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The Beginner’s Guide To Kidney Transplant

If you are here reading The Beginner’s Guide To Kidney Transplant than likely you or someone you love is faced with the prospect of needing a kidney transplant. This can be an overwhelming time and there is a lot of information out there and a lot to consider. This article is just to get you started and do a quick overview. Speak to your physicians, talk to your family and friends, get second opinions or even third – whatever it takes for you to feel able to make an informed decision and the one that is right for you.

The kidney is a fundamental element of excretory system. The two bean-shaped kidneys play a very critical role in the human body. They are responsible for filtering out the blood and other body fluids. This way, they ensure the release of waste.

Several sorts of kidney problems occur. You might experience a kidney stone, swelling or deterioration. All such kidney problems can halt excretory functions. The kidney becomes unable to filter blood. The wastes accumulate within different body parts, causing numerous issues like high blood pressure. When 90% of a kidney stops filtering and excreting, it results in kidney failure.

A kidney transplant is a life-saving procedure. It can cure kidney failure and other conditions requiring the removal of one or both kidneys.

In the initial stages, kidney wash through machines and dialysis works. However, in severe kidney failure, the only option is a kidney transplant.

Although a human body can survive on one kidney, weak individuals need another. People with other medicinal ailments or second kidney failure also rely on an outsourced kidney. This is only possible through a kidney transplant.

Causes of Kidney Failure

Despite occurring naturally, a few other factors can also cause kidney failure. Individuals having diabetes are more prone to kidney problems. Chronic or uncontrolled blood pressure levels also add to kidney damage. The consistent inflammation can affect the filtering process. They all eventually lead you towards severe kidney failure. That more possibly necessitates a kidney transplant.

Dialysis Vs. Kidney Transplant

With failed kidney, there can be two available options. Either one can go for dialysis, which is a machine-assisted excretion for a lifetime, or have a kidney transplant.

No doubt, a kidney transplant is scarier than dialysis. But it can be effective in the long term. With dialysis, a person has to continue undergoing the same procedure again and again. There is no point in getting recovered or coming back to normal. It is because dialysis is a procedure rather than a treatment.

A kidney transplant, on the other hand, offers you a one-time risk. Once you have matched the donor and undergone surgery, you will be free to continue living. That is why a kidney transplant is a preferable choice.

Some people are afraid of surgery or getting rejected during kidney transplants. Remember, it is still completely up to the patient what to opt for.

Why Opt for a Kidney transplant?

When compared to dialysis, a kidney transplant is preferable because of the following reasons;

  • Low Treatment Cost – It is one-time, whereas dialysis will continue to cost for a lifetime.
  • Better Quality of Life –It will let you live the rest of your life in peace and comfort.
  • Fewer Dietary Restrictions –Unlike dialysis patients, there is no limitation on what or what not to eat.
  • Lesser Health Risk –Unlike dialysis, it enables you to stay healthy in the long run.

Kidney transplant cannot always be in favor of everyone. A few things might restrict you from going for a transplant. It is potentially unsuitable for people with old age, severe heart diseases, cancer, mental illness, alcohol or drug addiction, etc. So, everyone needs to consult with the doctor first, and if it comes under any no-go category, the person will have to continue with dialysis.

Types of Donors for Kidney Transplant

For a kidney transplant, there can be two types of kidney donors. They are the following;

  1. Living Donor

A human body can rely completely on one healthy kidney for all metabolic activities. That is why an individual can always donate a kidney to someone in need. However, criteria to be met, such as blood group and tissues, should match to either donate or accept a kidney.

A kidney donor can be a family member or someone else. It is always preferable to receive a kidney from a blood relation as it lets you avoid the risk of rejection and is usually beneficial.

  1. Deceased Donor

Another way of getting a kidney is from a deceased person. It happens in a way that hospitals usually gather data on people needing a kidney. The hospital informs immediately whenever a deceased person’s kidney matches the patient. The doctor prepares an instant surgery for a transplant. It is significant because the kidney transplant should take place shortly for a kidney to be valuable.

Kidney Transplant Procedure

Kidney transplantation is more or less like other surgical treatments. During a kidney transplant surgery, the doctor injects the anesthetic dose within your blood through an intravenous line in your arm. It is basically to make you fall asleep or for a while to undergo the incision. Once unconscious, the doctor makes an incision to open up your abdominal region. He then puts in the donor’s kidney and connects the arteries and veins to your circulatory system. As the blood starts flowing, the new kidneys function within your body.

