How to Detect If You or Your Loved One is Addicted to Prescription Medication

Prescription addiction happens covertly, so you may not detect your own or your loved one’s dependence until much later in the process. Many people who abuse prescription painkillers simply tell others – and themselves – that they take their pills because of pain.

“Most of the time you are unable to decipher [an addiction] until an individual has experienced more deficits than benefits from abusing the medications,” Dr. Nancy B. Irwin, a primary therapist at Seasons in Malibu, says. “In other words, unless there are apparent impairments in functioning as a result of abuse, most individuals do not even realize they are abusing.”

The fact that prescription opioids come from a doctor tend to lull one into thinking that he or she is simply taking medicine instead of abusing hard drugs. “Prescription medication can be obtained legally and is largely covered by your health insurance,” Dr. Irwin says. “[Some believe] street drugs carry more risk than prescriptions because you are unaware of any additives or other drugs it could be combined with.”

On the contrary, prescription painkillers are actually one of the most common causes of lethal drug-related accidents in the country. The Centers for Disease Control and Prevention reports that nearly half of all U.S. opioid overdose deaths involve at least one prescription opioid. The report also reveals that more than 15,000 Americans died from overdoses involving prescription opioids in the year 2015 alone.

To help you or your loved one pull out of this dangerous cycle, here are four key questions that can unveil whether or not someone’s prescription medication use has developed into addiction.

1. How often are you taking the medication?

If you suspect prescription opioid abuse, Dr. Irwin says this should be one of the first questions to ask. Are you or your loved one taking the pills every few hours or are you actively trying to space them out as much as possible? Are the dosages low or high?

Bear in mind that all prescription medication must be taken as prescribed. Many doctors also write prescriptions for pain medication to be taken only “as needed.” If you find yourself or a loved one taking these medications on a regular basis or in higher doses, the prescribing doctor needs to know. Taking higher doses or more frequent doses is a sign of possible addiction.

2. Can you stop taking the medication?

Prescription pain killers are usually not an ideal way to manage chronic pain. They’re much more effective for acute pain, which should pass in a matter of weeks in most cases. If the person is unable to stop taking the medication after the appropriate amount of time, check to see if discontinuing the medication causes problems. This would be a tell-tale sign of dependence. Dr. Irwin says, “The abuse begins to happen when individuals become physically dependent on prescription medication and the desire to avoid the physical and psychological discomfort from withdrawal symptoms outweighs the choice to stop taking the medication.”

3. How do you act when you don’t have medicine?

If you or your loved one forgets the medication at home or can’t get a refill on time, what happens? Your behavior during this time is usually a telling sign as to whether you are an addict.

According to Dr. Irwin, initial signs and symptoms include changes in behavior or mood, decreased tolerance of others, increased agitation, irritability, anxiety or impulsivity.

“You will see changes in cognition which can include memory loss, confusion, poor concentration or focus, complaints regarding physical aches and pains, body sensations such a pins and needles, poor G.I. functioning or an urgency to get to the medication.”

Typically, right before a prescription runs out, addicts get “panicky” and spend a great deal of time scheduling doctor appointments and pharmacy pickups out of fear of missing a dose.

4. Where are you getting the medicine?

Most people with serious pain should not have an issue getting prescription medication from a doctor who can oversee their pain treatment plan. Whenever possible, it is best that the person gets all of his or her prescriptions filled from the same pharmacy. A pharmacist who gets to know the patient and his or her medications is in a good position to help spot signs of possible prescription addiction. If you or your loved one makes an effort to avoid seeing the same pharmacist, know that this may be a sign of addict behavior.

While prescription pain opioids are often useful and sometimes necessary to treat moderate to severe pain, they are far from harmless. The key is to monitor one’s intake of these prescriptions and maintain an open and honest dialogue with a medical professional.

Recovery from Prescription Medication Addiction

Not everyone who receives prescription painkillers become dependent, but when addiction does take hold, it’s important to look beyond the drug abuse. “The addiction is a symptom to underlying psychological and physiological ailments that have yet to be treated,” Dr. Irwin says.

The problem with addiction is that it contributes to the brain being hijacked and leads to poor judgment, often rendering them unable to seek help on their own. If you find that your loved one refuses to acknowledge their drug abuse, Dr. Irwin suggests an intervention along with other family and friends. “Be vigilant, stay informed, consult with professionals and ensure that you continue to be persistent.”

On the other hand, if you recognize the addiction symptoms in yourself and are ready to recover, allow yourself the time to heal. Get assistance and do what you can to prioritize your health and overall wellbeing.

“Prescription addiction requires a focused approach to eliminating the dependence and then facilitating a long-term plan for success,” Dr. Irwin says. “Seasons in Malibu thinks about that plan from the moment [the person] walks through the doors.” The recovery team’s approach includes a systemic treatment model that strongly takes the individual’s family, environment, vocation and activities of daily living into account, she says.

