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Posts Tagged ‘recovery’

Coping With the Stigma of Addiction

May 27th, 2010 No comments

Stigma is one of the meanest and most difficult aspects of addiction because it makes it harder for individuals and families to deal with their problems and get the help they need. Society imposes stigma – and its damage – on addicts and their families because many of us still believe that addiction is a character flaw or weakness that probably can’t be cured. The stigma against people with addictions is so deeply rooted that it continues even in the face of the scientific evidence that addiction is a treatable disease and even when we know people in our families and communities living wonderful lives in long-term recovery.

Stigma is the reason there is so much social and legal discrimination against people with addictions. It explains why addicts and their families hide the disease. Discrimination always hurts stigmatized groups because they are excluded from the rules that apply to “normal” people. So insurance companies get away with refusing to pay for alcohol or drug treatment, or with charging higher deductibles and co-pays than for treating any other disease. People who need the help are often afraid to speak up. State and federal agencies feel safe in denying food stamps and baby formula to mothers who have past drug convictions because mothers who used drugs have few supporters in the political system and face lots of people who think they must be “bad mothers.” Though studies have found that helping employees to recover is more cost-effective than termination, some employers believe that firing an employee with a drinking problem is a lot easier than providing rehabilitation. A firestorm of protest would erupt if employers treated workers with cancer or heart disease the same way.

People who are victims of stigma internalize the hate it carries, transforming it to shame and hiding from its effects. Too often, people with alcohol and drug problems and their families begin to accept the ideas that addiction is their own fault and that maybe they are too weak to do anything about it. In many ways, hiding an addiction problem is the rational thing to do because seeking help can mean losing a job and medical insurance, or even losing your child when a social service agency declares you an unfit parent because you have an alcohol or drug problem.

The stress of hiding often causes other medical and social problems for the individuals and their families. This is especially true when an adolescent has an alcohol or drug problem. Fear often prompts kids to conceal the problem from parents. Then, when parents find out, stigma makes them feel guilty and somehow negligent. Illness and family dysfunction explode. When that happens, parents find it even harder to fight for the care and resources their child urgently needs from a social and medical system that blames the family and the child.

By David L. Rosenbloom

Why Do Some People Become Addicted?

May 21st, 2010 No comments

For two decades, researchers have been struggling to identify the biological and environmental risk factors that can lead to addiction to alcohol and other drugs. These factors form a complex mélange in which the influences combine to bring about addiction and to make its treatment challenging. But scientists know more about addiction now than they did even 10 years ago, and have learned much about how the risk factors work together.

The widely recognized risk factors include:

  • Genes: Genetics play a significant role: having parents with alcoholism, for instance, makes you four times more likely than other children to become alcoholics. More than 60 percent of alcoholics have family histories of alcoholism.
  • Mental illness: Many addicted people also suffer from mental health disorders, especially anxiety, depression or mood illnesses.
  • Early use of drugs: The earlier a person begins to use drugs the more likely they are to progress to more serious abuse.
  • Social environment: People who live, work or go to school in an environment in which the use of alcohol and other drugs is common – such as a workplace in which people see heavy drinking as an important way to bond with coworkers – are more likely to abuse drugs.
  • Childhood trauma: Scientists know that abuse or neglect of children, persistent conflict in the family, sexual abuse and other traumatic childhood experiences can shape a child’s brain chemistry and subsequent vulnerability to addiction.

“The kids most likely to get addicted are the ones who also have other problems,” says Dr. Mark Willenbring, who directs the Division of Treatment and Recovery Research of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Forty percent of people who start drinking before they are 15 years old develop alcoholism. Addiction is at the end of a spectrum of substance use problems; for most people, though not all, addiction arrives after other phases of drinking or drugging go uninterrupted. That’s why it is so important to treat substance use problems in their earliest stages. Although genetic researchers are trying to identify the genes that confer vulnerability to alcoholism, this task is difficult because the illness is thought to be related to many different genes, each of which contributes only a portion of the vulnerability.


Stress and Addiction Science shows that stress and addiction are so closely intertwined that to recover, people with addictions must learn new ways of coping with stress. 

Co-occurring Disorders  

A significant portion of people with addictions also suffer from other mental health illnesses, called co-occurring disorders. Without comprehensive treatment, people with co-occurring disorders are far less likely to recover from their addictions. 

 

Source: HBO Understanding Addiction

Mom Hits Bottom After Years of Drinking

April 29th, 2010 No comments
Lynn Wardlow says concern for her health and family helped convince her to quit.

At the end of a country road, inside the walls of a quaint and calm Hattiesburg, Miss., home, a family was in crisis.

Lynn Wardlow, a 50-year-old wife and mother of three, had been a drinker for more than 20 years. All the while, though, she ran a family business and raised her children.

In January, “20/20? visited Wardlow. It was the day before she’d planned to give up alcohol for good.

“My hands are shaking,” said Wardlow as she packed her bags. “God, I hope I remembered to bring underwear.”

Watch the full story Friday on “20/20? at 10 p.m. ET

Click HERE for further “20/20? coverage of mothers and alcoholism.

In the morning, Wardlow would travel from the Gulf Coast to Palm Beach, Fla., check herself into a medical facility for detox and then enter a 30-day rehab program for her alcohol addiction.

Meanwhile, Wardlow planned one last hurrah. She took a bottle from a cabinet in her bedroom.

“Would this be my best choice for my last bottle of wine?” she asked.

The last year in the Wardlow home had been particularly difficult, especially for the children — Bo, 21; Jessy, 20; and Marina, 17.

“She’s been drinking every night for as far back as I don’t even know,” said Bo. “The last year there’s been a lot of drama, and it’d be nice if things were just normal for even just a little while.”

Wardlow poured herself some wine. “My kids want me to just stop, stop, stop, but I like, I don’t think I can just stop,” she said.

“And if I did, I don’t know if I would feel very good, or if we might have to go to the hospital, because I just stopped after I’ve been going, go, go, go for so long.”

Wardlow’s children have witnessed things no child should ever see: their mother passed out in her closet, in a drunken rage at a bookstore, in a car attempting to drive after an alcohol-infused fight.

