Sleep Problems in Addiction Recovery

by | 10. June 2015 08:20

Insomnia (difficulty initiating or maintaining sleep) is one of the most common issues tied to BOTH active substance abuse and the recovery process.  Lack of restful, productive sleep creates significant disruptions in day-to day functioning.  When someone is trying to re-establish stability in their job, relationships, health AND abstain from substances of abuse, sleeping problems represent a tremendous hurdle in reaching those goals.  SAMHSA addressed the sleep/insomnia issues in a Fall 2014 brief; they outlined several non-pharmacological interventions and several lifestyle tips for promoting healthy sleep.  These strategies are effective and minimize risk of relapse, the caveat is that they require vigilance, commitment and take time to produce results.  Patience, especially when not sleeping well, can be elusive for people in early recovery.  This process can open the door for relapse when (some) pharmacological remedies are recommended.  The ultimate challenge of recovery is to delay instant gratification & sleep medicines (mainly sedative-hypnotics and benzodiazepines) eliminate that delay.  Compounding that issue, often times, is the far too casual approach towards these medicines by prescribers and people in early recovery.  It can be easy to minimize or dismiss the risks associated with these medicines when they produce immediate results.  They are mistakenly perceived/presented as “low risk” or “not risky at all”.  The seeds for relapse are sewn far in advance of the actual event.  It is a poor decision to start planting these seeds by prescribing someone  with a substance abuse history these medicines that have documented abuse potential (even if they are not the person ‘drug of choice’).  It is equally risky (if you’re a person in recovery or loved one to someone in recovery) to start seeking these medicines for fast relief of insomnia.  A recent article published by NPR talks about the benefits of utilizing therapy to root out the underlying causes of insomnia.  This can help a person safely improve their sleep without the risks some medicines create.  A key statement from the NPR article quoting Dr. David Cunnington, director of the Melbourne Sleep Disorders Centre in Australia, explains the basic difference between lifestyle changes/therapy and sedatives to treat sleep problems: “A medication just puts a blanket over that anxiety and helps people get rest. But cognitive behavioral therapy addresses the core problems, challenging people’s thinking around sleep.  It can actually break the cycle of insomnia”.  SAMHSA, in the brief mentioned earlier in this commentary, cites Harvard Medical School, Division of Sleep Medicine and the National Sleep Foundation in their list of tips for Promoting Sleep Hygiene.  These tips include: 1) Go to bed and get up at the same times each day 2) Use natural light (that comes through a window) to remind yourself of when it’s time to be asleep & awake 3) EXERCISE regularly 4) If you take naps, keep them short and before 5pm 5) Don’t eat or drink too much when it is close to bedtime 6) Avoid caffeine and nicotine for several hours before bedtime 7) Wind down before going to bed (take a warm bath/shower, light reading or practice relaxation techniques). 8) Keep the bedroom a relaxing place – avoid paying bills or doing work from the bed 9) Sleep in a dark, quiet room that isn’t too hot or too cold & 10)Don’t lie in bed awake. If you can’t fall asleep within 20 minutes get up and do something relaxing.  To read more about sleep problems associated with addiction and recovery check out SAMHSA’s In Brief here.  To read more about hoe therapy & counseling can be helpful for sleep problems, check out NPR’s article here

Obstacles to Seeking Treatment

by | 02. June 2015 08:54

Funding and access to treatment is still a critical problem for many.  This topic, summarized in brief by NCADD from a USA Today article, identifies several factors that contribute to the biggest dilemma in addiction treatment. Check out NCADD’s summary here and the full USA Today article here