When dealing with drug addiction, remember that having a good spirit and keeping an open mind help tremendously during the recovery period. “Prescription abuse and dependence can be more difficult to spot early on, that is why staying vigilant, maintaining an open line of communication and seeking help immediately can make the crucial difference for you or your loved one.”

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Dr. Nancy B. Irwin is a Certified Hypnotherapist and the Primary Therapist at Seasons in Malibu, a world class, dual-diagnosis, CARF-accredited drug rehab and addiction treatment center in Malibu, CA that specializes in treating addictions such as alcoholism, cocaine addiction, opiate addiction, prescription drug abuse and more. Dr. Irwin earned her doctorate in clinical psychology from California Southern University and is a certified practitioner of Time Line Therapy, Emotion Free Therapy, and Neuro-Linguistic Programming (NLP). Over the years, she’s shared her expertise on CNN, CNBC, Fox, MSNBC and other popular radio and TV shows.

What is Sugar Alcohol?

Sugar alcohol is so-called because chemically, it’s a cross between sugar and alcohol. Other than that, there’s little to link it to either substance. It doesn’t cause quick blood sugar spikes and it doesn’t make you drunk. It has not been linked to cancer, liver deterioration or any other life-threatening disease. It’s considered a safe and non-toxic sugar substitute in many processed foods, including diet and diabetic foods.

Sugar Alcohol Defined

Sugar alcohol is granular and white like sugar and is used as a sugar alternative in “sugar free” or low sugar edibles such as chewing gum, jam, sweets, baked goods, soft drinks and protein bars. It’s also found in mouthwash, toothpaste and medicinal products such as cough medicine. Legally, it has to be contained on the labels of these products as a carbohydrate or sugar alcohol. The most common sugar alcohols are: Erythritol, Lactitol, Maltitol, Sorbitol, Mannitol, Isomalt and Xylitol. They are generally extracted from corn starch, sugar or plants.

Sweetness Level and Calories

The sugar alcohols vary in sweetness level and calorie content. Their sweetness levels range from 50 percent to 100 percent that of sugar. Sorbitol and also Mannitol has a sweetness level that is 50 percent that of sugar, Sorbitol 60 percent, Erythritol around 75 percent, and Maltitol and Xylitol, are on a par with regular sugar. Despite this, sugar alcohols have much less the caloric content of regular sugar. Erythritol, for example, has 0.2 calories per gram, Xylitol 2.4, and Sorbitol, 2.6 calories per gram. Regular sugar has 4 calories per gram.

Advantages of Sugar Alcohols

Sugar alcohols (with the exception of Erythritol) are not fully absorbed by the body with the result that they transform into glucose much more slowly leaving blood sugar and insulin levels largely unaffected. Absorption levels vary. For instance Xylitol has a 50 percent absorption level while Sorbitol has an 80 percent absorption level. But Erythritol, because it’s almost totally absorbed but not digested, has a caloric content of almost zero.

Sugar alcohols are prevalent in foods for diabetics because diabetics need to ensure that their blood sugar levels remain normal. They’re also found in many diet foods because they don’t interfere much with the fat burning process and have far fewer calories than sugar. On the other hand, the body absorbs sugar quickly. When you eat something with plenty of sugar, the body uses lots of insulin to convert it to energy and get it into the cells. This leads to yoyo blood sugar levels and fat accumulation.

Another plus is that sugar alcohols such as Xylitol don’t contribute to tooth decay as sugar does; that’s why they are popular in chewing gum and some candies. Xylitol is also believed to be able to limit middle ear infections in children.

Disadvantages of Sugar Alcohols

The parts of the sugar alcohol not fully absorbed in the blood stream may ferment in the intestines if you over eat them, resulting in gas, diarrhea, stomach cramping, bloating and other gastrointestinal problems. You may experience this feeling, for instance, if you chew piece after piece of sugar free chewing gum all day long. Some diabetics have reported experiencing a surge in their blood sugar levels after overeating the alcohols. Others have reported abdominal complications from eating only small amounts at a time. It’s because of these complications that manufacturers of gum, mints and other “sugar free” products that people may binge on are required by law to state on their labels that overconsumption may have laxative consequences. Binging may also lead to weight gain because it may obstruct the absorption of the fat of other foods. However, Erythritol, as it is totally absorbed, doesn’t cause laxative and other negative consequences and neither does it spike blood sugar and insulin levels. Consequently, the use of Erythritol is on the rise.

Implications for Alcohol Recovery

Recovering alcoholics who may not have had a taste for sweet foods before going sober, may suddenly find themselves with a sugar addiction. So in times of stress or loneliness, they might reach out repeatedly for cake, a box of chocolates, or a king-size soda, much as they did with alcohol before sobriety. They may even turn to sugar alcohol as a healthy alternative.

But recovering alcoholics can do without processed sugar alternatives. They need healthier long term solutions to their cravings. With time, they can adjust to getting their sugar from fruit especially those low in sugar such as apples, pears, grapefruit, strawberries and other berry alternatives. An all-round healthy diet rich in protein and fiber such as veggies, lean meats, grains and nuts, will help keep blood sugar levels and sugar cravings in check because they are slow to digest.

