Vaping refers to the process of using electronic cigarettes (also known as e-cigarettes, vapes, vape pens, or ENDS). Since 2007, when e-cigarettes began appearing in the United States, vaping has become fairly common.

Many believed e-cigarettes to be harmless, but as vaping has increased in popularity, news reports of vaping-related illnesses and deaths have also increased. In October 2019, the Centers for Disease Control and Prevention reported a total of 1,080 cases of lung injuries linked to vaping in the United States. They also reported 18 vaping-related deaths.

E-cigarettes have become popular among teens and young adults in particular. According to the same CDC statistics:

• 80% of patients were under 35 years old.
• 21% were between the ages of 18 and 20.
• 16% were under age 18.

Some people simply enjoy the taste of flavored e-cigarettes. Others may use them as a less harmful alternative to cigarette smoking. According to Johns Hopkins Medicine, while it is true that e-cigarettes generally don’t contain as many toxic chemicals as traditional cigarettes, they’re still not great for your health.

What Is Vaping?

The term “vaping” refers to the “vapor” produced by e-cigarettes. This vapor, which e-cigarette users inhale, comes from liquid heated inside the e-cigarette. Some assume it’s just water vapor, but in fact, it is an aerosol. In other words, the vapor is made up of very fine particles of the substances contained in the liquid. If the liquid contains toxic chemicals, so does the aerosol.

Although e-cigarettes don’t contain tobacco, the substances they do contain can vary widely. Most contain nicotine. In fact, according to the American Cancer Society, even e-cigarettes labeled as nicotine-free may still contain some nicotine. What’s more, JUULs, a specific brand of e-cigarette, always contain nicotine.

E-cigarette liquid and vapor could contain the following chemicals:

• Formaldehyde, which can form when the liquid gets too hot or when too little liquid reaches the heating element
• VOCs, or volatile organic compounds, which can damage the liver or kidney
• Flavoring agents that have varying levels of the chemical diacetyl, which in turn has been linked to lung disease
• THC (tetrahydrocannabinol, the agent in marijuana that creates the marijuana “high”)
• CBD (cannabinoid) oils
• Flakka or other synthetic drugs

In a September 2019 press release, the CDC suggested vaping THC products could be particularly dangerous, though experts continue to investigate the exact cause of the illnesses. Research supports the link between vaping THC and health issues. After interviewing 578 people who had become ill after vaping, the CDC found most had vaped THC products.

Dangers of Vaping

E-cigarette use involves the direct inhalation of vapor rather than the direct smoking of a substance. No smoke is produced, and since they don’t contain tobacco, they don’t produce any tobacco smell. Because of this, many users find vaping more appealing and believe it causes fewer, if any, harmful effects.

But this isn’t necessarily the case. Science hasn’t conclusively identified all potential health risks associated with vaping, but existing evidence does suggest e-cigarettes—while likely not as harmful as traditional cigarettes—can still negatively affect health.

What’s more, medical experts have linked the chemicals in e-cigarettes to a range of health conditions, including:

• Lung irritation and lung disease
• Nose and throat irritation
• Chest pain
• Liver, kidney, and nervous system damage
• Nausea, vomiting, or diarrhea
• Increased heart rate, high blood pressure, and other circulatory issues
• Cancer

As evidence linking THC in e-cigarettes to illness and death emerges, medical experts continue to advise against using e-cigarettes, especially e-cigarettes containing THC. Since e-cigarettes might, in theory, contain any chemical, people are encouraged to use extreme caution when unsure of exactly which substances they’re vaping.

Is Vaping Addictive?

E-cigarettes don’t contain as many harmful chemicals as traditional cigarettes (which contain thousands of chemicals). But they do typically contain nicotine—a toxic, addictive chemical, and some e-cigarettes may provide even more nicotine than a traditional cigarette. This means e-cigarettes are still addictive.

Even teens who do know e-cigarettes contain nicotine may not realize they’re addictive or that they can have serious health effects.Research also suggests e-cigarettes can function as a “gateway drug” to cigarette smoking and other tobacco use. The risk is especially high for teens and young adults who might not have started smoking otherwise.

Some people may look to e-cigarettes as a way to ease themselves out of smoking. However, the research on this strategy is mixed. One study suggests e-cigarettes work as well as other nicotine replacements such as patches or gums. Another study found most people who used vaping to quit nicotine ended up smoking both traditional and electronic cigarettes. The FDA has not approved of using e-cigarettes as a smoking cessation tool.

Why Is Vaping So Popular Among Teens?

An annual survey from the National Institutes of Health found that vaping increased among high school seniors by 9% between 2017 and 2018. The research found increases in vaping across several substances: nicotine, marijuana, and hash oil, as well as flavored e-cigarette liquid.

Experts point to a few key reasons that help explain why many teens find vaping appealing.

First, e-cigarette marketing often involves advertising methods like animation, bright colors, and youthful actors, all of which seem designed to attract teens and young adults. Ad messages also often appear to suggest vaping is linked to increased popularity and happiness. E-cigarettes also come in a range of flavors, which can make them seem more fun and enjoyable to younger people.

Lack of education on e-cigarettes can also further the mistaken belief that vaping doesn’t have any serious effects. Many teenagers don’t know much about e-cigarettes. Some aren’t aware they contain nicotine or other substances, and many believe the vapor contains nothing more than flavor. Even teens who do know e-cigarettes contain nicotine may not realize they’re addictive or that they can have serious health effects.

Treatment for E-Cig Addiction

Teenage vaping addiction is a growing health concern. Research has yet to determine the full effects of vaping on the brain and body, but experts believe it can have a particularly harmful impact on teens.

The brain continues to develop throughout the teen years, and while it’s still developing, teens face a higher risk for addiction than adults. Vaping during the teen years also has the potential to permanently affect brain development.

If you believe your teen is using e-cigarettes, these tips can help you start a conversation and get them help, if necessary.

• Have a conversation, not a lecture. If you don’t know anything about vaping, do some reading so you’re prepared to talk with your teen. Spend time reviewing articles and information from credible sources about vaping and the health effects it can cause with your teen.
• Start with general questions instead of asking directly, “Have you tried vaping?” For example, you might ask, “Do other kids at school/your friends use e-cigarettes?” “What do you know about vaping?” This can help you understand what your child knows about e-cigarette use and its effects.
• Talk with your teen about getting help with quitting. Offer your encouragement and support if they want to quit on their own. (Consider setting a good example and quitting yourself, if you also use e-cigarettes). If they’ve tried to quit and can’t, ask them to consider talking to their primary health care provider or a counselor who can offer professional assistance with quitting.

Medical science still has much to uncover about e-cigarettes, but recent news reports highlight a number of recognized concerns. E-cigarettes may involve fewer health risks than tobacco cigarettes, but that doesn’t mean they’re healthy. They may pose even more dangers to teens—an age group in which e-cigarette use has recently increased.

A compassionate therapist can support you in the process of quitting e-cigarettes or any other addiction. Begin your search today!