Overdose Deaths in Bucks County: 2014

by | 27. May 2015 11:02

The Pennsylvania State Coroners Association has released their Report on Overdose Death Statistics 2014.  This report is broken down by overall totals for the entire Commonwealth of PA and also county-by-county. It provides the raw data and percentages as they pertain to each drug in addition to breakdowns by day of week, month and gender totals for incidents of overdose deaths.  They identify 2488 overdose deaths in Pennsylvania for the period covering January 2014 to December 2014.  It is also important to recognize that “a vast majority”  of the deaths involved the presence of more than one drug in toxicology results.  Bucks County alone endured 205 overdose deaths in 2014: 66% male to 34% female.  A slight majority (30%) of those deaths fell in the 31-40 age group, closely followed by the 41-50 age group (29%) and then the 20-30 age group (23%).  The remainder fell in age groups under age 20 or over age 50.  Opioids (oxycodone, hydrocodone, oxymorphone, hydromorphone, morphine etc.), Benzodiazepines (Klonopin, Xanax, Ativan, Valium) and non-legal drugs (heroin, cocaine, methamphetamine etc.) accounted for the highest occurrences in toxicology results.  These are just a few of the black & white facts.  More than that, this study represents the irreversible tragedy associated with drug addiction.  It is the culmination of too many worst case scenarios that parents, siblings, wives, husbands, partners, grandparents, aunts, uncles, cousins, co-workers, employers & countless friends are trying to process in their grief.  The report itself is not all data and graphs; they preface the statistics with a poem written by the mother of a young woman who died from an overdose this past year.  It is a heartbreaking example of the ultimate pain caused by drug addiction.  This battle cannot solely be measured by its casualties in sheer, raw numbers. There is also a definitive, almost tangible, qualitative price levied by it and all illnesses. Treatment, support  and advocacy are the platforms that give us the greatest chance at conquering this epidemic. Those platforms are bolstered by individual perseverance, resiliency and compassion.  When we combine those elements, we can make these staggering numbers dissipate. We can improve the quality of life for the afflicted and their loved ones. The time to act is NOW.  If you or someone you know is sufferance from drug abuse/dependence seek help as quickly as possible.  It is unacceptable to let these numbers continue to grow or remain steady.  Seek out help, tirelessly if need be. Treatment is effective!  To read the full report m click here

Naltrexone May Be Helpful in Treating Methamphetamine Addiction

by | 26. May 2015 11:38

This summary posted by NCADD describes a small sample experiment that yielded results indicating the potential for naltrexone’s effectiveness in treating methamphetamine addiction.  Check it out here

College Age & Young Adult Drug/Alcohol Use Patterns: Current Topics in Addiction & Recovery

by | 18. May 2015 10:59

This news release from the National Institute on Drug Abuse (NIDA) re-introduces information from the 2013 Monitoring the Future study.  The updated info-graphic provides easy to read, hard facts regarding Alcohol, Marijuana and Prescriptions Stimulant (Ritalin & Adderall for example) abuse in the college age/young adult population.  The age group has traditionally been known as the time when addiction blossoms in most people.  Check it out here!

Generic Version of Narcotic was Most Prescribed Drug Under Medicare in 2013

by | 15. May 2015 09:26

Vicodin in generic version was the most widely prescribed drug under Medicare in 2013.  This article published in The Wall Street Journal and summarized by NCADD outlines a key contributing factor to narcotic addiction problem in the United States and the heroin problem, also.  Check out the NCADD summary here  and the full article from The Wall Street Journal here

Do I Have A Drug or Alcohol Problem?