Alongside that, your kidneys need a connection to the ureter. It can only then carry on the excretion process smoothly. The doctor connects the newly induced kidney to the ureter and the bladder.

As far as your original kidneys are concerned, they usually remain inside the body and aren’t disposed of. However, in some cases, when the failed kidney causes trouble, it is removed too.

Risks of Having a Kidney Transplant

Although a prevailing treatment for severe kidney issues or kidney failure, a kidney transplant is not a full-proof solution. It causes multiple risks either during the transplantation surgery or afterward.

  • Rejection of the Donor Organ – While operating, the donated kidney might not be compatible with your body. It is possible to even after undergoing the matching tests and everything else. Hence, it is risky.
  • Kidney Diseases –The transplantation, although it eradicates the ailment, for the time being, there are chances of the patient regaining a mild or severe ailment.
  • Side-effects –Undergoing the surgery can cause you side effects. It will leave an incision mark and temporarily cause redness, swelling, and pain.

None of the above three risks is unpreventable. Almost every doctor provides medication to minimize donor rejection, kidney diseases and surgical side effects.

Postoperative Possible Complications of  Kidney Transplant

  • Infection  – Minor infections like urinary tract infections, colds, and flu are common after kidney transplants. However, in most severe conditions, pneumonia or CMV infection may occur.
  • Blood clots –  The most common complication after a kidney transplant is the development of blood clots in the arteries connected to the donated kidney. In some cases, medications can be used to dissolve the blood clots.
  • Urine leakage –  Sometimes, after a kidney transplant, urine may leak through the connection between the ureter and bladder. This usually happens during the first-month post-kidney transplant.

Conclusion

Opting for a kidney transplant requires you to think twice before stepping in. It is all onto you because you must live with both the benefits and risks of the transplant. You must be brave enough to analyze the situation and make a decision.

Once you agree to the transplant, it might cause you mental stress. You may feel worried about undergoing surgery and have a fear of rejection. But it would help if you calm your mind. Do exercise, eat healthy, engage in positive activities, and take good care of yourself before and after the kidney transplant.

References

  1. https://www.ncbi.nlm.nih.gov/books/NBK567755/
  2. https://www.ncbi.nlm.nih.gov/books/NBK553074/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230851/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549004/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716102/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8711553/
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What Is Vivitrol?

“What Is Vivitrol?”  I get asked that more and more often. Vivitrol is the injection (shot) form of a medication known as Naltrexone. And it’s use has grown significantly over the past several years – and for good reason. This article is intended to give you a little info and hopefully provide some clarity too.

  • Most commonly used for Opioid and Alcohol Withdrawal and to inhibit cravings
  • Comes in oral (Naltrexone) and IM (Vivitrol) forms
  • Must be prescribed by an approved physician
  • Is not meant to be a “magic pill” cure
  • Like other Medication-Assisted Treatment (MAT) options – the highest successful outcomes are when it is paired with therapy/treatment and support.
  • It is very different than other MAT out there at this time. 

*If you or someone you love is struggling with addiction, please cheack out this resource page*

Stethoscope next to computer

Naltrexone is an opioid antagonist that has the highest affinity for the -opioid receptors. In addition to its ability to block the effects of opioids, this compound has very few, if any, inherent effects. In 1994, the Food and Drug Administration of the United States gave its approval for the use of Naltrexone in the treatment of alcoholism (Kranzler, Wesson, Billot, Clinical, & Research, 2004).

In spite of this permission, the studies that have been conducted to determine whether or not Naltrexone is effective in treating alcoholism have produced mixed results. Patients failure to follow the prescribed treatment regimen while taking oral Naltrexone is one factor that contributes to the treatment’s overall lack of efficacy.

Some studies have also shown that in order for subjects to have greater reductions in alcohol consumption and risk of relapse as compared to subjects who were treated with a placebo, they must be highly compliant with the Naltrexone treatment. Utilizing formulations that provide sustained release or depot treatment is one approach that can be taken to address this issue.

VivitrolTM, a depot injectible dosage form of Naltrexone, was approved by the FDA on April 13, 2006, for the treatment of alcohol dependence in patients who are capable of withdrawing from drinking in an outpatient setting and who are not actively drinking at the beginning of therapy. Patients must also not be drinking at the time treatment begins. The recommended dosage of Vivitrol is 380 milligrams, which should be injected once per month or every 28 days.