References:

1. 5 vaping facts you need to know. (n.d.). Johns Hopkins Medicine. Retrieved from https://www.hopkinsmedicine.org/health/wellness-and-prevention/5-truths-you-need-to-know-about-vaping
2. Bates, J. (2019, October 1). CDC says for first time that some THC products could be behind vaping deaths and illnesses. Time. Retrieved from https://time.com/5688229/cdc-thc-vaping-deaths
3. Hellman, J. (2019, October 3). CDC: Cases of vaping-related illness top 1,000. The Hill. Retrieved from https://thehill.com/policy/healthcare/464279-cdc-cases-of-vaping-related-illnesses-top-1000?fbclid=IwAR1N76JddJm8vCrx6D9T0oJTnLkc7u9cSdsBc39nJ-SnXgBGwQwqaXcC9Lc
4. Martinelli, K. (n.d.). Teen vaping: What you need to know. Child Mind Institute. Retrieved from https://childmind.org/article/teen-vaping-what-you-need-to-know/
5. Outbreak of lung injury associated with e-cigarette use, or vaping. (2019, September 27). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
6. Richter, L. (2018). What is vaping? Retrieved from https://www.centeronaddiction.org/e-cigarettes/recreational-vaping/what-vaping
7. Vaping rises among teens. (2019). National Institutes of Health. Retrieved from https://newsinhealth.nih.gov/2019/02/vaping-rises-among-teens
8. Vaping: What you need to know. (2019). KidsHealth. Retrieved from https://kidshealth.org/en/parents/e-cigarettes.html
9. What do we know about e-cigarettes? (2019). American Cancer Society. Retrieved from https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html

Drug abuse is a serious health concern. Overdose-related deaths in the United States have reached epidemic level. In fact, the Centers for Disease Control and Prevention (CDC) estimate an average of 130 people die from opioid overdose each day. This number doesn’t take into account deaths related to other drugs, which may increase this number.

Any drug use can become dangerous. Marijuana, now legal for medicinal and recreational use in many states, may help relieve pain, chemotherapy side effects, and symptoms of mental health concerns such as anxiety and posttraumatic stress. Research has also suggested marijuana may help treat addiction in some people. But despite these potential benefits, it can become addictive and could have health effects such as short-term memory impairment, impaired brain function, and respiratory health issues, among others.

Recreational use of illegal substances, even short-term use, can have serious health effects, including anxiety, paranoia, depression, suicidal thoughts, hallucinations, nausea, increased heart rate and blood pressure, and more. There’s also a risk of death due to overdose or complications. Long-term use of certain drugs could increase risk of violent behavior and may lead to legal trouble. Abusing drugs can also lead to drug dependency, or addiction.

Rehab can help people who’ve reached their absolute low work to overcome addiction, but it can also help people begin to break free of addiction before it significantly impacts their lives.

If you’re experiencing addiction, you’re not alone. According to statistics from the Substance Abuse and Mental Health Services Administration, more than 20 million Americans experienced a substance abuse disorder in 2014. Addiction can be difficult to overcome, no matter how hard a person tries. Professional support, in the form of inpatient or outpatient drug rehab, can benefit many people living with drug addiction.

Myths about drug rehab are plentiful. If you’re considering rehab for yourself or a loved one, making sure you have all the facts will help you make a more informed decision. Here, we present five common myths about drug rehab and the facts to counter them.

Drug Rehab Myths and Facts

Myth: Only wealthy people go to rehab.
Fact: Anyone can go to rehab.

It’s true that drug rehab can become expensive. Some people may not even consider inpatient rehab an option, believing it to be out of their budget. But the cost of drug rehab can depend on a number of factors, and there are rehab options for a range of budgets. See our article here for a more detailed explanation of rehab costs.

Some drug rehab centers offer low-cost or sliding-scale fees, based on your income. According to the 2012 National Survey of Substance Abuse, 62% of rehab facilities charge based on a sliding scale. Facilities may also offer payment programs or other types of financial assistance to people in need. Many drug rehab centers accept insurance, though not all insurance providers cover rehab.

When considering rehab, talk to your insurance provider and the rehab facility you’re interested in to get a better idea of the cost involved. Some centers may be able to work with you or refer you to another quality center that is more affordable. If the cost of inpatient rehab is a barrier, you might also consider outpatient drug rehab programs.

Myth: Rehab is for when you hit “rock bottom.”
Fact: You can begin recovering from addiction at any time.

Many people go to rehab when no other treatment option has worked. Often, they’ve lived with addiction for many years. Rehab can help people who’ve reached their absolute low work to overcome addiction, but it can also help people begin to break free of addiction before it significantly impacts their lives. Research suggests early intervention helps improve treatment outcomes.

Addiction not only contributes to emotional and physical health concerns, it can also lead to homelessness, unemployment, debt, and breakup or divorce. Choosing to enter rehab when you first find yourself becoming dependent on substances can help you begin the recovery process before addiction can have more of an effect on your life.

Myth: Rehab is only for people who can’t quit on their own.
Fact: Anyone experiencing addiction can get help in rehab.

The idea that addiction only happens to weak or flawed people is widespread. It might seem logical: Many people experiment with drugs, but not everyone becomes addicted. But drug abuse alters brain chemistry and affects cognitive function, leading to cravings for the substance and eventually addiction. Certain factors, including genetics, can increase a person’s risk for addiction.

Although a person might choose to try drugs, they don’t choose to become addicted. Once addicted, many people can’t stop using drugs without professional help. Needing rehab isn’t a sign of weakness. Changes in the brain resulting from addiction can make it extremely challenging, if not impossible, to stop using drugs without the support of health care providers trained in addiction support.

Whether you’ve tried to stop using drugs and relapsed or are just beginning to realize you may have a problem with substance abuse, rehab can help you begin recovery.

Myth: Rehab will prevent a person from relapsing.
Fact: Relapse is common, but treatment can help reduce its impact.

Between 40 and 60% of people dealing with addiction will relapse, according to the National Institute on Drug Abuse. While rehab may help reduce your risk of relapse, completing a drug rehab program doesn’t guarantee you’ll never relapse.

But rehab still has benefit. Research shows rehab can help by helping you develop skills to resist cravings, making relapse less likely. If you do relapse, the length of the relapse may be shorter. People who participate in treatment programs such as rehab also tend to relapse fewer times than people who don’t. Rehab can also lead to improvements in your relationships with friends, family, and loved ones. Developing stronger bonds with people you care for can also decrease the likelihood of relapse.

Myth: Rehab doesn’t work if you force someone to go.
Fact: Rehab can work even if you don’t want treatment.

Some people choose to enter rehab on their own, but some people experiencing addiction may not see its effects on their life, or they may not believe they have a problem with substance abuse. They may only decide to enter rehab grudgingly, after a court order or intervention from loved ones.

Being issued an ultimatum or feeling otherwise “forced” into rehab could make some people resistant to treatment, at first. According to the National Institute on Drug Abuse, however, people who feel pressured to overcome addiction in order to maintain an important relationship or avoid criminal charges, for example, often do better in treatment, even though they didn’t choose to enter rehab on their own.

Substance abuse and addiction can have serious, lifelong consequences. But there is help. Drug rehab may seem like an extreme measure, but this is partially due to the many myths surrounding rehab treatment.

Numerous studies support the benefits of rehab for addiction recovery. Inpatient centers provide a safe place to begin the detox and recovery process at any stage of addiction. Some facilities are expensive, but it’s possible to find affordable centers that will work with you to find a treatment program that’s right for your needs and your budget.

Don’t let myths about drug rehab keep you from getting addiction recovery support. Compassionate care is available! Begin your search today at GoodTherapy. Recovery may be a lifelong journey, but you are not alone.