by | 14. May 2015 11:18

The following self-assessment was published by the National Institute on Drug Abuse as part of the article “What To Do If You Have a Problem With Drugs” in June 2014.  It is a simple list of screening questions & it can help identify whether drug/alcohol use has become problematic.  It is a list of twelve “yes or no” questions.  Keep in mind, this list is not a diagnostic tool rather it can help someone to begin to identify the depth to which alcohol/drug use is effecting their life.  This is crucial to making the decision to seek help.  These are the 12 questions: 1) Do you think about drugs a lot? 2) Did you ever try to stop or cut down on your drug usage but couldn’t? 3) Have you ever thought you couldn’t fit it or have a good time without the use of drugs? 4) Do you ever use drugs because you are upset or angry at other people? 5) Have you ever used a drug without knowing what it was or what it would do to you? 6) Have you ever taken one drug to get over the effects of another? 7) Have you ever made mistakes at a job or at school because you were using drugs? 8) Does the thought of running out of drugs really scare you? 9) Have you ever stolen drugs or stolen to pay for drugs? 10) Have you ever been arrested or in the hospital because of your drug use? 11) Have you ever overdosed on drugs? 12) Has using drugs hurt your relationships with other people?  “Yes” answers to some or all of these questions indicates the need for professional assessment and possibly further treatment.  These can be difficult questions to answer in an honest fashion.  Beyond that (and a HUGE part of the recovery process) it can be exponentially MORE difficult to discuss those life consequences with another person.  A certified/licensed addiction professional provides a non-judgemental and compassionate environment to begin addressing these patterns without recrimination or shaming.  Physicians trained in addiction medicine (board certified by ABAM or board certified in Addiction Psychiatry) can discuss medication options that facilitate the recovery process.  A combination of medical and counseling services is the most effective treatment intervention.  Seeking a treatment professional in your area is the next step.  If you are in Bucks County, PA or the surrounding area contact BioCare Recovery at 267-392-5200 for more information about addiction recovery.    

Remission, Relapse & A Chronic Illness

by | 05. May 2015 11:33

Successful treatment for mostly all chronic illnesses is demonstrated by significant reduction in recurrence of acute symptoms.  The goal of most treatments for chronic illness is complete sustained remission of all symptoms.  The nature of chronic illness makes complete remission, in perpetuity, a painstaking task.  It is hard to get well.  It takes vigilance and sacrifice that can be challenging to accept and then maintain.  When we are diagnosed with a chronic condition, it is life altering.  We can be determined not to be limited by our illness.   This resiliency walks a razor’s edge, however.  On one end we have the capacity to face down our condition, alter our lifestyle, embrace our survival & make necessary changes to keep symptoms at bay.  On the other hand we can minimize the seriousness of the condition, soldier on with our current lifestyle & minimize/endure the damage it is causing.  There is no moral code for these decisions; it is our right as individuals to make independent choices for the life we want to lead.  Bearing that in mind, most people want to achieve or experience some level of contentment in their life.  Chronic, progressive conditions like addiction cause pain. Eventually that pain begins to intrude on a person’s ability to feel contentment; to the point where it can no longer be ignored.  We then contemplate getting help. Some, most, then decide they NEED help.  A menu of helpful options is available for people with substance abuse disorders.  There is definitive proof that these accepted, studied, and commonly practiced remedies can be effective at reducing relapse.  The combination of counseling and medication assistance is the gold standard from the treatment angle of the recovery process.  It requires vigilance, however, and that is the toughest part.  It can be easier to get well than to STAY well.  Human tendency can lead us to discard help in the belief that we are past its ability to aid us.  “I don’t need it anymore” or “I got this” are common refrains.  That is when relapse occurs.  Have you eve taken an antibiotic?  Notice that the instructions say to “Take all medication as directed until finished”  or some variation of that.  People preemptively stopping treatment is not unique to addiction.  Research treatment options, ask questions, seek second opinions, do the homework, make there tough decisions either for yourself or with a loved one in mind.  There is no shortage of resources in the greater Philadelphia five county area (Bucks, Montgomery, Delaware, Philly and Chester counties) .  For information about reducing relapse and utilizing treatment options, check out this press release from the National Council on Alcoholism & Drug Dependence here.  For the full article, check it out on Forbes website here

Current Topics in Addiction & Recovery: Neonatal Opioid Withdrawal Cases Increasing

by | 27. April 2015 09:22

This article from outlines some disturbing data directly caused by the nation’s burgeoning opioid problem.  The number of newborn babies suffering from neonatal opioid withdrawal has nearly quadrupled since 2004.  Alarming consequences from addiction and opioid abuse that MUST be addressed.  Check out the article here

