America’s addiction crisis is now so pandemic that it features on one of the most popular TV programs for children. As was revealed in a recent episode, one of the Muppet characters on “Sesame Street” is struggling with a big, “grown-up” problem. Show producer Sesame Workshop created a series of videos in which young Karli talks to her friends about her mom’s struggle with addiction. Karli came to “Sesame Street” in May to stay with a foster family because her mother was “having a hard time.” Continue reading “Addiction Reaches Sesame Street”
by Michael Rass
Addiction can sneak up on you. You may be unaware of it, but you might be genetically predisposed to develop a substance use disorder (SUD) more easily than other people. The alcohol-related SUD listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is termed alcohol use disorder (AUD), featuring eleven diagnostic criteria. The presence of six of those criteria indicates a severe AUD or an alcohol addiction.
Early Warning Signs
Several of the DSM-5 criteria can be regarded as early warning signs. Is alcohol taken in larger amounts or over a longer period than was intended? And has there been a persistent desire or unsuccessful efforts to cut down or control alcohol use?
Many alcoholics remember periods early on when they tried to slow down their drinking, only to find that it didn’t actually happen. According to the DSM-5, the presence of these two criteria already indicates a mild alcohol use disorder. If these early warning signs are ignored, the AUD is likely to escalate. More and more time could be spent on obtaining alcohol, drinking alcohol, or recovering from its effects, and “continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol” may ensue.
The Drinking Escalates
Continued, excessive alcohol use despite negative consequences is a serious red flag that should not be ignored. Take a step back and honestly ask yourself, why is this happening? Why are you drinking more than you should? For many recovering alcoholics the answer is that they were self-medicating emotional pain or intense stress.
Do you drink to reduce social anxiety? Are you suffering from an anxiety disorder or depression? Then you should not drink alcohol in an attempt to reduce the symptoms of those conditions. While drinking may initially suppress symptoms of mental health disorders, it will eventually make them worse. If you suffer from too much stress, you need to address the cause of that stress instead of fleeing into alcohol misuse.
Unfortunately, many users start to rationalize their excessive alcohol consumption at this point and deny any warning signs to themselves and to others. They keep on drinking even though it is beginning to cause serious problems in their relationships, for their professional career, and physical health. They start to experience craving, or a strong urge to use alcohol, as their alcohol use has begun to hijack the reward cycle of the brain. They need alcohol just to feel normal.
Recognize the Real Drivers
Stress (especially if caused by a traumatic experience) or any mood disorder, combined with frequent alcohol use and a possible genetic predisposition may now unleash a severe alcohol use disorder or alcohol addiction. Individuals may experience blackouts after heavy alcohol use. Uncontrolled, persistent drinking will eventually lead to tolerance—more and more alcohol is needed to achieve the same effect—and withdrawal symptoms will increase if alcohol consumption is discontinued.
Don’t let it get that far. Heed the warning signs. Be mindful of the real reasons you’re drinking excessive amounts of alcohol. Seek professional therapy for any mental health condition you might have and counseling for any trauma you may have suffered. Be aware of people with alcohol use disorder in your family and be extra-cautious if close relatives have an AUD. Engage in activities that relieve stress but don’t involve using addictive substances.
If you are unsure if you have developed a substance use disorder, seek an evaluation to assess your drinking behavior. Don’t despair and don’t drown in your addiction. Help is available and recovery is possible!
by: Michael Rass
Sobriety is no longer just the earnest goal of recovering alcoholics. As of late, it has also become the holy grail of so-called “gray area” drinkers.
According to former social drinker Amanda Kudo that gray area is the “place where you’re not a super-casual, once-in-a-while drinker, but you’re also not a hit-rockbottom, time-to-get-help drinker, either. You’re just there, somewhere in the middle, drinking in a way that is still deemed socially acceptable if not socially necessary.”
Or as health coach Jolene Park put it in her TED talk, “from the outside looking in, my drinking did not look problematic, but from the inside looking out, I knew, the way I was drinking was a problem for me.” Many people like Kuda and Park say they never had a real drinking problem, but they had a problem with drinking.