References:

1. American Addiction Centers. (2019, February 14). How much does rehab cost? Retrieved from https://americanaddictioncenters.org/alcohol-rehab/cost
2. American Addiction Centers. (2018, October 15). Rehab success rates and statistics. Retrieved from https://americanaddictioncenters.org/rehab-guide/success-rates-and-statistics
3. Blending perspectives and building common ground. Myths and facts about addiction treatment. (1999, April 1). U.S. Department of Health and Human Services. Retrieved from https://aspe.hhs.gov/report/blending-perspectives-and-building-common-ground/myths-and-facts-about-addiction-and-treatment
4. Centers for Disease Control and Prevention. (2018, December 19). Understanding the epidemic. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html
5. Leshner, A. I. (n.d.). Exploring myths about drug abuse. National Institute on Drug Abuse. Retrieved from https://archives.drugabuse.gov/exploring-myths-about-drug-abuse
6. Mayo Clinic. (2017, July 20). Intervention: Help a loved one overcome addiction. Retrieved from https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/intervention/art-20047451
7. Mayo Clinic. (2017, October 26). Drug addiction (substance use disorder). Retrieved from https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
8. National Academies of Science, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Retrieved from http://nationalacademies.org/hmd/reports/2017/health-effects-of-cannabis-and-cannabinoids.aspx
9. National Institute on Drug Abuse. (2018). Drugs, brains, and behavior: The science of addiction. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
10. National Institute on Drug Abuse. (2018). Is marijuana addictive? Retrieved from https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive
11. Substance Abuse and Mental Health Services Administration. (2015). Behavioral health trends in the United States: Results from the 2014 national survey on drug use and health. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf
12. Substance Abuse and Mental Health Services Administration. (2016). Early intervention, treatment, and management of substance use disorders. In Facing addiction in America: The surgeon general’s report on alcohol, drugs, and health [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK424859
13. Substance Abuse and Mental Health Services Administration. (2019, January 30). Mental health and substance use disorders. Retrieved from https://www.samhsa.gov/find-help/disorders
14. Walsh, Z., Gonzalez, R., Crosby, K., Thiessena, M. S., Carrolla, C., & Bonn-Miller, M. O. (2017). Medical cannabis and mental health: A guided systematic review. Clinical Psychology Review, 51, 15-29. Retrieved from https://www.sciencedirect.com/science/article/pii/S0272735816300939?via%3Dihub
15. Weber, L. (2015, July 11). How much does inpatient rehab cost? Retrieved from https://addictionblog.org/rehab/inpatient-rehab/how-much-does-inpatient-rehab-cost

Drug-induced psychosis is a common and usually temporary mental health symptom. Psychosis is a disconnection from reality that may cause false beliefs called delusions, or false sensory experiences called hallucinations. Psychosis may appear while a person is using drugs or as part of the drug withdrawal process.

The psychotic symptoms associated with drug use can be intense and tend to come on more suddenly and aggressively than psychosis associated with a mental health diagnosis such as schizophrenia.

It can be challenging to distinguish drug-induced psychosis from other forms of psychosis. This is because many people with diagnoses that cause psychosis may also use drugs.

A 2009 study found that 5.2% to 100% of users of amphetamine, cannabis, cocaine, and opioids experienced psychosis. More frequent users and those with more serious drug dependencies were more likely to experience psychosis.

Symptoms of Drug-Induced Psychosis

Many drugs, especially hallucinogens such as LSD, cause hallucinations and delusions. Drug-induced psychosis is a more severe form of these hallucinations. It may appear suddenly in a drug user who has never before experienced psychosis, or it can steadily get worse over time. Psychosis can also occur during drug withdrawal, especially in users with a long history of abuse and dependence.

Any drug that changes brain chemistry, including drugs that don’t typically cause hallucinations as part of the “high,” can cause psychosis. This includes prescription and over-the-counter drugs as well as illicit drugs. Even widely used drugs such as non-steroidal anti-inflammatory drugs can sometimes trigger a psychotic reaction.

Alcohol, amphetamines, phencyclidine (PCP), cocaine, and hallucinogens are among the most common causes of drug-induced psychosis. Symptoms of drug psychosis include:

• Paranoia and terror
• Hallucinations. A person might see, smell, or hear things that aren’t there.
• Delusions. A person may adopt demonstrably false beliefs, such as that a demon is pursuing them.
• Dangerous behavior. A person might attempt to fly, harm themselves because a voice told them to do so, or become a danger to others. Some people who experience psychosis become aggressive.
• Disconnection from other people or from reality. A person may appear catatonic or totally withdrawn.

Drug-related psychosis is distinct from other forms of psychosis in a few ways:

• It appears while under the influence of or withdrawing from a drug.
• It comes on suddenly.
• It is typically more intense than other forms of psychosis.

After the psychosis has passed, treatment may center around helping the person recover from drug abuse and dependency.

Some people experience mixed psychosis. This is when a person has a condition that causes psychosis, such as schizophrenia, and then develops psychotic symptoms from drug use. It can be difficult to treat this form of psychosis, and doctors may struggle to determine which symptoms are due to drugs and which are due to an underlying mental health condition.

People with an underlying condition that can cause psychosis may be more likely to experience drug-related psychosis.

How Long Does Drug-Induced Psychosis Last?

Drug-induced psychosis typically only lasts until the drug has cleared from the body. So heavy drug users may experience longer lasting symptoms because there is more of the drug in their body. In most cases, the psychosis lasts less than a day.

When amphetamines, PCP, or cocaine trigger psychosis, symptoms may last longer—sometimes for several weeks. Long-lasting psychosis may also be due to an underlying mental health condition, such as schizophrenia or bipolar.

Rarely, drugs can change the brain by damaging neurons or altering neurotransmitter levels. This may cause mental health diagnoses such as bipolar or schizophrenia. The mechanism through which drugs cause mental health disorders linked to psychosis is poorly understood. Moreover, because many people with mental health diagnoses use drugs, it is difficult for researchers to assess which mental health conditions merely appear following drug use and which are the result of drug use.

Treating Drug-Induced Psychosis: Recovery

Treatment for drug-induced psychosis usually involves stopping the drug that caused the psychosis and then monitoring the person in a safe and calm environment. Anti-anxiety drugs such as benzodiazepines can help with many symptoms of drug-induced psychosis. Antipsychotics can also help, especially when dopamine-stimulating drugs such as amphetamines trigger a psychotic episode.

It’s not always necessary to give a person medication to counteract psychosis. As long as they are in a safe environment, watchful waiting is sometimes the best strategy, especially when a person has taken a hallucinogenic drug such as LSD or psilocybin mushrooms. Cyndi Turner, LCSW, LSATP, MAC emphasizes the importance of safety when evaluating a situation that involves drug-induced psychosis and explains how to help someone who could be experiencing it:

Safety is the most important factor to consider when someone is experiencing a drug induced psychosis. We need to assess the person’s risk: What are they seeing, hearing, or experiencing? Are they going to hurt themselves? Is there any health risk like elevated heart rate or seizure? Who can stay with them until the effects of the drug have passed? Validate how scared the individual may be and let him or her know that this is unlikely to be a permanent state. While it may feel real to them, it is not actually happening. Once the drug clears their system, they usually go back to normal functioning.

After the psychosis has passed, treatment centers around helping the person recover from drug abuse and dependency. Inpatient addiction treatment, support groups, therapy, medication for underlying mental health conditions, and a supportive drug-free environment can help a person quit using drugs and avoid future episodes of drug-induced psychosis.

When prescription drugs cause drug-induced psychosis, it’s important to find an alternative medication—especially when the drug in question manages a serious medical condition such as a cardiovascular disorder. People with a history of drug-induced psychosis should tell doctors and pharmacists about their history, since one psychotic episode could mean a person is at risk of having future episodes.