Alcohol & Marijuana: What are the Risks For Teens? How to Address Them?

by | 20. March 2015 11:09

In our January 16th 2015 blog, “Trends In Our Youth”, we discussed the  Monitoring the Future survey conducted annually by the Nat’l Institute on Drug Abuse.  Today’s article will look again to this data in addressing the hot button topic of risk; specifically how this risk applies to Alcohol & Marijuana use in teens.  CBS News addressed this topic in a recently broadcasted segment.  They posed the question “what is worse, alcohol or marijuana?”, leading them to the inverse notion about which drug is “safer”.  This is like asking “What would you rather have in your house, lead paint or asbestos?”.  I will go out on a limb that most of us would say neither.   A greater concern is that this question is being posited for debate in that fashion.  Dr. Aaron Carroll, a professor of Pediatrics at Indiana University School of Medicine, was interviewed for the CBS piece and his initial response to the question of which is safer,  is a home run.  He states, “The first answer always has to be neither.” when referring to teen safety for drinking alcohol or smoking marijuana. It is unrealistic to expect that all teens everywhere will abstain from experimenting with Alcohol or other substances.  The issue at present is how we present these developmentally common rites of passage to them.  We need to peel away some layers of this topic in order to understand it more clearly.  Experimenting with substances is a risk.  It is a disservice to our youth to present the argument solely in the form of pitting one substance versus another as measured by “danger”.  In this structure,  less attention is given to the third option: abstaining.  Adolescence is a tumultuous time in our development.  Famed psychologist Erik Erikson outlined the task of our teenage years as being characterized by developing identity versus role confusion. We have more freedom to shape our future, make decisions and examine the complexities of our personalities.  “Youth has a certain quality in a person’s life. . . Youth is a time of radical change – the great body changes accompanying puberty, the ability to search one’s own intentions & the intentions of others, the suddenly sharpened awareness of the roles society has offered for later life” (F.L. Gross 1987).  We become concerned with how we appear to others, especially peers. Teens care about how they are perceived by others.  In 2014’s Monitoring the Future survey, it showed that most 12th graders who used them obtained narcotic painkillers “for free from a friend or relative”: see the table here.  As all of these newly shaping parts of life coalesce, teens are faced with decisions that may determine important parts of their future.  It is our responsibility as informed adults to help them make these decisions with as much information as needed.  It is incumbent upon the adults to mitigate as much risk as possible.  “The problem of adolescence is one of role confusion. A reluctance to commit which may haunt a person into his mature years.  Given the right conditions. . . what may emerge is a sense of identity,  an emotional and deep awareness of who he or she is” (Richard Stevens 1983). The ‘right conditions’ speaks directly to idea of substance use.  When perceived risk is low, the likelihood to try something is higher.  Marijuana use in particular has seen a decrease in perceived risk for regular use amongst teens (check it out here MTF 2014) and has a downward trend since 1991.  Marijuana use amongst teens has increased over a five year period amongst 10th graders.   The opposite has been true for alcohol use amongst teens.   Parents play a critical role.  Talking with their teens and parenting them can help shepherd a teen through some of the more difficult aspects of adolescence.  It is important to have a measured approach; to help a teenager make informed decisions.  Fear mongering or, in the opposite case, dismissal of real risk presents a continuum wherein we try to find balance when educating teenagers.  There are lots of resources to continue finding information about how to address these (sometimes uncomfortable) topics.  For Bucks County residents and the surrounding greater Philadelphia region, your children’s schools will have educators dedicated specifically to this via their Student Assistance Programs.  Find out more through the Council of Southeast PA.  BioCare Recovery also takes an active role and offers free consultation for anyone seeking information about treatment options or addiction topics in general.