Increase in Opioid Misuse: The Painful Truth

May 17, 2015 by  
Filed under Treatment and Recovery News


bottle of pillsA recent analysis of 35 existing studies about opioids has revealed an astounding increase in its use, misuse and addiction. Opioids—medications that include Vicodin, OxyContin, Percocet, morphine and codeine—are known to be both psychologically and physically addictive. Often, opioid users become dependent on the medication and get to a point where they need to up their doses to induce the same level of euphoria. Prescriptions of these highly addictive medications have exploded in the past decade, hiking up the cases of opioid reliance and uncontrollable usage.

The Rise of Opioid Prescriptions

An estimated 20 to 30 percent of opioid drugs legally prescribed by medical professionals are misused, according to a 2015 study published by the International Association for the Study of Pain (IASP). “On average, misuse was documented in approximately one out of four or five patients,” writes Kevin Vowles, a professor at University of New Mexico, and his colleagues. The study also states that “addiction [occurs] in approximately one out of ten or eleven patients.” The report, which is an analysis of 35 existing studies primarily conducted in the United States, classified three problematic types of opioid use:

  1. Misuse – When opioids are used contrary to instructions
  2. Abuse – Exploiting the drug for its euphoric effects for recreational purposes
  3. Addiction – Continued opioid use with actual or potential harmful effects

A Possible Solution

This update on the rising opioid usage has led many experts to call for a strategy and immediate plan to put an end to what the study dubs as an “opioid epidemic.” Generally, the study’s authors tout that helping to reduce the misuse of powerful pain killers may be as basic as educating and monitoring patients. Vowles, who is the study’s lead researcher, suggests that “[since] one in four patients on opioids display patterns of opioid misuse, but not addiction, then perhaps more efficient targeting of treatment resources would be of benefit.”

Audrey Beim holds two advanced degrees from major universities, including a Master’s Degree in Psychology. She has over 20 years of experience in the health, wellness, nutritional and fitness categories and has used her expertise to write articles for media outlets such as Linfield Media and

The Toll of Drug Use on 200 Million People Worldwide

May 8, 2015 by  
Filed under Treatment and Recovery News


hand reaching for pillsEarlier this year, Los Angeles Times reported numbers for drug abuse worldwide, commenting on the impact on the cost of healthcare due to widespread drug use. It is estimated that 200 million people worldwide use illegal drugs every year. These numbers do not include alcohol or tobacco use, which also impacts healthcare services and costs dramatically.

The Drugs

The study was conducted by The Lancet, a medical journal in the United Kingdom. The specific drugs that the study is focusing on are opioids, amphetamines, cocaine and marijuana. Their information is being compiled from reports on drug use and abuse, dependence, fatalities and other health concerns recognized to be consequential to drug abuse. While other substances may have health implications, these four drugs offer the most thorough information from which to conduct the study.


Globally, marijuana use is estimated at 125 to 203 million users. Amphetamine use is shown at 14 to 56 million users, opioids are reportedly used by 12 to 21 million and cocaine use is reportedly 14 to 21 million persons.

Total number of users has increased worldwide. 2012 statistics on illegal drug use have shown increases from 180 to 185 million in the 1990s to early 2000.

Drug users who inject drugs number from 11 million to 21 million. It is estimated that 1 in 20 persons who are in the age group between 15 and 64 are using illegal drugs.

Health Implications

Obvious side effects of drugs are deaths caused by overdose. Other far-reaching complications include heart disease, lung and breathing problems, kidney and liver disorders and mental illness.

Health care costs for those impacted by drug use include the astronomical number of persons who suffer from heart and lung diseases caused by tobacco use. While legal, tobacco is known to cause over 5 million fatalities per year worldwide. An increase of up to 8 million is expected by the year 2030.

This number does not include those 16 million Americans who suffer from some form of disease directly attributable to tobacco use. It is estimated that for each death from smoking, 30 more persons suffer from a smoking-related illness.