A Mental Health Approach to Drug-Induced Psychosis

For many, drug-induced psychosis is a short-term state. It can be frightening, and it may even harm relationships, especially if a person makes rash decisions or becomes abusive because of psychosis. Therapy can help people repair the damage of drug-induced psychosis.

The right therapist can also help a person talk through the issues that led to their drug use. For example, a person might use amphetamines to cope with the low motivation of depression or rely on cocaine to numb the pain of trauma. Therapy can also help people overcome drug addictions and find healthier coping mechanisms.

Occasionally, drug-induced psychosis signals a serious underlying psychotic disorder, such as schizophrenia. When psychotic symptoms don’t disappear within a day or two, it’s important to see a psychiatrist or neurologist who can assess a patient for mental health conditions, neurological disorders, and other diagnoses that may lead to psychosis. Management of these conditions usually means a combination of medication, lifestyle changes, and therapy. In therapy, a person may learn to interrogate their delusions and hallucinations, ground themselves in reality, and cope with any relationship and career challenges of living with psychosis.

References:

1. Ambizas, E. M. (2014, November 17). Nonpsychotropic medication-induced psychosis. U.S. Pharmacist, 39(11). Retrieved from https://www.uspharmacist.com/article/nonpsychotropic-medicationinduced-psychosis
2. Khan, M. A., & Akella, S. (2009). Cannabis-induced bipolar disorder with psychotic features: A case report. Psychiatry (Edgmont), 6(12), 44-48. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811144
3. Smith, M. J., Thirthalli, J., Abdallah, A. B., Murray, R. M., & Cottler, L. B. (2009). Prevalence of psychotic symptoms in substance users: A comparison across substances. Comprehensive Psychiatry, 50(3), 245-250. doi: 10.1016/j.comppsych.2008.07.009
4. Tamminga, C. (2018). Substance/medication-induced psychotic disorder. Retrieved from https://www.merckmanuals.com/professional/psychiatric-disorders/schizophrenia-and-related-disorders/substance-medication%E2%80%93induced-psychotic-disorder
5. What are the long-term effects of methamphetamine abuse? (n.d.). Retrieved from https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-are-long-term-effects-methamphetamine-abuse

Recovery from substance abuse is a long and complicated process. While much of the literature focuses on early recovery—a fragile and critical time—there are thousands of folks in long-term remission from substance use. The issues we face in long-term recovery are just as critical to our progress, relapse prevention, and ongoing health.

A person is considered in long-term recovery or remission when they have stopped or moderated their substance use and improved their quality of life for at least five years. The early stages of crisis stabilization are past, the damage drug use has inflicted is undergoing repair, and a “normal” life is being built. The critical issues of early recovery—staying clean, finding safe housing and employment, confronting legal consequences, and making new, sober friends—often feel more manageable by the time we enter long-term recovery.

At this point, a lot of us think we’re in the clear. We can breathe a little easier and begin to trust ourselves again. But we can’t make the mistake of thinking we’re done with recovery. With this false sense of complacency, we’re increasing our risk of relapse.

The truth is, long-term recovery has its own set of obstacles to overcome. It’s critical that we stay vigilant about our personal growth to increase our long-term chances of success. This can be done through self-study or by working with a counselor. Below are four tips to ensure success in long-term recovery.

4 Keys to Success in Long-Term Recovery

1. Healthy Relationship Skills

Many folks who struggle with substance use also struggle with finding and maintaining healthy relationships. Interpersonal struggles can wreak havoc on all areas of our lives, so it’s critical that we learn the skills to keep our relationships healthy. Whether our struggles are due to developmental trauma, unhealthy family relationships, or past hurt or abuse, developing healthy interpersonal skills is essential to continued success in recovery, stress management, and overall health.

Early recovery is often fraught with interpersonal difficulties that should stabilize as our lives and emotions do. However, intimate relationships can remain difficult at best. If this is the case, it’s important to engage in the work of building values, beliefs, and habits that support healthy, harmonious relationships.

Many of us with past substance use issues also struggle with a dichotomous personality. We feel there are two people living inside us: the person we were when we were using, and the person we are now.

2. Identity Integration

Many of us with past substance use issues also struggle with a dichotomous personality. We feel there are two people living inside us: the person we were when we were using, and the person we are now. The devil and angel sitting on each of our shoulders, both personalities try to pull us to their side.

It’s normal to want to push down our dark side in early recovery. We are scared of this other person living inside us and the damage they are capable of inflicting. Eventually we must integrate these two opposites and invite that dark side in. We must make peace with the person we were when we were using and become one whole human being.

3. Confronting the Wreckage of the Past

Bad decisions are one of the elements of substance use. These decisions can range from embarrassing to criminal. It’s normal to begin cleaning up that damage in early recovery, whether it’s completing jail sentences and probation, apologizing to loved ones, or living down a bad reputation.

But the impact of our past can last years into recovery, especially if our drug problems involved the legal system. This can be a source of great shame, stress, and embarrassment and can derail an otherwise strong recovery program if not managed appropriately.

4. A Balanced, Healthy Life

As many people in recovery know, stopping problematic substance use does not equal a healthy, happy life. In fact, early on we can be more miserable than ever as we learn to deal with stress while sober. Often, we are unhealthy people in general, not just in our relationship with drugs or alcohol, and we need to work on our physical, emotional, spiritual, and social health.

Developing and maintaining a balanced and healthy life is a critical piece of long-term recovery. This can include things such as exercise, mindfulness meditation, new relationships, eating healthier, or changing thought patterns.

Long-term substance use remission is a great achievement, but it is not a panacea for all our issues. In fact, this stage of the journey involves transitioning to different issues that must be addressed, including developing healthy relationships, integrating our dual identities, dealing with our troubled past, and establishing balanced lives.

Long-term recovery is a great time to review progress and set new goals for personal and professional development. As someone once told me, recovery is like going up a down escalator. You’re either moving forward or moving backward. The key is to keep going!

I would love to hear from those of you with five or more years of recovery. What are you dealing with? What should other folks entering this stage look out for?

As a couples therapist, I receive a lot of calls from couples in which one partner is either in or recently completed a recovery program. I wish there was a manual to help couples navigate this transition. Whether it’s completing inpatient treatment, starting therapy, or a beginning a 12-step program, navigating recovery in a relationship can be unfamiliar, uncertain, and tricky.

Through my years working with couples and drug and alcohol addiction, I have observed some helpful and not-so-helpful strategies. Here are 10 tips for couples navigating recovery:

1. Share your stories.

If one partner left for an extended period for inpatient treatment, the other may feel left out of the process. Additionally, the partner at home must manage the household alone and perhaps take care of the family as a single parent. Both partners have gone through significant ups and downs but have done so separately.

I encourage partners to debrief with each other and share their stories of time apart. What were the hardest parts? What were the biggest victories? How did they feel supported? When did they feel alone?

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2. Find healthy ways to include your partner in recovery.

At times, I see couples do their recovery completely separately. They attend meetings, share with sponsors, work their steps, and go through significant therapy. They create deep and meaningful relationships with others, but not with their partner.

While you do not want your partner to be your sponsor or the overseer of your program, it is important to include them in healthy ways. Whether you have attended Alcoholics Anonymous or Al-Anon or participated in a group therapy session, share how it impacted you. Share how it elicited compassion for the struggles of your partner, or how it made you think differently about something in your own recovery.