“It’s hard to see someone you love have to be addicted to something in order to feel better,” said Marina.

“It makes you feel like you’ve done something wrong,” said Jessy.

Drunken Moms: ‘When She Gets Like That’

The kids say their mother’s drinking had reached a critical point. Last April, Wardlow was diagnosed with hepatitis C, unrelated to her alcoholism. Unless she quit drinking, she could die.

But even the threat of losing her life, the family said, hadn’t stopped Wardlow from consuming alcohol.

“I want my mom to get better and not just for our sake but for her sake for her health,” said Jessy.

Wardlow’s last night at home was tense. The alcohol fueled her anxiety of what was to come.

“I think after two drinks, I’m like, you know what, these people aggravate me,” said Wardlow, who ran the family’s ceiling construction business. “And they aggravate me during the course of the day, and at the end of the day, I have a couple of drinks.”

The kids knew better than to stick around once Lynn started drinking. Wardlow’s husband, Bob, soon became a target.

“If you want to spend more time with Bill O’Reilly and your computer then go ahead,” Wardlow cracked.

“When she gets like that, conversations can turn to arguments,” said Bob.

“Or being an a**hole can turn to arguments,” said Wardlow. “Maybe I’m just able to say, you know what, [I've] had it up to here!”

The next morning, her head a little clearer, Wardlow acknowledged that rehab may be her last chance.

“I’ve affected my children. … Our relationships would be different if alcohol wasn’t a part of my life,” she said.

But just before she walked out the door, the leftover wine from the night before called to her.

“I’m not going to drink that,” Wardlow said, wavering before she gave in and took a sip.

Wardlow’s family walked her down the steps. She gave them kisses. She grew emotional.

“I’m not the only person who needs to be healed,” said Wardlow. “I’m not the only person who has been affected by this.

“It’s gonna be good,” she assured her famliy. “I’m going to get better.”

Two planes, three bloody mary’s and two beers later, Wardlow landed in Florida.

She was greeted by Loren Seaman from the Orchid Recovery Center, where Wardlow would surrender herself for treatment.

“Did you drink?” Seaman asked.

“Well, hell yeah,” Wardlow said.

Wardlow and Seaman had been talking for weeks on the phone to prepare for her arrival.

But before her bags had even make it downstairs, a shoeless Wardlow headed off for one more drink.

“We’re going to make a new martini,” Wardlow said. “It’s called the Lynn’s-quitting-drinking-and-going-to-rehab martini. Ready?

Drunken Moms: Tough Recovery Odds

Finally, it was time for Seaman to sign Wardlow into the center.

“Have you ever been to detox?” Seaman asked. The answer was no.

“It’s OK, I’m good,” said Wardlow, laughing. “I’m drunk, so right now I ain’t scared. Give me a day or two, and I’m probably going to be frightened out of my wits.”

Over a million people submit to detox and rehab programs for alcohol addiction every year in this country. The odds going into rehab were against Wardlow. Studies show that 90 percent of people in recovery relapse.

Wardlow had a session with Linda Burns, head of nursing at Sunrise Detox.

“How much are you drinking a day, about?” Linda asked.

“Four, five, six …” replied Wardlow.

According to the National Institute on Alcohol Abuse, one third of alcoholics in the United States are women.

Staff at both the Orchid and Sunrise Detox Center told “20/20? that about 95 percent of the women they pick up at the airport are intoxicated upon arrival. Wardlow was no exception.

A Sunrise Detox tech measured Wardlow’s blood alcohol content upon admission.

“You’re not too bad — .106,” the tech said.

“What does that mean?” said Wardlow. “Would I be arrested?”

“Oh, definitely, yeah.”

“I would be arrested.”

“Yeah.”

“Point-zero-8 is the limit, and I’m at point 1-plus over. I’m over the limit to drive a vehicle.”

“Yes, you would be wearing nice bracelets.”

For the next five days — standard for alcohol addiction — Wardlow remained at Sunrise. She was medicated with a drug called librium to eliminate the side effects of withdrawal, which can range from tremors and insomnia to delirium or even seizures.

From day one, Wardlow was restless.

“If you reached in your pocket right now and pulled out a beer, it would be really hard for me not to drink it,” she told “20/20.” “Quite honestly, it would.”

By day four, her impatience and boredom reached all-time highs.

“I have not had a good morning,” she said, talking to a portable camera “20/20? gave her to document her journey. “I have cried on more than one occasion today. I have come to the realization that this is the closest thing to a jail that I have ever been in.”

But it was only the beginning of a long and difficult journey.

The next step for Wardlow was the Orchid Recovery Center, a drug and alcohol rehabilitation center designed specifically to treat women.

“We’re just glad you’re here, Lynn,” said an Orchid staff member who welcomed her.

“Thank you,” said Wardlow. “I’m glad I’m here too.”

Drunken Moms: From Detox to Rehab

Normally, TV cameras are not permitted to see inside the walls of a rehab facility. But with Wardlow’s permission, the Orchid Recovery Center allowed “20/20? unprecedented access to their treatment process.

“You don’t know Lynn clean and sober,” Mindy Appel, Wardlow’s therapist at the Orchid, told her. “You don’t know that woman.”

Unlike at detox, Wardlow’s days at rehab would be packed, from six in the morning until nine at night. She would have individual and group therapy sessions mixed with yoga, meditation, accupuncture and art.

An all-female facility, the Orchid is run almost exclusively by women, many of whom have been through some type of addiction recovery of their own.

The Orchid places enormous weight on the honing of life skills, encouraging women to shop and cook for themselves — all of the things they’ll have to do back home. But sometimes, even a simple trip to the grocery store can spell trouble. Once a woman from the center drank vanilla extract from the store. It’s 24 percent alcohol. The woman drank five or six big bottles, staff said — and came back reeking of alcohol and walking funny.

For recovering alcoholics, triggers to resume drinking can be anything from beer commercials on TV to the wine store they used to frequent — anything that reminds them of drinking, said Orchid staff.

Wardlow’s heavy lifting for the next 30 days would happen inside the office of Appel, her therapist.

“We want to stay really focused, and I’m going to keep you on task here,” Appel told her.

