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

Drug Tourism Destinations to Avoid If You’re Clean and Sober

Traveling is expensive, even when you do it the cheap way. But we all eventually need a vacation; each of us need an opportunity to change our environment and thereby, change our perspective. However, not all vacation destinations are created equal. There are good and bad destination choices as well as everything in between. It mostly depends on the individual traveler. If you are in sobriety and looking to avoid drug culture, there are certain destinations you’ll want to be sure to avoid.

You might not recognize a destination as a name in drug tourism, but it’s good to do your research if you’re clean before booking a trip. A city that might not seem like a place that attracts drug users from the outside looking in might turn out to be anything but once you have arrived. If the latter winds up being the case, you could inadvertently find yourself inundated with drug culture, drug use, and temptation. Your “vacation” could easily become a nightmare of an exercise in self-control and walking on ice. You can avoid some of the biggest current drug tourism destinations by familiarizing yourself with the ones on this list, information from your own research, and making informed decisions based on your findings.

1. U.S. States Where Recreational Marijuana is Legal

US states where marijuana is recreationally legal now include: Colorado, Washington, Alaska, and Oregon. These are the states wherein you will encounter the most open and free use of marijuana and you should consider this factor if marijuana use is something that you would like to avoid. Plenty of other states have decriminalized marijuana or legal medical marijuana, but these four are the states most likely to have the most obvious and public displays of recreational marijuana use.

2. The Amazon Region Known for Psychedelics

Amazonia ayahuasca havens are dabbled throughout the Amazon region and in other parts of Latin America, as well. Tourists travel from across the globe to use this powerful psychedelic. The drug is often taken as a part of an ayahuasca “retreat.” Its use is seen as sacred and even a native right of passage for some visitors to these areas, but these destinations should be avoided by people who want to keep a distance from psychedelic use, especially those with a history of psychedelic use themselves.

3. The Cocaine Capital of the World: Colombia

Cocaine in Colombia is still very much a thing. Despite the government’s efforts to crack down on the white powder that has made the country famous, the shadows of Pablo Escobar are still creeping around everywhere, enticing tourists who had cocaine in mind when booking their trip. As pointed out in this article, cocaine is still readily abundant in Colombia and might even provide fodder for a relapse for someone with a history of cocaine use.

4. Moonshine And Pill-Mills

Certain regions of the US are notorious for this combination.

Moonshine and pill-mills are partners in crime in some US states. Spanning from the southern Ohio border and West Virginia and Kentucky all the way down to some areas of Florida, the Appalachian region of the US is notorious for the number of pill-mills present, but also, as most locals will tell you, the easily obtainable moonshine. These specific regions might not be the best destination for a person who has a struggle with pills “” specifically painkillers or anxiety medication “” or a history with alcohol abuse. These areas, which often see a great deal of prescription painkiller abuse, typically also are high in heroin use and availability as well as other opioids.

5. Southeast Asian Opiates And More

Heroin and several other drugs are widely available in Southeast Asia.

Southeast Asia has long been a destination those seeking heroin, as well as other types of drugs. Specifically speaking, Laos, Myanmar, and Thailand are particular hubs of drug tourism in this area. With Afghanistan and Myanmar leading the way in opiate production, it hasn’t been difficult for travelers in nearby countries to access heroin. Likewise, the area has also become a hotspot for ecstasy, magic mushrooms, speed and prescription pills.

Choose Your Destination Wisely

Making the right destination choice in terms of drug culture is important for recovering addicts. These are just a few of the drug tourism destinations for you to consider before making any travel plans. No matter your destination, do some research beforehand to understand the local drug culture and how appealing the destination might be to drug tourists. Doing this might save you from a relapse.

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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.

What is Mojo? The Growing Popularity Behind This Synthetic Drug

A relatively new drug trend is skyrocketing among teenagers these days and its name is “mojo.” Mojo, as the kids call it, or more commonly heard as synthetic marijuana, is an artificial chemical drug structured similarly to THC, the active ingredient found in pot, that when sprayed on herbs can be smoked and mimics the effects of marijuana. The reason for its surge of popularity among adolescents is due to the fact that it’s easy to get ahold of and it avoids the complications of the law. Synthetic cannabis can be purchased in local head shops or obtained online and is often marketed as incense or under brand names like Spice or K2. In addition, it doesn’t yield a positive drug test result.