Over 2 million people die from alcohol abuse each year around the world. This number far overshadows the 250,000 estimated annual deaths due to use of illegal drugs. However, the years of life lost for illegal drug use comes in at over 2 million. The reason it is higher than that of alcohol (1.5 million) is because many illicit drug users begin to experiment with drugs at a young age and subsequently die from them.

Healthcare costs for those who do not die from drug overdose are astronomical. Why? Those with persistent and ongoing healthcare issues caused by drugs will run in the billions of dollars per year. Care for chronic and persistent illness is costly and those who have these health issues are going to increase annually, as do the numbers of drug users who incur health issues around their drug use and abuse.

More Findings

The number of persons who use illegal drugs vary from those who actually become dependent. This ratio is impossible to determine, since there is no formula that applies. There is also little correlation that can be drawn between users who go on to incur healthcare costs because causal implications cannot be formulated either.

What is significant and does show strong trends for the future, as these statistics impact the field of healthcare, are the staggering number of persons who use illegal drugs. It must be recognized that costs will continue to rise as incidence of use escalates.


United Nations Office on Drugs and Crime. World Drug Report 2011. Retrieved online from:

Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

Naloxone Can Treat Cocaine and Heroin Addiction

May 1, 2015 by  
Filed under Treatment and Recovery News


naloxone molecular diagramThe search continues for ways to prevent rampant spread of addiction. Since treatment protocols are only somewhat effective, there is a search for replacement or substitute drugs that can interfere with the progression of addiction in those who use drugs.

Drugs can either interfere with the chemical reaction of the body to other substances of abuse or create adverse effects like Antabuse, which is used to stop drinking behaviors by making the drinker sick if they’re on the drug.

Researchers have discovered one drug, Naloxone, which has shown promise for heroin addicts. Recently, drug researchers at both the University of Adelaide, South Australia and University of Colorado in Boulder have shown interesting links in the use of Naloxone.

How Naxolene Works

Previously seen to be effective in blocking the use of a brain receptor believed to be linked in addiction to heroin, Naloxone has shown the same benefits when used to block the addictive properties of cocaine.

This receptor, known to scientists as Toll-like receptor 4 (TLR4) is an immune receptor in the brain that responds to cocaine to produce a pro-inflammatory response. This response is considered a vital link in the reward system underlying formation of the addictive process.

In previous testing, scientists proved that using the drug Naloxone, along with heroin or cocaine, disrupts the process of binding the drug(s) to the receptor, thus ceasing pleasurable sensations normally caused by the drug. Without these pleasurable sensations, the continued use of the drug has no pleasurable effect on the brain of the addict.

The User’s Brain

The first response that a heroin or cocaine user feels is a sense of well-being and pleasure, often called “a rush.” This rush is created, according to the research, in the receptor known as TLR4 which is known to play a key part in creating addiction to the drug.

The user continues to seek the rush and drug use escalates as more and more of the drug is required to achieve the same effect. This is the process of addiction called tolerance. When there is no pleasure involved, it is believed that the user will stop using the drug.

Making Progress

Discovering that the same receptor is responsible for the rush received with cocaine is a big step toward testing Naloxone for further use in substances of addiction, such as methamphetamine, alcohol and others. We can perhaps speculate that addiction has a common mental component that is as simple as overusing the TLR4 receptor in the brain of a user. We might even go so far as to wonder if this is the key to finding a common solution to stopping the addictive properties of all drugs on the brains of users who have this common factor for addiction.


Medical News Finding new ways to treat cocaine dependence could help with all addictions. Retrieved online from:

Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

Indiana Enacts Law Changes to Protect Drug Abusers from HIV Surge


red ribbonA portion of Southern Indiana has been the site of a rapid rise in HIV cases. The focal point of the recently enacted legislation is the rural town of Austin, Indiana, with a population of about 4,200 people. Indiana’s governor has recently declared a statewide Public Health Emergency in order to bring in necessary medical aid to combat this outbreak. He has reversed the laws in Indiana that prevent clean needle exchanges in order to stem the tide of the number of new cases. At that time, 80 persons ranging in age from 20 to 56 had been identified as being infected. Governor Mike Pence has also increased Medicaid programs in the state to fund treatment for infected persons.

