epipen For Addicts’ Prophylactic Naloxone Used To Counter Drug Overdoses

    ‘Epipen For Addicts’ Prophylactic Naloxone Used To Counter Drug Overdoses

    Heroin and opiate addiction is a deadly disease that continues to plague millions of Americans. Heroin is one of the most addictive and dangerous drugs and it carries with it a very high risk for death by overdose. As heroin and opiate addiction continues to become an increasingly large public health problem, many professionals in the medical and pharmaceutical industries have clamored to find ways in which the number of deaths related to heroin use may be minimized.

  • Dual-Diagnosis Was The Case For Demi Lovato

    Dual-Diagnosis Was The Case For Demi Lovato

    Demi Lovato is known by millions of Americans as a young and successful singer, actress, and television host. The twenty one year old celebrity has enjoyed quite a bit of public attention as both a recording artist and one of the hosts of the popular television show The X Factor.

  • How to Build a Strong Support Group in Recovery

    How to Build a Strong Support Group in Recovery

    Recovery is more than just abstaining from drug use or going through detox; it is a long process that can be filled with many ups and downs. There are a myriad of issues that a recovering addict must face even long after they have completed a rehab program.

  • 5 Tips To Avoid The Pitfalls Of Dating In Recovery

    5 Tips To Avoid The Pitfalls Of Dating In Recovery

    When someone gets sober, the "good feelings" that were produced from using drugs or alcohol seem like they are no longer available due to the fact that using drugs and alcohol is no longer an option.

  • Understanding The Process Of Heroin Withdrawal

    Understanding The Process Of Heroin Withdrawal

    One of the hardest parts of recovering from an addiction is going through the steps of detoxification. For a serious addiction like heroin abuse, the process can be especially painful and difficult to get through. It is crucial for anyone looking to quit their heroin addiction to find a safe and comfortable detoxification center or rehab facility that will help them through the process of withdrawal.

  • 'Take Back’ Programs For Unused Prescription Drugs Are On The Rise

    'Take Back’ Programs For Unused Prescription Drugs Are On The Rise

    The growing dangers of prescription drug abuse in the U.S. have prompted the creation of a number of programs designed to reduce the instances of abuse and addiction. These kinds of programs that are active across the country are known as "Take Back" programs which offer a way for communities to properly dispose of any unused prescription medications so that they do not end up in the wrong hands.

  • The Most Addictive Prescription Drugs Currently Available

    The Most Addictive Prescription Drugs Currently Available

    The abuse of prescription medications has become a problem in the U.S. with more than 2.4 million Americans using them non-medically on a regular basis. Although prescription drugs are provided by doctors and pharmacies to treat specific ailments, they are not always safe and in many cases can become highly addictive.

  • The Contagious Nature Of Drinking Alcohol

    The Contagious Nature Of Drinking Alcohol

    Many recovering alcoholics know that one of the biggest triggers for drinking can be the company of others who are drinking. Many alcoholics may have, for some time, been unaware of the severity of their problem because of the fact that they considered themselves "social drinkers." Many people may incorrectly assume that those who drink primarily in the company of others cannot be alcoholics. The reality is, however, that it is highly possible for alcoholism to be contagious and for a group of people who are addicted to alcohol to, in effect, enable one another.

  • Zohydro Abuse Concerns Go Nation-Wide As A Gateway To Heroin

    Zohydro Abuse Concerns Go Nation-Wide As A Gateway To Heroin

    Doctors. law enforcement agencies, and addiction treatment specialists have been disappointed with the recent approval by the FDA of a new drug call Zohydro, which many medical experts believe is the most dangerous opiate to hit the market to date. Many other experts believe that the drug, in addition to being highly addictive and dangerous in and of itself, may be a gateway to heroin use.

  • Russia's Recalcitrance to Recovery Movements

    Russia's Recalcitrance to Recovery Movements

    Alcoholism has been a significant problem in Russia for many years but citizens seem resistant to change and have not fully embraced the kind of recovery efforts that are common in the U.S. Russian leaders have made efforts to fight against the growing numbers of people suffering and even dying from alcoholism in the country but historically many of their attempts haven't worked.

