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

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.    

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


by | 13. February 2015 11:18

Addiction treatment is evolving.  This is a difficult process; older methods & interventions have been effective for millions of people.  This creates a dilemma.  For some, older “tried and true” methods can been seen as “the only way” or “the best way” to conquer addiction.  It creates skepticism, doubt and ignorance of newer methods for treating the disease.  Why does this happen?  That is for a longer and more open discussion.  Getting right to the point, there ARE numerous pathways to recovery.  It is cannibalistic for one effective paradigm to dismiss another simply on bias or because it is different from older ways. In EVERY OTHER area of health care we EMBRACE forward leaps & innovation.  Medication assisted treatment and counseling are firmly on the scene for substance abuse treatment.  They have a definitively valuable place on the “Mount Rushmore” of the battle against addiction.  Integration of effective resources is part of the solution; this means pooling the strengths from various different modalities rather than puffing out our chests and proclaiming that each of our respective approaches, program or ideologies is superior.  There is no skeleton key for opening up recovery to a person. Collaboration is key.  The Delaware Valley is a hotbed for addiction treatment.  There are many options available @ all levels of care in Bucks, Montgomery, Delaware, Chester & Philadelphia counties.  Check out some of the options available in this press release from NCADD, here

The Moment

by | 22. January 2015 11:41

There is always a new wrinkle that a client can experience in recovery; something that interferes with even the best efforts to maintain a satisfying life.  There is also an endless ability to overcome adversity in each of us. Stress always finds way in regardless of someones level of prosperity.  Stress creates rigid structures, barriers, in our ability to navigate the day to day.  It permeates, infiltrates and blankets our ability to focus on tasks at hand.  It is preoccupying & painful; frustrating and unrelenting.  We can try to push through our anxiety, put it in the back of our mind, ignore it, minimize it, dismiss it, inflate it, re-shape it, blame it or get lost in it.  How can we co-exist with this reality of existence?   Instinctual coping strategies have not brought adequate relief for many; similar to the instinct to struggle in quicksand thereby leading to faster sinking.  Sometimes impulsive actions bring more confinement within our problems than liberation.  The nature of stress & how it effects us requires a different tactic.  It needs a battle plan that deviates from typical methods of attacking a problem.  The challenge in recovery from substance use disorders is that these methods require dedication & vigilance.  These can be tremendously elusive characteristics for a person in early recovery.  Ambivalence is, oftentimes, profound.  Stress, ironically, is a byproduct of ambivalence.  It always keeps us teetering on the precipice of change.  Ambiguity when we seek feedback or support in turn feeds ambivalence.  When a problem and its accompanying stress presents itself, some solutions/remedies need to be direct and practical.  Even if one’s skepticism is high, the ability to consistently recommend a tried and true method is a foundation for resolving ambivalence.  Mindfulness based stress reduction is one such method.  It was developed in 1979 by Dr. Jon Kabat-Zinn.  He founded the first center for mindfulness based practices & research in Massachusetts.  Over the years, the practice of mindfulness has been proven to be a reliable asset.  Mindfulness requires work and consistent practice to yield long term benefits.  To summarize, “Mindful awareness is about learning to pay attention, in the present moment, and without judgement. It’s like training a muscle, training attention to where you want it to be.” ( There are many institutions where Bucks, Philadelphia, Delaware County, Chester County and Montgomery County resident can learn more about and be trained in mindfulness practices. To learn more about how mindfulness can aid addiction recovery, check out NIDA’s article here.

Inside Out: Towards Understanding Addiction

by | 22. December 2014 11:39

Experience with drug use/abuse, whether firsthand experience or by associate/observations, provides a person with a frame of reference to easily rattle off a list of signs & symptoms that identify if a person is under the influence.  These are the tip of iceberg warning signs.  Our personal observations are subjective. They may be similar to other people’s accounts on occasion, yet they can be influenced by personal biases just as easily.  We initially observe addiction from a personal vantage point. Understanding addiction means more than simply being able to talk about drugs, knowing slang, reciting drug facts, living with it or in it or parroting statistics.  It takes me than the “I’ve been there” approach. Personal experience is useful but limited.  Addiction is an illness that follows a distinct pathology that takes on unique patterns in each individual.  Recovery is also realized along  distinct themes that manifest in different ways by each person.  Perhaps a fresh start to gleaning an understanding of addiction is to start with the “below the surface” basics, rather than the “tip of the iceberg” observables? NIDA has provided a glimpse of what getting high looks like in the brain here: