Toolkit

Please feel free to copy, paste and edit the following materials to make your own documents for your own use.  If you have any questions or run into difficulty, you may reach out to us at contact@warmnetwork.net  Also, please let us know where you are planning to have your meeting so we can connect you with like minded people in your area.

GUIDE FOR FACILITATORS

This format has been created with the intent of making leading a Prescription Medication Withdrawal and Recovery Meeting doable for anyone.  It is intended to be used ONLY in conjunction with reliable drug safety resources. We suggest starting with the information and tools available through Data Based Medicine at both Rxisk.org and TaperMD.com, withdrawal resources such as those that can be found at Mad In America (madinamerica.com/drug-withdrawal-resources/), Will Hall’s Harm Reduction Guide (can be downloaded at willhall.net/comingoffmeds/) and the Inner Compass Initiative (see theinnercompass.org).  A more complete list can be found on the Suggested Resources page our website at warmnetwork.net. We urge groups to keep in touch as we seek to form a unified network of groups.  

Materials:

Materials such as this guide,  group format, readings, and outreach flyers, etc. can be downloaded, printed, and kept in a notebook or binder for use at meetings.  We suggest you choose a name for your group and tweak the format to suit your needs. The format is there to help you facilitate a meeting but does not have to be followed exactly.  We trust you will find what works for you.  Insert readings into page protectors and give them to volunteer readers at the meeting to increase group member participation.  At first you may just want to read them. To keep our network meetings uniform (similar meetings in different locations) we discourage major edits to the format and readings, however if you feel changes are needed, please contact us to advise us.

Toward a more informed consent:

We want to be clear about what our groups are intended to offer.  This format is meant to be used in conjunction with specific resources and readings that provide information to help people make more informed choices while taking or withdrawing from medication(s).  We encourage people to locate and communicate with supportive doctors or other professionals who are qualified to help them, but we do not become involved in anyone’s decision to either take or discontinue medications.

Meeting topics:

We suggest leaders choose a topic in advance (and perhaps leaders can rotate when group is going strong).  At the end of this guide, we included an example of basic topics. As meetings progress, pay attention to subjects that come up and make an attempt to cover them at future meetings.  Keep the focus on constructive actions that move us toward recovery, as opposed to aspects of the situation that produce fear and feelings of helplessness.  It is most important for the group to actively listen and learn together while sharing resources, utilizing available tools, and locating doctors and others who will validate us and/or support a taper.    

Speaking from our own experience:  

When it comes to sharing, we urge members speak from their own experience(s) with medication and withdrawal, or that of a loved one.  For example, people should be encouraged to share their story, how things are going, the various methods they use, spiritual or holistic health resources, etc.  However, we suggest not letting meetings transcend into “other things.”  For example, someone might mention experiences with marijuana, which is fine, but avoid letting the meeting then drift into legalization efforts, which strains are best, etc.  Leaders are encouraged to guide the general focus back to topics of safe withdrawal, self-care, and recovery.  Adhering to the general format, and keeping medication safety resources central, ensures our meetings don’t mutate into something unintended.

Listening to one another:

Most of us have had the experience of not being heard by our doctors, friends, and at times, even our families. Unless a person is actively inviting feedback or a discussion around their topic, we suggest holding the space in a way that each person has sufficient room to speak and be heard.   

Giving medical advice:

We suggest facilitators be mindful of self and others.  If someone is giving medical advice, gently address this.  While we should feel free to share our own experiences and resources, we do not give medical advice.  

Political issues and campaigns:

Not everyone agrees politically regarding what is going on in the medical, mental health, and the pharmaceutical worlds, yet we ALL need information on medications and withdrawal.  Activism can be helpful and we don’t want to discourage it.  However, we suggest campaigns be done separately from recovery meetings so that no one feels out of place.

Note taking and follow up:

Everyone is encouraged to jot down information as the meeting progresses, especially facilitators.  We suggest leaders listen for future topics, specific medications and their side effects, and try to identify situations where following up with a specific resource might be useful to the speaker. If a helpful doctor is mentioned, we suggest jotting down his/her name and then following up to get them on our list of doctors who are available to support people with medication withdrawal issues.

Facilitators are encouraged to become familiar with each of our suggested resources so that assistance can be given to those who need it.  We want to utilize what these resources have to offer in order to ensure everyone’s safety while still being careful not to promote them or any agenda of our own.

Costs and Contributions:

There are various costs that go along with hosting a meeting, such as renting a space, keeping a meeting binder, and creating outreach materials.  We suggest that members make a small donation at the end of the meeting. A group treasurer should be appointed to keep a detailed record of contributions, and groups should not keep a balance in excess of $150.00.  We also suggest renting spaces that are accessible for people with disabilities.