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Benhilda Chanetsa has a BA Honors degree in History and Sociology and a teaching diploma, both from the University of London. She was a high school teacher for 11 years, and chief subeditor at a weekly newspaper for four years. She’s been a freelance lifestyle writer for the past 10 years and has two nonfiction e-books published on Amazon. The books are on overcoming negative thinking and surviving abusive relationships.

Switching Addictions Detrimental to Recovery

Far too often drug rehabilitation clinics, drug prevention education, and even alcohol and drug abuse recovery programs focus on the primary drug of choice rather than addressing the underlying issue of a brain that is susceptible to addiction in its numerous forms.

These “numerous forms” of addiction can encompass and be transferred to anything from sugars and sweets, gambling, pornography, sex and even switching to other family’s drugs.

For whatever reason there remains the justification that says, “well at least it’s not as bad as ______.” Researchers have found that switching addictions only adds to the possibility of relapse due to the brain still receiving the same impulses and serotonin rushes as were achieved with the primary drug of choice.

“People who have one addiction are prone to others,” says Dr. Gregory Collins, section head of the Alcohol & Drug Recovery Center at the Cleveland Clinic. “If you are biologically programmed to addictive illnesses, you risk having more than one.”

Instead of tackling all addiction problems at once, what is commonly done is the worst is first addressed while the recovering addict continues on in their co-occurring addictions. Although the specific method or form of the addiction has changed, the behavior remains the same.

A rough example of this phenomenon could be illustrated by abstaining from alcohol but still hanging around the bar that you and your buddies used to drink at. Although there are not necessarily chemicals being ingested, the behavior itself has not undergone any transformation.

According to Collins, one in four addicts will switch addictions, only furthering their chances of relapse on the original drug of choice.

“Many of the clients we treat come in because one drug is their drug of choice, and they think they can use other substances because it’s not something they’ve struggled with,” says Jennifer Tulli, an addiction specialist at the Cleveland nonprofit agency. “The reality is, the addict is still chasing that feeling, the impairment, the numbing of their senses. It’s hard to think of a situation where that hasn’t happened.”

One of the most common forms of cross-addiction can be seen between alcohol and opiate users. The opiate user might switch over to alcohol because of its seemingly less harmful nature, and the alcoholic might switch over to opiates and painkillers as a form of misusing prescription medicine.

“They might not have used alcohol in 20 years, and they take the drug as prescribed initially,” Tulli says. “But because they really like the feeling, they can’t stop.”

Another common cross-addiction comes in the form of gambling, which can be seen in the way that those with alcohol dependency issues are three-times more likely to develop a gambling addiction.

“The best research we have is for those,” says Ray Isackila, an addiction specialist at University Hospitals Case Medical Center. “What we know is that people addicted to a substance — alcohol or drugs — are at greater risk of developing problems with process addictions, such as gambling.”

As described above, the fundamental search for an addict is a mechanism by which they can achieve the same “highs” by a safer means. Once again, this can take on a wide variety of forms stretching from chocolate or cigarettes all the way to gambling and pornography.

“When there’s a heavy focus on the primary addiction, it’s easy to lose sight of the other things that are gathering an unhealthy momentum, until they become very obvious,” said Collins.

Collins’ went on to say that the only reason cross-addiction numbers have stayed at 25 percent is because of growing awareness and rehabilitation centers adapting recovery strategies to help curve the problem.

Tulli states that the best bet for maintaining sobriety is cutting out all addictions at one time, including nicotine, which is seldom counted as a cross-addiction.

“It’s hard for people to give up everything at once, and it’s a tough sell we have to make,” she says. “But the point is, as we say in treatment, to deal with life on life’s terms.”

The superseding premise is that the recovery process should be looked at as a behavioral transformation, in which the overt goal is to monitor and moderate all facets of addictive behaviors. Since the range is so broad and diverse between individuals it is hard to classify any particular behavior as being a “death-trap” of sorts.

Instead the point is to remain vigilant of activities or behaviors that resemble the same compulsions and reactions once obtained from the users primary drug of choice. It is not enough simply switch, an entire behavioral transformation must be undergone in order to give the recovering substance abuser the best possible chance at maintaining sobriety.

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Chad Arias has a B.A. in journalism and is a contributor for the Latino Post and Opposing Views. In his free time, Arias writes poetry, short stories and is currently working on a novel detailing his experiences with substance abuse. He is most interested on the philosophical and psychological aspects of the subject.

The Relationship Between Stress and Addiction

It should come as no surprise that stress and addiction are closely related. When we’re under stress, we seek out a method to deal with, and avoid uncomfortable feelings. Our mind and our bodies search for the easiest ways to reduce the stress.

While we all feel the strain of stress, we react to it in different ways. Some people handle it well on their own, some exercise, some meditate and unfortunately, some people turn to substances that can be easily abused.