Both DepotrexTM and NaltrelTM are examples of alternative depot parenteral formulations of Naltrexone. Naltrel helped to promote abstinence and decreased the incidence of relapse in two samples of alcohol-dependent subjects, while Vivitrol was shown to be effective at reducing heavy drinking among alcohol-dependent males (Chick et al., 2000; Monti et al., 2001).

The use of Naltrexone provides a blockade against the intoxicating and reinforcing effects of opioid-like compounds, which, in theory, can result in the elimination of drug-taking behavior. It does not produce euphoric effects, and as a result, it is not abused. Additionally, it does not result in physiological dependence on the user.

Similar to the situation with alcohol, the primary challenge presented by the oral formulation of Naltrexone for the treatment of opium or heroin dependence is low compliance (adherence). Long-acting sustained release formulations of Naltrexone (injectable or implantable) may help to develop compliance and, as a result, augment the efficacy of abstinence-oriented treatments with Naltrexone for heroin or opium dependence. Following the completion of opioid detoxification, the administration of Vivitrol is done for the purpose of preventing a return to opiate dependence (B. A. J. T. Johnson & management, 2007).

Mechanism of Action 

Dopaminergic pathways, (which have their origins in the ventral tegmental area, relay to the nucleus accumbens with neuronal inputs from other limbic regions, and progress to the cortex), are responsible for mediating the reinforcing effects of alcohol, which are associated with the substance’s potential for abuse. An antagonist for the mu-opioid receptor, Naltrexone, reduces the positive effects of alcohol through two distinct mechanisms. First, it prevents alcohol from causing beta-endorphin stimulation of dopamine neurons directly in the nucleus accumbens. Second, it prevents beta-endorphin from disabling the tonic inhibition of dopamine cells caused by gamma-aminobutyric acid neurons in the ventral tegmental area (Koob & Research, 2003; Wise & Bozarth, 1987).

Oral Dosage Form and Its Effects 

In alcohol-dependent people who had recently stopped drinking, taking oral Naltrexone was effective at reducing the likelihood of relapsing and going back to drinking heavily. Its general effectiveness has been limited by two consequential factors, one of which is that the pharmacokinetic properties of oral Naltrexone lead to significant fluctuations in plasma levels with oral daily dosing. A medication adherence rate of at least 85 percent is necessary in order for there to be a therapeutic response. First, the low plasma trough level of oral Naltrexone reduces the efficacy of the drug, which may explain why this requirement exists. Second, it is believed that high peak levels are responsible for adverse events, and it is estimated that up to 15% of people who receive oral Naltrexone will discontinue treatment due to adverse events, particularly nausea (B. A. Johnson & Ait-Daoud, 2000).

Therefore, optimizing the pharmacokinetic profile of Naltrexone by developing a deep intramuscular injection that would release Naltrexone over the course of several weeks would make the drug more effective as a whole. Therefore, plasma levels would remain relatively constant, and while they would be low enough to cut down on the number of adverse events, they would still be high enough to produce the desired anti-drinking effects. In other words, even though it is not anticipated that the effect size of the long-acting, intramuscular formulation of Naltrexone will be greater than the effect size of oral Naltrexone, it is likely that the overall outcome will be improved because of the increased compliance and longer exposure to a therapeutic dose (Bartus et al., 2003).

Patients are typically given 380 mg of the long-acting injectable (LAI) form of Naltrexone once every 28 days, and oral Naltrexone is typically titrated up to the target dose of 50 mg per day. Although the use of LAI Naltrexone does not require a trial period of oral Naltrexone, it is standard practise to determine the patient’s level of toleraance with oral doses before moving on to higher concentrations. It is possible that the use of LAI Naltrexone has benefits for adherence when compared to the use of oral Naltrexone. This is due to the fact that non-adherence is common among patients who are taking medication for alcohol use disorder.