During her first session, Wardlow confessed her reasons for drinking went back to her relationship with her father.

“So what was growing up like for you?” asked Appel.

“I had times of sadness,” said Wardlow. “My father was an alcoholic… When I was 15 he decided it was time to go … so he died.”

Genetics may also have had a role in Wardlow’s addiction. Studies show that children of alcoholics are four times more likely to develop the problem.

A week into her treatment, “20/20? co-anchor Elizabeth Vargas paid a visit to Wardlow at Orchid. She appeared more calm and focused but still struggled with her addiction.

Vargas asked her if it was hard.

“It’s really hard,” she said. “It is hard and it’s, and it’s hurtful, and you realize how many people that you’ve hurt. And my children are amazing. I mean, I look at them, and I know I’ve not been a bad mother. I’m like, I know I’m a good mother. I’ve mothered them well — but how much better could it have been if these past 10 years, I hadn’t been living in the bottom, in the bottom of a bottle?”

Wardlow described the cycle of her drinking.

“I wake up the next morning, you feel horrible, and you say, ‘I’m gonna do better. I’m gonna do better. I’m gonna do better. So, but I don’t feel very good today. So this afternoon, I’m just gonna have a beer.’” Which turns into “three or four or five or six.”

Are Mothers Drinking More?

The team of therapists at the Orchid said regrets and expectations about being the perfect mother are often what push a woman deeper into her addiction.

“There’s so many women that are so sophisticated at covering up and being, you know, the PTA mom and being the soccer mom and doing all things for everyone,” said Appel.

But are women, particularly mothers, drinking more — or are we just finding out about it more?

“I think we’re finding out about it more,” said Mindy Agler, another therapist on the Orchid team. “[It's] just not something you talk about. … If a man walks away from a family because he needs to focus on his recovery, everybody says OK, so he needs to do that. But if a woman leaves her family to go get treatment and then decides ‘You know what, I’m not ready, I got to go to a halfway house before I go back to my kids,’ everybody goes, ‘Oh my God.’”

That double standard and the stigma of alcoholism can keep a woman’s disease under wraps. But past traumas, the therapists say, can also play a role.

In her short time at the Orchid, Wardlow opened up about not only her alcoholic father but other traumatic experiences: an abortion at 17, and a horrific gang-rape on her 18th birthday.

“She identifies, from 15 to 18, these were horrible years for her,” said Appel. “That she’s never, never dealt with.”

The entire time, a question hung in the background: Would Wardlow make it through treatment, and would she be able to stay away from alcohol once she was back home?

“I’ll be honest with you, I’m scared as hell,” she said. “I’m scared, I’m scared to go home.

Wardlow left the Orchid with 30 days clean and a lifetime of hurdles in front of her. We visited Wardlow in Hattiesburg after her release. She was ready to add another day to her sobriety.

“This is my little tablet,” she said, indicating a pad of paper. “And I wad up yesterday and I write today down, put my little tablet back up there, and if I drink, I have to put that tablet on zero — and I don’t want to have to do that.”

The time back home had not always been easy.

“We had to relearn how to live with one another,” said Wardlow. “The first week or two was pretty volatile. Not in a physical way, but there was lots of screaming and gnashing of teeth.”

But there are signs of healing.

“We’re all really proud of her,” said Marina. “I know if she sets her mind to anything, that’s what she’s going to do. I’m just glad that she finally set her mind to it.”

“I think she’s trying to be more aware, and I think she’s trying to make up for, in some aspects, everything that’s happened and stuff,” said Jessy. “But I think she’s working on it. … I think she’ll do it. I believe in her.”

Wardlow had followed her care plan closely. She had daily phone calls with her sponsor and attended support group meetings regularly.

To stay with the recovery program, Wardlow can never consume a drop of alcohol — or take any habit-forming medication — again.

“No mood-altering drugs, as far as any type of benzos or opiates or whatever,” she said. “I was on tremizal for joint pain. Also I was taking lunesta to sleep, and I’m not taking that any more either.”

Wardlow left one support meeting with a chip marking how long it had been since she’d stopped drinking.

“Ninety days! 90 Days,” she said. “Big three months. Three months sober.”

By SEAN DOOLEY and SHANA DRUCKERMAN

Drug and Alcohol Relapse Prevention

April 15th, 2010 No comments

Drug Residues Remain in Fatty Tissues

Drugs are broken down in the liver into substances called metabolites. Although removed rapidly from the blood stream, metabolites can become trapped in the fatty tissues. The one thing in common—and the problem that needs to be addressed—is that these drug residues remain trapped for years.

Tissues in our bodies that are high in fats are turned over very slowly. When they are turned over, the stored drug metabolites are released into the blood stream and reactivate the same brain centers as if the person actually took the drug. The former addict now experiences restimulation of a drug episode (or “flashback”) and subsequent drug craving. This is common in the months after an addict quits and can continue to occur for years, even decades.


Drug and Alcohol Relapse Prevention

The Cycle of Quitting, Withdrawal, Craving And Relapse

When the addict initially tries to quit, cells in the brain that have become used to large amounts of these metabolites are now forced to deal with much decreased amounts. Even as the withdrawal symptoms subside, the brain “demands” that the addict give it more of the drug. This is called drug craving.

Craving is an extremely powerful urge and can cause a person to create all kinds of “reasons” they should begin using drugs again. He is now trapped in an endless cycle of trying to quit, craving, relapse and fear of withdrawal.

Eventually, the brain cells will again become used to having lowered drug metabolites. But, because deposits of drug metabolites release back into the bloodstream from fatty tissues for years, craving and relapse remain a cause for concern.

Left unhandled, the presence of metabolites even in microscopic amounts cause the brain to react as if the addict had again actually taken the drug and can set up craving and relapse even after years of sobriety.

Source: Narconan

Substance Abuse & Mental Health

April 7th, 2010 No comments

Co-occurring disorders, also referred to as dual diagnosis, is a term used when you have both a mental health disorder—such as depression, anxiety, or bipolar disorder—and a drug or alcohol problem. Both the mental health issue and the addiction have their own unique symptoms that may get in the way of your ability to function, handle life’s difficulties, and relate to others.