New cases of HIV infection are reported, by law, to the Indiana’s Public Health Department, which is how the trend was first recognized. One report, only a week later, found over 100 cases of positive test results. HIV testing has reached only those who report having sex or sharing needles with persons who are known to have tested positive for the virus which causes AIDS.

Public Reception

Little response to the widespread promotion of exchanging dirty needles for clean ones has been seen thus far. Only four residents had come forward and exchanged over 300 dirty needles. Most of the addicts, who are credited with spreading the virus, are afraid of legal repercussions and will not come forward to receive clean needles.

Most citizens of the small community blame the medical crisis on residents in a part of town called the “North End” and houses designated as “shooting galleries.” These are houses where those addicted to pain medications gather to use drugs intravenously, using and sharing needles, thereby spreading the virus. Police in the community are aware of the high incidence of drug use in this area and have doubled their efforts to control drug trafficking in and out of the neighborhood. Prostitution in this area is another danger, since most of those who engage in this form of sexual activity are infected.


The drug most commonly used by the population of this area is Opana, a narcotic designated for treatment of pain. Crushed pills are mixed with liquid to allow injection of the medication. This gives the user a faster and more intense high than taking the pills orally. Efforts by the makers of Opana in 2012 to make it more difficult to use in this fashion have not succeeded. The pills are sold illegally for an average of $30 per pill.

The only physician in the town of Austin has initiated much of the effort to work with those who test positive to receive treatment and information about the virus. He and his staff are hard at work to educate and inform everyone in town about the dangers of HIV and sharing needles and sexual activity with known HIV positive persons. Several medical professionals from the Center for Disease Control (CDC) have been brought in to help test and refer patients for treatment.

Medical treatment for HIV-positive individuals is high, at about $20,000 per year for each patient. The closest clinic to Austin providing HIV treatment is in Louisville, KY, a short commute away. This is the biggest rural outbreak of HIV cases since 1985, when a town in Florida was the focus of concern for cases of the virus.


Goodnough, Abbey. (March 30, 2015) The New York Times. Indiana Races to Fight H.I.V. Surge Tied to Drug Abuse. Retrieved online from:

NBC News. HIV Outbreak in Indiana Tops 100 Cases. Retrieved online from:

Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

Tide Detergents Stolen in Exchange for Drugs

April 3, 2015 by  
Filed under Treatment and Recovery News


shelves of tide in grocery aisleCall it customer loyalty or call it “liquid gold,” the new street name for Tide liquid detergent. Thieves in New York and some other areas along the East Coast have one specific brand in mind when they shoplift from supermarkets, bodegas and discount stores (such as Target, Walmart, Costco, etc.).

Considered a number-one target for theft, Tide detergent remains at the top of a list of consumer products that have gained strong survival during the economic downturn of the last 8 years. Along with two other producers, Kraft and Coca Cola, Tide is a brand that few people will leave to use discount products.

Because of this popularity with consumers, it has become a hugely desired item in East Coast black market streets. Lower incidence is seen on the West Coast, although reports were made of a high-speed chase following a detergent robbery in California.

Recognizing the high level of theft that this product receives, police began to investigate what was happening with Tide and found that it was the number one item being stolen from retailers. One city in Bowie, Maryland reported losses of $10,000.00 to $15,000.00 per month in this one product alone.

What’s Really Happening

Thieves are selling Tide on the streets for less than the nearly $20.00 per bottle it draws in the marketplace and most of the money made from the sales is going for drugs. In fact, thieves who were willing to talk about their use of the detergent reported that a single bottle could be exchanged for $5.00 in cash or $10.00 in weed or crack cocaine.