  • Short And Long Term Effects Of Alcoholism On The Human Body

    Short And Long Term Effects Of Alcoholism On The Human Body

    There is no doubt that alcoholism can have devastating effects on a person's emotional life but it can also cause serious physical health problems and harm to the body. Alcohol is a drug that affects the body dramatically over a period of time.

  • Suboxone Carries A Heavy Price For Recovering Addicts

    Suboxone Carries A Heavy Price For Recovering Addicts

    Heroin and opiate addiction are two of the fastest growing health problems currently facing America. Heroin has long been viewed as one of the most dangerous and addictive drugs, and every year, the number of deaths related to opiate use and abuse sky rockets. Detoxing from opiates can be an extremely painful, uncomfortable, and even dangerous process. 

  • Scott Storch Recovers From Cocaine Addiction

    Scott Storch Recovers From Cocaine Addiction

    Famed music producer Scott Stortch has been reported to be in jail and, at times, even dead over the last several years. After publicly battling cocaine addiction and then relapsing after spending time in rehab, the producer has come out of his private life and announced that he is keeping a lower profile after struggling with a serious cocaine addiction that led him to lose virtually everything he owned, including almost all of a thirty million dollar fortune. 

  • Ray Charles’s Daughter To Sing And Speak About Addiction Recovery

    Ray Charles’s Daughter To Sing And Speak About Addiction Recovery

    Sheila Raye Charles is one of the singer’s 12 children and she too went down the path of addiction for years before finally experiencing recovery.She is traveling to a number of venues including churches and prisons across the country to speak about her experiences with addiction while singing and performing some of Ray Charles’ music as well. Sheila is now living a more successful sober life after recovering from her issues of drug abuse.

  • Powdered Alcohol (Palcohol) Is As Dangerous As It Sounds

    Powdered Alcohol (Palcohol) Is As Dangerous As It Sounds

    A new product has recently hit the market that has caused quite a stir among parents, teachers, and law enforcement agencies as well as those who work in drug treatment centers. The product, dubbed “Palcohol,” is powdered alcohol.

  • Ibogaine And Its Role In Heroin Addiction Treatment

    Ibogaine And Its Role In Heroin Addiction Treatment

    Heroin and opiate addiction is one of the most serious and rapidly growing health problems currently facing the United States. Heroin is a very dangerous drug for a number of reasons: it is highly addictive (many experts rank it as the most addictive narcotic), and it is linked to overdose more often than almost any other drug.

     

  • Mental Health And Addiction Often Coincide

    Mental Health And Addiction Often Coincide

    Addiction can already be a complex problem to resolve but addicts often suffer from issues of mental health which can compound the situation, making it harder for them to reach a full recovery. 

  • Elizabeth Vargas Writing A Memoir Of Her Struggle With Alcoholism

    Elizabeth Vargas Writing A Memoir Of Her Struggle With Alcoholism

    The co-anchor of 20/20, Elizabeth Vargas has only recently begun to open up about her issues with alcoholism after completing a stay in rehab. She is now willing to share the details of her story by writing a memoir about her alcohol problem and the process of her recovery. 

  • The Courage It Takes To Identify As An Addict

    The Courage It Takes To Identify As An Addict

    A common saying in recovery groups is that the first step to quitting an addiction is admitting you have a problem. Even though it is only the first step in a long journey, it is often one of the hardest things for people to do. 

OxyContin Addiction

While for most people, the idea of a dangerous drug brings to mind heroin, crack, and even methamphetamine, OxyContin is actually one of the deadliest and most addictive substances available. The fact that OxyContin is manmade and is accessible through a doctor’s prescription does not make it safer for human use than a drug like heroin. In fact, prescriptions for OxyContin are what have led to the majority of drug use progressing to abuse and onto addiction in the United States.