One of those “gray area” drinkers was British expat Ruby Warrington, currently living in Brooklyn, who— according to the New York Times—”spent her early career quaffing gratis cocktails at industry events, only to regret the groggy mornings.”
“After moving to New York in 2012, Ms. Warrington tried 12-step programs briefly but decided that ‘Ruby, alcoholic’ was not the person she saw in the mirror,” wrote Alex Williams in the Times feature about a new sobriety trend spreading across the nation. “Three years ago she started Club Soda NYC, an event series for other ‘sober curious,’ as she termed them: young professionals who were ‘kind-of-just-a-little-bit-addicted-to-booze.’”
Being “sober curious” has caught on and Warrington wrote a whole book about this latest health fad. “For these New Abstainers, sobriety is a thing to be, yes, toasted over $15 artisanal mocktails at alcohol-free nights at chic bars around the country, or at ‘sober-curious’ yoga retreats, or early-morning dance parties for those with no need to sleep off the previous night’s bender,” wrote Williams.
But there is a serious side to avoiding alcohol use, of course. It is after all an addictive substance without any health benefits that physicians would acknowledge. And while the sober-curious vogue may well be short-lived, reducing or giving up alcohol consumption is certainly laudable since it comes with all kinds of health benefits.
When Jolene Park described her alcohol use as knowing “the way I was drinking was a problem for me,” she was actually paraphrasing the first diagnostic criterion of alcohol use disorder (AUD) in the of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which reads: “Alcohol is often taken in larger amounts or over a longer period than was intended.” And when she said in the same TED talk that she had no trouble stopping but couldn’t “stay stopped,” she was paraphrasing the second AUD criterion in the DSM-5. Two criteria (out of eleven) indicate a mild alcohol use disorder.
Park probably wasn’t aware of the DSM-5 criteria at the time but she read the warning signs correctly and realized that she was “kind-of-just-a-little-bit-addicted-to-booze.” She understood that her alcohol use could escalate further and made the right decision. She embraced sobriety.
She also realized that her alcohol use was a coping mechanism for her anxiety issues and designed a new coping strategy for herself based on connecting with nature and other people, exercise, and meditation. Park now shares this healthy approach to life with other people.
Amanda Kuda also realized that she needed to drink in order to relax. “But there was a bigger part of me that wanted to feel happy, joyful, vibrant, inspired, energized, motivated, fulfilled. Once I realized that alcohol was not only failing to contribute to those feelings, but was actually dragging me further and further away from them, I no longer wanted to drink.” Neither Park, Warrington, or Kuda sought detox or residential addiction treatment for their alcohol problem, and only Warrington briefly tried a 12step program. This low level of care for a mild or moderate alcohol use disorder may not be the right choice in all cases, though. Some patients might require an intensive outpatient program or even partial hospitalization. Only a careful assessment of the patient’s individual needs can determine the appropriate level of care.
Although none of the three “gray-drinking” women made use of a treatment program, they nevertheless realized a core principle of recovery. Stop using and change your life! Real recovery goes far beyond giving up substance misuse. It is a life-changing journey to long-term wellness that should make you feel happy, joyful, and inspired.
IF YOU OR A LOVED ONE IS STRUGGLING WITH SUBSTANCE USE DISORDER, OR YOU HAVE QUESTIONS ABOUT OUR PROGRAMS, CALL HARMONY TODAY AT 970.432.8075 TO GET THE HELP NEEDED AS SOON AS POSSIBLE
by Dr. Annie Peters: Harmony Foundation’s Chief Clinical Officer
Harmony has been helping people who are struggling with addiction to find recovery since 1969. While Harmony is well-known in Colorado for providing clients and families with support and quality services for many decades, reputation means little without demonstrating that people do, in fact, get better.
