Ashwood Recovery is an independent, comprehensive outpatient treatment center located in the Boise/Meridian Idaho area. They specializes in treating adults and adolescents suffering from addictive disorders, co-occurring disorders, eating disorders, co-dependency and trauma.
You may have read stories about heroin addiction, and you wonder why is heroin so addictive? A common belief about this drug is that it is in a class of drugs all by itself. Heroin has the status of superpower.
Dangerous and powerful, heroin is considered to be one of the most addictive of all drugs. Even the name comes from a German word meaning “heroic, strong.” To give so much credit to a powdery substance might seem to be a bit over the top. But in reality, heroin is so addictive that many people who take the drug recreationally find out quickly that they are hooked. In fact, it can happen with just one use. The risk of overdose is high with the number of deaths in 2013 almost four times what they were in 2002.
If you’ve been using heroin or have a family member who is using, you may want to know how to help them. First, you need to understand the power of this drug and how it affects your system. You should also learn about the help that is available because it is possible to kick your addiction if you know where to go for treatment.
How the Brain Functions
To better understand how addiction happens, we need to take a look at the part the brain plays in controlling our lives. The brain is like a central control tower, sending signals to all other parts of the body. The brain is responsible for keeping us alive!
Recent studies have given us new insights as to how the brain functions. The brain makes the chemicals that control how we feel. Feelings influence our choices.
Pain and pleasure are the two biggies. A healthy brain keeps these two feelings in balance so one can survive and be happy.
There is an area of the brain called the nucleus accumbens. This part of the brain is the central control for making and sending out the chemicals dopamine and serotonin. These two chemicals could be described as the feel–good and feel–satisfied chemicals. Without a good supply of dopamine and serotonin, a person would not be able to experience feelings of pleasure or pain. Dopamine works to dull pain. Serotonin is the chemical that helps us calm down and feel happy.
Our thoughts have a lot of influence on how our brains respond. An example might be when you are looking at a desert menu and anticipating what you would like to order. The chemical reaction in your brain will begin the process for you to feel pleasure and to feel satisfied. The same sort of response happens when we get hurt. The brain sends signals to dull the pain, so you can respond appropriately to the trauma. Feelings produced naturally are in proportion to the intensity of the moment.
What is Heroin and Why is It So Addictive?
Heroin is made from morphine, which is derived from the poppy plant. It’s an opioid drug that comes in various forms. While it’s most recognizable as white powder, it can also be a brown powder or a sticky substance that is dark, labeled as black tar heroin.
This drug is often snorted or injected, which means it reaches the brain faster than most medications which are swallowed. The chemicals in the heroin attach to the cells in the brain and cause a euphoric feeling. This feeling is pleasurable to the user who then seeks to replicate it by using again.
Thoughts and actions trigger the brain to respond. Drugs like heroin also trigger these same responses, but the surge of chemicals stimulated by drugs is much more intense. The response to heroin is faster and longer lasting. Eventually, the brain will become exhausted because the drugs force the brain to work harder and faster than humanly possible. Over-stimulation causes the brain to slow down. It will no longer produce the chemicals that create feelings of happiness and pleasure. Instead, it will become dependent on the drug to make the chemical reaction happen. Don’t blame your brain though, it can only be a brain. It learns to let the drug have its way.
Heroin is very addictive because it takes over the brain by storm. It will take some time for it to recover. Quitting heroin can be hard, and maybe risky, if done without medical supervision.
Increasing Heroin Addiction by Mixing It with Other Drugs
Heroin is often not used alone. It’s part of a combination of drugs the addict uses to get high. Sometimes, the drug is mixed with another substance when it’s made. The dealer does this to stretch their supply and to make more money. However, it’s also just as common for the user to mix it with other drugs for a more intense experience.
As the body develops a tolerance to the heroin, it will take more for the person to attain the high they are seeking. They may turn to another drug to help them get this effect. Heroin depresses the central nervous system and users may look for another drug to do the same thing. They will often turn to a depressant like Fentanyl or OxyContin that are painkillers and known to help a person relax. When the two substances are combined, it can lead to a slowed heart rate and shallow breathing. The risk for a coma or even death increases dramatically with this combination.
Some users choose to mix heroin with a stimulant like meth. Meth excites the nervous system while heroin relaxes it. The two together can mask the symptoms of the other. Which can lead to an overdose because you take more to get high, not realizing when you have taken too much. Cocaine is a stimulant commonly mixed with heroin, and this combination is known as a speedball.
If you or a loved one are mixing heroin with another substance, you should be aware of the risks in this activity. Not only can it increase your likelihood of heroin addiction, it can lead to many complex health problems and even death.
Is There a Cure for Heroin Addiction?
If heroin is so addictive, you may wonder if there’s a cure for this problem. Technically, the answer is “no” but it’s not that simple. While addiction cannot be cured, it can be managed. In fact, many options have been developed to help with management of heroin abuse and other opioid addictions.
Detox is Essential
You must cleanse your system of the drug before you can do anything else. This is called detoxing, and it involves stopping the use of the drug and letting your system return to normal.
Since the brain has stopped producing its own chemicals for pleasure and happiness, it relies on the drug. When the drug isn’t in the system, you experience withdrawal symptoms. During detox you go through these symptoms until your body learns to function normally again. However, the detox process does come with some help if you go to a drug treatment center.
Medications may be given to help with the symptoms of withdrawal. Some of these medications are also opioids that mimic the euphoria provided by the heroin but with less intensity. When you take this medication, it tricks the brain into thinking you’re still using so it won’t go into withdrawal. The dosage is gradually reduced until you no longer need it.
Because the symptoms of withdrawal are so intense for heroin users, they may avoid getting help. With medical detox, they aren’t as afraid of what will happen during detox. Withdrawal from heroin is like having a bad flu along with irritability, depression, anxiety and paranoia. It’s no wonder addicts want to avoid this condition.
Drug Rehab for a Heroin Addict
Once you’ve made it through detox, you may start to feel better. Your brain is clearer and you have more energy. It will take some time for everything to return to normal, especially if you’ve been using for a long time. Some damage may even be permanent. However, you’re now on the road to a healthier version of you.
It’s time for the next step which is drug rehab. You’ll need to learn about your addiction and determine what caused you to start using. This is an important component to recovery because you want to avoid the same thing in the future. You may need to address issues in therapy to deal with your addiction problem.