OxyContin: The Drug

OxyContin works as a painkiller by blocking messages to the brain alerting of discomfort or a problem somewhere in the human body. Because of its potential for abuse, its side effects, and its propensity for addiction, OxyContin’s composition and labeling were required to change, per the FDA. As a result, demand has decreased, but the drug is still extremely dangerous.

OxyContin, the brand name of Purdue Pharmaceuticals’ pill version of the painkiller, oxycodone, is a narcotic, just like heroin. Along with Vicodin, Percodan, Percocet, morphine, codeine, methadone and heroin, OxyContin and this entire classification of drugs, called opiates or opioids, have an extremely high rate of abuse, an even higher rate of addiction, and an undeniable link as the cause of thousands of overdose deaths every year.

What Does OxyContin Do?

OxyContin, created to mimic the effects of morphine, is comprised mainly of oxycodone. The drug works by blocking pain messengers in the brain, via the central nervous system. Internal levels of the natural neurotransmitter, dopamine, are affected, making the individual feel more pleasure and even euphoria, but the whole experience is chemically created. As a result, organic dopamine production is thrown out of whack, and the drug seems to be the only way to ever have a positive experience again.

Medicine

When used properly, as medically prescribed, OxyContin is a highly effective painkiller that relieves the suffering of cancer patients and those with major physical pain. In an effort to treat acute and chronic pain, the Food and Drug Administration (FDA) approved OxyContin for medical use in 1995. Since its introduction to the medical community, OxyContin has quickly become one of the most addictive and most deadly drugs available. When taking more OxyContin than medically necessary, the drug produces a euphoric feeling, but that is never why a physician has recommended the drug for use.

Drug Formulation

The pill version of oxycodone was designed with a slow-release formula so that only the appropriate amount of medication makes its way into the user’s bloodstream at any given time. With this method, ongoing pain can be properly alleviated. However, the potential for ways to abuse OxyContin were realized almost immediately. Instead of just relieving pain, OxyContin users figured out how to manipulate the drug to also get high.

Statistics

OxyContin has been the subject of countless news reports and research studies. As the FDA witnessed the impact of OxyContin on the United States’ population, the organization began conducting research studies. Results, published in The Journal of the American Medical Association, announced that oxycodone-related deaths increased 93% and oxycodone-related emergency room visits increased 32% between 1997 and 1998.

The Centers for Disease Control and Prevention (CDC) released information that 15,000 Americans died of opiate and opioid related deaths in 2008, which marked a 300% increase from 1999. The rate of prescription pill deaths in one year was more than the total number of deaths linked to heroin and cocaine combined. Further, in 2008, Purdue Pharmaceuticals reported over $2 billion in annual OxyContin sales, nearly double the amount sold in 2007. The drug’s sales increased to nearly $3 billion the next year, and made it to $3.1 billion in 2010. This means that enough prescriptions for painkillers had been administered in 2010 to medicate every adult in the U.S., 24 hours a day, for an entire month.

Legal Involvement

After years of OxyContin sales, Purdue Pharmaceuticals was found liable for the drug’s addiction and death rates. The company entered a guilty plea to a single felony count of misbranding and paid out $600.5 million. Plus, three of the company’s top executives were each charged with misbranding misdemeanors and fined $34.5 million, which the company paid.

Changes to the Deadly Drug

As a result of the law suit, Purdue Pharmaceuticals reformulated OxyContin to reduce its abuse potential. Along with the changes came a new label warning of the drug’s side effects, dangers, and probability toward addiction. The combined changed have proven effective in decreasing the demand for OxyContin.

OxyContin: The Effects

The use of OxyContin affects the entire nervous system: the heart, the lungs, the brain, the reproductive, respiratory, digestive, and immune systems, and every major organ in the human body.

Unlike some other pharmaceutical drugs, the side effects of taking OxyContin are not mild. Instead of just possible dizziness and dry mouth, OxyContin affects the entire central nervous system. This means that the heart, the lungs, the brain, the reproductive, respiratory, digestive, and immune systems, and every major organ are impacted by the drug’s abuse.