3. Share your process and your struggles.

While it may not be helpful or advisable to tell your partner about every urge and triggering thought, a daily or nightly check-in could help. Questions you could ask each other: What were your highs and lows from the day? What was a success? What was a struggle? What are some ways I can be there for you?

These are not fix-it sessions or opportunities to give advice. You are just listening—without judgment—to your partner about where they are.

4. Find ways to encourage each other’s recovery.

If you feel your partner isn’t taking their recovery seriously, it can be tempting to criticize or put down their efforts. Instead, try encouraging their recovery. Try phrases such as: “I know it can be hard to stay the course. I believe in you.” “It brings me a lot of relief and reassurance when I see you commit to your program.” “I have a lot of hope for us when I see you prioritize your recovery.”

Criticism can be deflating, but hope can be motivating.

5. Practice compassion and empathy.

Put yourself in your partner’s shoes. How hard is it to fight the daily battle of addiction? What kinds of feelings and emotions do they experience due to their addictive behaviors? What is the hardest part of their recovery?

Alternatively, how hard is it to watch a loved one struggle with addictive behaviors? What kinds of feelings and emotions do they experience as a result of their partner’s addictive behaviors?

6. Find healthy ways to lean on each other emotionally.

Couples in recovery often struggle to connect with each other in a way that isn’t “codependent.” I view codependency as the unhealthy behaviors we use to try to connect or protect the relationship.

However, there are healthy ways to connect. There is this amazing tool in your recovery tool belt called your relationship. Not learning to use the power of your relationship for emotional comfort and support is like not using a top-of-the-line tool in your toolbox. It’s true your partner cannot be your sponsor or CEO of your recovery. People in recovery tend to lean on others in their recovery community when they struggle. While these relationships are crucial to success, your partner is an important person to talk to, confide in, and draw support from.

7. Praise each other!

Has your partner completed a milestone in their sobriety? Have they taken a risk and tried something new? Tell them what a great job they’re doing. Share your successes with each other and use praise liberally. Make sure your partner knows you see their efforts.

8. Learn.

Pick up a book, read a blog, talk to people on the other side of the fence. If you are struggling with addiction, read about what loved ones go through. Or talk to a partner of someone dealing with addiction.

If your partner has addictive behaviors, read about the grip of addiction and how hard it is to break. Talk to someone who is also in recovery.

9. Work through the hurts.

This may require the help of a couples therapist. Addictive behaviors can create a lot of hurt in a couple and family. Seek the help of an experienced therapist who can guide you both toward healing. Ultimately, you want to create a safe space for each other to share any painful emotions that develop.

10. Share your fears.

It is normal to have fears about the recovery process. Will my partner stay committed? Will they relapse? Will I have to go through this again? Will my partner be there for me? Will they ever forgive me?

You may cover up fears with questions or by criticizing your partner’s recovery. Did you go to your meeting today? Have you been to therapy lately? Which leads to the next fear: Is this relationship going to survive?

Instead of criticizing or questioning your partner’s efforts, share your fears and your need for reassurance.

More and more Americans with mental health concerns are becoming incarcerated. This population of has reached “crisis proportions,” according to the National Alliance on Mental Health (NAMI).

Evidence shows incarceration is likely to worsen mental health symptoms. Most institutions do not have the resources to treat such a great number of people. Reduced mental health can lead to recidivism, meaning a recurrence of criminal behavior. When more people are rearrested, the population of imprisoned people stays high.

However, there are ways to reduce recidivism in these populations. People who receive mental health treatment during and after their sentences are less likely to reoffend. Alternatives to imprisonment can also reduce recidivism.

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Mental Health in the Criminal Justice System

In the United States, around 2 million people go to jail or prison each year. In general, jails are run by local forces. They hold inmates for terms of one year or less. Prisons are run by state or federal forces. They typically house prisoners for longer periods.

Many people in prisons and jails have a mental health diagnosis.

• A 2005 Department of Justice study found 64% of inmates in local jails have a mental health concern. The rates were 56% for state prisoners and 45% for federal prisoners.
• Around 50% of incarcerated people have a dual diagnosis. A dual diagnosis occurs when someone has both a mental health concern and substance addiction.
• According to NAMI, 20% of incarcerated individuals been diagnosed with “serious mental illness.” Someone with a “serious” condition may require daily assistance. This category includes conditions such as schizophrenia, major depression, and bipolar.

Estimates on recidivism rates vary. Most studies show offenders with diagnoses have higher recidivism rates than those without.

• The 2005 study above found 75% of incarcerated individuals with a diagnosis had been arrested before.
• A 2017 study showed offenders with diagnoses have a 9% greater chance of rearrest one year after release. Five years after release, the difference increases to 15%.
• The same 2017 study found people with severe diagnoses are 4% more likely to be rearrested than those with milder conditions.

How Jails and Prisons Became Mental Health Facilities

The criminal justice system has not favored people with mental health concerns in the past. From straitjackets to lobotomies, history is full of inhumane attempts to manage mental health. Pervasive stigma impacted nearly every step of incarceration and treatment.

In the 1950s and 1960s, the government closed many mental institutions and psychiatric hospitals. The intent was to serve people through community resources instead. Yet a lack of funding and commitment left many states with few treatment options.

In a Stanford Law Report, Senator Darrell Steinberg and Professor David Mills write, “Although deinstitutionalization was originally understood as a humane way to offer more suitable services … in community-based settings, some politicians seized upon it as a way to save money by shutting down institutions without providing any meaningful treatment alternatives.”

Many prisons and jails are ill-equipped to provide adequate mental health care. But for some people, these facilities are where they first encounter treatment. In the 1980s, the “war on drugs” complicated matters. The government began assigning mandatory sentences for drug-related offenses. More people with substance addiction were put behind bars. Many of these people had co-occurring mental health concerns. In the last 40 years, the rate of incarceration has increased five-fold in the U.S.

People with mental health issues are more likely to be the victim of a crime than commit one. Yet research shows living with untreated conditions can be extremely damaging to individuals. An untreated condition may affect a person’s judgment and lead to criminal behavior. This likelihood increases if other large-scale stressors (poverty, abuse, etc.) are present.

Many prisons and jails are ill-equipped to provide adequate mental health care. But for some people, these facilities are where they first encounter treatment. A person may not get a diagnosis until they are already behind bars.

The Incarceration Cycle for People with Mental Health Concerns

Today’s criminal justice system treats individuals more humanely than in the past. Yet offenders with mental health concerns still face discrimination. Someone with a diagnosis is likely to get a longer, harsher sentence than a neurotypical peer convicted of the same crime. They are also less likely to be granted release.

Incarceration itself can worsen mental health. Offenders often experience a drastic drop in agency. Strict rules and isolation can exacerbate stress. An individual may develop additional mental health concerns as they adjust to the transition.

Incarceration itself can worsen mental health.The Bureau of Justice Statistics held a survey asking offenders about their mental health in the prior 30 days. Fourteen percent of state or federal prisoners reported having severe psychological distress. The rate was almost double (26%) for jail inmates.

Compromised mental health and relative isolation can promote substance abuse. Andrew Archer, LCSW explains, “American incarceration operates as a perfect recipe to perpetuate habitual patterns for individuals. Extreme isolation and societal alienation demoralize the person to the extent that often times substances are the only form of self-regulation.”

In this way, alcohol and drug addiction can spread through populations of offenders. The sale, trade, and consumption of drugs can broaden one’s criminal network. Being insulated with other offenders can also reinforce attitudes that encourage further crime.