Many heroin addicts are prescribed medication throughout treatment to help them avoid relapse. These medications block the effects of the drug, so they can’t feel the euphoria even if they do use. It can even make them sick if they try. There is a risk of a secondary addiction because many of these medications are similar to heroin.
Another approach in addiction treatment is the holistic method. A focus is made on helping the addict become healthier through nutrition and exercise. They also treat the entire person by working on their emotional issues and family or other relational problems through family therapy. These programs may provide social interaction and physical activities like yoga and hiking as well as community involvement through volunteering. The idea is that when you treat the entire person, they won’t need the artificial high the drug gives them. They will develop self-confidence and strength to stay away from the drugs and manage life’s stresses in a positive way.
Getting Help for an Addiction to Heroin
If you or a loved one is addicted to heroin, you must get help through a drug addiction treatment center. You can find inpatient or outpatient programs to help you begin recovery. Inpatient programs allow you to stay in the facility while you go through therapy and other treatments. You can focus on getting well without any distractions or negative factors.
For some, outpatient rehab is the only option. They may have family to care for or a job they must consider. Outpatient programs will work around their schedule while they attend therapy on a regular basis. For outpatient treatment to work, you must be dedicated and have a strong support system from family and friends. However, it can be beneficial to help you become drug-free while dealing with your other obligations.
If you are ready to seek help for your heroin addiction, visit Ashwood Recovery. Our modern facility is inviting and comfortable and you can get the help you need throughout intensive outpatient program. If you need more assistance than what we can provide, we’ll be happy to recommend an inpatient treatment center. We use a variety of programs that are tailored to your individual needs. They include group and individual therapy, 12-step program, trauma resolution and family counseling. We’ll assess your needs at the beginning and design a plan that is specifically for you.
You’ll attend three sessions a week that are 9 hours or more in total to provide the support you need to maintain recovery and manage your addiction. With family therapy, you can restore broken and damaged relationships which will also build your path to success. Our staff is trained in heroin addiction and understands why this drug is so addictive. As a result, we have a program that will help you break free from that addiction and live a normal, successful life for the long-term.
Please get help if you have an addiction to heroin. Call Ashwood Recovery to begin your journey to sobriety.
When a person is seeking treatment for a substance abuse disorder such as alcoholism or addiction to illicit or prescription drugs, there are a number of treatment options that, when used in combination, can prove particularly effective. One of the “tried and true” tools that a professional addiction counselor uses to help people struggling with addictive disorders is group therapy.
An addiction recovery group can be a valuable tool to help a person maintain sobriety in the early days of treatment and for the long term. However, it can be a frightening concept for someone to talk about such a personal subject and be vulnerable to strangers. They may avoid treatment because the concept of group therapy is intimidating. Before you write off this type of support, it’s good to understand what it’s all about and why you need it.
What Is Group Therapy?
As the name implies, group therapy is when the addiction counselor brings together a number of people who are all facing similar issues. Within the confines of a safe, controlled therapeutic atmosphere, participants are able to discuss challenges that are common to the group.
The goal of group therapy is for each participant to gain a deeper understanding of their disorder, while at the same time giving support to and from others in the group. Most addiction treatment centers include group therapy as part of the treatment plan. It is used in conjunction with individual counseling and other programs. A person may attend meetings every day, once a week or even multiple times a day if it’s necessary to help them stay on the road to recovery.
There are a number of benefits that can arise from professionally-supervised group therapy. Before looking at those benefits, you need to understand what addiction group therapy is like.
How to Join an Addiction Recovery Group
If you’re interested in finding an addiction therapy group, you can check out local meetings such as Narcotics Anonymous or Alcoholics Anonymous. Many drug rehab clinics feature groups as part of treatment.
You can be part of a group when you check into rehab. It will be part of your program to overcome addiction. You can also find groups in your local area through the AA or NA websites. With these groups, you don’t need to sign up or register. You just show up to a meeting. There’s no requirement to attend a certain number of meetings or other obligations.
Many recovering addicts start out going to meetings every day or even more than once a day. As they learn how to handle their addiction, they may only go once a week or even less. As time goes on, an addict may only feel the need to attend a meeting if they are going through a difficult situation in life such as divorce or a death in the family. This is one of the reasons that addiction recovery groups are so valuable. A person can attend them whenever they want and gain the support they need to deal with their addiction no matter how long it’s been since they’ve used.
What to Expect with Addiction Group Meetings
You may wonder what will happen when you show up at a group meeting. It can help alleviate your fears if you have an idea of what to expect. First, everyone will probably state their names so you can get to know each person. They may talk about what led them to the group or something else regarding their addiction.
As you attend these meetings, you will learn more about how addiction affects others and what issues they face. The other people may talk about how they have been dealing with cravings or how they learned to avoid certain triggers. Sometimes, these groups may have a special speaker which could be an expert but is more likely another addict who has been in recovery for some time. You can learn from their experiences.
These meetings will have a leader who will keep everyone on track. When someone has a question, everyone can contribute with advice or suggestions. However, no one is made to feel their ideas are wrong or the answers they provide incorrect.
You’ll get to know the other attendees and develop friendships. You may even maintain contact outside of the group with those who you feel a connection with. It’s good to have someone you can call on when you’re struggling with a craving or dealing with a problem that leads to the desire to use.
While dealing with addiction is an important component to these meetings, they aren’t always serious. Sometimes, you’ll find a meeting that includes a potluck meal, birthday celebration or other social event. Not only does this give you a chance to relax in a drug-free environment, but it teaches you how to have fun without the use of drugs. It you were a long-term addict or someone who used at parties, you may not realize that it’s possible to enjoy an evening of fun without the help of an addictive substance.
What is the Cost of an Addiction Recovery Group?
When determining whether you can afford an addiction recovery group, you’ll want to think about the cost. Groups like AA and NA are free. Addiction groups in treatment centers are part of the treatment programs and don’t have an additional cost.
Groups in drug rehab centers are included as part of the total program. With the changes to the healthcare industry, your health insurance will cover the expenses related to treatment. You can get help without paying a fortune for the resources available.
Reasons to Attend Group Addiction Therapy
You may see the reasons behind going to individual counseling since that is where much of the work on addiction recovery is done. However, there are numerous benefits to group addiction therapy which you should consider when it comes to determining where and how you will get treatment for your problem.