List of possible topics

Tapering options

Tapering speed (suggest marathon not sprint)

Self-care practices

Managing anxiety

Managing insomnia

Managing the fear of coming off medication

Friend and family issues

Talking to doctors

Building social support

Discomforts of withdrawal and comfort measures

WIthdrawal symptoms, in general

Dealing with the medical system

How to navigate resource websites

RxISK Tools

Complex Withdrawal

Recognizing Akathisia

Success stories


Disclaimer:  We will incur no liability in regard to how anyone chooses to utilize the resources offered through WARM.  Individual members are encouraged to work with a trusted professional when making healthcare decisions.


 


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Format

Withdrawal and Recovery Meeting (WARM) Suggested Format

(1 ½ hrs)

LEADER:  Thank you for coming to ___(name of your group)___, a mutual support group for people wanting to withdrawal and recover from prescribed drugs safely.  My name is _________ and I will be leading today’s meeting. Let’s begin with a moment of silence to become present.

(moment of silence)

LEADER:  Today we set out a chair for the person who is too sick in withdrawal to attend.  If you know of such a person, please let us know so we might offer to take a meeting to them.

LEADER reads: The Introduction    

(approximately a 5-minute read – kept in a page protector)

LEADER: Before we get started are there any announcements?

(up to 5 min)

LEADER:  I have asked a friend to read The Welcome.

(approximately a 5-minute read – kept in a page protector)

LEADER:  Thank you.  Before we start on today’s topic, let’s go around the room and introduce ourselves and maybe tell a little bit about why we are here or how things are going.  Everyone is invited to share but no one is obligated; anyone is free to pass. We ask that you focus your discussion on your direct experience or that of a loved one.  You could tell us about your medications, why they were prescribed, and side-effects either positive or negative. If you have goals for getting off of medication, please share your concerns about withdrawal and what kind of support you are looking for.  If you have strategies you find useful, you could share about them. We would also like to hear about positive encounters you’ve had with doctors or supportive others so we might contact them about being added to a list of doctors that patients can turn to to find help for withdrawal issues.  

This part of the meeting is an opportunity for each of us to be heard as well as to practice non-judgmental listening.  Out of respect for other members, please refrain from interrupting, giving advice, or starting a discussion on a person’s share.  Comments and questions can be saved for later in the meeting when we discuss the topic.

If larger group: Please limit your sharing to 3 to 5 minutes so everyone has a chance to be heard.  

LEADER: Would anyone like to share first?

I’m________ and (this is how I’m doing)   

(Ideally, one person has the floor at a time, up to about 30 minutes total for check-ins).

LEADER:  Thank you everyone.  The topic for today’s meeting is _______________.  

(Present and discuss the topic – up to about 30 min total).  

If your group is open to it and time permits, you may want to add 5 or more minutes of deep breathing exercises or a similar stress-reducing practice toward the end of the meeting.

LEADER:  It’s time to wrap up our meeting.  I have asked a friend to read the _ Closing Statement__.

LEADER:  This support group is intended to complement, not replace, professional treatments. We encourage you to work with your doctor or another trusted professional when making healthcare decisions. Remember, we respect the anonymity of all of our participants.  What you’ve heard at this meeting is strictly confidential. Please respect the privacy of all who have shared here today. Please join me as we close our meeting with a moment of silence.

(moment of silence)

LEADER:  We are fully self-supporting through our own contributions.  Group funds go towards rent, program literature, and outreach materials.  Before you leave please consider placing a small donation in the basket. Thank you.

 


 


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Suggested Readings for WARM Groups

Introduction:

This Prescription Medication Withdrawal and Recovery Group is a confidential support group for people seeking to taper and recover from the effects of prescribed medications. These medications were often promoted as solutions for mental distress, physical pain, and various other ailments. Some of us found ourselves with additional problems and suspected the medications were causing them; many of us found these problems were only compounded when we tried to stop taking medication. Now we come together for mutual support as we explore our options together and share our experiences, as well as the resources that have been helpful to us. The only requirement for participation is a desire to learn about the effects of prescribed medications and how to safely manage withdrawal.

For this group’s purpose and in the interest of safety, we suggest utilizing the information and tools made available through Data Based Medicine at Rxisk.org, as well as the withdrawal resources available through Mad In America, Will Hall’s Harm Reduction Guide, and the Inner Compass Initiative’s Withdrawal Project.  The complete list can be found on teh resource page of WARM’s website at: warmnetwork.net. 