After years of incarceration, prisoners tend to struggle once they are released. Trey Cole, PsyD, says, “Relationally speaking, incarcerated individuals often become accustomed to the externally controlled environment (i.e. when to eat, sleep, etc.). When released, then, usually with few resources, becoming accountable to oneself and internally motivated become more difficult.”

Released offenders may find themselves without any resources or support. They may struggle to find housing or employment due to stigma. Reduced mental health can also impact one’s ability to make a living.

In other words, the factors which led a person to crime may be even stronger after release. Their ability to survive within the law may have been reduced. In this context, a person can easily be drawn into recidivism.

Compassionate Solutions for Lowering Recidivism Rates

A report by the Council of State Governments (CSG) Justice Center calls for an overhaul of the way U.S. criminal justice systems address people with mental health issues. Special attention was called to the way such people are released from jail and prison.

According to the CSG, a successful system of reentry into society would:

• Combine a range of services and professional efforts.
• Coordinate treatment for substance abuse and other mental health issues.
• Integrate both mental health care and primary healthcare.
• Provide housing for individuals with mental health issues.
• Draw upon family connections and community resources for treatment.
• Ensure people can access the full range of government entitlements for which they are eligible, such as Social Security Disability Insurance.

Some states have already begun to implement these measures. Colorado, Texas, and North Carolina have used grant money to expand mental health care and substance abuse treatment for offenders. These states also saw large drops in recidivism.

• North Carolina had a 42% reduction in people sent back to prison after probation violations between 2006 and 2015.
• Texas had a 25% reduction in the 3-year reincarceration rate between 2004 and 2013.
• Colorado saw probation revocations and the 3-year reincarnation rate reduced by at least 23% in around the same time frame.

How Diversion can Reduce Recidivism

Diversion has also been shown to reduce recidivism rates in people with mental illness. Diversion is a practice of placing offenders in mental health treatment instead of prison or jail. It often takes one of two forms.

The first form is forensic hospitalization. Offenders who have been found not guilty by reason of insanity are typically sent to forensic hospitals. These facilities do confine people like prisons and jails do. Yet their aim is typically rehabilitation rather than punishment. Less than 1% of people in the criminal justice system qualify for the insanity defense.

A 2005 study found offenders released from forensic hospitals had very low recidivism rates. They were less likely to reoffend than released inmates with mental health concerns. They were also less likely to offend than inmates without a diagnosis.

It is often cheaper to send nonviolent offenders to mental health treatment than jail. The other path of diversion involves mental health courts. These courts are for offenders who have mental health concerns but don’t qualify for the insanity defense. Judges may offer defendants reduced sentences in exchange for getting treatment. In many cases, a defendant may not go to jail or prison at all.

A 2007 study found participation in mental health courts cut the risk of violent offense in half. People who had gone through mental health courts also went longer without reoffending than those who went through traditional courts.

NAMI strongly supports diversion as a more humane and cost-effective approach to incarceration. According to NAMI, the cost of jailing adults with mental health concerns is two to three times the cost of keeping other inmates. It is often cheaper to send nonviolent offenders to mental health treatment than jail.

Just as psychotherapists who practice good therapy see people as whole beings independent of any mental health issues they may have, NAMI’s compassionate justice system would see all individuals as worthy of treatment and change. This system would classify mental health concerns not as moral defects, but as results of adversity or strain. Prioritizing treatment over punishment could have lasting benefits for the criminal justice system.

References:

1. Agnew, R. (2001). Building on the foundation of general strain theory: Specifying the types of strain most likely to lead to crime and delinquency. Journal of Research in Crime and Delinquency, 38(4), 319-361. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/0022427801038004001
2. Bales, W.D., Nadel, M., Reed, C. & Blomberg, T. G. (2017). Recidivism and inmate mental illness. International Journal of Criminology and Sociology, 6(1) 40-51.
3. Bloom, J. D., & Novosad, D. (2017). The Forensic Mental Health Services Census of forensic populations in state facilities. The Journal of the American Academy of Psychiatry and the Law, 45(4), 447-451. Retrieved from http://jaapl.org/content/45/4/447
4. Bronson, J. & Berzofsky, M. (2017). Indicators of mental health problems reported by prisoners and jail inmates, 2011-12. Bureau of Justice Statistics. Retrieved from https://www.bjs.gov/content/pub/pdf/imhprpji1112.pdf
5. Criminals need mental health care. (2014, March 1). Scientific American. Retrieved from https://www.scientificamerican.com/article/criminals-need-mental-health-care
6. What is the difference between jails and prisons? (n.d.). Bureau of Justice Statistics. Retrieved from https://www.bjs.gov/index.cfm?ty=qa&iid=322
7. Lerman, A. E. (2013). The modern prison paradox: Politics, punishment, and social community. Cambridge University Press. Retrieved from https://gspp.berkeley.edu/research/selected-publications/the-modern-prison-paradox-politics-punishment-and-social-community
8. NAMI warns senate about criminalization of mental illness; Supports Cornyn bill. (2016, February 10). NAMI. Retrieved from https://www.nami.org/Press-Media/Press-Releases/2016/NAMI-Warns-Senate-about-Criminalization-of-Mental
9. The new asylums: Some frequently asked questions. (2005, May 10). PBS. Retrieved from https://www.pbs.org/wgbh/pages/frontline/shows/asylums/etc/faqs.html
10. Reducing recidivism: States deliver results. (2017). The Council of State Governments Justice Center. Retrieved from https://csgjusticecenter.org/wp-content/uploads/2018/03/Reducing-Recidivism_State-Deliver-Results_2017.pdf
11. Steinberg, D. & Mills, D. (n.d.) When did prisons become acceptable mental health care facilities? Stanford Law School: Three Strikes Project. Retrieved from http://law.stanford.edu/wp-content/uploads/sites/default/files/child-page/632655/doc/slspublic/Report_v12.pdf

Working in the field of complex posttraumatic stress (C-PTSD) is immensely rewarding. Exploring a new field and finding more effective ways to help individuals in acute distress is as exciting as it is important. However, there are times when working in a developing and fertile field can also be frustrating. As a relatively new diagnosis that is still yet to be included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there is a paucity of reliable evidence about many of the features of C-PTSD. One of these is the connection between C-PTSD and addiction to drugs and alcohol, as well as “lifestyle addictions” to things like sex, pornography, gambling, or shopping, to name a few.

On an anecdotal level, clinicians, including myself, have observed that people with C-PTSD often have trouble regulating and controlling their use of potentially addictive substances. Excessive alcohol or narcotic consumption is frequently one of the factors that brings people to therapy, where underlying C-PTSD is discovered. There are also good reasons, some of which I discuss in this article, to suspect a causal link between C-PTSD and addiction exists. However, without further research we cannot say with certainty what the relationship between addiction and C-PTSD is, and whether the former should be understood more as an aggravating factor or a core symptom.

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The need for further research in this area is pressing. If there is one thing we know about addiction, it is that treatment is most effective when it deals with the underlying causes. Treatment methods that address problematic drinking and drug use often have an immediate effect of allowing the person to “go clean,” only to relapse half a year later because the same factors that drove the person to alcohol or narcotics in the first place are still present. A profile of the type of addictive behavior that is likely to be an expression of C-PTSD would help addiction specialists provide targeted help and make appropriate referrals.