Addiction is a lonely disease — active substance abusers often feel lonely and cut off from others, especially from loved ones who may not share their illness. This loneliness perpetuates the cycle, because the substance abuser will often self-medicate with drugs or alcohol to numb the pain of loneliness, which in turn only serves to isolate them even more.
In a group therapy setting, participants find out that they are not alone. They learn—often to their surprise — that there are others who understand their struggles because they share them.
The discovery of these common bonds often serves as a basis for ongoing supportive mutual relationships that each person can draw upon for strength and inspiration when they feel overwhelmed or tempted to resume alcohol or drug use.
People trapped in an active addiction often have no one they can talk to about their problems. They have no healthy outlet where they can vent their frustrations or try to work things out.
In a group setting among their peers, recovering addicts and alcoholics find that they can speak freely about their problems—without being judged.
Often, simply by being able to voice what is bothering them, the person speaking is able to work out solutions to their problems. Even when they can’t, someone in the group may have faced something similar and is able to offer a helpful suggestion.
The listeners gain something tangible, as well. They are able to lose the feeling of isolation that addiction has imposed upon them, because the person speaking is talking about familiar issues that matter to the listener, too.
Best of all, this “everybody-gets-a-turn” interaction enhances the confidence, communication, and social skills of everyone in the group, all positive changes that can aid in relapse prevention.
Sometimes, a person cannot find a solution to a problem because they’re too close or emotionally involved to see the best option. Talking about common issues in front of one’s peers and asking for feedback can provide new perspectives that the person may never have thought of on their own.
Because everyone in attendance has similar problems to deal with, solutions are offered up non-critically, so there is no need for the original speaker to feel uncomfortable or defensive.
One of the things a person quickly learns when attending group therapy sessions is that they are stronger together with their peers than they are alone. In the best, most tight-knit groups, a mentality of “we’re all in this together” forms, and each person feels responsible for and accountable to the other.
This mutual responsibility is invaluable, because when one of the group members is in trouble and about to relapse they know that they can call on any of their peers to help them through a difficult moment.
The mutual accountability is also extremely important to a successful recovery, because sometimes a struggling addict will go to extreme lengths to avoid letting down their peers by returning to drinking or using. A person may reach out to someone that has been going to the same meetings to help them stay on the road to sobriety when they’re feeling tempted.
In addition, someone who is seen as the mentor will feel more responsibility to maintain their recovery because others are watching them and counting on them to be a role model. Accountability works both ways, for the person who has been in recovery for some time and the person who is just starting out.
How to Find an Addiction Treatment Group
You can go online to locate a recovery group. You can do a search for groups in your city or neighborhood through NA or AA. However, there are other 12-step programs available as well. If you can’t find a group in your area, you can look for those that are online. Some of these groups only hold meetings online while others may offer both online and offline meetings.
There are different programs available with the recovery groups. Many of them do the round-table format where everyone gets a chance to talk. You don’t necessarily have to speak up in your first meeting, but you can listen and learn from others.
Some of these groups offer a study format. You may read a chapter in a book and talk about what you read. Or, you may read some other literature or watch a video about addiction and then have a discussion.
Addiction is a disease with many causal factors—genetics, past trauma, environment, family history, etc. Because of this, it is good to have multiple tools that can be used in the fight to regain sobriety.
Ashwood Recovery—one of the premier outpatient addiction recovery programs in Idaho — makes extensive use of group therapy and other recovery techniques to attack the disease of addiction on multiple levels. We provide a customized treatment plan for each person because we understand that each addict has a unique story. However, we also recognize that certain types of therapy are beneficial for everyone. Our goal is to help you learn how to manage your addiction and live a successful life today, tomorrow and in the future.
If you or someone you care about is struggling with an addiction, call Ashwood Recovery today to get the help, hope, and support you need as you begin the first steps on your journey.
“Addictive personality is not an actual psychiatric diagnosis. Personalities are very complex, and while there’s not one specific type that’s more prone to addiction than others, there are several factors that can combine to make you more likely to become addicted.”
~ Dr. Michael Weaver, MD, Medical Director, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston
The term “addictive personality” gets thrown around a lot –usually as a half-joking excuse from someone who overindulges in a relatively harmless behavior – binge-watching shows on Netflix or staying up late playing the newest smartphone game, for example.
But would it surprise you to know that for millions of Americans, their addictive personalities directly contribute to their ongoing struggles with problematic compulsive behaviors, including:
Let’s take a closer look at this overused, yet poorly-understood psychological term—what it is, how it affects you, and most importantly, how to live a manageable life if you have one.
First Things First – What Is an “Addictive Personality”?
“If we can better identify the personality factors, they can help us devise better treatment and can open up new strategies to intervene and break the patterns of addiction.”
~ Dr. Alan R. Lang, Department of Psychology, Florida State University
It may surprise you to learn that there is no actual medical diagnosis describing a specific personality type that is at greater risk of addiction. However, many experts believe that there is a set of personality traits that can predispose an individual to various addictions, including legitimate medical conditions such as Substance Use Disorder (SUD).
In simplest terms, an addictive personality is a combination of traits that help explain why some people can avoid getting hooked, while others completely lose control and suffer through unmanageable lives ruled by compulsive substance use and behaviors.
The Four A’s of Addictive Personalities
Almost everyone plays the “IF” game – “If I do/get/achieve THIS, then I will finally feel THAT.” But people with addictive personalities have a seemingly-endless list of if/then scenarios:
“If I get this promotion/make more money, then I will finally be happy.”
“If I buy this new car/house, I will be satisfied.”
“If my spouse/partner/child does THIS, I will feel loved.
“If I get drunk or high, I won’t feel so angry/sad/scared.”
Among certain people with compulsive personalities, this not-quite-a-game manifests as a constant obsession with the “Four A’s”:
Acquisition (Things)—The shine of new things soon dulls.
Approval (Love)—Conditional love is never enough.
Accomplishment (Building)—Progress for its own sake is empty.
The theme is consistent—looking outward rarely brings inward satisfaction.
The Factors That Shape Addictive Personalities
Research has identified several significant personality factors, including:
Impulsiveness—The tendency to act without regard to consequences.