Complicating the situation, the two problems affect each other and interact. When a mental health problem goes untreated, the substance abuse problem usually gets worse as well. And when alcohol or drug abuse increases, mental health problems usually increase too.

Recovery depends on treating both the addiction and the mental health problem

Whether your mental health or substance abuse problem came first, recovery depends on treating both illnesses. The good news is that most people suffering from co-occurring addiction and mental health problems are able to recover, given proper treatment and support.

  • There is hope. Recovering from co-occurring disorders takes time, commitment, and courage. It may take months or even years. But people with substance abuse and mental health problems can and do get better.
  • Combined treatment is best. Your best chance of recovery is through integrated treatment for both the substance abuse problem and the mental health problem. This means getting combined mental health and addiction treatment from the same treatment provider or team.
  • Relapses are part of the recovery process. Don’t get too discouraged if you relapse. Slips and setbacks happen, but, with hard work, most people can recover from their relapses and move on with recovery.
  • Peer support can help. You may benefit from joining a self-help support group like Alcoholics Anonymous or Narcotics Anonymous. They give you a chance to lean on others who know what you’re going through and learn from their experiences.

What comes first: Substance abuse or the mental health problem?

Addiction is common in people with mental health problems. But although substance abuse and mental health disorders like depression and anxiety are closely linked, one does not directly cause the other.

The relationship between substance abuse and mental health problems

  • Alcohol or drugs are often used to self-medicate the symptoms of depression or anxiety. Unfortunately, substance abuse causes side effects and in the long run worsens the very symptoms they initially numbed or relieved.
  • Alcohol and drug abuse can increase underlying risk for mental disorders. Mental disorders are caused by a complex interplay of genetics, the environment, and other outside factors. If you are at risk for a mental disorder, drug or alcohol abuse may push you over the edge.
  • Alcohol and drug abuse can make symptoms of a mental health problem worse. Substance abuse may sharply increase symptoms of mental illness or trigger new symptoms. Alcohol and drug abuse also interact with medications such as antidepressants, anti-anxiety pills, and mood stabilizers, making them less effective.

Addiction is common in people with mental health problems

According to reports published in the Journal of the American Medical Association:

  • Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.
  • Thirty-seven percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
  • Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs.

Source: National Alliance on Mental Illness

Recognizing and diagnosing co-occurring disorders

It can be difficult to diagnose a substance abuse problem and a co-occurring mental health disorder such as depression, anxiety, or bipolar disorder. It takes time to tease out what might be a mental disorder and what might be a drug or alcohol problem.

Complicating the issue is denial. Denial is common in substance abuse. It’s hard to admit how dependent you are on alcohol or drugs or how much they affect your life. Denial frequently occurs in mental disorders as well. The symptoms of depression or anxiety can be frightening, so you may ignore them and hope they go away. Or you may be ashamed or afraid of being viewed as weak if you admit the problem.

Admitting you have a problem is the first step on the road to recovery

Just remember: substance abuse problems and mental health issues don’t get better when they’re ignored. In fact, they are likely to get much worse. You don’t have to feel this way! Admitting you have a problem is the first step towards conquering your demons and enjoying life again.

  • Consider family history. If people in your family have grappled with either a mental disorder such as depression or an alcohol or drug addiction, you have a higher risk of developing these problems yourself.
  • Consider your sensitivity to alcohol or drugs. Are you highly sensitive to the effects of alcohol or drugs? Have you noticed a relationship between your substance use and your mental health? For example, do you get depressed when you drink?
  • Look at symptoms when you’re sober. While some depression or anxiety is normal after you’ve stopped drinking or doing drugs, if the symptoms persist after you’ve achieved sobriety, you may be dealing with a mental health problem.
  • Review your treatment history. Have you been treated before for either your addiction or your mental health problem? Did the substance abuse treatment fail because of complications from your mental health issue or vice versa?

Signs and symptoms of alcohol or drug addiction

If you’re wondering whether you have a substance abuse problem, the following questions may help. The more “yes” answers, the more likely your drinking or drug use is a problem.

  • Have you ever felt you should cut down on your drinking or drug use?
  • Have you tried to cut back, but couldn’t?
  • Do you ever lie about how much or how often you drink or use drugs?
  • Have your friends or family members expressed concern about your alcohol or drug use?
  • Do you ever felt bad, guilty, or ashamed about your drinking or drug use?
  • On more than one occasion, have you done or said something while drunk or high that you later regret?
  • Have you ever blacked out from drinking or drug use?
  • Has your alcohol or drug use caused problems in your relationships?
  • Has you alcohol or drug use gotten you into trouble at work or with the law?
Signs and symptoms of common co-occurring disorders

The mental health problems that most commonly co-occur with substance abuse are depression, anxiety disorders, and bipolar disorder.

Common signs and symptoms of depression

  • Feelings of helplessness and hopelessness
  • Loss of interest in daily activities
  • Inability to experience pleasure
  • Appetite or weight changes
  • Sleep changes
  • Loss of energy
  • Strong feelings of worthlessness or guilt
  • Concentration problems

Common signs and symptoms of mania

  • Feelings of euphoria or extreme irritability
  • Unrealistic, grandiose beliefs
  • Decreased need for sleep
  • Increased energy
  • Rapid speech and racing thoughts
  • Impaired judgment and impulsivity
  • Hyperactivity
  • Anger or rage

Common signs and symptoms of anxiety

  • Excessive tension and worry
  • Feeling restless or jumpy
  • Irritability or feeling “on edge”
  • Racing heart or shortness of breath
  • Nausea, trembling, or dizziness
  • Muscle tension, headaches
  • Trouble concentrating
  • Insomnia

Treatment for co-occurring substance abuse and mental health problems

The best treatment for co-occurring disorders is an integrated approach, where both the substance abuse problem and the mental disorder are treated simultaneously.

How do I find the right program for co-occurring disorders?

As with a substance abuse program, you want to make sure that the program is appropriately licensed and accredited, that the treatment methods are backed by research, and that there is an aftercare program to prevent relapse. Additionally, you should make sure that the program has experience with your particular mental health issue. Some programs, for example, may have experience treating depression or anxiety, but not schizophrenia or bipolar disorder.