3.1% of patients in the study were given any form of Naltrexone, but only 0.24% of patients were given LAI Naltrexone. This information was obtained from a study. Even though about 40% of people have experienced alcohol abuse of some kind at some point in their lives, very few people are actually receiving the help they need. According to the findings of the same study, the patients who were given the intramuscular injection were more likely to make use of both outpatient and inpatient mental health services. Patients battling alcohol use disorders who receive treatment that is both pharmacologic and makes use of mental health resources have better outcomes as a result of their treatment. These resources for mental health include individual drug counselling, care management, monitoring of a patient’s substance use, and intensive outpatient treatment, among other options (Aletraris, Shelton, & Roman, 2015; Marienfeld, Iheanacho, Issa, & Rosenheck, 2014).

More research is needed in order to find out the effects and outcomes of drug with the use of oral dosage form and other dosage forms. 

References 

Aletraris, Lydia, Shelton, Jeff S, & Roman, Paul M %J Journal of substance abuse treatment. (2015). Counselor attitudes toward contingency management for substance use disorder: Effectiveness, acceptability, and endorsement of incentives for treatment attendance and abstinence. 57, 41-48. 

Bartus, Raymond T, Emerich, Dwaine F, Hotz, Joyce, Blaustein, Marc, Dean, Reginald L, Perdomo, Brigido, & Basile, Anthony S %J Neuropsychopharmacology. (2003). Vivitrex®, an injectable, extended-release formulation of naltrexone, provides pharmacokinetic and pharmacodynamic evidence of efficacy for 1 month in rats.28(11), 1973-1982. 

Chick, Jonathan, Anton, Raymond, Checinski, Ken, Croop, Robert, Drummond, D Colin, Farmer, Roger, . . . alcoholism. (2000). A multicentre, randomized, double-blind, placebo-controlled trial of naltrexone in the treatment of alcohol dependence or abuse. 35(6), 587-593. 

Johnson, Bankole A %J Therapeutics, & management, clinical risk. (2007). Naltrexone long-acting formulation in the treatment of alcohol dependence. 3(5), 741. 

Johnson, Bankole A, & Ait-Daoud, Nassima %J Psychopharmacology. (2000). Neuropharmacological treatments for alcoholism: scientific basis and clinical findings. 149(4), 327-344. 

Koob, George F %J Alcoholism: Clinical, & Research, Experimental. (2003). Alcoholism: allostasis and beyond.27(2), 232-243. 

Kranzler, Henry R, Wesson, Donald R, Billot, Laurent, Clinical, DrugAbuse Sciences Naltrexone Depot Study Group %J Alcoholism:, & Research, Experimental. (2004). Naltrexone depot for treatment of alcohol dependence: a multicenter, randomized, placebo‐controlled clinical trial.28(7), 1051-1059. 

Marienfeld, Carla, Iheanacho, Theddeus, Issa, Mohammed, & Rosenheck, Robert A %J Addictive Behaviors. (2014). Long-acting injectable depot naltrexone use in the Veterans’ Health Administration: a national study. 39(2), 434-438. 

Monti, Peter M, Rohsenow, Damaris J, Swift, Robert M, Gulliver, Suzy B, Colby, Suzanne M, Mueller, Timothy I, . . . Research, Experimental. (2001). Naltrexone and cue exposure with coping and communication skills training for alcoholics: treatment process and 1‐year outcomes. 25(11), 1634-1647. 

Wise, Roy A, & Bozarth, Michael A %J Psychological review. (1987). A psychomotor stimulant theory of addiction.94(4), 469.

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Is It Time for An Addiction Intervention? – How to Tell

Addiction is serious, no matter what. If someone you love is going through struggles with drugs or alcohol, an addiction intervention can be the best way to kick start the treatment they need.

However, an addiction intervention needs to happen at the right time. If someone you care about feels ambushed or that they’re not being understood, it could end poorly, and they could refuse to get any help.

It’s never easy to see someone you love struggle with drugs or alcohol. So, when can you know if it’s the right time for an addiction intervention? Let’s take a look at some of the signs.

Sudden Behavioral Changes

Let’s face it; you know your close friends and family members. You know how they typically act—their normal behaviors, their personality, their preferences, etc. One of the best ways to tell if it’s time for an addiction intervention is simply to pay attention.

Has their behavior changed? Does something about them seem off? These subtle changes can be a good indicator when it comes to some of the first signs of an addiction. It’s essential to find out whether it’s an addiction causing the shift in behavior or something else. But, sudden behavioral changes are nothing to take lightly.

Stuck in a Fog

Has the person you care about become increasingly “foggy?” Do they have a hard time keeping up with conversations? Do they get confused easily? Maybe they’re struggling at work or school and can’t stay organized or be on time.

