Alcohol Abuse and Addiction
Alcohol abuse can be the most common form of addiction and/or substance abuse.
According to the National Institute for Alcohol Abuse and Alcoholism, between 8 and 9 percent of adults in the United States have some form of problem with alcohol. If you are one of them, you may be looking for solutions to help you quit drinking.
Abuse of any substance – including alcohol - is when the user begins seeking the substance compulsively and continues to use the substance even though there have been harmful effects to their lives, including problems with family, school, work or the legal system.
You can take a free self-assessment AUDIT to help you develop a better understanding of your drinking including the risks and costs that your drinking could pose.
When you quit drinking, it can be uncomfortable – particularly if you have abused alcohol for some time. If you believe that you have an addiction to alcohol, it is important to talk to your doctor about whether you need to withdraw from alcohol under medical supervision.
Whether you work with your doctor, or cut back on your own, as alcohol works its way out of your body, you will begin to feel better and your body will begin to repair damage that drinking may have caused you. However, some people require support to help them quit drinking.
SMART Recovery provides its members with tools and support that they can use to help them recover from addictions – be it alcohol, or other drugs or negative behaviors. SMART Recovery's 4-Point Program® is designed to help you overcome your problems with abusing alcohol and quit drinking:
1. Building & Maintaining Motivation – Helps you identify and keep up with your reasons to quit. Why do you want to stop drinking - what will keep you focused on that goal?
2. Coping with Urges – Dealing with urges and cravings is part of recovery. SMART has tools designed to help our members cope with urges to drink alcohol that can help you maintain abstinence.
3. Managing Thoughts, Feelings and Behaviors – We frequently turn to using drugs to either escape from or avoid addressing problems. SMART Recovery participants learn problem-solving tools to help them manage challenges along the way.
4. Living a Balanced Life– When you abuse alcohol, your life frequently falls out of balance – you may find yourself opting to drink rather than go to work or school. You may find that things you once enjoyed aren’t fun anymore. SMART give members skills to help balance both short and long-term goals, pleasures and needs that were once out of balance due to drug abuse.
Prescription Drug Abuse
What is prescription drug abuse?
Prescription drug abuse means taking a prescription medication that is not prescribed for you, or taking it for reasons or in dosages other than as prescribed.
Addiction of any substance is when the user begins seeking the substance compulsively and continues to use the substance even though there have been harmful effects to their lives, including problems with family, school, work or the legal system.
Common drugs of abuse
According to the National Institute on Drug Abuse (NIDA), the commonly abused classes of prescription medications include opioids (intended for pain), central nervous system depressants (for anxiety as well as sleep disorders), and stimulants (prescribed for ADHD as well asnarcolepsy).
Opioids include hydrocodone (sold as Vicodin®), oxycodone (sold as OxyContin®), propoxyphene (Darvon®), hydromorphone (Dilaudid®), meperidine (Demerol®), and diphenoxylate (Lomotil®).
Long-term abuse of opioid-based medications can lead to physical dependence as well as addiction. Opioids can produce drowsiness, constipation and can even depress breathing. (1)
Central nervous system depressants
Central nervous system depressants include barbiturates such as pentobarbital sodium (sold as Nembutal®), and benzodiazepines such as diazepam (Valium®) and alprazolam (Xanax®).
Central nervous system depressants slow down brain function and, if combined with other medications that cause drowsiness or with alcohol, heart rate and respiration can slow down dangerously. (2)
Stimulant medications include dextroamphetamine (Dexedrine®), methylphenidate (Ritalin® and Concerta®), and amphetamines (Adderall®).
Stimulants can cause anxiety, paranoia, dangerously high body temperatures, irregular heartbeat, or seizures when taken repeatedly or in high doses. (3)What happens if I try to stop and I'm addicted?
If you believe that you have an addiction or physical dependence to prescription medication, it is important to talk with your doctor about whether you need to withdraw under medical supervision. Sudden withdrawal from some medications can be quite dangerous!
Some people require support to help them as quitting, even under a doctor's care, can be difficult and quite uncomfortable.
Heroin and Opiate Addiction
In 2009, 605,000 Americans age 12 and older had abused heroin at least once in the year prior to being surveyed. Source: National Survey on Drug Use and Health (Substance Abuse and Mental Health Administration web site). The NIDA-funded 2010 Monitoring the Future Study showed that 0.8% of 8th graders, 0.8% of 10th graders, and 0.9% of 12th graders had abused heroin at least once in the year prior to being surveyed. Source: Monitoring the Future (University of Michigan web site.)
Heroin is a highly addictive drug that is processed from morphine and usually appears as a white or brown powder or as a black, sticky substance. It is injected, snorted, or smoked.