PTSD and Addiction

While the relationship between C-PTSD and addiction awaits adequate investigation, the link between addiction and non-complex posttraumatic stress (PTSD) is much better established. Studies have demonstrated that people with PTSD are two to four times more likely to have a substance abuse disorder compared to the general population. More than 50% of people receiving treatment for PTSD have a co-occurring issue with substance abuse. Such a strong correlation suggests a definite relationship. Three suggested mechanisms for this relationship are known, respectively, as the self-medication hypothesis, the high-risk hypothesis, and the susceptibility hypothesis.

More than 50% of people receiving treatment for PTSD have a co-occurring issue with substance abuse. Such a strong correlation suggests a definite relationship.

The high-risk hypothesis posits not that PTSD leads to substance abuse and addictive behavior, but that the two are highly correlated because they often come from the same cause. People who engage in high-risk behaviors, according to this theory, are more likely to become addicted to alcohol or narcotics and are more likely to have a traumatic experience, perhaps even as a result of being under their influence.

The susceptibility hypothesis suggests that people who have a history of alcohol or drug abuse alter their brain in such a way that they are more likely to develop PTSD. It is well known that even if two people go through near-identical experiences, one may develop PTSD while the other does not. Indeed, effective screening for PTSD after traumatic events is one of the most sought-after but elusive goals of the mental health profession. According to this theory, substance and alcohol abuse should be considered as a risk factor for PTSD.

Finally, the self-medication theory, in contrast to its two rivals, suggests the causality runs from PTSD to addiction because men and women experiencing PTSD turn to drugs or alcohol as a way of relieving their distressing symptoms. Of course, while this may work in the short term, excessive use of alcohol and other substances only serves to exacerbate the problem, because the brain adapts to these chemical stimuli and demands ever greater doses of the drug to produce ever smaller highs. In short, while the person with PTSD begins by drinking or using drugs in a hopeless attempt to briefly feel good, they end up taking them in an even more hopeless struggle to feel a little less bad.

Which of these theories may be correct has massive implications for the relationship between C-PTSD and addiction. C-PTSD is the result of prolonged, interpersonal trauma, most often experienced during childhood. If the susceptibility or high-risk hypotheses are true, we would expect there to be a lesser link between C-PTSD and addiction. While there are cases of young people falling into abusive relationships after a period of drug use, it usually works the other way around. Indeed, many people with C-PTSD began their experience of trauma as small children.

On the other hand, if the self-medication hypothesis is correct, as many professionals believe, we would expect the link to be even greater. In addition to the symptoms of PTSD, people with C-PTSD also typically have negative self-image, difficulty forming relationships, and an inability to control feelings of anger or sadness (known as affect regulation). The urge to self-medicate among people with C-PTSD would therefore be even more intense.

Of course, speculation and data are two different things. Let us hope the next few years bring to light more evidence about the nature of the connection between C-PTSD and addiction.

References:

1. Ford, J. D., & Courtois, C. A. (2014). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 1, 9.
2. Lawson, D.M. (2017). Treating adults with complex trauma: An evidence-based case study. Journal of Counseling and Development, 95(3), 288-298. Retrieved from http://doi.org/10.1002/jcad.12143
3. McCauley, J. L., Killeen, T., Gros, D. F., Brady, K. T., & Back, S. E. (2012). Posttraumatic stress disorder and co-occuring substance use disorders: advances in assessment and treatment. Clinical Psychology: A Publication of the Division of Clinical Psychology of the American Psychological Association, 19(3), 10.1111/cpsp.12006. Retrieved from http://doi.org/10.1111/cpsp.12006
4. McFarlane, A. C. (2010). The long-term costs of traumatic stress: Intertwined physical and psychological consequences. World Psychiatry, 9(1), 3–10.
5. Sar, V. (2011). Developmental trauma, complex PTSD, and the current proposal of DSM-5. European Journal of Psychotraumatology, 2, 10.3402/ejpt.v2i0.5622. Retrieved from http://doi.org/10.3402/ejpt.v2i0.5622

About 46% of people who once had an issue with drug or alcohol use achieved sobriety without formal treatment or assistance, according to a study published in Drug and Alcohol Dependence. The study found that addiction issues are common, with 9.1% of participants in a nationally representative survey reporting they had recovered from an addiction.

The study undermines some popular beliefs about addiction, particularly that all individuals recovering from addiction must see themselves as “in recovery” or seek inpatient treatment.

Many Pathways to Sobriety

The study began with a nationally representative survey of 39,809 people. Researchers followed up with 2,047 participants who answered in the affirmative to, “Did you once have a problem with alcohol or drugs but no longer do?” Some participants responded to follow-up questions incompletely or in ways that suggested they had not actually had an addiction. This left 2,002 responses to analyze. [fat_widget_right]

Slightly more than half (53.9%) of people who recovered from an addiction said they sought help to become sober. The most popular path to sobriety was through self-help groups like Alcoholics Anonymous. Around half (45.1%) of people in recovery used these programs to get sober. Medical treatment was another popular option, with 27.6% using some form of treatment in either inpatient or outpatient settings.

Recovery support services, such as faith-based programs and sober housing, helped another 21.8% of respondents become sober. About 37% used multiple forms of assistance to get sober.

The remaining 46% of respondents did not use traditional treatment or support to get sober. Just 46% of people who were once addicted to drugs or alcohol reported viewing themselves as “in recovery.” Many addiction treatment programs encourage people with substance abuse issues to see themselves as in recovery for a lifetime.

Authors of the study argue that this suggests there are many ways to achieve sobriety. Treatment providers might need to reconsider the way they talk about addiction and the way they encourage people in recovery to view themselves.

Who Seeks Treatment for Addiction?

The study also analyzed factors that correlate with seeking formal assistance to get sober. People who abused substances at an earlier age, who abused several substances, who were involved with drug courts, and who were diagnosed with a substance use or mental health issue were more likely to seek assistance to get sober.

People with opioid addiction were more likely to seek help, while those with an addiction to cannabis were less likely to pursue assistance.

References:

1. Almost half of those who resolve a problem with drugs or alcohol do so without assistance. (2017, November 01). Retrieved from https://medicalxpress.com/news/2017-11-problem-drugs-alcohol.html
2. Kelly, J. F., Bergman, B., Hoeppner, B. B., Vilsaint, C., & White, W. L. (2017). Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy. Drug and Alcohol Dependence, 181, 162-169. doi:10.1016/j.drugalcdep.2017.09.028

Not everyone who drinks alcohol has a drinking problem. Most people fall on a continuum of alcohol use throughout their lives. An increase in alcohol use and problems associated with it is typically gradual. No one becomes dependent on alcohol upon their first sip.

Check out where you fall on the spectrum of alcohol use:

Experimental Use

This first stage is often driven by curiosity about what alcohol does and what it tastes like. This often occurs during the teenage years. First-time alcohol users often want to see what all the fuss is about. After trying it, some decide they can take it or leave it. Others will have too much, pray to the “porcelain god,” and not drink again for a long time, having gained a better understanding of their limits.

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A small percentage of first-time drinkers will describe their first intoxication as “meeting my best friend,” “finding the answer to my problems,” or “something I couldn’t wait to do again.” This population has experienced not only the chemical change associated with alcohol, but also a physiological rush. Dr. Nora Volkow, head of the National Institute on Drug Abuse since 2003, describes this as a hijacking of the brain. It is like flipping a switch. Once on, it stays on. This group of drinkers may develop addiction if their alcohol use continues. The experimental use of alcohol becomes potentially dangerous when curiosity is quenched, yet the person returns for more.