The idea of customer loyalty to the point where families will buy black market Tide is a serious indicator of hard times. Approximately 30 percent of the money going toward laundry detergent is spent on this product, which remains at the top of the list of products that have the strongest name identification; and consumers insist on using only this brand.

The exchange of detergent for drugs is an interesting market trade. While there were no comments available from the manufacturers, this can hardly be a source of good advertising for them. It appears that clean clothes are precious enough to exchange for drugs in today’s economy.


NewYork Magazine. Suds for Drugs. Tide detergent: Works on tough stains. Can now also be traded for crack. A case study in American ingenuity, legal and otherwise. Retrieved online from:

Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

Krokodil Drug Use in US

March 20, 2015 by  
Filed under Treatment and Recovery News


Australian Freshwater crocodileKrokodil comes from Russia, where there is a severe shortage of heroin. The war in Afghanistan, amongst other factors in decreasing production of opium in that country (the world’s largest producer of opium poppies) is directly attributed to the creation of this drug.

The drug is made from codeine tablets with lighter fluid or paint thinner, and is a highly toxic substance. Injection of the drug increases the rapid effects. An active ingredient in codeine medication is Desomorphine, which is 8-10 times more potent and addictive than morphine. Desomorphine also acts much faster than morphine. These factors account for the widespread use of the drug, despite its horrific side effects.

The other ingredients that create its toxic and flesh-rotting effects are red phosphorous and high quantities of gasoline, paint thinner or other solvents.

What Does It Do?

Named Krokodil, the Russian name for crocodile, this drug destroys human flesh from inside the body. Named for the green scales covering human skin, it eats away at the site of the injection, causing unsightly wounds to appear, along with the horrible skin affliction.

Flesh is dissolved from the inside of the body, usually eating from the bones outward, exposing the bones and leaving little or no flesh. Users can seldom be saved from death, except in cases where surgical intervention is done and use is discontinued. Amputation of damaged limbs is often the only way to save the life of the user, in order to remove the rapidly rotting flesh. Most users who continue to use the drug die within two years of first use.

Blood diseases are also another outcome of use of Krokodil. As blood vessels are destroyed by the drug, it enters the bloodstream and causes damage in various ways and can travel throughout the body to infest sites other than where the injection takes place. This rapidly increases its damaging effects.

Why are Addicts Using Krokodil?

Costs are low for this drug. Because of the shortage of heroin in certain European and Russian markets, as mentioned above, this drug presents addicts with a cheaper and more readily available alternative.

Another reason for using Krokodil is its faster assimilation into the body. Desomorphine is much more rapidly synthesized, making it virtually untraceable by methods used to test for drugs. Those who are likely to be randomly drug screened may turn to Krokodil because it is more difficult to detect with standard test methods.

What is the Popularity?

Numbers of cases found in the United States are low. This is believed to be due to the low cost and high grade heroin that is readily available in the US. This heroin comes from neighboring Mexico, where opium production has increased rapidly since the early 2000s.

There are thought to be only 3-4 cases of Krokodil in the US and one of those was an American teen who was diagnosed in Mexico, although she reportedly used the drug in the US before traveling there.

While reports vary widely on the number of Russian and European addicts who have been diagnosed with Krokodil use and outbreaks are reportedly dwindling, it was once believed to have been affecting upwards of 100,000 people. The numbers are hard to confirm, due to conflicting reports. Part of the reason is the Russian silence regarding treatment of addicts and the various diseases killing them. Reports are silenced and altered by their media, and medical statistics are unconfirmed.