Short-term effects of heroin include a surge of euphoria and clouded thinking followed by alternately wakeful and drowsy states. Heroin depresses breathing, and therefore, overdose can be fatal. Users who inject the drug risk infectious diseases such as HIV/AIDS and hepatitis.
Nobody wants to be in pain
As human beings, there are many different kinds of pain: physical pain like aches and burns; and then there is emotional pain like heartache, painful memories, guilt, sadness, insecurity and anxiety. Most any living creature has a very instinctual drive to not hurt or to avoid pain, but it might be said that humans are subjected to many more types of pain than any other known organism.
One of the many less-than-healthy ways that some of us choose to try to remove pain and gain pleasure is by taking alcohol and other drugs. Historically, heroin and other opioids have appeared to many people as a viable means, or even as the only route, to do that very natural thing that all living organisms try to do: avoid pain and feel good.
What is heroin and how does it work?
Heroin and other opioids, like prescription pain-killers, have a very addictive quality to them due largely to how when consumed, they mimic the brain’s natural processes for seeking pleasure. Opioids access and alter the very components that are involved in producing pleasure and removing pain, i.e. the brain’s pleasure center and opioid receptors, dopamine and endorphins. This very rewarding process also affects an individual’s cognitive process – how we think and feel about pain and pleasure, adding a complicated layer to the risk of addiction.
Heroin and other opioids can be injected, smoked, used as a suppository or swallowed. They are central nervous system depressants and have several short-term effects such as: euphoria, sedation, reduction of pain and anxiety, breathing complications and nausea. In addition, there are risky physical effects associated with opiate and heroin addiction and these include: HIV/ AIDS, hepatitis, skin infections, or bacterial or viral infections, collapsed veins, lung infections and death from overdose. Who gets addicted to heroin and why?
Can you imagine having a magical button that you could push and all of your body’s aches and pains would go away in a matter of seconds? What if your pain was suddenly replaced with a euphoric feeling? What if that same button could take away every insecurity, worry, painful memory and sadness in your life? Sounds too good to be true, right? Well, it is, because the consequences of opioid addiction are often unimaginably scary. Although, the truth is, that for many people who are struggling and even for those who are just young and confused or dealing with self-exploration, the allure of this kind of freedom, this type of reward, this access to so much pleasure, is very, very powerful.
Heroin isn’t just for bikers and homeless people anymore. Anyone can become addicted to heroin: from troubled youth in single parent families to cheerleaders and football players from affluent families; from people with mental health issues to lawyers and judges. In fact, more and more "well-adjusted" young people are becoming addicted to heroin every day. Just as there are as many paths to recovery as there are people, so are there as many reasons why a person becomes addicted to heroin.
Statistically, most people, especially youth, are introduced to heroin and other opioids in the form of prescription pain-killers such as Oxycontin, Vicodin, Percocet, Hydrocodone, Oxycodone and Fentanyl; drugs which when viewed at a molecular level are virtually identical to heroin (heroin was actually invented by the pharmaceutical company, Bayer). Many people are prescribed these medications appropriately for the purpose of relieving physical pain. This is not the only way, however, for an individual to acquire a prescribed opioid. Currently, acquiring prescription opioids is considered an easy task due to the overabundance of prescription pills in our medicine cabinets and society at large.
What this overabundance of prescription pills has done is to take the needle, and thus the stigma, out of opioid addiction and opened it up an entirely new audience to its dangers. Pills come from well-intended family and friends, they are sold to us or shared with us by our peers as a means of relaxing. For a number of people who use opioids, as prescribed or not, addiction is a marked risk and they may form maladaptive and dangerous behaviors, poor emotional and psychological patterns and unhealthy relationships with the drug. As prescription opioids become harder for them to obtain, heroin becomes more and more appealing in terms of cost and effect. Further, as many find out, the lifestyle that heroin addiction brings can be one wrought with danger and despair.
What does it mean to be addicted?
Chronic heroin and other opioid use results, in effect, in the body producing more and more opioid-receptors to meet the needs of the flood of opioids in the system. At the same time the body now believes that it no longer needs to produce its own pleasure-giving and pain-reducing chemicals. This is the point at which we say a person is physically dependent on the drug. The body can no longer function at its normal level without the drug. This dependence leads to painful and often frightening withdrawals when the drug is removed and the body begins the process of figuring out how to live without the extra opioids it has become accustomed to.
Withdrawals: Around 10 hours after a heroin-dependent person has last used heroin they begin to feel anxious or agitated, their eyes begin to tear-up and they begin yawning a lot. They also begin sweating and getting feverish, start to have stomach cramps and diarrhea, begin to have muscle cramps and spasms and experience chills. This gamut of physical and emotional pain and discomfort tends to peak at around three days but can be prolonged for nearly ten days. Many people addicted to heroin describe experiencing their "bones aching" and a feeling that they want to "crawl out of their skin". The fear of this experience is felt by many who are addicted to be the reason that they get "stuck" in the addiction as they have convinced their mind and body on some level that to not have heroin is akin to dying.