The Connection

When we experience stressful situations, our bodies automatically release hormones that were designed to allow us to react to danger; the classic “fight or flight response,” also known as the acute stress response. In this situation, the heart pounds and breathing quickens.

Those under extreme stress may feel overwhelmed and are unable to cope with significant and unrelenting stress. Food, drugs, and alcohol all provide a release of the chemical dopamine and result in pleasurable emotions that contradict the stress.

Drugs and alcohol may provide a temporary calming effect, so a person may feel like their stress is gone. Unfortunately, this can lead to a dependence on the drugs or alcohol, at increasingly higher quantities, to help diminish stress levels.

Using these substances may help relieve the anxiety and tension, albeit, only in the short term. Unfortunately, when the drugs wear off, the person will experience the stress and unpleasant feelings again. Even people who are not hard-wired for addiction can be made dependent on drugs if they are stressed.

Supported by Research

Stress is a well-known risk factor in both the development of addiction and in addiction relapse, as published research reveals. ^[1]

• One research group found that “before beginning substance use, the occurrence rate of various psychosocial stressors in opium addict patients was statistically higher than normal subjects in the last two-year period.” ^[1]
• Studies have also discovered that stress levels contribute to the success of substance abuse recovery and actually lead to being vulnerable to
• Stress was directly related to relapse, specifically in cocaine users. ^[2]
• Stress can cause relapse even after a four to six-week drug-free period. ^[3]

Stress Management

All the data clearly points to the need for treatment of stress to reduce drug and alcohol dependence and prevent the occurrence of relapse.

If individuals believe they have problems with both stress and addiction, they should seek the assistance of a professional and incorporate these following suggestions in order to begin to live a sober life:

• Ask for help. Alcohol and drug addiction rehab may include inpatient or outpatient care, individual or group therapy, and a 12-step program. You reduce stress or get clean alone.
• Yoga, Meditation and Lifestyle Skills. These practices place a focus on mindfulness that allows you to be aware of your own thoughts and emotions. Meditation involves clearing your mind of stressful thoughts and focusing only on the present. By making lifestyle changes, studies demonstrate you can reduce your stress levels and gain control. ^[4]
• Exercise. Regular exercise naturally makes you feel better by raising your body’s level of endorphins, which are linked to a positive mindset. These are the same endorphins your body releases while you abused substances. But when you exercise, you create a “natural high.” Your body will learn that it is capable of regulating its own brain chemistry and mood in healthy, natural ways.

A Final Thought

Stressful life events and ineffective coping strategies in addicts play a major role in the development of drug abuse and relapse. To help prevent the occurrence of severe stress and alcohol/drug abuse, skills such as stress prevention, must be taught.

Learning effective methods to manage stress is essential to long-term recovery. The addict must find a way to deal with stress in a healthy and productive manner so they will not revert to substance abuse when stress appears.

References:

[1] http://www.sciencedirect.com/science/article/pii/S1877042813018260

[2] http://www.cell.com/neuron/abstract/S0896-6273%2813%2900042-1

[3] https://link.springer.com/article/10.1007%2Fs002130050150

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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 Examiner.com.

 

Exercise Can Lower Lower Alcoholism Risk

Although alcoholism is likely to be a genetic disorder, scientists across the globe have always been laced with a curiosity to explore other environmental factors that could possibly play a pivotal role.
A recent 20-year study conducted in Denmark by Dr. Ulrik Becker of the National Institute of Public Health at the University of Southern Denmark in Copenhagen has potentially found a link between exercise and an individual’s susceptibility to alcoholism.

Between 1976 and 2003 researchers in Copenhagen sent out more than 18,000 surveys, which were used to classify and keep track of participants exercise habits as well as if they were hospitalized for alcohol treatment.
The participants were broken up into three groups: high activity (more than four hours a week), low activity (two to four hours a week), and sedentary (less than two hours). After establishing the classifications researchers then checked in every year to see which groups had a greater frequency of being hospitalized for an alcohol related illnesses.
After 20 years, 736 participants had been at one point hospitalized or diagnosed for an alcohol related disorder. When correlating those affected with their levels of exercise, researchers found that low and high exercise participants were 40 percent less likely to have been diagnosed with an alcohol related disorder.
It is key to note that this does not form a “causal relationship” between exercise frequency and alcoholism, but what it does do is shed some light on the environmental factors that can either increase or decrease a person’s chances of being diagnosed with alcoholism.

“Although we and for that matter others have not proven a causal relationship between physical activity and risk of developing alcohol use disorders, it is likely that there is a causal link,” said Becker.
Becker and other researchers remain unclear on what exactly the relationship is between the two, but future studies will likely hone in on this issue. There a wide variety of personality traits that may go along with individuals who engage in frequent exercise, but other than survey research there is no real way to form a scientific opinion or theory about the topic.