CritCom. The Quietest Casualties: Russian Public Health Policies Cause Patient Deaths in Crimea. Retrieved online from:

Doheny, Kathleen. (9/30/2013). Krokodil Drug FAQ. Deadly Drug May Have Entered the US.Retrieved online from:

Ehrenfreund, Max. (10/07/2013). Washington Post. Homemade Heroin First Developed in Russia may have come to the US. Retrieved online from:

Newser. Teen’s Lesions Linked to Cheap Heroin Substitute. Retrieved online from:

Time. The Curse of the Crocodile: Russia’s Deadly Designer Drug. Retrieved online from:,8599,2078355,00.html

Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

Preventing Relapses by Embracing Prolapses

March 6, 2015 by  
Filed under Treatment and Recovery News


Girl-DepressedWe all make mistakes and miss the mark at times. If we allow a single lapse to cause us to move backwards, relapse begins and can take over our lives. If we learn something from the lapse and it helps us to grow, we can instead experience a prolapse.

Most of us are familiar with the concept of a relapse from what we know about addictions. Someone who is addicted to a drug stops using the drug and then at some point starts using again. Often the person is more enslaved to the drug than they were before. This cycle is common in drug addiction, but it can also apply to any habit we attempt to change. The disorganized person fails to put away a day’s worth of mail and suddenly finds a month’s worth of mail scattered across the dining room table. The successful dieter eats cake at a birthday party and suddenly finds cake has become a daily indulgence. What if every lapse did not turn into a relapse? What if a lapse became an opportunity to grow and become stronger? This is the idea behind a prolapse.

A lapse turns into a prolapse when one is able to identify the triggers contributing to the lapse, increase outside support and create a viable plan for moving forward. The first of these three steps—identifying the triggers to the lapse—is a key step that’s often overlooked but all three steps are an important part of the process.

Discovering Your Triggers

Triggers can include events or circumstances, emotional or hormonal changes, anniversaries and the like. Triggers vary significantly from person to person and monitoring how someone else is triggered may help increase understanding of the concept—but it will not necessarily help one gain personal insight. Consider, for example, three former gamblers. The first ex-gambler played the lottery for the excitement. She is triggered when the jackpot gets over $100 million dollars. The second ex-gambler enjoyed going to the casino with friends. He is triggered when feeling lonely. The final former gambler enjoyed a wide range of gambling and gravitates to whatever is closest if she is short on cash. For her, being low on funds is a trigger. Each gambler had a different set of triggers for the same behavior. In each case, identifying the trigger for the unwanted behavior starts with understanding why the unwanted behavior started in the first place.

Once we understand why unwanted behaviors surface, we can then start looking for patterns. A smoker may notice that they lapse and have a cigarette right after work. Ending the work day is therefore a trigger. A former gossiper may notice they lapse when a certain person is in the office. That person’s presence then is a trigger. Finding patterns may mean taking a look back to when the habit was commonplace even though that may be a painful process.

Increasing Outside Support

Support can come from many different directions. Involving friends and family in the process is a great first step. This could include asking them to be mindful of what they bring into your presence, asking them to hold you accountable or helping you get to other resources. Many times the people who are closest to you know you best and also how to help. Other times friends and family are too emotionally involved to provide true support or have needs of their own to take care of. You may have to look elsewhere.

Outside support could alternatively include professional assistance. For serious or dangerous lapses, that could mean the assistance of a mental health or substance abuse professional. For other situations that could mean hiring a life coach or accountability coach. A dieter with frequent lapses may want to turn to a weight loss program with an accountability component such as Weight Watchers. Asking for professional help is not a sign of weakness. Rather, it demonstrates true courage.

Outside support may also come from setting up systems to slow or delay the negative behavior. For example, someone who struggles with overspending on their credit cards could freeze their cards in a block of ice, call the card company and request the card be placed on hold for a period of time, or cancel their cards altogether. It can be very valuable to take some time to consider what creative intervention sparked by a person, computer or circumstance may slow down impulsive behaviors.

Creating a Plan

Understanding triggers and finding support may help one feel good, but without a plan for moving forward, the first two steps will likely be ineffective. In the addictions field this plan is formally referred to as a relapse prevention plan. It should just as easily be called a prolapse plan. Such plans can be applied to any behavior we are trying to overcome – not just addictions.