How do I know if I have a problem and what sort of help do I need?
*This is in no way intended as a substitute for professional or medical advice!
If you are worried about your heroin or pill-form opioid use you may already qualify, clinically-speaking, for "opioid abuse". Any behavior is technically "abusive" if it interferes in your life in any way and yet you continue with it. This could mean that the substance or any behavior that is related to its use leads to fighting with your family or friends, giving up or interfering with things that you previously enjoyed, spending too much money, feelings of guilt, feelings of being out of control, legal issues or many other things. "Abuse" is continuing a behavior despite negative consequences. Only you can decide if a substance or behavior is a problem in your life; it has to come from you, otherwise, change will be superficial and short-lived.
If you are experiencing: physical withdrawals, tolerance to the substance, an inability to cut-down or control your use, spending large amounts of time in activities related to the substance, interference with important things in your life or continued use of the substance despite severe physical or psychological consequences, this is a strong indicator of dependency. This means you may want to consider more immediate professional help and possibly medically assisted detox. Also remember that, although you may feel like it, very few people actually die from opioid withdrawal (with the exception of Methadone).
There are various treatments and treatment combinations that may be effective for opioid abuse and dependence and these include, but are not limited to, talk therapy (e.g. Cognitive Behavioral Therapy, Motivational Interviewing and therapies which include contingency management), support groups (such as SMART Recovery), medically assisted treatment or replacement therapy (Methadone or Suboxone) and antagonist therapy (such as Vivitrol).
Above all, it is most important that you take action. Reach out. Let someone know that you want to talk. Please, know that you are not alone in this.
*Please remember that if you have not used heroin or other opioids before or have been off of them for a while due to being in jail or rehab, you are especially susceptible to overdose and, potentially, death.
Eating Disorders and Disordered Eating
By Ann Hull, The Hull Institute
What is disordered eating?
Disordered eating: Isn’t everyone doing it? Well, most of us are doing it. We are skipping breakfast, eating too much fast food, eating bags of chocolate then starving the whole next day, trying to figure out what to eat every day and what size body is right for us. We eat the "wrong foods" or don’t follow the plan we set out for ourselves, then feel bad about ourselves and vow not to do it again. It used to just be women who do this, now men do it too. It feels like a vicious addictive cycle.
Disordered eating is complicated and difficult to overcome, mostly because high calorie and less nutritious foods tend to taste better to us. However, this is not an eating disorder. Poor eating is unhealthy and can get us frustrated and down, and it can develop into an eating disorder, but in itself, it is not an actual disorder.
What are eating disorders?
Daily, new research is revealing that eating disorders are much like any other addiction. They affect the pleasure centers of the brain much like cocaine or heroin, and can be even more dangerous. Eating disorders are biologically based brain disorders.
In medical terms, there are 3 classes of eating disorders: ANOREXIA, BULIMIA and BINGE EATING DISORDER. The criteria used to make these diagnoses have recently changed, such that more people meet the diagnosis than ever before.
Restricting your food intake to the point that it affects your brain, your body, your functioning in work or school, and your relationships. Anorexia starts as a way to manage your weight, then it quickly becomes a way to manage your emotions and your life. It often includes extreme weight loss, loss of your period (or low testosterone in men), physical problems such as dizziness, headaches, hair loss, dry skin, lack of sleep, and being cold all the time. Not eating can cause many physical problems such as a shrinking brain, bone loss, muscle loss, heart problems, and a host of other problems. It causes you to become depressed, have no energy, not be able to see yourself clearly in the mirror and it convinces you that you are fat even when others tell you that you are too thin. It has a negative effect on your relationships and your self esteem. It can happen to women and men of any age.
Eating large amounts of food then purging it. Purging usually means throwing up, but it also means any way to get rid of food once it is eaten; for example: laxatives and diuretics and over-exercising to burn off the food. "Large amounts" of food means eating more than is usual in an average time frame, to the point of feeling stuffed or overstuffed, and physically ill or uncomfortable. Binging is usually done in secret, outside or regular eating.
Some people will restrict, or eat nothing, all day, then binge and purge at night; some people will eat OK during the rest of the day, and still binge and purge during certain periods other times. Bulimia is also very dangerous as it can cause electrolyte imbalances in the body, which puts a huge strain on your heart. Think of it this way: every time you throw up your food, you inflict trauma on your body. Our bodies were not designed for this sort of trauma. Over time, it takes its toll. And don’t forget about how all the acid in your vomit can rot your teeth after even a short time of purging. Women and men of any age can get bulimia.