Defining what recovery is, and demonstrating that people who use Harmony’s services begin finding recovery, are essential components to the provision of ethical and effective care. Harmony’s mission is to provide the foundation for recovery from the diseases of drug and alcohol addiction. If clients leave treatment and begin re-developing lives of purpose, satisfaction, and rewarding relationships, we know we have helped to provide the foundation for a journey toward wellness.
Harmony contracts with an external research organization, OMNI Institute, to examine treatment outcomes regarding substance use, psychological well-being, and improvement in life satisfaction.
Data collection for the most recent outcomes study performed by OMNI began in March 2015, and the study was finalized in 2017. One hundred and forty eight (148) Harmony clients were assessed upon admission, at discharge, and at 1, 6, and 12 months post-discharge. The percentage of clients who responded at these time points were, respectively, 100%, 94%, 63%, 61%, and 64%. While results cannot be generalized to clients who were unable to be reached for follow up, a number of statistically significant findings can be reported and provide valuable information about the effectiveness of care provided at Harmony.
Understanding the people we serve helps us provide the highest quality of care by tailoring treatment interventions to the specific needs of our clients. In this study, the average age of clients was 38, with a range from 18-65. Sixty-four percent (64%) of clients identified as male, and 36% identified as female. All clients were asked to identify their “primary drug.” The majority of clients (74%) identified this as alcohol, followed by heroin (10%), methamphetamine (6%), other opiates/painkillers (5%), and marijuana (3%).
Clients under the age of 25 typically used more substances – the average number was four. The primary drug differed by age as well; clients under 25 identified heroin or alcohol (38% for each), followed by marijuana (13%).
REASONS FOR DRUG/ALCOHOL USE
Clients were asked about the reasons they used alcohol and drugs, and their responses help us understand how to help people better. Many clients (30%) said they used substances for “self-medication” or emotional pain/mental illness (28%). Other common answers were using for pleasure (22%), to escape reality (15%), habit (13%), or pain (5%).
PREVIOUS TREATMENT AND REASONS FOR SEEKING TREATMENT
About a third of clients had been to a detox treatment before, and about a third reported a prior treatment for substance use. Another third reported never having any treatment for drug or alcohol use.
About half of clients surveyed reported a prior diagnosis of a mental health disorder, with the most common diagnoses being depression (37%), anxiety (25%), ADHD (11%), PTSD (7%), and bipolar disorder (6%).
Most clients said that coming to treatment was a personal decision (71%). Other common reasons given for seeking treatment were a family situation, health reasons, a legal situation, or a job-related reason.
POST TREATMENT OUTCOMES
After leaving Harmony, clients were asked at 1, 6, and 12 months about their drug and alcohol use. They were asked whether they had been continuously abstinent from drugs/alcohol since discharge, and they were also asked if they had been clean/sober for the previous 30 days. As can be seen in the table below, over half of clients at one year post-discharge had been continuously abstinent since coming to Harmony, and 71% of them had been abstinent for the past 30 days.
Follow-up %Abstinent for %Continuously Abstinent
Time Past 30 Days since Discharge
1-month 77% (n=88) 68% (n=91)
6-month 64% (n=90) 57% (n=91)
12-month 71% (n=90) 54% (n=95)
Abstinence since treatment is not the only outcome that demonstrates that clients are recovering and have improved their lives. In this study, we also wanted to determine how quality of life had improved for people who had come to Harmony. So all those surveyed were asked questions about relationships with family and friends, physical/emotional health, and other factors. Clients reported significant improvements over time in their family relationships, friendships, spiritual connection, physical health, emotional health. They also reported significant positive changes in their ability to handle finances and handling problems or conflicts, as well as improvements in self-respect. There were also significant reductions in arrests and other legal problems post-discharge, as well as improvements in employment status.
Because so many of our clients have co-occurring mental health issues, we also asked questions about symptoms of anxiety and depression. There were statistically significant reductions in symptoms such as hopelessness, fatigue, nervousness, restlessness, sadness, and feelings of worthlessness.