A great plan begins with an acknowledgement of triggers and a list of how to reach identified supporters. The next major part of the plan is what can be done when the triggers have risen. This is a detailed list of realistic actions that can be taken during times of temptation. For the overeater it could mean drinking a bottle of water. The disorganized may plan for 10 minutes of uninterrupted cleaning. The lonely ex-gambler may call a sponsor or have coffee with a friend. These small steps are what make the prolapse come to life.

If Another Lapse Occurs

Lapses happen. When they do, start the prolapse process immediately. Identify the triggers. Write them down. If you are not able to identify a trigger, talk with a supporter for suggestions. Revisit your list of outside supporters. How can your support system be modified to be more effective? Finally, revisit your plan while keeping what you have learned in mind. Tweak the plan as needed and move forward.

Cyndy Adeniyi is a counselor and founder of Out of the Woods Life Coaching. She enjoys hiking, Zumba, and flea markets in her spare time. She lives with her husband and two children in Maryland.

The Rising Epidemic of Heroin Addiction


SONY DSCWhen people think about heroin, they often think back to the junkies of the 1960s and 1970s; sunken-eyed, skinny and unwashed young men and women who represented the poorer class of our social structure, stealing to support their habit and mostly living in dirty ghetto rooms with other junkies.

Today we see a whole new paradigm with heroin use and abuse. Most of those who abuse heroin now are professional or para-professional men and women who started using much later in life. They are doctors, nurses, police, clergy—those with high levels of education and living in nicer suburbs where addiction was not previously believed to travel in such high numbers. Again, these addicts most often speak of their addiction as having begun with prescription pain medications. Often, they first became addicted to pain medication that proved too difficult, illegal or expensive to maintain.

Why Heroin?

Heroin in today’s market is less expensive than ever before and more abundant in availability. One source reported that prescription pain pills sell on the street for approximately $1.00 per milligram. The cost for a 30-milligram pill would therefore be $30.00. This is far more than heroin costs, which would be somewhere between $10.00 and $25.00 a single use. The heroin available in most public settings today is of much higher quality than the black tar heroin of the 1960s and 1970s, since it is being refined more efficiently by producers before reaching the open market.

The United States is the world’s largest consumer of pain medication, buying 80% of the medication produced. Overdose of prescription pain medication is the highest cause of accidental death in this country, with death occurring every 19 minutes nationwide. Overdose from heroin use is rising sharply over the period of the last ten years; often observed with higher incidence in celebrity overdose cases in recent years.

The Center for Disease Control (CDC), reports that while overdose deaths from cocaine and prescription opiate medications have remained consistent in the period between 2011 and 2013, deaths from heroin overdose have doubled in number during that time.

A National Concern

Treatment professionals are seeing a steady increase in rates of admissions for addiction treatment regarding heroin, as well as prescribed opiates. In Denver, rates increased nearly one full percentage point between 2011 and 2012. In Vermont, the governor spent his entire ‘State of the State’ address in January, 2014 talking about the rising rates of heroin addiction, calling it a public health crisis. Cases there of heroin trafficking increased 135 percent between 2012 and 2013. From 2000 to 2013, the rate of heroin addiction treatment increased over 250 percent.

Most of the heroin coming in to the U.S. is coming from drug cartels in Mexico. Mexican heroin has decreased dramatically in cost for several reasons. Farmers who once grew acres of marijuana have switched to fields of heroin poppies. This is primarily due to the higher prices paid for the same volume of product. Drug cartels will pay the high price for tar produced by opium poppies and risk the dangerous transport of tar from mountain villages where they grow faster than crops that cannot be sold at the same high price.