There are a variety of approaches that treatment programs may take, but there are some basics of effective treatment that you should look for:

  • Treatment addresses both the substance abuse problem and your mental health problem.
  • You share in the decision-making process and are actively involved in setting goals and developing strategies for change.
  • Treatment includes basic education about your disorder and related problems.
  • You are taught healthy coping skills and strategies to minimize substance abuse, cope with upset, and strengthen your relationships.

You will know if you are receiving integrated treatment because your clinician or treatment team will do several things at the same time, including:

  • Help you think about the role that alcohol and other drugs play in your life. This should be done confidentially, without any negative consequences. People feel free to discuss these issues when the discussion is confidential, nonjudgmental, and not tied to legal consequences.
  • Offer you a chance to learn more about alcohol and drugs, to learn about how they interact with mental illnesses and with medications, and to discuss your own use of alcohol and drugs.
  • Help you become involved with supported employment and other services that may help your process of recovery.
  • Help you identify and develop your own recovery goals. If you decide that your use of alcohol or drugs may be a problem, a counselor trained in integrated dual disorders treatment can help you identify and develop your own recovery goals. This process includes learning about steps toward recovery from both illnesses.
  • Provide special counseling specifically designed for people with dual disorders. If you decide that your use of alcohol or drugs may be a problem, a trained counselor can provide special counseling specifically designed for people with dual disorders. This can be done individually, with a group of peers, with your family, or with a combination of these.

Source: SAMHSA’s National Mental Health Information Center

Group support for co-occurring substance abuse and mental health disorders

As with other addictions, groups are very helpful, not only in maintaining sobriety, but also as a safe place to get support and discuss challenges. Sometimes treatment programs for co-occurring disorders provide groups that continue to meet on an aftercare basis. Your doctor or treatment provider may also be able to refer you to a group for people with co-occurring disorders.

While it’s often best to join a group that addresses both substance abuse and your mental health disorder, twelve-step groups for substance abuse can also be helpful—plus they’re more common, so you’re likely to find one in your area. These free programs, facilitated by peers, use group support and a set of guided principles—the twelve stepsto obtain and maintain sobriety.

Just make sure your group is accepting of the idea of co-occurring disorders and psychiatric medication. Some people in these groups, although well meaning, may mistake taking psychiatric medication as another form of addiction. You want a place to feel safe, not pressured.

Locating a 12-step program in your area

Twelve-step programs, such as Alcoholics Anonymous or Narcotics Anonymous, can be a good source of support as you go through recovery. There are also specific 12-step groups that address co-occurring substance abuse and mental health disorders:

Supporting recovery from alcohol or drug addiction and mental health problems

Getting sober is only the beginning. Your continued recovery depends on continuing mental health treatment, learning healthier coping strategies, and making better decisions when dealing with life’s challenges.

  • Get therapy or stay involved in a support group. Your chances of staying sober improve if you are participating in a social support group like Alcoholics Anonymous or Narcotics Anonymous or if you are getting therapy.

  • Follow doctor’s orders. Once you are sober and you feel better, you might think you no longer need medication or treatment. But arbitrarily stopping medication or treatment is a common reason for relapse in people with co-occurring disorders. Always talk with your doctor before making any changes to your medication or treatment routine.
  • Learn how to manage stress. Stress is inevitable, so it’s important to have healthy coping skills so you can deal with stress without turning to alcohol or drugs. Stress management skills go a long way towards preventing relapse and keeping your symptoms at bay.

  • Know your triggers and have an action plan. If you’re coping with a mental disorder as well, it’s especially important to know signs that your illness is flaring up. Common causes include stressful events, big life changes, or unhealthy sleeping or eating. At these times, having a plan in place is essential to preventing drug relapse. Who will you talk to? What do you need to do?
  • Adopt healthy habits to support your mental health. Basic self-care practices are essential to good mental and physical health. Eating right gives you plenty of energy and helps prevent mood swings. Sleep and exercise are also key to good mental health. Regular exercise is a powerful antidepressant and sticking to a sleep routine helps balance mood.

Helping a loved one with co-occurring disorders

Helping a loved one with both a substance abuse and a mental health problem can be a roller coaster. Resistance to treatment is common and the road to recovery can be long. It’s common to feel isolated, overwhelmed, scared, and confused.

The best way to help someone is to accept what you can and cannot do. You cannot force someone to remain sober, nor can you make someone take their medication or keep appointments. What you can do is make positive choices for yourself, encourage your loved one to get help, and offer your support while making sure you don’t lose yourself in the process.

  • Seek support. Dealing with a loved one’s mental illness and substance abuse problem can be painful and isolating. Make sure you’re getting the emotional support you need to cope. Talk to someone you trust about what you’re going through. It can also help to get your own therapy or join a support group.
  • Set boundaries. Be realistic about the amount of care you’re able to provide without feeling overwhelmed and resentful. Set limits on disruptive behaviors, and stick to them. Letting the substance abuse problem or mental illness take over your life isn’t healthy for you or your loved one.
  • Educate yourself. Learn all you can about your loved one’s mental health problem, as well as substance abuse treatment and recovery. The more you understand what you’re loved one is going through, the better able you’ll be to support recovery.
  • Be patient. Recovering from addiction and mental health problems doesn’t happen overnight. Recovery is an ongoing process that can take months or years, and relapse is common. Ongoing support for both you and your loved one is crucial as you work toward recovery.

Source: Helpguide.org

Addiction and the Brain

April 3rd, 2010 No comments

The truth about the cycle of addiction

The brain and addiction… what is the relationship? There has been an ongoing debate for years about where addiction actually originates from. You will find some drug addiction treatment professionals who claim addiction is a lack of willpower, while others insist that addiction is a disease of the brain, complete with signs and symptoms. The truth about addiction, as concluded by the American Medical Association with research-based criteria, is that addiction is most definitely a disease that is chronic in nature not unlike cancer, diabetes or bipolar disorder. Another critical outcome of the research-based study showed that the brain of the individual suffering from drug or alcohol addiction is both chemically and physiologically dissimilar from that of the normal brain. This particular finding supports the theory that the brain and addiction are interconnected. This is critical to understanding addiction, its development and an individual’s recovery process.