Sensation seeking—A willingness to constantly take risks for the sake of new experiences and feelings. This includes substance use, as well as unconventional lifestyle choices and associations.
Noncompliance—A lack of identification with accepted social norms and values.
Tolerance for deviance—Accepting of the rejection and violation of society’s expectations, customs, and laws.
Social alienation—Weak or even nonexistent connections to others.
Poor coping skills
Types of Addictive Personalities
Interestingly, some studies point to three seemingly-distinct personality pathways that can lead to addiction:
Boldness/Impulsivity/Sensation Seeking: Found most often among males. People with these traits find it hard to control their behaviors.
Anxiety/Sadness/Inhibition: Found most often among females. People with these traits tend to self-medicate with intoxicants to cope with painful emotions or memories.
A Combination of the other two—Individuals may be reckless and impulsive, yet at the same time, fearful of their established routines. Out of anxiety, they may meticulously plan many aspects of their lives, but show a paradoxical lack of restraint in other areas.
But in actuality, there may not be much of a paradox at all. Each personality pathway to addiction is possibly a manifestation of the same underlying issue – a problem with self-regulation.
On one hand, this problem may manifest as an inability to resist strong impulses—drug or alcohol cravings, for example.
But on the other hand, it may also present as a difficulty in processing negative emotions such as fear or sadness, leading to self-medication.
This helps explain why seemingly-opposite character traits are evident during the development of a SUD—disinhibition and recklessness AND obsession and compulsion.
Can an Addictive Personality Ever be a Good Thing?
Surprisingly, certain addictive personality traits can contribute to being a good leader. While at first glance, this might seem contradictory, the truth is that many pioneering leaders are also risk-takers who are never satisfied with the status quo.
There is a long list of people who were innovators and leaders in their chosen fields, even while they battled addictive disorders:
Buzz Aldrin (alcohol)—astronaut, 2nd man to walk on the moon
Marion Barry (crack cocaine)—Mayor of the District of Columbia
Ray Charles (heroin)—singer/songwriter and musician known as “The Genius”
Kurt Cobain (heroin)—musician, pioneer of the “grunge” movement
Samuel Taylor Coleridge (opium)—English poet
Sir Anthony Eden (amphetamines) – British Prime Minister
F. Scott Fitzgerald (alcohol) – one of the greatest American writers of the 20th century
Brett Favre (alcohol and painkillers) – NFL Hall of Fame quarterback
Mark Foley (alcohol)—US Representative
Betty Ford (alcohol and painkillers) – US First Lady
Judy Garland (barbiturates and morphine) – iconic American entertainer
Sir John Paul Getty Jr. (heroin)—billionaire philanthropist
Dwight Gooden (alcohol and cocaine)—Triple Crown-winning baseball pitcher
Ulysses S. Grant (alcohol) – 18th US president
Michael Jackson (painkillers)—global entertainment icon dubbed the “King of Pop”
Stephen King (marijuana, tranquilizers, cocaine, and alcohol)—best-selling author
John F. Kennedy (amphetamines) – 35th US president
Ted Kennedy (alcohol)—US Senator who served 47 years
Ray Kroc (alcohol)—businessman behind the McDonald’s chain
Pat O’Brian (alcohol and cocaine), sportscaster and TV personality
Franklin Pierce (alcohol) – 14th US president
Jackson Pollock (alcohol) – influential abstract expressions painter
Oliver Stone (cocaine)—Academy Award-winning director
Al Unser Jr. (alcohol)—Indianapolis 500-winning race car driver
Martin Van Buren (alcohol)—8th US President, nicknamed “Blue Whiskey Van”
Hank Williams (alcohol and painkillers) – the “King of Country Music”
Robin Williams (alcohol and cocaine)—actor and comedian
Tiger Woods (painkillers)—record-setting professional golfer
The Biology of Addictive Personalities
There is a biological reason for this concurrence.
As any gambling addict can tell you, the pleasure circuits of the brain can be activated by high-risk, high-reward opportunities – even if the risk does not pay off in the end. This is why compulsive gamblers are attracted to the activity, rather than their winnings – the draw of the next card, the spin of the roulette wheel, the placing of the bet, etc.
Leaders and innovators parlay their need for sensation-seeking into new creations, better opportunities, higher personal standards, and advancements of their personal goals.
But most people with addiction-driven personalities are instead controlled by their compulsions. Any positives they realize are outweighed by the mounting negative consequences of their substance abuse and/or dysfunctional behaviors.
In fact, a person with a gambling problem can win a large jackpot, and instead of enjoying their good fortune, they turn around and bet it all again.
Because the risky activity IS part of the reward.
The human brain is hardwired to activate pleasure pathways when unpredictable rewards are presented, and a surge of dopamine is triggered. Dopamine is the body’s “feel-good” neurotransmitter, associated with reward, pleasure, learning, and motivation.
In short, a person performs some “positive” activity – sex or eating, for example – and are subsequently rewarded with pleasurable sensations. Over time, they learn to associate the action with the reward and are motivated – consciously and unconsciously – to repeat the action.
This helps explain why some addictive personalities are driven to succeed.
The Difference for Addicts
But there are two key considerations when it comes to people with SUDs.
FIRST, alcohol and psychoactive drugs don’t just prompt a release of dopamine – they trigger a MASSIVE surge of intense pleasure. There is a measurable comparison. For example, researchers at UCLA determined that orgasm releases 200 units of dopamine.
But among addictive substances, the dopamine spike can be much, much higher:
Dr. Richard Rawson, Ph.D., an Adjunct Associate Professor in the Department of Psychiatry and Biobehavioral Sciences at UCLA’s David Geffen School of Medicine, describes it perfectly, saying:
“This produces an extreme peak of euphoria that people describe as something like they’ve never experienced, and they probably never have experienced before because the brain really isn’t made to do this. And that’s why people will be attracted to it and want to take it over and over and over again.”
SECOND, the latest evidence indicates that while addicts may want these pleasurable sensations more than other people, they actually enjoy them less, because of a blunted response to reward.
The artificially-elevated dopamine levels resulting from chronic substance abuse eventually impairs the body’s reward system. A habitual user will develop a tolerance to their drug of choice, meaning they will need ever-increasing amounts in order to experience the same pleasurable effects.