Typical Opioid User Has Changed. Real Time Recovery. Retrieved from

Edelsten, Josh. (August 2014). Vermont Quits War on Drugs to Treat Heroin Abuse as Health Issue.BloombergBusiness. Retrieved from

O’Reilly, Andrew. (February 5, 2015). Gang warfare on streets of Chicago fueled by Sinaloa Cartel heroin.Fox News. Retrieved from

Stevenson, Mark. (February 3, 2015). Mexican Cartels Expand Offerings to Feed America’s Growing Heroin Addiction. Huffington Post.  Retrieved from

Torres, Kevin. (January 7, 2015). Heroin Cheaper than Pain Killers. Denver News. Retrieved from

Weathers, Helen & Carmen Bruegmann. Heroin Britain.Daily Mail Online. Retrieved from

Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

Reasons for Relapse and Avoiding Them

February 20, 2015 by  
Filed under Treatment and Recovery News


Businessman wearing blue shirt drunk at desk on white backgroundRelapse (i.e., going back to using after abstaining for a length of time) happens to many people on their road to recovery and, if it does, is not a sign of failure. The National Drug Association reports the relapse rate for drug addiction to be 40 to 60 percent. People relapse and then try again. But being aware of these three signs can help you be mindful and avoid your own triggers before relapse happens.

1. Old Playgrounds and Playmates

This is a big one to put on your priority list. Even those who have been sober for years are subject to relapse if they choose to play in old playgrounds with old playmates. For those of you who are unfamiliar with the term often used in AA and NA, this refers to people and places you have used with or at. It’s easy for others to say if he or she is sober to obviously avoid the crack house, but it’s not always that simple. It may mean leaving behind your best friend of 20 years. It may mean breaking up with the love of your life, if they are actively using. Changing your surroundings is a vital part of your sobriety.

2. The Pink Cloud

If you have already gotten sober, congratulations. I’m sure everyone has heard of “the pink cloud” or, more bluntly, your new drug-free beginning. The first few weeks and even months of sobriety is so exciting, new and refreshing. The feeling of getting clean successfully is quite overwhelming, in a good way, but can also be something to remain wary of. Overconfidence may be something to watch out for, as those who are overconfident can overstep their boundaries, fall back into old practices and relapse more rapidly than they ever thought. When referring to the pink cloud, it is associated with those who think they can hang out in old places or around drug or alcohol use and assume that they themselves will not use. It may sound unreal but let me tell you from experience—it is real. It’s okay to stay away from people or places because you think you might use. There is no shame in being honest with yourself.

3. Emotional and Physical Triggers

A trigger is simplistically described as something that can set you off. It may be a person, place, thing that reminds you or even drives you to use drugs or alcohol. It can be anything from seeing someone you used to get high or drunk with to even the feeling you get when listening to a song you enjoyed while using. Recognizing your triggers is a key part in your recovery, although they aren’t always easy to spot in the beginning. Some people have to immediately experience their trigger to know that they are dangerously close to a relapse. If you have attempted to get clean several times before, you may already have a general idea of what sets you off to relapse. Unfortunately for myself, that was the only way I discovered my triggers to begin with; relapsing because of them, over and over again.

Other causes for relapse can sometimes be identified as H.A.L.T – hungry, angry, lonely or tired. Those feelings or states of mind are also closely associated with reasons of relapse and are extremely important to stay mindful of. Ridding the chaos in your life is a big change for many addicts but getting bored may also lead you to a relapse, so keep your interests peaked and engaged. Do not forget that addiction is a disease, just like diabetes or cancer. We take steps every day to avoid consequences caused by our disease even if they may not always be laid out in front of you.


Cassandra Huerta is a freelance writer who lives in an extremely small Michigan town and lives life one day at a time. She enjoys regularly entertaining her six-month-old daughter and can thank her wonderful fiance and coffee for all of her work.

Are E-cigarettes the Lesser of Two Evils?


iStock_000044677596_Large (1)E-cigarettes are electronic devices that have come into popular use after being initially created to replace cigarettes and/or wean smokers off dangerous chemical effects of nicotine. They have several names but the terms most often used to describe these devices for vaping are “vapes” or vaporizers.