Addiction Definition

The word addiction is best defined as the obsessive thinking and compulsive need for and use of drugs, alcohol, food, sex or anything that is psychologically or physically addicting. Addiction can also be described by the development of tolerance with distinguishable withdrawal symptoms upon discontinuing the use of the particular drug or behavior. In addition to the development of tolerance with regards to addiction, the addict or alcoholic will experience intense physical cravings for the drug accompanied by an emotional obsession to take the drug regardless of the consequences. The process of addiction that leads the individual to experience the compulsive need for drugs regardless of the consequences is directly related to the change in brain chemistry affecting the process of thought.

The Science Behind the Brain and Addiction Relationship

Scientifically-based research on the brain and addiction relationship has demonstrated to us that drugs, alcohol and specific behaviors have a significant impact on the reward center located in the brain. Levels relating to certain neurotransmitters, send messages to the brain. These neurotransmitters include serotonin and dopamine. Chronic use of drugs and alcohol tends to over-stimulate the brain until it must depend upon substances and behaviors to produce the needed chemicals. This chemical dependency is what leads to tolerance and addiction.

Most people believe that drug addiction lies in the additional use of drugs or alcohol when it truly is related to chemical imbalances in the brain and the compulsion to use, regardless of the consequences. In light of all of this scientific research, we still find professionals who adopt the philosophy that addiction is due to a lack of willpower and/or moral imperfections.

Brain Chemistry and Addiction

Most individuals suffering from addiction use drugs or alcohol to feel “good” or to self-medicate physical or emotional pain. Substance use and addictive behaviors stimulate and increase the brain’s production and use of REWARD chemicals such as dopamine. Depending on the dose of the drug, the brain accepts neurotransmitters that are significantly more intense than they would experience during the “natural” highs produced by the brain normally. In basic terms, this is why addiction takes place physically and emotionally.

Addiction Alters the Brain

Over time, the continued use of a drug alters the way the brain functions. A person’s brain becomes dependent on receiving the substance. These changes in brain chemistry create the addiction and create the tolerance, withdrawal symptoms and cravings. The only “good” part regarding drug addiction is the disease is treatable and recovery is possible.

By Jonathan Huttner

What If Your Loved Ones Cannot Forgive Your Addiction

April 2nd, 2010 No comments

Coming back from the cycle of addiction is a long and tough road. Not only does it take a lot of courage and determination, but it’s physically and mentally taxing as well. When you’ve finished your treatment and are in recovery, you really need the love, support and encouragement of your loved ones to help you maintain your sobriety. So what happens if your loved ones cannot forgive your addiction? What if there’s so much weight in your baggage that they can’t look beyond the past?

Don’t worry. You can get past this. Here are some things to keep in mind.

First Things First

It’s important to recognize yourself first for the incredible achievement you’ve attained. At this stage of the game, you’ve completed your treatment – however personally challenging that may have been – and are now in recovery. This accomplishment alone is reason to celebrate. Sure, it would be great if your loved ones stood up and gave you credit for this, but it doesn’t detract from the fact that you did it. So, before you think about anything else, give yourself high marks for reaching this milestone.

Count Your Blessings

Now, while you are still giving yourself kudos for reaching the recovery stage, count your blessings for all the positive things that you have in your life. Loved ones notwithstanding, you do have them. Here are some that should rate high on your list. You now have a healthier physical condition, due to the fact that your body is no longer full of the harmful substances you previously ingested, or the addictive lifestyle you once maintained. You’ve made a lot of progress in understanding the roots and underlying causes for your addiction, learned how to identify triggers and how to avoid giving in to them. You worked hard on your self-esteem and self-confidence, learning that you have contributions that you can make to society. Even if you never felt that you made much of a difference before, you now know that each person can impact the lives of many around them, and that you have a tremendous opportunity to not only benefit your own future, but those of others as well.

These are all terrific blessings – and they don’t cost you a penny. While you’re at it, you can probably rattle off a few more. Include the fact that you now sleep better, are less depressed and anxious, look forward to each day rather than dreading what it will bring, and others.

How Bad is the Relationship?

Still, you need the love and support of those closest to you. Whether this is your spouse or partner, children, siblings or parents, the relationships mean a lot and are definitely worth preserving or repairing. Before you attempt to make any amends, however, you should first look at how bad the situation is with your loved ones. What do you see is the biggest obstacle to being whole again in their eyes? In other words, what will it take for them to forgive you – if you know? Maybe you think it is one thing, when, in fact, it may be something else altogether. Don’t just assume. Sit down and really try to figure it out.

Let’s say you’re the husband of a working wife who’s been struggling to keep the family together while you were in treatment. If there are children involved, magnify that struggle by increments depending on what shape (financially, emotionally, socially, etc.) the family was in prior to your entering treatment. Chances are, the inability of your loved ones to forgive you have a lot to do with heavy-duty emotional turmoil. Your spouse, for example, shouldered the burdens while you were away. She had to make many decisions on her own, not being able to get your input, or the situation demanded immediate attention. For a wife used to sharing decisions with her husband, this can take a tremendous toll.

Perhaps she had to scrimp to help pay for your treatment, since your insurance coverage either only covered part of it or you didn’t have any coverage. Having to sacrifice comforts the family has come to rely on or even pare necessities to the bone will build up resentment in the strongest and most caring person. Add that to the list of perceived grievances.

Being the sole parent also meant she shouldered dual roles in your absence. It’s tough to show love, dole out discipline when necessary, keep up appearances and try to ensure the children still have fun when you’ve got so much riding on the situation. She may have begun to wonder if the family would be better off without you. This thought, which is certainly understandable, would likely be instantly quashed as out of the question or a sign of betrayal (although it could still lurk beneath the surface). As you know from your own treatment, when you bury your emotions, they come back to haunt you or, at the very least, make growth more difficult.

While the above is just one example, the point is that you should make a list of the things that you believe stand in the way of your loved one forgiving you for your addiction. Once you have the list, you can go on to the next step.