We are not affiliated with any medical, political, religious or other organizations, including those mentioned above. We do not wish to engage in any controversy; we neither endorse nor oppose any causes. People are free to pursue these things outside of our meeting. We are not doctors or therapists although we welcome them as members sharing in our common experience. Anyone may join us regardless of age, race, sexual identity, ability, creed or denomination, whether taking medication or not. We are each responsible for what we take from our group discussions, how we use the information shared, and for our own individual healing process.

The opinions and experiences expressed here are not intended to be a substitute for professional medical advice, nor do we assert in any way to be qualified to act in this capacity. It is imperative that each and every person deciding to withdrawal from prescribed medication do so under the supervision of an experienced professional when one can be found, someone who is well-informed and thus able to respectfully support a person’s desire to explore non-drug alternatives. We do not give advice or tell anyone how they personally should taper, we simply share what we have learned and what we have done.

We will incur no liability in regard to how each member chooses to utilize the resources offered through this group.

In the interest of confidentiality – what you hear here, who you see here, when you leave here, let it stay here.



Welcome:

Welcome to all who are seeking to taper and recover from prescribed medications. While we recognize that drugs have their place, our focus here is on the awareness of risks, on reducing dosages, and on utilizing various alternatives. Many of us have taken medications as prescribed only to experience problems as a result. Some of us are still on medication, while others are tapering, or have finished tapering. We come together to facilitate our healing process and that of others through the sharing of our experience, strength and hope in a shared journey of recovery.

Optional: Regarding psychiatric diagnoses, we understand there are many causes of “symptoms” such as unresolved trauma, grief, hormone imbalances, poor diet and nutritional deficiencies, toxins in our food and water supply, reactions to medications, including vaccines, and more. Those of us who have come from troubled childhoods, without having been taught proper coping skills, were easily overwhelmed by stress. Many of us sought relief from counselors who diagnosed us as “mentally ill” and then referred us to other professionals who prescribed psychiatric drugs.]

Whether prescribed psychiatric or other drugs, most of us were denied the opportunity to have true “informed consent’ regarding a drug’s risks, its addictive properties, potential to cause long-term damage, and the need for support with the withdrawal and recovery process. Instead, many of us were told the medications were safe and that we would need them for the rest of our lives. Many of us continued taking medication for years until the effects caught up with us and we began to realize the medication might be the problem. It was then that we recognized that if we had been given true informed consent, we likely would have never taken the drugs in the first place.

Therefore, most of us are recovering from injuries to our brains and our bodies, as well as to our emotional, social, and spiritual selves. Our meetings are a place where we can talk about the losses we may have incurred, such as our health, education, careers, relationships with loved ones, self-esteem, sense of security, etc. As we recognize these losses, we have an opportunity to express our grief in the supportive presence of others who can identify because our stories are so similar.

Many of us question how long it takes to recover. This often depends on things such as the type of drug, stress levels, finances, diet, spirituality, support system, etc. Recovery is an individual process and we try not to compare our stories with others. Healing takes time and pushing ourselves to “recover faster” only sets us back. Acknowledging our progress while letting go of perfection, in time we become grateful for the experiences that have made us into stronger and wiser people.

We are happy you have joined us. You are not alone.



Closing Statement:

The WARM Network of groups exists through the volunteer efforts of a growing number of laypeople within the withdrawal community who recognize that change is up to us.  We seek the healing power that only connections can provide, knowing that face-to-face meetings promote wellness in ways that surpass our valuable, yet limited, internet connections. As we exit the dark corners of the web and venture into our local communities, we find strength in solidarity, with the presence of our groups conveying an undeniable message: Withdrawal syndromes are real and must be addressed. We are confident that this positive action benefits us as much as it benefits others. It allows our vulnerability and invisibility to disappear, as our strength in unity grows, because in unity, there is strength.

 


 


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 5 Minute Mindful Breathing Exercise Example

1.) Find a comfortable and stable posture either sitting or lying on your back. Allow your back to be straight but not rigid. Let your arms and hands rest in a relaxed position.

Pause here and after each subsequent step.

2.) Close your eyes, if it feels comfortable. If not, soften your gaze.

3.) Bring your attention to the present moment by noticing how you’re feeling physically. Scan your body from head to toe and consciously try to let any tension slip away. Take a moment to notice your environment – any sounds you might hear in the background, what the temperature feels like in the room.

4.) After that, bring your attention to your breathing from three vantage points:

–First, notice the sensation of your breath going in/out of your nostrils or mouth.

–Second, as you breath, pay attention to the rise/fall of your chest.

–Third, notice the rise/fall of your belly as you breath.