Initially only marketed and sold on the internet, the first e-cigarettes were sold without legislation by the agencies who monitor and control tobacco products. As they became more popular, agencies who manufacture tobacco products began to step into this arena as well. Advertising increased and use became more widespread.

Today, entire stores are devoted to the practice of inhaling vapors through the mechanisms being developed and constantly upgraded as “e-cigarettes.” There are many models, styles and combinations of flavors to choose from. There are customized vapors as well as holders, allowing for a wide variety of experiences with “vapes.”

What We Know About Them

At the beginning of the conversation about vaporizing, there was little risk seen with the devices or the manner of delivery for the product. Concern with the chemicals used for the vapors in e-cigarettes, however, has risen since their early inception. This is due to the fact that some of the problematic effects of the chemicals are seen at higher temperatures. These temperatures were not possible with the early types sold. Today, there is a much higher temperature that’s possible in vaping.

This chemical, propylene glycol, a common component in e-cigarettes, is known to cause eye and lung irritation. It carries a warning from the manufacturer, Dow Chemical Company, against inhalation. Additionally, the toxic formation of carbonyls is even higher than that produced from tobacco products. This is the danger seen at higher temperatures that can be achieved with newer models of e-cigarettes.

Some of the carbonyls shown to be formed are formaldehyde, acetaldehyde, acetone and butanol. Added to this risk are the flavorings added to the vapor liquids to make them taste like flavors ranging from bubble gum to rum. While they are listed as safe ingredients for consumption in food substances, vaporizing these compounds with propylene glycol may produce far different results.

While research is ongoing, there is no definitive information about e-cigarettes that raises alarms at this time. However, there are several factors that bring up the conversation about regulating them in ways similar to tobacco products.

Arguments for Regulation

First of all, there is no age requirement for buying e-cigarettes which makes them widely popular with adolescents and pre-teens. Since there are recognized health risks possible, it would seem that this makes a good argument for regulation of sale for use of this product.

Many manufacturers are targeting this specific population for marketing purposes. Even if the use of “vapes” is as innocuous as they argue, the habit of smoking these may increase chances for addiction, which may raise the possibility of moving from this product to tobacco use in the young.

Additionally, many users have already created ways to use other substances with e-cigarettes. Allowing minors to use them increases the possible risk of moving into use of substances that can be masked by “vaping.”

Until specific health benefits can be recognized over the use of tobacco, one argument for regulation remains consistent: age requirements should be legislated.

Health Risks

Again, research has shown little consistent data with e-cigarette use. Comparison is drawn between a known danger, tobacco product use, and that of vapors. This is similar to stating that it is safer to shoot someone in the foot than to shoot them in the head. Or to say that use of strychnine is more favorable than use of arsenic or vice-versa. When something as dangerous and addictive as nicotine in tobacco products is compared to a less dangerous practice, there is considerable risk involved either way.

There is some evidence that health risks are present with use of vapors. There is also some evidence that secondary exposure to vapors is harmful. At any time, there is little benefit for human consumption of chemical compounds such as those produced by or used in either product.

Until the exact extent of danger of these products is known, perhaps the burden of proof should be on the manufacturers of the products to show a benefit of their use. Why smoke at all? What possible benefit can be found for developing a taste for vapors of chemical compounds?

Why Use E-Cigarettes?

The most common reason people use e-cigarettes is to help themselves stop smoking tobacco products. Many former smokers remain steadfast in their support of vaporizing as a means of substitution of tobacco. However, thousands, if not millions, of former smokers have shown that there is no need for this product to stop smoking tobacco products. That argument simply does not hold together.


Environmental Health Perspectives: National Institute of Environmental Health Sciences: National Institute of Health. “Vaping and Health: What Do We Know about E-Cigarettes?” Retrieved online from:

Oxford Journals. “Carbonyl Compounds in Electronic Cigarette Vapors—Effects of Nicotine Solvent and Battery Output Voltage.” Retrieved online from:


Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

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