But over time and with chronic abuse, natural dopamine production slows or even stops completely. This means that an addicted person will be unable to experience pleasure – or even feel normal – unless they are under the effects of the drug.
This disruption of the reward system is what drives addiction, causes drug cravings, and triggers withdrawal symptoms.
Addictive Thinking and the Addictive Personality
One of the first things a person new to recovery learns is that there is no cure for addiction. It is important to keep this in mind when dealing with the effect of personality factors.
Of special relevance, while it is possible to break free from the physical compulsion to use substances, it is much harder to break free from the psychological need. And it takes an even greater effort to adopt lifestyle changes that support long-term sobriety – not just new ways of doing things, but also new ways of feeling and thinking about them.
Craig Nakken, author of Addictive Thinking and the Addictive Personality, writes, “The Addict side of the personality is very important for recovering addicts to understand because it will stay with them for life. On some level, the Addict will always be searching for an object or some type of event with which to form an addictive relationship. On some level, this personality will always want to give the person the illusion that there is an object or event that can nurture him or her.”
Addiction has sometimes been referred to as a disease of dissatisfaction, because the person is always searching for what’s NEXT – the next drunk, the next high, the next sexual encounter, the next bet – in the hopes that they will finally find satisfaction.
How an Addictive Personality Can Disrupt Your Life
But addiction doesn’t work that way.
In fact, because it is a progressive disease that always worsens without direct intervention, addiction isn’t even satisfied when it takes everything you have – your job, your home, your relationships, and ultimately, your life.
But even before a SUD is fully developed, a person with addictive traits can still have their life disrupted:
Impulsivity can lead to risky behaviors and negative consequences.
Constant sensation-seeking can lead to boredom, dissatisfaction, and a need to repeatedly and dangerously “push the envelope” in order to receive (temporary) gratification.
Noncompliance with accepted rules and values results in personal, professional, and legal difficulties.
A tolerance for deviance can lead to unhealthy associations and relationships.
Social alienation causes loneliness and depression.
Increased stress without a healthy outlet can severely impact physical and mental health.
A lack of healthy coping skills directly influences other, less healthy choices.
Getting Help for An Addictive Personality
It is important to understand that the treatment for an addiction differs from that receive for an addictive personality, although they are related.
The best addiction treatment programs are abstinence-based. It is understood that an addicted person’s brain has been so profoundly and permanently changed that they are forever vulnerable to intoxicating substances – for the rest of their life. For that reason, the use of alcohol or ANY psychoactive substance is considered contrary to successful recovery.
However, recovery from an addictive personality focuses on moderation, rather than excess, with a goal of achieving a balance between healthy desire and obsession. Behavioral therapy is a commonly-employed strategy that can help the person develop new behaviors and thought patterns.
Significantly, one of the best ways to support continued recovery and prevent relapse is to focus on both maintaining abstinence AND working on problematic addictive personality traits.
Here’s the bottom line – while the BAD news is an addictive personality does put a person at higher risk of problematic substance use, the GOOD news is that with timely intervention and evidence-based treatment, those traits can be modified to support a return to sobriety.
Read any article about the continuing drug addiction and overdose public health crisis, and you may see a term that you’re not familiar with – “harm reduction”. And if substance abuse has touched your life or the life of someone you care about, you will want to become familiar with this controversial concept.
First Things First – What Is “Harm Reduction”?
“Harm reduction” is a catchall phrase used to describe any public health strategy or policy aimed at limiting or minimizing the individual and societal damage caused by the potential problems typically associated with drug abuse – crime, disease, death, etc. – without necessarily focusing on completely eliminating drug use among those people who are unwilling or unable to stop.
In other words, the strategy is to prevent harm, rather than prevent drug use.
Why Are Harm Reduction Strategies Necessary?
One only has to look around at the epidemic of drug overdose deaths in the United States to understand the necessity of effective harm reduction strategies:
2014: 47,055 (+7%)
2015: 52,404 (+11.4%)
2016: 64,070 (+22.3%)
2017: 71,600 (est.) (+11.8%)
Every year, the number of drug deaths has increased, usually by double digits. According to the Centers for Disease Control and Prevention’s latest Vital Signs report, every part of America saw an increase in opioid overdoses between 2016 and 2017.
And this is despite prevention efforts, public awareness campaigns, drug takeback locations, expanded insurance coverage, and even new prescribing guidelines.
These statistics highlight one critically-important consideration – what we have done to this point isn’t working. And considering that there are nearly29 million Americans who report using an illicit drug within the past 30 days, there is an overwhelming need to expand public health options for people struggling with substance abuse.
To that end, let’s look at some of the harm minimization programs that are available.
Good Samaritan Laws
In general, so-called “Good Samaritan” laws offer a degree of legal protection to bystanders who volunteer to help someone suffering a medical emergency – keeping them from being sued for unintentional injury or wrongful death, for example.
Currently, 40 states and the District of Colombia have some kind of Good Samaritan drug law in place. In general, these measures provide immunity from arrest, charge or prosecution for certain drug possession/paraphernalia crimes for anyone either experiencing or rendering aid for a drug overdose.
Many state laws also provide immunity from violations of pretrial, parole, probation, or protective order conditions.
But because many people with HIV are unaware of their condition, up to 14% of IV drug users worldwide may be HIV-positive.
Syringe Services Programs, also known as needle exchange programs, are a means of reducing the spread of these diseases. People who inject drugs can obtain sterile needles free of charge and safely dispose of their used ones. These programs have other benefits, including:
Preventing accidental needlestick injuries – 1 in 3 law enforcement officers are stuck with a needle during their career.
Reducing the number of overdose deaths – Participants are taught how to recognize and respond to a drug overdose.
Increases entries into substance abuse treatment – SSP participants who are interested in reducing or stopping drug use are put in touch with treatment programs and are 5 times more likely to enter drug rehab than non-participants.
But critics are correct when they point out that needle exchange programs do relatively little to remedy the underlying problem of drug addiction. Despite the benefits, there are still serious harms that exist while that issue is under-addressed. Some of the issues include:
Supervised Injection Sites (SISs), also known as “fix rooms”, are medically-supervised facilities where addicts can go to safely consume their illegal drugs. Although the idea is extremely controversial here in the United States, there are already close to 100 SIS facilities in Europe and Canada.