As a result, the Drug Enforcement Administration (DEA) reports record high cases of OxyContin abuse, physical and psychological dependence (i.e. addiction), and overdose deaths. Purdue Pharmaceuticals has been criticized for downplaying the dangers of OxyContin and has been required, by the FDA, to make changes to the label. The side effects are now listed right on the bottle of OxyContin along with what the FDA calls the strongest warning ever for a pharmaceutical drug.

Actual side effects of OxyContin use are:
  • Depressed respiration, or respiratory failure
  • Constipation
  • Lowered blood pressure
  • Slowed pulse
  • Confusion
  • Nausea, vomiting, or stomach cramps
  • Slurred speech
  • Lack of coordination
  • Inability to stay awake
  • Impairment of menstrual cycle in females
  • Severe withdrawal symptoms when drug use stops

Increased OxyContin Use

Similar to heroin, an increased tolerance to the pain-blocking euphoric effects leads an OxyContin user to want a larger dosage of the drug each day. Accidental OxyContin overdose is caused when a user does not stop increasing the dose, until one day, the amount of the drug is too much for the body to metabolize. Rarely does an OxyContin overdose result in an outcome other than death or permanent brain damage.

Stopping the Progression of OxyContin Use

The dangerous side effects of OxyContin make its use incredibly risky. If you are using OxyContin, or know someone who is, the behavior can stop with the right medical help. Recovery Now TV finds the treatment centers with the most experience and the best staff to help stop the progression of OxyContin use to abuse and addiction.

Under the guidance of medical doctors and substance abuse professionals, our team at Recovery Now TV has helped many opiate addicts get through medical detoxification and onto formal treatment. We work with licensed counselors who customize treatment plans, complete with tools for preventing dependence on OxyContin, skills for dealing with cravings for narcotics, lifelong coping skills to sustain a new life without substances.

Give Recovery Now TV a call today at 800-281-4731 to find out where you can start your new life.

OxyContin Abuse

Substance abuse, the step before addiction, consists of the continuation of any drug use despite its negative impact on the user’s life.

When a prescription drug is used in any way other than how a doctor prescribed it, the drug is being abused. The purpose is no longer proper pain treatment; the goal is to get high.

If a 90-day supply of OxyContin is deemed necessary for recovery after surgery, for example, and the individual uses the given quantity in 60 days, the drug has been abused. Similarly, when a portion of one’s personal quantity of OxyContin is sold to someone who does not also have a doctor’s prescription, the drug is being abused.

Although OxyContin was manufactured as a time-release pill, designed to relieve pain for up to 12 hours, when the drug is crushed and injected, snorted, chewed, smoked, or dissolved into a liquid, the time-release function is destroyed. Abusers feel a heroin-like rush from eating, drinking, snorting, or injecting the powdered, or pulverized, form of OxyContin.

The pleasurable feeling created by the abuse of OxyContin is leading even those who truly needed a prescription, to abuse the drug for the euphoria and the complete alleviation of all pain. Since the pharmaceutical drug can be so easily abused, often users quickly progress from legitimate use to abuse, and then onto addiction. Individuals who have not been educated on the dangers and side effects of OxyContin may not understand the drug’s powerful narcotic impact on the human body.

All too often, a person who has been prescribed OxyContin believes that the drug is safe because a doctor has deemed it medically appropriate. Sadly, the true effects of OxyContin abuse are widely unknown to most of the people who are taking the pharmaceutical. Consequently, OxyContin’s side effects become the reason for thousands of emergency room visits and causes of death every year.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), via the organization’s Drug Abuse Warning Network, emergency room incidents involving oxycodone increased 89% between 1993 and 1999. Those rates jumped another 68% from 1999 to 2000; illustrating the reality of the influence OxyContin abuse is having on our society.

As one of the most powerful pain relievers on the market, OxyContin became a substitute for heroin. Instead of injecting a risky street drug, individuals started going to a doctor, complaining of chronic pain, in an effort to get what is essentially the pill form of heroin. The pharmaceutical versions seem less dangerous than heroin, are perceived with less cultural stigma than “street drugs,” and come in a pretty little pill instead of via a needle, but make no mistake: prescription opiate narcotics are no less dangerous than any other version, like heroin, codeine, and morphine.