Occasional Use

Occasional users are not preoccupied with drinking. They often drink only in social situations like when they go out to eat, attend a party, celebrate an important event, or want to relax on some weekends. Left unsupervised, teenagers may choose to consume alcohol as part of an event like homecoming, prom, or a concert. This type of drinking is often not a major concern; however, younger drinkers tend to drink more for effect and to binge drink to become intoxicated, potentially leading to problematic or dangerous behaviors.

Situational Use

Situational use is also not usually a problem. However, the amount and frequency of alcohol use begins to increase. What was once special-occasion drinking becomes more consistent and may be associated with specific events such as every weekend, parties, birthdays, sporting events, clubs, and other such things.

Bingeing can be a part of normal experimentation. The person who experiences the consequences of drinking too much and refrains from use for a period of time may not develop a problem, whereas a problem drinker may experience the consequence yet do the same thing the very next night, weekend, or party.

Binge Use

A binge drinker is someone who consumes a large quantity of alcohol—usually five or more drinks in two hours for men and four or more drinks for women—with the intent of becoming intoxicated. Bingeing can be a part of normal experimentation. The person who experiences the consequences of drinking too much and refrains from use for a period of time may not develop a problem, whereas a problem drinker may experience the consequence yet do the same thing the very next night, weekend, or party.

In this middle part of the spectrum are individuals who drink too much or drink on a regular basis. They may drink in college, in early adulthood, after a breakup, in a crisis period, or because of grief. Many people in this group recognize that their drinking, either the amount or the frequency, is getting out of control and can make some behavioral and lifestyle changes to bring it back to a non-detrimental level.

The National Institute on Alcohol Abuse and Alcoholism estimates about 28% of adults drink at levels that put them at risk for alcohol dependence and alcohol-related problems. They include these next two areas:

Alcohol Abuse

This consumption pattern tends not to occur every day and is not a problem every time a person drinks; however, it is beginning to cause problems. Many drinkers will slow down or stop drinking when they have had a fight, developed a health problem, or faced legal consequences. People who abuse alcohol tend to continue their drinking patterns despite recurrent problems.

The person who abuses alcohol tends to drink in a larger amount than others and does so more frequently. However, at this stage, many people either minimize the existence of a problem or deny alcohol’s impact. They may say such things as “I can stop anytime I want,” “It’s not like I drink every day,” or “I’m not as bad as _____.”

Alcohol Dependence

At this stage, alcohol use has become a serious problem, and the person may be commonly described as an “alcoholic.” Someone who is dependent on alcohol tends to imbibe on a very regular basis and in large quantities, needing it to function despite having suffered severe consequences such as DUIs and losing something of importance or value to them—spouse, child, job, home, or health.

When someone is dependent on alcohol, the body has changed. The person has developed a tolerance to alcohol, meaning increasing amounts are necessary to achieve the same effect. This person may also experience withdrawal symptoms if denied alcohol, including physiological responses such as delirium tremens (the shakes), seizures, hallucinations, delusions, heart attack, or stroke. These are dangerous, can be life threatening, and may require medical attention.

Only a small percentage of the population, about 6%, is dependent on alcohol. People who are alcohol dependent or experiencing a severe alcohol use issue are what many nondrinkers, drinkers, and even treatment providers picture when they think of someone with a drinking problem. This 6% of individuals may be the ones you compare yourself to in order to validate that you do not have a drinking problem.

So, where do you fall on the spectrum of alcohol use? What are you willing to do about it?

References:

1. Alcohol facts and statistics. (2017). Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics
2. Maldonado, L. (2014). Drug addiction statistics – Alcoholism statistics and data sources. Retrieved from https://www.projectknow.com/research/drug-addiction-statistics-alcoholism-statistics
3. Substance Abuse and Mental Health Services Administration. (2013). Results for the 2012 national survey on drug use and health: Summary of national findings. NSDUH Series H-46, HHS Publications No. (SMA) 13-4795. Rockville, MD.
4. Turner, C. (2017). Can I keep drinking? How you can decide when enough is enough. New York: Morgan James Publishing.

Anyone who has ever been in recovery from addiction or abuse can attest to the fact it is not easy. The process of recognizing there is a problem; increasing motivation to take control; seeking support; and identifying the types of people, environments, and situations that will allow for recovery may, at times, seem impossible. It is the difficulty of the work of recovery that makes recovery communities all the more important—in many cases, crucial.

What Are Recovery Communities?

Recovery communities are organized and structured support networks that focus on the specific issues and needs that are relevant to the participants. For those recovering from substance abuse, the recovery community may focus on understanding the urges and triggers surrounding substance use. The community taps the experience of newer and longer-term community members to foster support as well as key strategies to prevent relapse.

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In the instance of people recovering from sexual, physical, or emotional abuse, these communities provide a safe space for individuals to share and process their experiences; connect with others who have had similar experiences; and receive ongoing support to promote healing, self-confidence, and self-worth. They may also include a prevention aspect to help recovering people learn how to identify and avoid situations and environments that may be harmful. These communities can be broad or highly specific, virtual or in-person, open or closed.

Why Should I Join a Recovery Community?

Two of the most insidious issues with addiction and abuse are the feelings of shame and isolation that typically accompany those experiences. It becomes difficult to know who you can talk to, to know who is safe and who will provide support in helping work through things.

Recovery communities are a collection of people who are motivated both to promote their own recovery and to form relationships that decrease the sense of shame or isolation they faced because of the abuse or addiction.

Once you’ve identified yourself as someone in recovery, it becomes important to reengage with the world around you in new and different ways. For some people, this might mean finding new people to be around, people who help support and maintain habits you are adopting in your recovery.

Recovery communities are a collection of people who are motivated both to promote their own recovery and to form relationships that decrease the sense of shame or isolation they faced because of the abuse or addiction. Joining a recovery community allows those in recovery to connect with and help others. Knowing that your story and your engagement in a recovery community helps others through their own recovery process can have significantly positive effects on self-worth and self-efficacy.

How Do I Choose a Recovery Community?

First, it’s important to identify what you are recovering from. You are not limited to joining one recovery community. If, for example, you are recovering from intimate partner violence and substance abuse, you may find yourself part of two different recovery communities that focus on separate areas of recovery.

Second, consider what community of people you feel would be best suited to help you through recovery. You may decide you want to join a community with participants of the same gender identity or groups with a particular cultural understanding. Or perhaps you want to join a community that uses spiritual or religious practices that you want to incorporate into your life. Doing a little research on who is in the community beforehand may lead you to feel more comfortable when you join. It may also encourage greater participation and involvement within your chosen community.

Another key consideration when choosing a recovery community has to do with access and availability. Would you prefer a community that is local? While some people may prefer anonymity as they work through their recovery, others may enjoy knowing that members of their community are close by and readily accessible. Some community groups may be open, meaning new members might be able to join or drop by at any time. Other groups are closed or may have limited opportunities for new members to join.

Do in-person groups appeal to you or are you more interested in virtual communities? In-person communities allow you to be with people in real time but may be harder to attend because of physical or time restrictions, whereas virtual communities may allow you have greater access to members and get support during hours that an in-person group might not be available.

If you are interested in joining a recovery community and are already seeing a professional, they may be able to recommend a group for you. Well-known recovery communities include AA (Alcoholics Anonymous), Al-Anon (for family and friends), NA (Narcotics Anonymous), and RAINN (Rape, Abuse, and Incest National Network). If you are at the beginning stages of recovery, meeting with a mental health professional may be a valuable first step before entering a recovery community.