It is hard to argue with successful results. One facility in Vancouver has been open since 2003 and has monitored almost 3 million injections. Therehave been ZERO fatalities.
As with SSPs, interested participants are connected to rehab resources.
But there are critics who argue that fix rooms send the wrong message and imply government-sponsored approval of an illegal behavior that kills tens of thousands of Americans every year.
No less of an authority than Tony Clement, who formerly served as Canada’s Health Minister, said, SISs are like “…a doctor holding a cigarette to make sure a smoker doesn’t burn his lips, or watching a woman with cardiac problems eat fatty french fries to ensure she swallows them properly.”
Opioid Replacement Therapy (ORT) is when people who are dependent on or addicted to opioids such as heroin or prescription painkiller are given a safer, longer-lasting, and less-euphoric opioid medication as a substitute.
The immediate goal of ORT is not cessation of drug use, but rather to “manage” the opioid addiction and allow patients to live safer, more stable lives. The evidence shows that ORT does just that:
Two-thirds of patients receiving ORT eventually stop abusing opioids.
Up to 95% significantly reduce their use.
IV drug use is reduced, limiting the spread of hepatitis and HIV/AIDS.
The requirement of daily attendance at a methadone clinic provides many addicts with the structure that they otherwise lack.
ORT patients can enjoy stable and productive lives – living at home with their families, working, going to school, etc.
The biggest controversy surrounding ORT is the fact that some of the medications used are themselves powerful, dangerous, and addicted potential substances of abuse. Methadone, in particular, is associated with thousands of overdose deaths per year.
Naloxone—commonly-recognized under the brand-name Narcan – is an emergency medication that can reverse an opioid overdose in a matter of minutes. Quite literally, this easy-to-use medication has saved tens of thousands of lives.
Because of that, there is a huge push going on right now to expand access to Narcan and make it available everywhere. Even the US Surgeon General is on board, and in early April 2018, issued an advisory recommending urging all Americans to carry naloxone and learn how to administer it.
Many addiction experts are of the opinion that addicts are especially open to the idea of treatment immediately following a survived overdose. Upon request, victims are referred to appropriate recovery services.
However, there are still concerns.
As Dr. Sanjay Gupta, the Chief Medical Correspondent for CNN, says, “You’re basically saying, as a doctor, ‘I’m giving you this opioid for your pain, and by the way, you might kill yourself, so here’s this as well.”
In fact, a controversial new study published in March 2018 concluded that increased naloxone access may be unintentionally increasing opioid abuse rates. The biggest supporting argument for this conclusion is the fact that even as availability is expanding, and the number of painkiller prescriptions issued is decreasing, the number of opioid deaths is still going up.
Dr. Jennifer Doleac, one of the study’s authors, says, “While naloxone can be a good harm-reduction strategy, it’s clear that naloxone access alone is not a solution to the opioid epidemic. As currently implemented, these policies may be making things worse.”
Moderation Management is a harm reduction strategy for alcoholics who agree there is a problem but still don’t want to give up drinking. The philosophy of is that with the proper help and support, it is possible to “control” one’s drinking and live a productive life.
MM is at odds with the currently-accepted view that addiction is a disease. Instead, MM practitioners propose that drinking is a bad habit that can be controlled.
As evidence of this, members of MM fellowship groups placed strict limits on their drinking:
Women – 9 drinks per week/Men – 14 drinks per week
No driving after drinking
No drinking during risky situations
Abstaining from alcohol during the initial 30 days of the program
Unfortunately, both science and anecdotal evidence contradicts the idea of alcoholics being able to successfully control their drinking.
Firstly, addiction in all its forms – includingalcoholism – is a disease of the brain, and as that disease progresses, it impairs the person’s ability to make rational choices concerning their substance use.
In fact, attempting to “bargain” with one’s drinking is one of the primary telltale signs of alcoholism.
Secondly, to see how Moderation Management works in practice, we need only look at the tragic story of the movement’s founder, Audrey Kishline.
In 2000, just six years after she founded the Moderation Management movement, Kishline drove her vehicle the wrong way down the highway, crashing and killing a father and his daughter. At the time, her blood alcohol content was triple the legal limit.
Kishline served time in prison for the accident, and after she was released, she relapsed numerous times, battling not only her alcoholism, but also severe remorse for the deaths she had caused. In 2015, she took her own life.
A “wet shelter” is a homeless shelter that gives residents alcoholic drinks – typically, one drink every 60-90 minutes. Supporters argue that wet shelters reduce the harm associated with alcoholism in several ways:
Reduces exposure deaths by attracting residents that would otherwise not seek shelter in abstinence-only lodgings.
Prevents severely alcohol-dependent residents from going into dangerous, possibly-fatal alcohol withdrawal.
85% reduction in the time residents spend in the hospital and/or in jail.
A reduction in drinking – 40%less daily alcohol consumed.
Cost-effectiveness – In one study, it was determined that the taxpayer burden imposed by homelessness – medical bills, law enforcement, detox, incarceration, etc. – had reached $4066 per person per month. But among wet shelter residents, the cost was drastically reduced, to $958 per person per month.
Dr. Susan Collins, an Assistant Professor of Psychiatry at the University of Washington, says “Participants in the study told us that they’re happy to have a home, and happy that they no longer have to drink to stay warm or put themselves to sleep or to forget that they’re on the streets.”
But there are valid criticisms with this method of reducing harm, as well.
FIRST, there are no requirements mandating that wet housing residents receive any kind of treatment or even counseling about their drinking.
SECOND, although there is a limit on the frequency of drinking, there is no limit on the amount. Residents can have their hourly drink EVERY hour, all day long. For comparison purposes, modern guidelines classify more than one daily drink for women or more than two for men as “heavy drinking”.
THIRD, the long-term cost-effectiveness of wet housing is questionable, because lengthy alcohol abuse is associated with over 200 diseases and chronic conditions. This means that healthcare costs among residents with access to that much alcohol are only going to increase exponentially.
A basic philosophy shared by many harm reduction supporters is that there never has been and never will be a society that is completely drug-free. And since that is the sad-but-true reality, public health efforts should focus on reducing the harms and negative consequences associated with drug abuse, without judgement or condemnation.
Supporters say that they are neither for nor against drug use, likening the matter to other personal health choices such as dieting or smoking.
According to advocates of harm reduction, drug prevention and control efforts inflict more damage than less-restrictive measures.