5.) Pick the vantage point that seems to be the easiest for you to focus on. Follow the breath for its full duration, from the start to finish. Notice that the breath happens on its own, without any conscious effort. Some breaths may be slow, some fast, some shallow or deep. You don’t need to control the breath, you just need to notice it.

6.) If you find it helpful, you can say “1″ to yourself on each in-breath and “2″ on each out-breath.

7.) Each time your mind wanders away from the breath (and this will happen many times), notice where it goes and then gently bring your attention back to the feeling of the breath going in and out.

When the mind wanders, you can make a mental note of it. For example, if you drift away from your breath to thinking about the future, you can say to yourself “planning, planning.” If your mind is pulled to a sensation of pain in your body, you can say to yourself “pain, pain.” Or, if you notice you’re focused on something worrisome from the past, you can say “worry, worry” and then gently bring your attention back to the present moment – noticing the breath.

8.) Your mind may wander hundreds of times or more during these 5 minutes – that’s ok and quite natural! Your “job” is to catch yourself when you’ve wandered and to gently bring your focus back to the breath every time, without judging yourself for how “well” or “poorly” you’re doing the exercise.

9.) Try to practice this exercise for 5 minutes (or longer if you’d like) every day, for at least one week. Notice how it feels to spend some time each day just being with your breath.

Practicing mindful breathing is like strengthening your muscle of living in the present; as you practice more, you’ll find it easier to remain in the here and now, rather than being caught up in the past or in some fantasy about the future.

Living in the “now” tends to feel more peaceful and clear, even when external circumstances are difficult.  Mindfulness practice is not a prescription for tuning out the world; rather, it’s about tuning in with open and compassionate awareness.  Relating to life from this vantage point not only feels better, but often results in more skillful living.

Source: https://healthypsych.com/5-minute-mindful-breathing-exercise/

 


 


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Links to Google Docs

Sample Brochure:  

https://docs.google.com/document/d/1RG2AEyMOaTCXno0JyiPmS3343PeJCKARtzbX4yYnHG8/edit?usp=sharing

Sample Flyer:  

https://docs.google.com/document/d/19bj-xlFzdT9fkAT7Nz4GZmZ_rOdMlnU-ajUDD1b7Qsg/edit?usp=sharing

Please contact us if you have any difficulty accessing these documents in google. You may add your own meeting information to them or feel free to design your own.  

 


Guiding Principles coming soon!

 


Additional Materials:

Added September 2018

WITHDRAWAL TIPS:

Here are some tips that might help us on our journey of recovery.  They may or may not apply to everyone.

  1. On your worst days in withdrawal, remind yourself you’re not crazy, that it’s withdrawal and it will pass.
  2. Avoid alcohol if possible – it often hinders the healing process and can cause more damage.
  3. Don’t compare your story or symptoms to others, as everyone is different.
  4. Don’t push your brain/body to function beyond its capacity. Distractions are good and so is rest/lack of stress. Listen to your body’s needs daily realizing that needs change.
  5. Journal your taper/recovery process: daily symptoms, progress, setbacks, triggers that aggravate symptoms (helps to stay in the day/accept the process).
  6. Stay focused on the progress, especially on bad days, while keeping your eye on the goal.
  7. Remember, ‘windows and waves’ are normal (good days/bad days) while the brain and body continue to heal.
  8. Let go of expectations for healing. Don’t project a time limit. Stay in the day.
  9. Trust in your body’s ability to heal.
  10. Set limits with others when necessary because you’re fighting for your life.
  11. Don’t over-explain your story/symptoms to those who aren’t willing to hear or believe you – you don’t have that kind of energy. Instead, refer them to the proper resources.
  12. Treat yourself with gentleness and care as you would towards anyone who’s suffered TBI (Traumatic Brain Injury).
  13. Not only are we injured by drug damage and withdrawal that doctors didn’t warn about, we also experience Betrayal Trauma by prescribers once we realize the damage they have caused (via prescriptions and deception), when in fact, they were supposed to “cause no harm” (Hippocratic Oath). This can take a long time to recover from.
  14. Rage against your prescriber is normal and healthy, but it’s wise to wait until more healed before placing accountability. As long as you’re tapering, it’s important to ‘play the game’ while you make your gradual escape. Best not to ‘rock the boat’ or ‘threaten’ your prescriber in any way as long as you depend on the scripts. This is when placating might prevent being dropped/cold turkey. (Typically, they feel threatened when we’ve discovered the truth about the drugs and seem to know more than they do).
  15. For relief from head swelling; lay on your back with an ice pack/clay pack under the back of your neck or on your forehead.
  16. Take time out to deep breathe on a regular basis.