What Recovering Alcoholics Should Know About Kombucha

Kombucha is a beverage that has been popularized in western culture for years now. You might have seen the drink on the shelves of your local grocery store or co-op or read about it online. It can be purchased from the store in a variety of flavors or made at home. Kombucha is a fermented tea that has many purported benefits, but many of these benefits are not supported by research. The drink does contain probiotics, however, and a good amount of recent research suggests that probiotics can be beneficial. But if you’re a recovering alcoholic, you should stay away from this drink. Why? Because it contains alcohol.

Whole Foods actually pulled all of these drinks from their store shelves for a period of time back in 2010 because the 0.5% alcohol content limit was being exceeded in some cases. The kombucha that was being sold continued to ferment as it was stored on shelves and the alcohol content in some bottles reached 3%. The problem was quickly remedied, but for those who make their own kombucha at home, the issue of alcohol content remains. For one, home brewers don’t usually know how much alcohol their kombucha contains once they have deemed it ready to drink and secondly, the drink does continue to ferment, which can raise the alcohol content in the drink significantly over time.

These are risks that are generally acceptable for non-alcoholics to take. But for recovering alcoholics, these risks are just too high. The trace amounts of alcohol found in kombucha might not register as significant for most people, but they can be a crutch or an introduction to a relapse for a recovering addict. According to Vice, a spokesperson for AA has said that kombucha consumption can be dangerous for recovering alcoholics, stating that if a recovering addict knows that there is alcohol in a beverage but still feels like they are doing fine with it, it wouldn’t necessarily be a far throw for that person to then move onto drinks that contain slightly more alcohol.

So if you want the benefits of drinking kombucha but you don’t want to risk having even a trace amount of alcohol, here’s what you should do:

1. Drink tea. 

If you like tea, drink it! Tea is the base of kombucha “” usually black or green tea. The tea contributes in part to the “kombucha buzz.” Kombucha drinks that have fruity flavors have a tiny bit of the respective juice in them. If you like the way that tastes, consider simply adding some of your favorite juice to your tea.

2. Consume probiotics.

If you find that consuming probiotics makes you feel better, you can get them from places other than kombucha. Some foods that contain probiotics include: yogurt, kefir, sauerkraut, miso, soft cheeses, sourdough bread, sour pickles, and tempeh.

3. Drink club soda or mix it in.

Perhaps you just like the effervescent aspect of kombucha. If you like the bubbly part of the drink, consider consuming club soda or sparkling juices as a replacement.

How Alcohol Use Affects Mental Health

1. Alcohol interferes with the mechanism by which most medications used in treating mental illness work. Drinking alcohol typically nullifies the effects (if any) from psychotropic medications.

2. Alcohol use interferes with the process of learning and memory. This relationship is such that the more alcohol one uses the more the process is disrupted. Someone in a treatment program for mental illness or substance abuse drinks heavily will not process, encode, and retain information as well as if they did not drink at all.

3. Alcohol can be dangerous and even lethal when used in combination with certain medications such as anti-anxiety medications.

4. Alcohol use contributes to increased impulsivity in people. People with mental illness are at risk for acting impulsively and irrationally. Drinking alcohol makes this all the worse.

5. Heavy alcohol use leads to poor decision-making that can intensify guilt, shame, depression.

6. Alcohol is a central nervous system depressant. What this means is that it dampens the firing of certain neurons in the brain. For people prone to depressive reactions alcohol use can actually intensify their depression and increase thoughts of self “” harm.

7. Heavy alcohol use may initially reduce a person’s anxiety; however, it also leads to something known as rebound anxiety where the person will experience more anxious symptoms as they withdraw from alcohol use.

8. Alcohol use is known to increase recall for negative events such as traumatic experiences that occurred when one was using alcohol. This can lead to increased shame, depression, etc.

9. Regular alcohol use disrupts sleep patterns and REM sleep. Disrupting one’s sleep can lead to more issues with fatigue, anxiety, depression, etc.

10. Alcohol use is associated with other substance abuse, especially in individuals diagnosed with some form of mental health issue or mental illness. This can lead to more distressed, increased legal issues, and issues in recovery and treatment.

The bottom line is this: If you are diagnosed with a mental health issue DO NOT drink alcohol at all unless you are instructed to do so by your physician (this last situation would be VERY rare).

References

[1] American Psychiatric Association. (2013). Diagnostic and statistical manual for mental disorders (5th ed.). Washington DC: Author.

[2] Hatfield, R. C. (2013). The everything guide to the human brain. Avon, MA: Adams.

A Look at the Cumulative Effects of Anti-Depressant and Anti-Anxiety Medications on People With Addiction

The dangers lie in belief that this is an open and shut situation for anyone, especially when it comes to the neurological damage caused by addiction, the fact that many addicts have self-medicated underlying mental health issues, and the difficulty of diagnosis for early recovery.