When the first high is experienced from OxyContin, abuse goes beyond just pain relief. The desire for an amount of the drug that creates that euphoric high is continuously pursued. For those users, who are not educated on the dangers of opiates, OxyContin use can unintentionally spiral out of control.

The body begins to change and chemicals in the brain begin to adapt to the continuous, and often rising, presence of OxyContin. The appropriate pain relief that used to come from one or two pills now requires five or six pills. As abuse continues to progress, it is not unusual for an individual to then need a dozen pills of OxyContin to feel the effect that used to come with just a couple. Physical tolerance to the drug has developed and the systems of the body and the brain now require more pills to ward off pain, or to get high.

When the body can no longer handle the dose that is being taken, meaning that the amount of the drug in the person’s system can no longer be metabolized, the drug becomes lethal. This is an overdose. The body does not distinguish between OxyContin, another pharmaceutical, and heroin when dosages become so high that breathing stops and other organs shut down, including the heart. OxyContin overdoses are just like heroin overdoses. The body cannot handle the level of narcotics present.

The good news is that complete recovery from any opiate is possible. With help from trained professionals, OxyContin abuse can stop before an overdose, or the progression to addiction, ends a life.

Recovery Now TV offers the latest in medical detoxification and effective therapeutic techniques for treating OxyContin abuse. Through effective referrals, our treatment team will help find the best detox and treatment program for you. Call Recovery Now TV to find out more: 800-281-4731.

OxyContin Addiction

Addiction includes:
  1. Loss of control over substance use
  2. Obsession with use
  3. Continued use despite adverse life consequences
  4. Denial that there is a problem with a substance
  5. A powerful likelihood of relapse

Addiction is defined as a chronic disease with a high probability of relapse. When a person fits the criteria of addiction, he or she can be diagnosed with physical and psychological dependence upon at least one mind-altering drug, or life-impairing behavior. The ability to stop using is diminished, and every aspect of the person’s life can reach incapacitation.

The use of OxyContin negatively impacts the entire central nervous system. The influence on the body and the brain decrease a person’s ability to make good choices. OxyContin addiction begins to affect relationships, commitments, and responsibilities, as the drug begins taking daily priority. When abuse crosses over into addiction, jobs are lost, schoolwork falls by the wayside, relationships crumble, families are torn apart, physical and mental health deteriorates, and even legal consequences can begin dictating a person’s life.

While this process can happen for any drug, the cycle of addiction is most difficult to break for opiates and opioids. The drugs in this classification alter brain chemistry as they relieve pain, and create a euphoric high when taken in higher doses than physically necessary. Without an intension of addiction, or even abuse of the drug, thousands of people find themselves fitting the criteria for OxyContin addiction.

A well-cited definition of addiction includes these five criteria:

  1. A Loss of Control over substance use;
  2. Obsession with substance use;
  3. Continued use Despite Negative Life Consequences;
  4. Denial of a problem with substances and/or behaviors; and,
  5. A powerful tendency to Relapse back to substance use.

When used in an example, a person who has become addicted to OxyContin is unable to stop taking pills on his or her own. Each day this person is obsessed with finding the drug and using it, and even after this behavior has caused adverse life consequences (i.e. loss of a job, complete financial devastation, or the end of an important relationship), OxyContin use continues.

Through all of this, the addict denies that there is a problem with OxyContin, sometimes in the some form of, “I need the drug to treat my chronic pain.” Denial is very powerful, and so is OxyContin. Even when use stops, whether the person admits a problem with the substance or not, someone who can be diagnosed with addiction returns to the drug, or relapses, often after just a short time of cessation.