Figure Out What to Do About It

Work down your list and try to come up with solutions to the problems. Again, this is something you do on your own even before having any conversation with your loved ones. Taking financial concerns into consideration, perhaps you can address how and when you will be able to alleviate this concern. Can you go back to your previous job? What are your employment prospects?
Did you get training in a new vocation or skill while you were in treatment? How willing are you to take any kind of job to
immediately start contributing to the family’s well being?

Recognize that you may have to start from scratch. You may have burned your job bridge behind you if you were fired for your addictive behavior. Or, your prospects upon your return may be limited for some time to come. In either case, start where you are and work your way back up. It’s really the only option you have, since you do have obligations and need to resume your role within society.

If you need training, look into how you can get it. Take any job and go to school at night, or learn a new trade or skill in an apprenticeship. Another advantage to tackling the financial concerns that may stand in the way of your loved ones’ forgiveness is that you will be doing something positive for yourself as well. Now could be the opportunity to ditch the old job you found boring or distasteful, or not reflective of your true talents or desires. Figure out what it will take for you to get where you really want to be – and then draft a plan to make it happen.

No, this goal won’t be realized overnight. It may take years for you to complete your degree, build up your own business, or become profitable, for example, but it is a positive first step toward eventually achieving the goal.

Speaking of time, it may be that you’ll need to prove yourself to your loved ones by being on your own for a while. It may be too painful for them to have you home on a full-time basis for now. You will need to accept that and really work at making the kinds of changes that can turn that around.

As for the emotional barrier that undoubtedly puts a strain on your relationship moving forward, this, too, requires time. Your loved ones may miss the financial security and feeling of self worth that came from having things in control – prior to your problems with addiction. A drastic drop in self confidence and self worth inevitably follows in the path of addiction, affecting everyone in the family. In fact, emotional turmoil is difficult for loved ones to overcome without some form of family treatment or counseling. They often are not able to see past barriers without professional help. Fortunately, such counseling is relatively easy to access – either as part of your aftercare treatment program, or through community services or self-help groups such as Al-Anon/Alateen, Nar-Anon, and others.

Remain Positive and Upbeat About the Future

Although it seems hard to look at a future without your loved ones in it, for now just keep as upbeat and positive as you can. Reach out to your support network of 12-step members and step up your meeting attendance. This is especially important at time in your life when your family environment may be severely constrained or restricted.

Your 12-step allies also include your sponsor. Don’t be afraid to ask for help from your sponsor, since he or she is ready, willing and able to give you the kind of encouragement and support you need, 24/7. You already have a pretty good familiarity with the 12-step process through contacts during your treatment program – if you went through a formal treatment program. If not, you do have a ready-made support network available to you through 12-step fellowships. There are 12-step groups for every kind of addiction. They are free to attend and have no memberships or dues. All they ask is for voluntary donations if you are able.
While the philosophies are similar and all are based on the 12-step principles, each has its own original focus and personality, if you will.

Here are some of the 12-step groups:

• Alcoholics Anonymous
• Cocaine Anonymous
• Crystal Meth Anonymous
• Debtors Anonymous
• Gamblers Anonymous
• Marijuana Anonymous
• Narcotics Anonymous
• Sexaholics Anonymous
• Sex and Love Addicts Anonymous
• Sex Addicts Anonymous
• Sexual Compulsives Anonymous
• Workaholics Anonymous

Besides in-person meetings, 12-step groups often offer online and phone meetings, blogs, and chats. Each group has its own website which provides access to articles, news, books, CDs, DVDs, and other resources, as well as helpful links for additional help. When you’re feeling down or lonely in the middle of the night, go online and check out some literature that may help – or get in touch with your sponsor or other 12-step group member with whom you have established a connection.

Make a Plan – and Stick To It

Besides continuing counseling, keeping an upbeat attitude and seeking the support and encouragement from your 12-step groups, what else can you do? The best advice is to make a plan, and stick to it. What do we mean by that? What kind of a plan are we talking about? It doesn’t matter what your plan is, or how simple or detailed. The point is that you will be doing yourself a great service by sitting down and designing a plan for your future.

Note the emphasis on your future. Here we are talking about what it is that you want for yourself one year, 5 to 10 years, or longer down the road. Make a list of your short-term (1 to 2 years), intermediate term (3 to 5 years), and long-term (5 to 10 years and beyond) goals. In the next column, jot down what you may need to do in order to reach the particular goal. This may include going to school, getting training, learning a new language, becoming proficient at a sport, joining a recreational or travel group, or something else. In the next column, write down everything you can think of in the way of resources available to help you get started. Include websites, organizations, advice or recommendations from friends, scholarships, grants, community, state or federal programs, etc.

Once you have your list, get started on the short-term goals, things you can tackle right away. Keep in mind that you should strive to make some progress each day or week toward your intermediate and long-term goals as well. This can take the form of gathering information, checking out websites, filling out applications, taking a class, and so on. Remember that your list of goals is only a guideline. Nothing is written in stone. Keep it flexible and always consider it a work in progress. Once you achieve a goal, take time to acknowledge your achievement. Give yourself the credit you deserve.

While you are pursuing your goals, and especially when you reach milestones in your sobriety (first year of sobriety, for example), take a moment to reflect how much differently you feel now than at the beginning of your recovery. Each small step you take toward the future means that much more progress that you have made. Your overall outlook will change as well. You will look forward to each day as a new opportunity to make a difference.

During this time, if not before, you may have been able to repair your relationship with your loved ones. If they have not forgiven you, they may have at least accepted your sincere expression of wanting to make amends. You will find that you will be able to move on. To do this most effectively, you need to be able to forgive yourself. Forgiveness from others, including your loved ones, has more of a chance.

There is an old expression, When one door closes, another opens. This is true in recovery from addiction as well. Open your heart to be able to receive love, as well as give it.

Source: www.drugaddictiontreatment.com

Buprenorphine & Opiate Addiction

March 25th, 2010 1 comment

Buprenorphine was initially introduced on the market in the 1980s as an analgesic. Now, its primary use is for the treatment of opioid addiction.