“So if it’s technically legal, what’s the big deal?” is a question that’s constantly asked among the adolescent population in drug rehabilitation. Well in recent years, the Drug Enforcement Administration (DEA) has deemed it a, “drug of concern” (1) due to the fact that it’s causing a flood of emergency room visits and calls to poison control centers. “Adverse health affects associated with its use include seizures, hallucination, paranoid behavior, agitation, anxiety, nausea, vomiting, racing heartbeat, and elevated blood pressure (2). In essence, it’s far more dangerous than regular marijuana because it’s artificially created rather than coming from a natural plant source like it was originally thought to and therefore its side effects are far more severe. It can easily be compared to other legal synthetic drugs like bath salts that are also known to induce states of disturbing psychosis and are not FDA approved (3). As a recovery support specialist, examples of behavior observed firsthand from our adolescent clients going through withdrawal from mojo include violent shaking, ghostly white complexion, fever, nausea, psychotic episodes, rage, and or hallucinations believing that they were Jesus Christ resurrected. “Psychiatrists have suggested that the lack of an antipsychotic chemical, similar to cannabidiol found in natural cannabis, may make synthetic cannabis more likely to induce psychosis than natural cannabis” (4). This drug can yield especially dangerous results for individuals with a preexisting history of mental illness as these, “dramatic psychotic states induced by use have been reported to last for weeks” (5).

Various states have been working feverishly to ban the sale of the substance and there are national efforts at work to gain control of the matter because it’s becoming readily apparent that this mood-altering drug is quickly becoming a risk to our youth. The scariest part of the epidemic however, is the blind eye adolescents seem to be turning to the reality of its danger. They want what they can get their hands on easily, it makes them feel high, and it avoids the law. Most of them don’t even view it as a real drug but rather a “fake” drug so therefore they see no real risk. It’s gotten to the point where the vast majority of our admitted adolescent clients to our rehabilitation facility are there for synthetic cannabis use and due to the overwhelming numbers on our wait list for admittance, the trend doesn’t appear to be slowing down anytime soon.

References:

1. Donna Leinwand (May 24, 2010).24, 2010-k2_N.htm “Places race to outlaw K2 ‘Spice’ drug”.USA Today. Retrieved March 23, 2015.
2. Meserve, Jeanne (February 28, 2011).“DEA imposes “emergency” ban to control synthetic marijuana”. CNN. Retrieved March 23, 2015.
3. “K2 Drug Facts”. K2drugfacts.com. Retrieved 2015-03-23.
4. Müller, H.; Sperling, W.; Köhrmann, M.; Huttner, H.; Kornhuber, J.; Maler, J. (2010). “The synthetic cannabinoid Spice as a trigger for an acute exacerbation of cannabis induced recurrent psychotic episodes”.Schizophrenia research118 (1″”3): 309″”310. doi:10.1016/j.schres.2009.12.001. PMID 20056392.
5. Hurst, D; Loeffler, G; McLay, R (October 2011). “Psychosis associated with synthetic cannabinoid agonists: a case series.”.The American Journal of Psychiatry168 (10): 1119. doi:10.1176/appi.ajp.2011.11010176. PMID 21969050.

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M. Lujan has a Bachelor of Science degree in Psychology from Tulane University. She now works with adolescents in drug rehabilitation centers providing recovery support and teaching life skills.

TV Alcohol Ads and Its Impact on Teen Drinking

In October 2013,a CDC (Center for Disease Control) studyrevealed that alcohol is the most common drug used by young people and it is responsible for over 4,300 annual deaths among underage youth. Furthermore, data from theNational Institute on Alcohol Abuse and Alcoholism reportsthat by age 15, more than 50% of teens have had at least one drink and an estimated four out of five college students drink alcohol.

The resultsand consequences of underage drinking by minor children are absolutely horrifying, especially since these actions are largely preventable. Where are our youth viewing and how are they learning to emulate this destructive and deadly behavior?

Television’s Influence on Underage Drinking

In this media driven world, advertising is everywhere we look, every minute of every day. Alcoholic products are no exception. Television, pop up computer ads, advertisements on mobile devices, bill boards, sporting events”¦there is simply no way to avoid the onslaught of corporations trying to sell their intoxicating beverages.

The latest liquor ads are also intoxicating to our youth. These recent media vehicles associated with drinking alcohol focus on utilizing trendy music, enhancing romance, promoting the “coolness” factor and displaying fun entertainment occasions with liquor in the spotlight.

The celebrity actors featured in these branded commercials promote the message that drinking is for those individuals who are successful, confident and have a large social network.
Although beer commercials filmed around swimming pools or backyard barbeques are familiar, the latest entries to attract young drinkers spotlight superstars close to their age who are pushing hard liquor.