WHAT PREDICTS ABSTINENCE
In order to continuously improve Harmony’s services, we wanted to determine if there were factors that were associated with post-treatment abstinence. For example, do older clients have better abstinence rates than younger clients? Is primary drug related to abstinence rates, such that clients who primarily used alcohol do better than clients who primarily used heroin?
Interestingly, the only variable that predicted abstinence was the reduction in mental health symptoms during treatment. In other words, the more clients’ symptoms of depression and anxiety decreased during their time at Harmony, the more likely they were to remain abstinent after leaving treatment.
WHERE DO WE GO FROM HERE
One of the most compelling and recurrent themes in this study was the importance of mental health care and support. As mentioned above, self-medication of emotional pain and mental health issues were primary reasons clients reported for using drugs and alcohol. Half of our clients had co-occurring mental health diagnoses. And the single best predictor of post-treatment abstinence was the reduction in symptoms of depression and anxiety that clients reported during their treatment at Harmony. For the past few years, Harmony has worked to improve the quantity and quality of support provided for mental health issues. We have added mindfulness groups, a trauma coping skills group, and education groups on a variety of mental health topics. Clients can receive both addiction-specific counseling at Harmony and counseling specific to psychological issues. Given the results of this study, Harmony plans to continue enhancing the services provided to help people recover not just from chemical use, but from underlying emotional issues that can increase risk for relapse.
While the results of this study show that Harmony clients do, overall, have improved lives and decreased drug and alcohol use, we want to help more individuals and more families to recover, with more significant reductions in substance problems and more improvement in life functioning. Harmony is committed to continuous improvement in our services to provide even better care and help more people find their way to recovery. Studies such as this one remind us why this work is so important and why we need to always examine ourselves and find areas for improvement.
At the end of each survey, clients were asked if they had any feedback about the Harmony experience. Common answers were that they appreciated the support provided by staff as well as the community they built with the other clients. While data can provide us with important feedback on who we serve and how we can continually do better at helping people find recovery, it is these comments that remind us why we do what we do at Harmony:
“I have come to better understand myself, my need to use, and what I am struggling with so that I won’t need to turn to drugs and alcohol to deal with my problems.”
“I’m really grateful to Harmony…it helped me a lot… I was in really bad shape. If I would have went somewhere else, I probably wouldn’t still be clean.”
“The staff here was absolutely amazing and seemed to truly care about me and my recovery. They were instrumental to my time here and truly helped me recognize qualities and worth in myself that make my sobriety worth fighting for.”
By Michael Rass
About forty percent of Americans make New Year’s resolutions around this time. They typically resolve to live healthier in the new year or improve their lifestyle in other ways. Popular resolutions include staying fit and healthy, losing weight, enjoying life to the fullest, getting organized, and traveling more.
The good intentions listed above all share the same problem: they are rather vague. That is probably why most people give up on their resolutions by February. Most resolutions are not kept. As Nielsen.com notes, “43 percent of Americans say they plan to lose weight by making healthier food choices, but 76 percent said they did not follow a weight loss or diet program in 2014.”
So, if you have a substance use disorder, should you put recovery on the list? Should fighting a serious disease like addiction be a New Year’s resolution?
Don’t Set Yourself Up for Failure
Yes and no. It’s not a bad idea to have goals for the new year, but they should be SMART—specific, measurable, agreed, realistic and time based. In other words, your resolution should not be “drink less” or “cut back on smoking marijuana,” because those intentions have no time frame and cannot be measured effectively.
Goals are important to achieving recovery but ideally they are objectives agreed with a therapist or sponsor as part of a treatment program. They should not be the vague declarations of intent that New Year’s resolutions tend to be.
Goal-Setting Can Make You Heal Faster
When done right, setting specific goals can be surprisingly effective. In his 2012 book, The Power of Habit, author Charles Duhigg describes a Scottish study that examined the power of goal setting for patients recovering from knee or hip surgery. Mobilization and exercise are very important for these patients but the pain can be so extreme that many skip rehab sessions and refuse to get on their feet. Participants in the study had to set weekly goals, writing down exactly what they were going to do. Patients in a control group did not have to set any goals.