Binge Eating Disorder
This is a new diagnosis, although binging has been around for a long time. Binging is eating a large amount of food in an out of control fashion, and not using any sort of behaviors to get rid of it. Binge eating disorder can be as dangerous as anorexia and bulimia, though most people don’t know that. Sometimes it is more dangerous because no one notices the behaviors and bingers may be less likely to get help. We still live in a society that believes that overweight people cannot possibly have an eating disorder; it is just that the person is weak. Binge eating disorder is a brain disorder like anorexia and bulimia, and without treatment, it will probably get worse with time.
Binge eating disorder affects almost as many men as women, and affects all shapes and sizes of adults and children. When people binge, it is almost always on sugar, or simple carbohydrates that break down into sugars, and fats and salty foods. Rarely do people binge on broccoli and salad, because those foods don’t have the addictive qualities that sugar, fat (fast food) and salt have.
Over exercising is very common in today’s world where we hear we need to eat less and exercise more. While "dieting" means you are burning more calories than you are eating, it can be dangerous if you are working out for more time than your body can handle. If working out becomes an obsession where you are putting it first over all other activities, then you may have a problem. If you work out even when your body is exhausted and hurting, you may have an exercise addiction.
Eating disorders are like other addictions because, without treatment, they will probably get worse. Like with alcohol and drugs, over time, you will need more of the "drug", the eating disorder behavior, to get the high or numbing you are looking for. If left untreated, it will get worse and cause more negative consequences. It is like other addictions because even when you no longer like the effects and you try to quit, you can only go a short period of time until it comes back full force.
Up to half of people with substance addictions also have eating disorders. Anyone in recovery knows how easy it is to change addictions, from drugs, to eating disorder, gambling, spending, etc. It is common for one addiction to be replaced by another one, because all of them are brain disorders and until the brain is trained to do something other than numb out or get high, the addicted person’s brain’s "go to" will be some sort of addictive behavior.
Hence SMART Recovery, a method for overcoming addictions.
More people die of eating disorders than any other addiction or mental illness.
How do I know if I have an eating disorder?
Take this on line test. The EAT-26 is a good way to tell if you have a problem and what to do about it. If these test results say you need to seek help, SEEK HELP.
What sort of help do I need?
Like in other addictions, the eating disorder (sometimes called "food addiction") convinces you that you don’t really have it or that it "isn’t that bad". If you are reading this, it might be "that bad". You might also be using drugs and alcohol, or be having other self harm behaviors such as cutting or burning yourself. Often, depression and anxiety go hand in hand with eating disorders.
Put all this together, and you have a very complicated and dangerous problem. It is not likely that you can figure out on your own how to tackle these problems.
First, talk with your doctor. Be direct and honest with him or her, and ask for help. Surprisingly, many doctors do not know how to treat eating disorders. If your doctor doesn’t know what to do, consider finding another.
Second, seek therapy. An eating disorders specialist can help you identify the problem, and determine what sort of help you need. Be careful in choosing a specialist. Many therapists know very little about eating disorders, and therefore may be unhelpful.
Third, see a registered dietitian. Be sure they are registered and have training in eating disorders treatment. Eating disorders are complicated and dangerous and not just anyone can safely advise you how to eat properly.
Fourth, attend a SMART Recovery group.
Is gambling addiction a problem for me?
- Think about gambling a great deal of your time?
- Lie about your gambling to others?
- Gamble while bills go unpaid?
- Borrow money to finance your gambling?
- Miss work because of your gambling?
- Feel anxious, depressed or suicidal after you gamble, but not quitting?
If you answered yes to any of these, you could have a gambling addiction problem.
How do I stop my problem gambling?
Gambling addiction (compulsive gambling and pathological gambling) is a growing problem in the United States. Casinos, lotteries, and the availability of bookies are easier, faster, and more widespread. Internet gambling impact reaches far and wide. The good news is that Cognitive Behavior Therapy (CBT) based Professional Treatment and Self-Help models such as SMART Recovery (Self-Management and Recovery Training) can be very helpful for gaining independence from addictions, including problem gambling. SMART Recovery is an alternative to Gamblers Anonymous (GA) as well as other 12-step programs.
SMART Recovery’s potential effectiveness for assisting individuals to find relief from gambling addiction is supported by research. The National Center for Responsible Gambling Conference, co-sponsored by Harvard Medical School’s Division on Addictions and the Gaming Industry, introduced research clearly showing CBT to be an effective way to assist individuals interested in reducing problem gambling. Studies also show a correlation between alcohol, nicotine and other drugs, as well as gambling. Problematic gambling can lead to more destructive actions such as criminal behavior (i.e., embezzlement) and, possibly, suicide.