The decision to seek or reject treatment is a personal decision that should not be coerced.
The biggest criticism about most harm reduction methods is that in some ways, it can be compared to enabling addiction. Many substance abusers are fully aware that they have certain safety nets that are provided by harm minimization programs. When they are protected from some of the consequences of their alcohol-and-drug-driven behaviors – and see that their fellow addicts will are likewise protected – they know that they can continue to use with relative impunity.
Looked at another way, these programs can appear to grant tacit approval of substance abuse, because in many cases, they make it easier for active addicts to feed their disease. Clean needles…a safe place to shoot up…overdose reversal medications…free room and board – too much of the “rock bottom” motivation necessary for change is lost, all in the name of reducing harm.
And therein lies the true rub – addiction can be prolonged by misguided notions of so-called “harm reduction”. For example, the goal of methadone maintenance – in theory – is to slowly wean a person off drugs by gradually reducing the dosage. But ORT in practice can mean YEARS of daily clinic visits, where the physical urges are addressed, but nothing may ever be done about the psychosocial factors that play a role in addiction.
What’s the Bottom Line?
“The controversy, is, does it encourage people to keep using if we make their lives less dangerous and less miserable, or can we scare people into care?”
~ Dr. Barbara Herbert, M.D., President of the Massachusetts chapter of the American Society of Addiction Medicine
There are two key considerations in this debate.
On the one hand, there is no denying the fact that certain strategies aimed at reducing harm have had dramatic and positive effects – thousands of lives have been saved. An even greater number of people have gone from a hellish existence ruled by active, out-of-control addiction to a more manageable—if not quite completely abstinent – daily life.
The harm reduction statistics only tell part of the story.
As long as an addiction continues, the risks and the harms continue to add up—deepened dependence, physical and mental decline, broken families, generational substance abuse, and the unfulfilled promise of a life.
The best thing a person struggling with an addictive disorder can do for their health, their family, and their future is to participate in an abstinence-based rehab program. And here’s the thing—if their addiction is so severe that they aren’t willing to make that decision on their own, then there are other things that can be done in their best interest–interventions by family and friends or compulsory attendance as directed by the Court, for instance.
In fact, multiple studies have determined that among individuals who entered treatment because of legal pressure have recovery outcomes that are as good as or better than those who went without being legal pressure.
The problem isn’t that most of these strategies are totally without merit. Rather, it’s the fact that they could do so much more. To TRULY “reduce harm”, treatment should always be a required offering.
If you are a football fan, you are probably somewhat familiar with the story of NFL Hall of Famer Brett Favre and how he battled an addiction to Vicodin in 1996. Today, it is the stuff of sports legend—how he overcame his issues, won both the Most Valuable Player award and the Super Bowl, and went on to have one of the longest and most celebrated pro football careers in history.
But as is usually the case with problematic substance abuse, there is much more to the story. In fact, Favre’s issues with alcohol and drugs were far more serious than most people knew. In a recent candid interview, he admitted that he actually needed to go to inpatient treatment on three separate occasions.
Let’s take a closer look at why this was necessary, and what the rest of us can learn from it.
1990: The Car Crash That Could Have Killed Brett Favre
On an early evening in mid-July 1990, Favre, then a 20-year-old about to start his senior season at Southern Miss, was returning home to his parents’ house after a day of fishing and drinking… and drinking… and drinking with his older brother and two football teammates.
Alone in his 1989 Nissan Maxima, Favre was driving up to 35 miles an hour over the speed limit, failed to notice an oncoming car, overcorrected, slid off the road, flipped several times, and crashed into a telephone pole. The impact of the crash was so great that Favre ended up behind the car’s backseat. His brother and one of his teammates, who had been following in a separate vehicle, had to break the car’s windows with a golf club to pull Brett out.
Favre had multiple injuries, but the impact to his abdomen was potentially life-threatening. Favre had a hematoma on his liver, and a blood blockage meant doctors eventually had to remove 30 inches of his intestine.
As a local athletic hero, Favre was never charged with a DUI.
Addiction doesn’t just happen overnight. It is a progressive disease with stages and warning signs that should serve as red flags that a problem may exist. In young Brett Favre’s case, there were at least four causes for concern –
Alcohol played a major part in the wreck that could have taken EVERYTHING from a promising young man—football, freedom, even his LIFE. This would have been the perfect time for Favre to change his behaviors, or for someone to step in and get him the help he needed before the problem got any worse.
But as future developments would show, neither of these things happened.
1995: 28 Days
“Deanna (Favre’s wife) and Bus (Cook, his agent) talked me into it. I didn’t think I had a problem, but they talked me into it. I went for 28 days. When I got out, I was able to control myself for a while. I wouldn’t take anything for a day or two, and I wouldn’t drink.”
The first time, it was painkillers.
In 1994, in addition to the usual checklist of nagging football injuries, Favre was still dealing with lingering pain from the 1990 wreck. In 1994, he had to have additional abdominal surgery to correct residual issues from the earlier injuries.
But evidently, the pain medication regimen he was prescribed developed into a dependence and addiction. Urged by his wife and manager, Favre checked into a treatment center in Rayville, Louisiana.
The first takeaway is that opioid painkillers are highly habit-forming, even when taken exactly as prescribed. Favre had real health concerns, was legitimately-prescribed pain medication, and still ended up with a problem.
Next, the era must be considered. In 1995, most physicians were still under the mistaken impression that opioids were generally safe and non-addictive, thanks to a letter published in the New England Journal of Medicine and overly-aggressive marketing by Big Pharma drug companies. Pain was treated as a vital sign and opioid drugs were freely dispensed.
Additionally, Favre was in constant pain. In 2016, research conducted at the Columbia University Medical Center shows that people suffering from mild-to-severe pain have a 41% greater risk of opioid addiction.
Finally, we see that intervention works. In his own words, Favre says that he didn’t think he had a problem, but two of the people closest to him—his wife and his agent—were able to convince him to go to rehab.
1996: 72 Days
“But I was a binge drinker. When I drank, I drank to excess. So when I went in the second time…I remember vividly fighting them in there. They said drinking was the gateway drug for me, and they were right, absolutely right, but I wouldn’t admit it. I will never forget one of the nurses. I had it all figured out. I fought with this nurse all the time. I would not admit the drinking problem. At the end she said to me, ‘You’ll be back.’”