Of course there is a plethora of material touting the use of antidepressants. Anyone who suffers the crippling effects of depression, whether it is long-term, chronic depression or a shorter-term, situational depression can testify that medication can be a God-sent assistant in navigating daily life. For some, it allows functioning in a world that appeared sinister and overwhelming to accommodate.

However, the challenges for those who are in early stages of recovery from addiction to substances that alter their brain function for months or years are in appropriately being diagnosed for said mental health issues.

What are the Challenges of Diagnosing Addicts?

Alcohol, some benzos (Benzodiazepines), Opiates, and Central Nervous System (CNS)-Depressant medications may cause long-term damage to the synapse responses in the addict’s brain over long periods of abuse. How and when those functions are returned to homeostasis is questionable. Diagnosing these addicts as depressed may be tricky, if not impossible, during the early stages of recovery.

Many addicts have lied to their providers when asked about alcohol and drug use. An addict using these substances is going to present symptoms that are being created by the drug, not the addict’s natural mental state.

Addicts who have been abusing stimulant medications over a period of time may present with symptoms of depression when newly eliminating these drugs from their system. They feel depressed, because their continual state of hyper-alertness, caused by the drugs they were abusing, is missing. This may go on for up to a year after they stop drug use. Treating these symptoms with medication may not be the best way for them to stabilize and return to homeostasis.

For that purpose, it is important to question the use of medications during this period, as well as to determine a shorter period of use of medications, due to the changing brain chemistry of the addict overall.

What are the specific issues of use of antidepressants?

For anyone facing the question of whether or not use of antidepressants is their best bet, there are several pieces of information to consider. There are many articles and much information about the side effects of various antidepressant medications, which will not be addressed in this article. These should be weighed by the person who is considering medication.

They may need to try more than one medication before the appropriate fit is found for their personal use. It is highly recommended by doctors and pharmacists that the patient work closely with their physician to find the appropriate medication, dose and term of treatment. Staying on top of your use of medication requires a team effort. DO NOT ATTEMPT TO STOP USE OF MEDICATION WITHOUT MEDICAL SUPERVISION.

Any and all use of medications during the taking of anti-depressant medication needs to be consulted with a physician to determine best course of action. MAKE SURE YOUR DOCTOR KNOWS ABOUT ALL MEDICINE, EVEN OVER-THE-COUNTER VITAMINS OR SUPPLEMENTS BEING TAKEN.

Why is this a personal decision?

In March, 2010, a report made by Dr. Charles Raison, a psychiatrist at Emory University Medical School for CNN spoke of cataracts being caused in long-term use of medications used for treatment of depression. In addressing this finding, Dr. Raison stated his opinion that few long-term studies had been conducted to find long-term effects of medications because there are so many variables in patients. Another reason is that there is no baseline for “normal” in the human brain or one established for all of the factors that may lead to the “causal” nature of depression, much less the lifestyle variables and conditions for each patient.

Given these factors, it is important to remember that not everyone:

(a) Is appropriately diagnosed,

(b) Is willing to make lifestyle changes that will enhance recovery options,

(c) Is suffering the same levels of depression,

(d) Has the same state of homeostasis in their brain chemistry,

(e) Understands what depression feels like,

(f) Recognizes the responsibility they have to work through their issues to recover.

These are all roadblocks that must be understood, recognized and navigated when treating depression. If the condition exists in co-occurrence with addiction, the challenges are multiplied.

What is known about side effects with long-term use?

Research has indicated several things that need to be recognized with side effects of anti-depressant medication.

• Weight gain: Over any period of time, health issues surrounding body weight gain are many. These must be addressed with use of anti-depressants, because new health risks may occur.
• Some types may cause heart problems such as arrhythmia and palpitations.
• Drug interactions that can be fatal, especially when combined long-term.
• Most medications are designed to be used only by those who maintain abstinence from other drugs. Addicts in relapse create additional risks for adverse effects of these medications.
• Loss of effectiveness. After months or years, the brain becomes less responsive to the medication, a condition known as tolerance. This can cause a return of depressed symptoms, as well as the need for an increased dose or change to another type of medication for treatment.
• Nausea and other digestive problems seen with use of anti-depressants can become chronic and cause additional digestive conditions when medication is used over years.
• Recognized sexual difficulties seen with anti-depressant medication can lead to relationship difficulties, and may require the use of other medications; thereby increasing risk of harmful drug interactions. In a long-term sense, these may also create permanent breaches in relationships between sexual partners.
• Sluggishness and lack of energy caused by medication may create trouble for those with depression, because they are using medication to offset some of these symptoms, which may persist or worsen with use of anti-depressant medication.
• Sleep pattern disruptions are another source of trouble. Many depressed patients report trouble with sleep on anti-depressant medication. This causes further sluggishness and lack of energy, thus exacerbating the problem.
• Medications may have some opposite effects, such as agitation, nervousness, twitching and involuntary muscle movement. Long-term use may worsen or create greater frequency of these problems.
• Headaches have been reported after initial use of anti-depressant medication, and may continue or develop into chronic, episodic events in long-term use of medications.

Specific conditions recognized by long-term use

One of the things seen to be occurring over long-term use of anti-depressants is seen through a group of published papers in Minnesota. They were specifically looking for an answer to the question of whether medications worsen the condition of depression over the course of long-term use. This was a concern first addressed in the late 1960s and early 70s.

A term called “chronification” of depression was coined to address the condition being recognized by an Italian psychiatrist by the name of Giovanni Fava. In a description of how anti-depressants work on the brain, he spoke to the mechanism that was created when the brain developed what he called “oppositional tolerance”.

As the brain seeks stability when being medicated and brain function is altered, it may begin to overcompensate for the medication’s interference, thus creating a worsening of the brain malfunction that creates the condition to begin with.

The human body and brain will always seek to maintain homeostasis. In battling the introduction of medication, the brain may create a counter-balance effect in response. Numerous scientists have explored this theory over the course of the ensuing 40-50 years.

Treating depression that was NOT labeled major depressive illness, or those who had symptoms that were other than a chronic type of depression actually created brain responses to medication-intervention that simulated depression. This is caused by the oppositional forces of medication, even after it is discontinued in those persons who had initial success with the medication. After an initial stabilizing effect, continuing the use of the medication may create what one doctor termed “prodepressant effect”. This doctor is El-Mallakh, a physician who began his research shortly after reading about “oppositional tolerance”. The effect takes place often in those who relapse and stop use of their medication, those who suffer from anxiety, panic disorder or those with no symptoms who take the medication after being mis-diagnosed or who have acted as “controls” during trial drug tests. While they may not have presented with symptoms of acute depression of a major type, they develop these symptoms after use of an anti-depressant medication. Some of these symptoms may last for long periods after discontinuing medication and may not be completely reversible.

How is this important to addicts?

Recognizing serious depressive disorders is challenging for those in early recovery, due to the many factors involved in their brain and body conditions during that time. For that purpose, it is imperative to determine appropriate treatment and to alter the treatment to fit the newfound stability of the patient.

Because symptoms may mimic depression and other mental illness diagnoses, it is important to monitor how medications are affecting these patients. For that reason, most doctors continue to recommend counseling or therapy, along with medication in order to shorten the time of use of medication if possible.

Working closely with mental and physical health providers will ensure that appropriate care is provided for those who suffer from depression. Medications for treatment of depression are most effective when used for short periods of time. They may become ineffective when not needed by the person taking them.

Another danger of long-term use of anti-depressant medications is seen when tolerance is created. Patients are then much more likely to relapse into depressed states. This danger escalates with potency of the prescribed dose, along with the length of use. Also important to note are the side effects when withdrawing from the medication; which also increase incrementally, depending on dosage and length of time the patient has used the drug.

Dr. Peter Breggin, a psychiatrist educated at Harvard, summarizes Dr. El-Mallakh’s body of research in an article whose main focus is finding the balance each patient must come to when considering treatment for depression. His pivotal message is: that when viewing the preponderance of evidence showing the side effects that, for many patients outweigh any benefits; it becomes increasingly important to understand and explore all possible options before prescribing or taking medication of this type.

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References:

[1] CNN.com. Ask the Expert: What are antidepressants’ long-term effects? Retrieved online from: http://www.cnn.com/2010/HEALTH/expert.q.a/03/16/antidepressants.long.term.effects/index.html

[2] Web MD.com. How Long Should You Take Antidepressants? Retrieved online from: http://www.webmd.com/depression/features/antidepressants

[3] Psychology Today. Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria

New research on why antidepressants may worsen long-term outcomes. Retrieved online from: https://www.psychologytoday.com/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria

[4] Harvard Health Publications: Harvard Medical School. What are the real risks of antidepressants? Retrieved online from: http://www.health.harvard.edu/mind-and-mood/what_are_the_real_risks_of_antidepressants

[5] Huffington Post: Healthy Living. New Research: Antidepressants Can Cause Long-Term Depression. Retrieved online from: http://www.huffingtonpost.com/dr-peter-breggin/antidepressants-long-term-depression_b_1077185.html

The Connection Between Eating Disorders and Substance Abuse

Eating disorders are widely and notoriously misunderstood. The psychological illness at the core of an eating disorder is often a monstrous force to contend with. One that, at best, corrodes the self-esteem and haunts every daily interaction with food and, at worst, physically eats away at the body until a person can no longer survive. Not only are eating disorders difficult for sufferers to recover from, but they often co-occur with substance abuse problems as well. Understanding the connection between eating disorders and substance abuse can help those who suffer from both to address the issues simultaneously and finally receive the kind of help needed for a full recovery.

An eating disorder can take the form of bulimia nervosa, anorexia nervosa, binge eating disorder, or OSFED (Other Specified Feeding or Eating Disorder). Anorexia is categorized by a severe restriction of calories. This is usually achieved by limiting caloric intake. This disorder brings heavy stress onto the body, especially the heart. In the case of bulimia, sufferers eat as a part of a binge and purge cycle. Though both of the illnesses vary, there is a high rate of co-occurrence between eating disorders and substance abuse, regardless of the specific eating disorder type. Other types of eating disorders, like compulsive overeating, result in excessive and unhealthy amounts of weight gain. Compensatory behaviors are sometimes seen in individuals who eat, but do not purge. One common type of compensatory behavior is over-exercising. Indviduals with this compensatory behavior trait will obsessively exercise until he or she has burned off enough calories to make up for the food eaten that day (or the day before) in one way or another.

Some research suggests that substance abuse might occur in sufferers of eating disorders as frequently as 50 percent of the time. Individuals that have eating disorders, according to the report, are much more likely than individuals without eating disorders to turn to substance use and abuse””five times more likely, in fact.

Substances Most Commonly Used

Drugs and other illicit substances most commonly used among those with eating disorders include:

• Nicotine, especially in the form of cigarettes
• Stimulants, especially cocaine and other types of drugs that work to suppress the appetite, like diet pills and speed
• Inhalants

A combination of a substance use disorder and an eating disorder can be lethal. It’s important that anyone suffering from both types of disorders seek appropriate treatment for both conditions if treatment and recovery is to be successful. The reason why these two disorders are particularly difficult to address when they coexist is because they feed off of each other: a person might use a substance as a result of an eating disorder or as a way to perpetuate the eating disorder, but a person also might turn to disordered eating or an eating disorder as a result of his or her substance use, perhaps even as a coping mechanism for a substance use disorder that feels out of control.

Oftentimes, these two types of disorders are both rooted in psychological issues in the sufferer “” ones that need to be addressed by an experienced professional for treatment to be effective. If you or someone you love is suffering from both of these disorders, understand that treatment must target both issues at once “” there’s no successful method of treating one without addressing the other.

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Elizabeth Seward has written about health and wellness for Discovery Health, National Geographic, How Stuff Works Health, and many other online and print publications. As a former touring rock musician, Elizabeth has firsthand experience with the struggles of substance abuse and the loss of loved ones because of it. She believes in the restorative power of yoga, meditation, talk therapy, and plant-based diets and she is an advocate for progressive drug policy reform.

Kombucha: An Alcoholic Beverage

Kombucha is a beverage that has been popularized in western culture for years now. You might have seen the drink on the shelves of your local grocery store or read about it online. It can be purchased from the store in a variety of flavors or made at home.

It is a fermented tea that has many purported benefits, but many of these benefits are not supported by research. The drink does contain probiotics, which research suggests brings health benefits. However, if you’re a recovering alcoholic, you should probably stay away from this drink.

The Unstable Fermentation Process

Back in 2010, Whole Foods pulled kombucha out of store shelves because the drink continued to ferment in-store, with some bottles reaching up to 3 percent in alcohol content. In the U.S., the Alcohol and Tobacco Tax and Trade Bureau (TTB) mandates that anything containing more than 0.5 percent alcohol be regulated like an alcoholic drink.

Soon after, makers remedied the problem with new formulation, but the amount of alcohol one bottle will produce remains unpredictable. For those who make their own kombucha at home, alcohol content remains an issue. Brewers don’t usually know how much alcohol a particular batch has until it’s ready for consumption. The drink also continues to ferment when stored, significantly raising the alcohol content over time.

These risks are generally acceptable for most adults, but recovering alcoholics face a much bigger issue. While the trace amounts of alcohol are low, they can make for a crutch or an introduction to a relapse for a recovering addict.

According to this article, an AA spokesperson has said that kombucha consumption can be dangerous for recovering alcoholics, stating that if a recovering addict knows that there is alcohol in a beverage but still feels like they are doing fine with it, it wouldn’t necessarily be a far throw for that person to then move onto drinks that contain slightly more alcohol.

What You Should Do Instead

If you want to reap the benefits of drinking kombucha but you don’t want to risk consuming alcohol, here are three other alternatives you can do:

1. Drink tea.

If you like tea, drink it! Tea is the base of kombucha””usually black or green tea. The tea contributes in part to the “kombucha buzz.” Kombucha drinks that have fruity flavors have a tiny bit of the respective juice in them. If you like the way that tastes, consider simply adding some of your favorite juice to your tea.

2. Consume probiotics.

If you find that consuming probiotics makes you feel better, you can get them from things other than kombucha. Some foods that contain probiotics include: yogurt, kefir, sauerkraut, miso, soft cheeses, sourdough bread, sour pickles, and tempeh.

3. Drink club soda or mix it in.

Perhaps you just like the effervescent aspect of kombucha. If you like the bubbly part of the drink, consider club soda or sparkling juices as a replacement.

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Elizabeth Seward has written about health and wellness for Discovery Health, National Geographic, How Stuff Works Health, and many other online and print publications. As a former touring rock musician, Elizabeth has firsthand experience with the struggles of substance abuse and the loss of

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