Whether for you or for a loved one, this list provides signs and symptoms of addiction to look for in someone who is taking OxyContin:

  • Feeling physically sick when the supply of OxyContin is gone. (i.e. withdrawal symptoms)
  • Engaging in illegal activity to get OxyContin.
  • Increasing the amount of OxyContin taken each day. (i.e. increased tolerance)
  • Experiencing feelings of guilt or shame about OxyContin use.
  • Losing a job, failing out of school, or losing a loved one because of OxyContin use.
  • Changes in eating and sleeping patterns.
  • Mood swings.

Additionally, in an effort to feel a satiable high again, many opiate addicts will combine alcohol, marijuana, cocaine, and other pharmaceutical drugs with OxyContin. This signals drug addiction. The act of combining chemicals is extremely dangerous because drug interactions in your body are unpredictable, and therefore, high risk and often life-threatening. Via several famous opiate addicts, like Heath Ledger, Cory Monteith, and most recently, Philip Seymour Hoffman, we see just how easily prescription pills, heroin, and the mixture of several drugs can lead to an untimely death.

Instead of suffering through the life of addiction, break the cycle by calling Recovery Now TV. OxyContin addiction must be treated, and with the help of our team, you can begin the detox and recovery process today.

Recovery Now TV has helped hundreds of people overcome opiate and opioid addiction. With proven techniques and effective medical procedures, recovery begins with medically supervised detoxification. Once OxyContin is out of the body, rehab can begin where treatment plans are customized to each individual client and a wide variety of services are available to heal the mind, body, and soul.

Give Recovery Now TV a call today at 800- 281-4731 to explore your options and to treat your OxyContin addiction.

Withdrawal from OxyContin

OxyContin Withdrawal Symptoms:
  1. Muscle and bone pain
  2. Restlessness
  3. Diarrhea
  4. Insomnia
  5. Vomiting
  6. Cold flashes
  7. Involuntary leg movements

OxyContin withdrawal is no less serious than quitting heroin, despite the fact that OxyContin use may have started with a legitimate doctor prescription.

Opiate and opioid withdrawal indicators are physical symptoms experienced when the body reacts to a lack of any drug in the opiate family. The body and the brain have become accustomed to having a painkiller to function, so when a substance like OxyContin is suddenly taken away, pain seems excruciating, digestion is a major problem, and the entire central nervous system revolts. Muscles cramp, bones and joints ache, and the entire body sweats. Nausea, an inability to sleep or eat, and a relentless experience of anxiety also ensue. Overall, OxyContin withdrawal produces flu-like symptoms and major discomfort.

The pain and distress of OxyContin withdrawal can be minimized under proper medical supervision. Recovery Now TV has connections with monitored detoxification programs for opiate addiction.

OxyContin withdrawal is not a process you want to go through on you own. To stand a chance at making it through the first few days without returning to OxyContin use, seek participation in one of Recovery Now TV’s referrals with medical facilities, professional doctors, and licensed counselors helping you through the entire process.

Give us a call today at 800-281-4731 for a private consultation. We can help you stop using OxyContin and start a new life free of addiction.

Detox & Treatment

OxyContin addiction requires monitored detoxification and formal treatment. The team at Recovery Now TV is here to help you find the best program to fit all of your recovery needs. Call now, 800-281-4731.

Completely ridding the body of OxyContin is vital for any chance at recovery from opiate addiction. As the most addictive class of drugs, these substances are not easily forgotten. With the assistance of medical professionals, who can administer proper medications and can continuously monitor vital signs, detoxification can be completed with greater ease.

Participation in a detox program sets a former OxyContin addict up for entry into a formal inpatient opiate treatment program. With individual therapy, peer group processing, family therapy, and other proven therapeutic approaches to recovery, an OxyContin addict can make changes with a positive attitude and a readiness to change. While not easy, a substance free life is available to addicts everywhere.

Recovery Now TV has dealt with hundreds of clients with your exact symptoms. Our effective treatment referrals are based on experience and research. If you are addicted to OxyContin, or someone in your life cannot stop using an opiate, it is time for help.

To find out where you can receive the best in opiate and opioid treatment, contact our team at Recovery Now TV, 800-281-4731. Our professional staff is standing by to give you a confidential consultation.