For example, the gorgeous Mila Kunis now stars multiple Jim Beam whiskey commercials. Justin Timberlake can be found in trendy and stylish clothes selling tequila. Even rapperLudacrisendorses his Conjure Cognac.

Although these popular celebrities cannot be shown to actually drink the beverage, it is clear that brands like “Hard Lemonade” and “Apple Orchard Hard Cider” are targeting a very young audience”¦not just with their ads, but with their labels, product names, promotions and packaging.

Make no mistake about it. These sexy and enticing new marketing programs are captivating the attention of our youth.

A portion of the adult population doubts the concept that television advertising can actually influence negative behavior. But now there can be no dispute.

The latest study, released in January 2015, found that television viewing habits have a powerful influence in kid’s behavior.

This recent study published inJAMA Pediatricsstudied over 2,500 adolescents. The authors found evidence that:

• “seeing and liking alcohol advertising on television among underage youths was associated with the onset of drinking”
• “familiarity with images of television alcohol marketing was associated with the subsequent onset of drinking”
• “underage youths (who) are exposed to and engaged by alcohol marketing… prompts initiation of drinking”
• even more disturbing, theauthors concludedfrom this data that “(not only does exposition to alcohol marketing initiate drinking, it also) transitions from trying tohazardous drinking.”

But there is hope. There is always hope.

TheSurgeon General’s reportsuggests that The greatest influence on young people’s decisions to begin drinking is the world they live in, which includes their families, friends, schools, the larger community, and society as a whole.

• If you are a parent, do not, under any circumstances, purchase alcohol for your underage child
• No one knows your child as well as you do. Although it is “easier said than done,” families must be involved and pay attention to the daily activities of their kids
• Parents and guardians cannot be afraid to intervene or confront their child if something appears to be wrong or if there is a change in behavior. It is likely that if you suspect your kid is engaging in dangerous behavior, it is true
• Schools must help educate students on the dangers, repercussions and risks of drug and alcohol use. Role playing assists teenagers on developing strategies when encountering negative peer pressure
• After-school enrichment programs and extra-curricular activities are of critical importance in keeping teenagers busy, motivated and focused
• If you discover your underage offspring is using alcohol, get help as quickly as possible before the behavior escalates. Alcoholism treatment programs can help adolescents transform their behaviors, rebuild their lives and give them the childhood they deserve

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AudreyBeim holds two advanced degrees from major universities, including a Master’s Degree in Psychology. Shehas 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.

Substance Abuse and Mental Illness

There are many reasons why alcohol use and having a mental health issue do not mix.This article explores the top 10 reasons why alcohol and mental illness do not mix.

People who have a mental illness also have a higher risk of having a substance abuse problem [1]. Alcohol is one of the most commonly misused substances and high rates of alcoholuse disorders occur in people with diagnose mental illnesses. There are many reasons why individuals were diagnosed with a mental illness, even something as common as depression, should not drink alcohol.

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).

There are many reasons why alcohol use and having a mental health issue do not mix.This article explores the top 10 reasons why alcohol and mental illness do not mix.

People who have a mental illness also have a higher risk of having a substance abuse problem [1]. Alcohol is one of the most commonly misused substances and high rates of alcoholuse disorders occur in people with diagnose mental illnesses. There are many reasons why individuals were diagnosed with a mental illness, even something as common as depression, should not drink alcohol.

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.

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Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

 

Are You Abusing Your Prescription Medication?

Prescription painkiller abuse has been increasing dramatically over the years. Overdoses of prescription painkillers are one of the most lethal and common drug-related accidents and unfortunately, many people who abuse these medications are obtaining them both illegally and legally. Because so many doctors and clinics are relatively quick to prescribe them (sometimes these places are referred to as “pill mills”), people who get them legally can go on to sell them to others. The problem with prescription painkillers has been called an epidemic and rightfully so.

One of the reasons a problem like this has been able to take such a strong hold on otherwise non-addict citizens is because prescription medication can provide the addict with the illusion that he or she is simply taking medicine rather than abusing a hard drug. This phenomenon is even more nuanced when the medication has been prescribed directly to the patient. Sometimes doctors prescribe pills that are stronger or at a higher frequency than necessary, which can lead to addiction. Even when this isn’t the case, many who are in pain up their dosage on their own because they view the increase as a harmless medical decision. But prescription painkillers are not harmless. And when they’re overdone, they can be life-threatening.