These are all vital signs that shouldn’t be ignored. It might be easy to make up excuses for someone, suggesting they’re just tired or stressed. If these signs become consistent, however, they might be turning to drugs or alcohol, and it could be the right time for an addiction intervention.

Isolation from Friends and Family

Common indicators of addiction are when someone stops doing the things they typically enjoy and isolates themselves from the people they love.

An addict often knows that what they’re doing is problematic. They can become ashamed or feel like no one will understand them. Isolation is often more comfortable for an addict than it is to face reality or people.

If someone you care about is spending much of their time alone, avoiding friends, making excuses to stay by themselves, it could be a sign of a bigger problem.

Talk to Someone About It

If you feel worried about your loved one, there’s a good chance someone else is, too. Don’t be afraid to talk to another close mutual friend or family member about your worries.

One of the worst things you can do is to keep your concerns to yourself. Or, to wait until the signs become extremely obvious, and your loved one is even deeper into their addiction.

Instead, pay attention to some of these warning signs to know when it’s time for an addiction intervention. Make sure you understand what the intervention itself should look like. You can choose to perform a “soft” intervention that is a bit more positive with fewer consequences, or a “hard” intervention that may require the one you love to get professional help to overcome their addiction.

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It’s okay to be nervous about launching an addiction intervention for someone you care about. But you don’t have to do it yourself. A trusted therapist can help you to understand some of the signs indicating our loved one is dealing with addiction.

If you’re not sure how to navigate an addiction intervention, feel free to contact me or visit my page on addiction interventions to learn more.

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Addiction Recovery

Addiction Recovery – for Professionals

If you are reading this, you are already taking a step in the right direction. Whether you are struggling with addiction yourself or love someone who is, getting more information is a good place to start. Addiction is a devastating disease that affects not just the addict but the entire circle of family and friends who care about them. And yes, addiction is a disease – a disease of the brain. The actual changes in physiology and neurochemistry are there – it is not a choice. However, just like a person fighting cancer – choice is involved in treatment and follow through. Genetics, lifestyle and and experiences all play a part, but once addiction is awakened, it’s a devil that doesn’t just go away. Lives change in it’s wake. Whether they change in bad ways or healthy ways is the choice an addict has in their addiction recovery – but sometimes that choice cannot even be discussed until the brain has been detoxed from the substance of abuse and begun to heal. Whether alcohol, prescription opiates, heroin, cocaine, marijuana or designer/synthetics – if you are committed to your recovery, or are the loved one of someone struggling with any of these – I’d like to help.

Addiction And The Brain 101

So, in simple terms, by the time addiction is in play – the brain sees the need for the alcohol or drug as an issue of actual survival. Seriously, the same part of the brain that tells you to jump back from the rattlesnake or get out of the way of the oncoming truck is lit up like a bonfire during a craving episode in addiction. This is old brain – old world brain – it’s the part of the brain that essentially makes up the brain of a reptile. We all have it. It’s concern is survival (and aspects around that) and nothing else. And in addiction, it trumps logic, reasoning, emotions – everything. During addiction the reptile part of the brain that usually sits in the back seat, jumps up and grabs the wheel.

So, how on earth can you expect to reason with old brain crisis-response wiring? Ultimately, you can’t. Not while the substance is still in control. Although the survival response comes from the non-dominant part of the brain, when it triggers the life-or-death survival button – it takes over and no argument or heartfelt plea is going to overcome it.

That being said, there are strong windows of opportunity to springboard addiction recovery. Sometimes it’s when an addict has hit an incredible wall of losses, sometimes it’s the edge of losing everything, sometimes it’s a wearing down to a few moments of openness amidst despair – it can come in many forms and no, it doesn’t require hitting “rock bottom”. If the addict is willing – don’t wait. No holiday, or inconvenience is worth an opportunity to get in front of this disease and begin to heal all the lives it is hurting. Whatever the excuse – remember that the risk is ultimately, death.