–Jennifer Bryant


Added September 2018

Some Commonly Asked Questions

Adapted from: Starting/Running Support Groups

Buz Overbeck – Joanie Overbeck

TLC Group – Dallas, TX 1995

Certain questions always seem to come up in the discussion of support
groups. In this section, we address some of the more common questions
that arise based on our experience and the experience of others in the
support group community.

1) “I don’t have any credentials. Can I still run a support group?”

  You don’t have to have credentials to successfully run a support group. What you
  must have are the qualities and instincts of a good facilitator and the ability to
  listen to, empathize with, and sensitively draw out the participants.

2) “Is it best to have a Professional involved with my support group?”

  There are advantages and disadvantages with professional involvement. A profes-
  sional can be helpful in providing a meeting place, assisting with facilitation, pro-
  viding intervention, if and when needed, and being a referral resource for members
  needing help beyond the group’s capabilities. However, one of the most important
  benefits to members is that the support group is “for participants by participants”
  and free from the judgements and expectations of a professional (see question 7.).

  Further, it is not always easy to find a professional with intimate experience in
  the type of issues addressed by the group. In our experience, it is “best” to have
  access to a professional for advice, guidance and referral capabilities, but keep the
  support group for participants only.

3) “How many people do I need to start a support group?”

  More than one! Support groups may be any size and often will vary with time. We
  have found that 8-16 people is a good number for one facilitator. Larger groups
  may be split into smaller groups assuring all members equal opportunity to disclose
  and share.

4) “Do support groups really work and, if so, why?”

  Plenty of anecdotal evidence suggests groups do work. Now statistical evidence is
  appearing as well. Researchers, such as Dr. James Pennebaker at SMU, are finding
  that disclosing, or “opening up” has distinct and measurable health benefits (1).
  
5) “Is there any commonality between the many types of support groups?”

  In our experience, the one theme running through all support groups regardless of
  type is loss. Primary or secondary losses are fundamental to any and all tragedies,
  crises, or transitional events. Further, the commonality to all types of losses is
  loss of control. Often the most immediate, initial impact of any support group
  is the reestablishment of personal control which often begins the moment the
  potential member picks up the phone to make contact. This seems to explain
  why Grief Counseling and Therapy is so effective in tandem with support group
  participation.

6) “Are Support Groups for everyone?”

  No. It is possible for some people to
  become so overwhelmed by the tragic experiences of others that they can’t carry
  on with their own burden. Others may develop feelings of inferiority or failure for
  not living up to perceived group expectations or peer pressure. Finally, one can
  join a group before they are ready or too soon after the tragedy and may dropout.

7) “What do participants actually get out of support groups?”

  The New Jersey Support Group Clearinghouse staff identified four common char-
  acteristics that fundamentally define self-help groups (2):
    a) Mutual Help–People helping people by pooling knowledge and sharing expe-
       riences and the striving to help one another.
    b) Peer Support–Members all share a common problem or stressful life situation
       resulting in a powerful “your are not alone” sense of understanding, often from
       the very first meeting.
    c) Affordable–Support groups are voluntary, nonprofit groups usually charging
       no fees. Some Open-Ended groups may charge minimal dues while some
       Time-Limited groups may charge a fee for books or materials.
    d) Exclusivity–The groups are run by members for members. The locus of
       control is with the group members rather than with professionals. This assures
       that the needs addressed will be those of the members rather than their needs
       as perceived by others.

8) “Can I be sued if anything goes wrong?”

  According to Janice Harris Lord, Director of Victim Services for MADD, opinions
  differ as to the liability of uncredentialed peer counselors, but the general rule
  is that a helper cannot be made liable for malpractice if there are no recognized
  standards of practice for him or her to violate (3). Again, it has been our experience
  that as long as the facilitator is truly “facilitating” and the group focus is on
  support, liability issues should not arise.


                                     References

1. Pennebaker, J.W. (1990). Opening Up: The Healing Power of Confiding in Others,
  New York: William Morrow)

2. E.J. Madara, Maximizing the Potential for Community Self-Help Through Clearinghouse Approaches,
  in Prevention in Human Services, Vol. 7, No. 2, 1990

3. Janice Lord, Developing An Effective Victim Support Group, NOVA Newsletter, Vol. 12, No. 12,
  December, 1988

Source: http://home.windstream.net/overbeck/grfbrf06.html

TLC Group grants anyone the right to use this information without compensation so long as the copy is not used for profit or as training materials in a profit making activity such as workshops, lectures, and seminars, and so long as this paragraph is retained in its entirety.