“It seems absurd to think that giving people a few pieces of blank paper might make a difference in how they recover from surgery,” writes Duhigg. “But when the researcher visited the patients three months later, she found a striking difference between the two groups.The patients who had written plans in their booklets had started walking almost twice as fast as the ones who had not. They had started getting in and out of their chairs, unassisted, almost three times as fast.”
Goal-setting is an important tool in addiction treatment as well. The right goals formulated in small achievable steps combined with appropriate therapy can improve clients’ chances of a successful recovery, but they should not just settle for a generic “I want to be sober.” They should formulate specific steps on how to achieve sobriety on a day-to-day basis.
For many people with addiction, pledges like “I will never use drugs again” often seem frighteningly daunting in early recovery. It is mentally easier for them to commit to the much more modest “I will not use today” and have that same goal every day. One patient in the Scottish study had the goal always to take a second step and not sit back down after the excruciatingly painful first step when getting up. Presumably, that was more effective for him than “keep walking.”
New Year’s resolutions like “enjoying life to the fullest” fail because they are too global. You wouldn’t even know at what point you have achieved it.
No Need to Wait
New Year’s resolutions also involve the risk of delay. Drugs and alcohol can kill you, often sooner than later, and waiting for New Year’s Day to come along to get better can be dangerous.
If you are battling a severe substance use disorder, your recovery should start as soon as possible.
Don’t resolve to quit drinking or using drugs next year and then go on a binge before New Year’s Eve. There is absolutely no need to wait until New Year before enjoying sobriety. The time to quit is right now. Get help before it is too late. Your life depends on it.
This month we are talking about alcohol, because April is Alcohol Awareness Month. The annual occurrence involves a number of events taking place throughout the country, with the aim of increasing public awareness and understanding about the dangers of alcohol use. Alcohol Awareness Month is sponsored by the National Council on Alcoholism and Drug Dependence, Inc. (NCADD) – the leading advocacy organization in the world addressing alcoholism and drug dependence since 1942. This year’s Alcohol Awareness Month theme is: “Talk Early, Talk Often: Parents Can Make a Difference in Teen Alcohol Use.”
Having an unhealthy relationship with alcohol during adolescence can lead to an alcohol use disorder as early as young adulthood. Parents who have open, honest conversations with their children drastically reduce the likelihood of their kids using drugs or alcohol. The more teenagers know about the dangers commonly associated with alcohol use, the greater the chance they will stay away from the insidious substance.
“Alcohol and drug use is a very risky business for young people,” says Andrew Pucher, President and Chief Executive Officer of NCADD, “and parents can make a difference. The longer children delay drinking and drug use, the less likely they are to develop any problems associated with it. That’s why it is so important to help your child make smart decisions about alcohol and drugs.”
Unfortunately, many young adults are already living with an alcohol use disorder (AUD), which is why researchers have a huge incentive to develop effective treatments. Residential treatment centers give people struggling with alcohol the best shot at recovery, but there are times when medications are used to help prevent relapse, such as:
While some people recovering from alcoholism respond well to the aforementioned medications, others have not been so fortunate. Researchers from QUT’s Institute of Health and Biomedical Innovation may have found a new treatment for AUD, and the beta blocker pindolol has already been approved by the Food and Drug Administration (FDA), Science Daily reports. The findings were published in Addiction Biology, the Journal of the Society for the Study of Addiction.
“Drugs currently used for AUDs (alcohol use disorders) — acamprosate, naltrexone and disulfiram — have limited success — so this is a ground-breaking development with enormous potential,” said Professor Bartlett who is based at the Translational Research Institute. “In an internationally-significant breakthrough, our study showed pindolol was able to reduce ethanol/alcohol consumption, particularly in relation to binge drinking, a key behaviour observed in human alcohol dependence.”