What The Different Levels of Treatment Looks Like

There are many levels of care and below I have listed from highest to lowest, the more common titles. There may be hybrids and extensions out there – but these are the core:

*Detox – Inpatient
*Residential-Inpatient
*Partial Hospitalization-Outpatient (although some with overnight exist)
*Intensive Outpatient Program (IOP) – Outpatient
*Counseling/Psychotherapy
*Community Support Orgs (12 Steps, SMART, Celebrate Recovery, etc)
*Sober Living (this provides housing environment to support any/all outpatient services above and I highly, highly recommend this for no less than 3-4 months in a reputable Sober Living residence)

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Why Discharge Plans and Recovery Plans Are Critical

Far too often, patients are so excited and looking forward to getting out of treatment and back home that they fail to put the amount of focus, investment and commitment into the ongoing plan for their recovery after they leave inpatient treatment. Remember the reptile brain we spoke of earlier? Well, here’s the kicker – he isn’t really restrained until 18 months after the last use. (and for life it’s a risk) But it gets better – it’s 18 months after the last use of any mood-altering substance – not just the one the addict happened to be dependent on. Although the first 60-120 days are likely to show the greatest improvement (longer with meth and a few other substances) – the old brain “reptile” is still going strong and the risk of relapse is great. Perhaps even greater because to the addict and many around them – life is already so much better and so our vigilance relaxes a bit.

After a residential treatment stay, I would encourage most people, especially those in treatment for the first time, to definitely go to an Intensive Outpatient Program (IOP). This helps to bridge the experiences and tools learned in the secure and protected environment of inpatient or residential with the transition back into the open community where the environment poses many more risks to the recovering addict.

Sober Living Homes

(*in a safe, professional and reputable establishment) are a must in my book. If you want to significantly raise the chances of long term recovery then this extends the intensive support frame during those critical months and gets you ahead of the game. Sober living provides an extension of the organization and security, in part, that an inpatient treatment level gives but allows for the recovering addict to return to work, school and family. Many professionals dismiss this as being intrusive, others do not want to burden their families in their absence and even collegiates will say they don’t want to lose a semester. Stop. Losing all of the progress that has been made with a fast relapse back to use, or worse, is what is at stake. Loved ones, this is your arena too, don’t let convenience keep you from supporting what is necessary. Compassion is not about what is wanted, but what is needed. Be clear about this.

evoNemot12 Step and Community Support Groups

A word about 12 Step and other community support organizations. While I strongly support these the fact remains that they are not a replacement for counseling – and counseling is not a replacement for them. These groups are built as communities of mentors and peers – it is a communal path of support. Counseling is a clinical service delivered by professionals – it addresses emotional, psychological and complex cognitive issues. They are not the same and most long term recovering addicts will tell you they have used both. (be very cautious about a representative of either group who maligns or diminishes the other – this is your recovery path, get what you need from it.)

Why Loved Ones Need Help Too

Parents, partners, family – loved ones. This is called a “family disease” for a reason – it affects the whole family. No matter how strong or removed from it you may think you are – it affects the family; everyone. Many addiction recovery situations are made so much more complicated and jeopardized because of the false beliefs that the addict “is the one who’s sick” or “it’s their problem” – and so the hurt, confusion, resentment and pain just sits and ferments in all those around them. If you are a loved one of an addict – in addiction recovery, in treatment or actively using – you need support and information too, a lot of it. The denial that addicts have in the midst of their disease is less insipid because everyone but the addict sees it. The denial held by the loved ones is much harder because usually very few see it and even fewer will call it out and confront it. The very best gift you will ever give yourself and the addict you love is to get some help – private counseling, a support group of other loved ones of addicts – there are lots of resources out there. If you or a loved is struggling with the disease of addiction and you are ready to make changes and get your life back, I am here and I can help you.grief

Ben Carrettin is Nationally Board Certified, a Licensed Professional Counselor and Licensed Chemical Dependency Counselor with over 20 years of experience. Ben has worked in the arena of addiction/emotional health and the corporate world for many years. He works with both addicts and with the spouses, partners and parents of addicts – ask about his “What Now?” workshops for loved ones or his recovery consults for professionals. If you have reached a point where you are ready for change, Ben is here to help.

Call Now (346)-493-6181

Addiction Recovery Counseling and Support

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Ben Carrettin is a Nationally Board Certified Counselor (NCC), Licensed Professional Counselor-Supervisor (LPC-S) and Licensed Chemical Dependency Counselor (LCDC). He is the owner of Practice Improvement Resources, LLC; a private business which offers an array of specialized counseling, evidenced-based clinical consultation, Critical Incident Stress Management (CISM) and targeted ESI-based services to individuals and businesses.