So how can you tell the difference between a person who is taking their medication for legitimate pain with healing and health in mind vs. a person who is abusing prescription painkillers? Most people who abuse prescription painkillers will tell others “” and themselves “” that they are taking them because of pain. Whether or not this pain is real is only one aspect to consider when trying to figure out if someone us abusing this kind of medication or using it properly.

If you think that someone you know might actually be abusing their prescription medication, here are some things to think about:

• Is the medication prescribed? If not, where are they 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.
• How frequently are they taking the medication and what is the dosage? Is the person taking the pills every few hours or are they actively trying to space them out as much as possible? Are they taking a low dosage or a high dosage?
• How does the person act when they don’t have medicine? If they forget their medicine at home or can’t get a refill on their prescription in time, how do they act? Their behavior during this time is usually a telling sign as to whether or not they are an addict. Those who are addicted might also find that they need to continually increase their dosage.
• Does the person try to go to different doctors because of an issue they are having with getting their prescription written from their original pain doctor? If this is the case, they might be “doctor shopping,” perhaps without even knowing it.
• How long as the person been taking painkillers? 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 you know is still taking this medication many months or even years later, it’s possible that they’re addicted.

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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.

Long-Term Effects of Anti-Depressants on Addicts

Since the 1980s, diagnosing and treatment for depression has come to be a big part of recovery for millions of addicts. The controversy surrounding medication for depression and when and how it is determined necessary has created an ongoing conversation that can, from time to time, be addressed with fresh information.

The cumulative, long-term effects

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 benzo (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 “pro-depressant 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 misdiagnosed 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.

 

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

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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.

 

Treating Addiction as a Chronic Disease

In November of last year, the US Surgeon General issued a ground-breaking report on addiction. It reiterated what many alcohol and drug abuse counselors believe: that addiction is a chronic illness and not a moral failure.

Nearly 21 million Americans were directly affected by drug or alcohol addiction last year, but just one in ten received treatment.

Needless to say, addiction is often misunderstood. The person abusing the substance often believes they can quit whenever they want to. Regretfully, this is a myth. Family and friends also often believe that addicts simply lack willpower and could really quit if they wanted to do so.

Addiction and the Brain

Though it’s true that the initial decision to take drugs may be voluntary, repeated drug use can lead to brain changes that alter the chemical structure and inhibit self-control. Research has shown that drugs and alcohol can negatively affect the brain, often making it impossible to quit without professional and/or medical intervention.

Most drugs affect the brain’s “reward center” by releasing the chemical dopamine that controls the body’s ability to feel pleasure. Taking drugs that affect dopamine leads to temporary emotions of excitement and exhilaration. This motivates a person to repeat the behavior and creates a pleasurable “high” that encourages continuous use of the drug again and again, even though the action is destructive.

Over time, the brain adjusts to higher dopamine levels, forcing the person to take an increasing amount of the substance to reach the same euphoria. It is no longer about willpower; it is a matter of a chemical reaction in the brain that has become unmanageable.

Effective Addiction Programs

As with most chronic diseases, addiction can be treated, but may never be completely cured. It’s common for a person to relapse. In fact, the National Institute on Drug Abuse says 40-60% of alcoholics and addicts will experience a relapse. However, this does not mean that sobriety is altogether a lost cause.

Effective addiction treatment programs support patients in exploring and implementing methods to avoid relapse and ultimately to stop abusing drugs. Rehabilitation helps the addict focus on coping skills and making better choices while avoiding triggers and managing cravings. Interventions, cognitive behavioral therapy, medical treatments, and family support are just a few of the treatments used to break the cycle of addiction. Creating new habits and rewiring the brain develops new and healthy routines and behaviors. A strong social support network is essential to remain on track and serves to remind an individual why they dedicated themselves to recovery in the first place.

Addiction is a powerful and complex disease. Ultimately, recovery requires an individual to take responsibility for their actions, commit to on-going treatment and embrace a passion for a life without drug abuse. As US Surgeon General Murphy stated in his landmark report, “We must help everyone see that addiction is not a character flaw – it is a chronic illness that we must approach with the same skill and compassion with which we approach heart disease, diabetes, and cancer.”

References:

1. http://www.sciencealert.com/the-surgeon-general-has-issued-a-report-calling-addiction-a-brain-disease

2. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain

3. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

 

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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.

Reasons for Relapse and Avoiding Them

Relapse (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 experienceit 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.

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