Alcohol use disorder (AUD) affects millions of Americans, a disorder which can have serious impact on one’s health and can be fatal. Without effective, evidence-based treatments, the chances of recovery are slim. Sadly, many young adults have an AUD which usually arose in their teenage years. Preventing teenage alcohol misuse and abuse is crucial, and doctors can play a huge role in intervening early on.
New research has found that physicians who ask teens just one question about drinking frequency in the past year can help them determine who is at risk for developing an AUD down the road, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) press release. The study involved almost 1,200 young people ages 12 to 20. The findings were published in the Journal of Pediatrics.
“Primary care physicians are encouraged to screen adolescents for alcohol problems, yet many do not, citing time constraints and other issues,” NIAAA Director George Koob, PhD said in a news release. “This study demonstrates that simple screening tools such as those in NIAAA’s Youth Guide are efficient and effective.”
Using a computer-based questionnaire at a primary care clinic, the teens involved in the study were asked about how much alcohol they use and were screened for an AUD, the press release reports. The researchers found that 10 percent of those over age 14 met the diagnostic criteria for an AUD. The NIAAA funded study found that 44 percent of teens between 12 and 17 years old who had at least one drink on three or more days in the past year met the criteria for AUD. But everyone who drank that much was at risk for alcohol problems. Thirty-one percent of 18-20 year olds who reported 12 or more drinking days in the last year were found to have an AUD.
“This finding confirms that a single question can be an effective screen for AUD,” said lead researcher Duncan B. Clark, MD, PhD, Professor of Psychiatry at the University of Pittsburgh Medical Center.
If you are a young adult and believe that you have a problem with alcohol, please contact Harmony Foundation. Our Young Adult Recovery Track (YART) is specifically tailored for treating young adults with substance use disorders, let us help you begin the journey of recovery.
The major substance use news these days deals primarily with the opioid epidemic in America; we need to remember that there are plenty of other addictive mind altering substances that can wreak havoc on one’s life. Alcohol remains to be the most commonly used drug in America, alcohol is pervasive and deeply rooted in our society. It’s a substance that takes an enormous toll on both the public health and the economy; it’s responsible for thousands of deaths every year from alcohol related illness and driving under the influence (DUI).
While the Centers for Disease Control and Prevention (CDC) reports that 44 people die of an overdose every day, a staggering figure to be sure, the agency also reports that in the United States almost 30 people die in motor vehicle crashes that involve alcohol-impaired drivers. Despite the fact that even teenagers are aware that driving under the influence is unsafe, people continue to put their lives and the lives of others in their hands in danger, which often times ends in tragedy.
Over the last decade there have been a number of efforts made to mitigate both the effects and the likelihood of drunk driving. Those who are caught drunk driving face heavy financial penalties, possible jail time, and loss of license for varying lengths of time. What’s more, in many states those convicted of DUIs are required to have ignition interlock devices installed in their vehicle. The instruments keep the car from starting unless the driver blows into a breathalyzer; if alcohol is detected the device will prevent the car from starting and the driver will have to go back to court and may be sent to jail.
A new report highlights the success of requiring interlocks, showing that the devices have stopped more than 1.77 million people from attempting to drive drunk since 1999, the Associated Press reports. The findings come from data released by 11 major ignition interlock manufacturers.
“MADD knows ignition interlocks save lives, and they could save even more lives if every offender is required to use the device after the first arrest,” said Colleen Sheehey-Church, the president of Mothers Against Drunk Driving.
Currently, twenty-five states require ignition interlocks for any drunk driving offense, even for a first-time DUI, according to the article. All 50 states have passed some kind of ignition interlock law, but some are much stricter than others and MADD would like to see the states with softer laws, toughen up.
It is often the case that people convicted of DUIs are required to attend 12-step recovery meetings. That is not to say that everyone who gets a DUI has an alcohol use disorder, and most of those who are required to go to meetings do so begrudgingly; however, there are some who are required to attend meetings of Alcoholics Anonymous that realize that they do have a problem with alcohol and are willing to give recovery a chance. While getting a DUI is never fun, it can be the catalyst that leads to recovery.