One dose of buprenorphine remains active in the human body for as long as 48 hours, which provides a longer duration than morphine. This is one of the qualities that make this drug ideal for helping opioid addicts to break free of their addiction. Since the drug remains in the body for 48 hours, it also ensures that the withdrawal symptoms that people experience are significantly decreased.

Buprenorphine requires sublingual (under the tongue) administration on a frequent basis. Drug administration should always be supervised by a substance abuse treatment professional, and doses must be strictly monitored. Federal regulations require this in order for treatment centers and medical facilities to be able to administer the drug at all.

There are some side effects that can occur along with the use of buprenorphine. They range from moderate to severe, and it should be pointed out that this drug can, in some cases, produce fatal side effects. The most commonly occurring side effects include the following:

• Headache

• Drowsiness

• Dizziness

• Vomiting

• Decreased libido

• Constipation

• Respiratory depression

Respiratory depression is the side effect that presents the most serious problems with the use of buprenorphine, as it can be fatal in some people. Unfortunately, there is no way to correct or treat this problem should it develop.

While undergoing buprenorphine treatment, all patients are regularly monitored to see how their livers are functioning, as some adverse effects can be caused by using this drug.

Even though buprenorphine is used to treat people with opioid addictions, the possibility does exist for an addiction to the buprenorphine itself to develop. The types of dependencies that can develop include both physical and psychological. People who are considering undergoing treatment with this drug should be aware, however, that instances of people becoming addicted to buprenorphine are quite rare.

Often times, one of the primary questions that people have is whether they should choose buprenorphine or methadone as a treatment option. Both of these drugs are routinely used for short-term and long-term treatment of opioid addiction. Dosing requirements may be a bit better with buprenorphine simply because of the drug’s ability to remain in the body for 48 hours, thereby offering longer-term effects. With buprenorphine, patients typically only have to receive a dose every other day, while methadone requires daily dosing.

Buprenorphine also has an advantage regarding the total amount of treatment time that is required to successfully complete a detoxification program. With buprenorphine, treatments generally last for a few months, while with methadone indefinite or sometimes lifelong treatment is necessary.

It is very important that buprenorphine be administered in an inpatient treatment facility, particularly one that specializes in substance abuse treatment. Inpatient treatment programs not only offer patients detox programs, they also offer treatment or rehabilitation programs that are designed to help people learn healthier ways of living. Some of these treatment programs include counseling, diet and exercise, massage, acupuncture, and group therapy.

The purpose in these additional treatments is to give patients a better chance of maintaining success by giving them the tools they need to lead lives that are free of substance abuse. If patients learn how to be healthy and happy (physically and emotionally) then they will be far less likely to have a relapse.

Dual Diagnosis What Is It & How It Affects Us

March 16th, 2010 No comments

A dual diagnosis is when a person has been diagnosed with two or “dual” conditions: an alcohol, drug or other substance addiction coupled with a mental health disorder. Many patients that are in addiction treatment are found to have a dual diagnosis. Of the two million people in the United States that suffer from mental illness, about 50% of them also are an alcohol, drug or other type of substance abuser. For an alcoholic, whether they have a dual diagnosis or not, they need to enter an alcohol addiction treatment program. For others that have substance abuse and addiction, a dual diagnosis, addiction treatment is not only warranted but desperately needed. Not every addiction treatment center is equipped to help this illness. It’s vitally important that a center with professional staff prepared to work with patients with a dual diagnosis is chosen.

Probably the most challenging area for health care providers is diagnosing patients who truly have a dual diagnosis. The reason a dual diagnosis is so difficult to determine is because more cases than not, a mental illness is coupled with a substance abuse and addiction situation. It is for this reason that many of these patients are placed in addiction treatment homes or centers only to discover that they are in fact dealing with a dual diagnosis. The problem is that substance dependence can masquerade as a psychiatric disorder, so many times the mental illness is not discovered or revealed until much later than at the initial evaluation.

It can be a very difficult situation to identify a patient with dual diagnosis. Most times they are in denial about their substance abuse so when the addiction is discovered, they overlook the fact that the mental illness is still exacerbating the substance problem and vice-versa. Therefore only one of the two issues is identified. And with teens it is even more difficult. With kids going through puberty and all of the emotional fluctuations that accompany that, how can you be sure that this young man or woman are actually suffering from a bi-polar disorder or even depression? For that very reason it is imperative that when seeking an addiction treatment center you find one that has an acute awareness of this dual disease. It is only then that you can truly have hope for a full recovery.

by Groshan Fabiola

When and Why to Go to Detox

November 4th, 2009 1 comment

Whether or not you think you need to go to a detox center it’s important to understand why detox is important and how it fits into rehabilitation. Detox is necessary to remove the physical addiction. Patients at a center will undergo a cleansing of their body to rid themselves of all the side effects that the drug or alcohol use could have caused. Many different types of detox can be utilized and will help different parts of the body cleanse themselves since excessive alcohol and drug use is not only damaging to someone’s life its also damaging to their body.

When you experience detoxification it involves taking control of the drugs that are causing the addiction. It can begin by purging the body of the drug and all residues that can still be contained within major organs. After this has occurred a very difficult phase for the addict begins called withdrawal. The body will still be craving the drugs and will cause the addict to become sick and overwhelmed by the physical demands of the body. This is a very emotional and hard time for the addict and its severity changes from person to person working with a detox center that has experience with withdraw is very important at this stage.

Now that the body is free of the drugs it is time for it to help healing. The drugs would have caused many changes in a person that they will not be fully aware of. The drugs affect the body and the mind and now that the mind is clear from the drugs then steps can be taken in finding the underlying issues that may have caused the addition in the first place. Creating a stable place is also an important function of a detox center and this can be done with medication at times but, sometimes especially with stopping alcohol use, a healthy lifestyle can be something that helps with the feeling of stability.

Moving beyond drug use and into a better life doesn’t stop at the detox center. It’s important to begin other programs that will help the recovery of the addict and form a support network when times are difficult. Finding a detox center that will help with the transition to other facilities or has programs also associated with the center will be very beneficial in the days, weeks, and months after detox has taken place.

By Jennifer E