In mid-May 1996, Favre announced he was entering a treatment facility in Kansas City, saying, “This is kind of a difficult time . . . because . . . throughout the last couple of years, playing with pain and injuries, I’ve become dependent on medication.”
This time was different, because now, Favre was getting Vicodin illicitly. A so-called “friend” would obtain the drug and give it to him. Brian Noble, a Packer TV announcer, said, “Brett is hanging around the wrong group of guys, people who aren’t interested in Brett Favre the quarterback. He has to be more cognizant of what people want from Brett Favre…He needs to find a better quality of people to hang around with.”
Also different was the depth of Favre’s addiction. It had gotten so bad that he had suffered a dangerous seizure earlier in the year.
Favre entered treatment partially under compulsion. If he had not agreed to go to rehab, he would have been subject to a $900,000 fine from the NFL.
But once in treatment, Favre stubbornly refused to admit that he had a problem with alcohol as well as with painkillers. And not only was he abusing alcohol, it had also become the gateway drug that impaired his judgement and made it more likely that he would misuse Vicodin.
As evidenced by Favre’s continued struggles after his first stint in rehab, relapse is all-too-common during recovery. In fact, relapse rates are up to 60% for people who remain in treatment for 90 days or more, and even higher for people who go for a shorter period of time.
Next, associations matter. One of the first lessons learned during early recovery is the need to avoid triggers—those people, places, and things that might lead to relapse. Favre still hung around the “wrong group of guys”.
Also, compulsory attendance works. Favre wasn’t convinced by his accident, his earlier rehab stay, or even his seizure in February, but when facing a HUGE fine of almost a million dollars, he acquiesced.
Finally, addiction is addiction is addiction. While Favre insisted that his problem was pills and not alcohol, he was missing the point. Chronic abuse changes the brain and makes a person vulnerable to cross-addiction to other substances, not just the drug of choice. This is why people in recovery are taught to avoid ALL intoxicants, even legal ones like alcohol, opioid pain medications, and marijuana.
75% of overdoses and 98% of those that are fatal involve multiple substances.
1998: 28 Days and Final Lessons?
“I was back. 1998. Guess who was waiting there when I walked in — that same nurse. This time it was strictly for drinking. I didn’t go back to the pills. I admitted my problem, I was in there 28 days, and it worked.
When I got out, the toughest thing was the first three months, because I had to change my thought process…I realized with each passing day I really didn’t like drinking.”
Favre had to go back to rehab in 1998, this time “strictly” for drinking, and it appears that the third time has been more successful thus far than his earlier attempts.
In his own words, Favre admits that he had to change his thoughts. At the core, his issues weren’t just the alcohol or the pills. Rather, it was a maladaptive way of thinking about and dealing with things. And whether it resulted from a sense of entitlement because he was a rich and famous athlete who felt he could do no wrong, or whether it was due to poor coping skills in response to physical pain and the extreme stress of playing professional sports, it was his way of thinking that had to change in order for Brett Favre to achieve and maintain lasting successful sobriety.
Once his way of thinking about things changed, staying sober became easier.
And that’s the biggest lesson for the rest of us—RECOVERY IS POSSIBLE, even if it takes multiple attempts.
After all, as Coach Vince Lombardi, the legendary coach who led the Green Bay Packers to five NFL Championships said, “It does not matter how many times you get knocked down, but how many times you get up”.
Modafinil (Provigil) may be a sleeping drug, but a growing number of people are misusing the medication with ulterior motives. Drug abuse and addiction are serious public health issues that affect just about every community and family in one way or another. Rates of drug use and addiction in America have been increasing substantially for more than twenty years, and each year these issues cause millions of serious illnesses or injuries.
Prescription drug abuse, in particular, is a major public health problem in America. The majority of people take their prescription medications responsibly, but according to the National Institute on Drug Abuse (NIDA) an estimated 54 million people (more than 20% of all people in the US aged 12 and older) have used such medications for nonmedical reasons at least once in their lifetime
When the words “abuse” and “addiction” are brought up in conversations, many people automatically assume the terms are associated with illegal substances, but the truth is Americans struggle with alcohol, prescription drugs and other legal substances as well.
The unfortunate reality is that many prescription drugs that were developed to treat people with legitimate medical needs have become notorious for their abuse potential. Drug abuse does not always start on the streets and does not only involve criminals. In many cases, prescription drug abuse begins because of people reaching into their own medicine cabinets.
Prescription Stimulant Abuse: A Pervasive Problem
Over-prescribing and inadequate regulation of prescription stimulants have made it easier for people to get their hands on these potentially dangerous medications. In particular, prescription stimulants have a high abuse potential. They are typically indicated to treat disorders that affect alertness, attention and energy – for example attention-deficit hyperactivity disorder (ADHD) or narcolepsy. Data from NIDA show that between the early 90’s and 2010, the rate of prescription stimulants prescribed increased fourfold. Commonly prescribed stimulants include:
Stimulant abuse is not just an adult problem. NIDA data show that nearly 170,000 teenagers between the ages of 12 and 17 report using prescription stimulants without actually having a prescription. Popular slang terms for prescription stimulants include Speed, Uppers, and Vitamin R.
When it comes to stimulant abuse, smoking and injection use generally produce the fastest effects, while swallowing and snorting tend to be slower at increasing blood levels, thus producing less intense onset of effects.
No matter how a stimulant is used, the user risks falling into a pattern of abuse and subsequent addiction. It is possible to die from prescription stimulant abuse due to heart attack, stroke, and seizure of drug-induced psychotic episodes. The signs and symptoms of a potential prescription stimulant overdose include:
Overheating/high body temperature
Agitation and paranoia
What is Modafinil?
One of the lesser-advertised stimulants on the markets is modafinil. The Food and Drug Administration approved modafinil, sold as brand name Provigil, in 1998 as a treatment for narcolepsy. The drug can also be prescribed for people who have a sleep disorder due to shift work or for people with obstructive sleep apnea.
Narcolepsy is a sleep disorder that is characterized by excessive sleepiness, sleep attacks, sleep paralysis, hallucinations and in some cases sudden loss of muscle control. The condition affects about one in every 2,000-3,000 people, although it can go undiagnosed for many years. Meanwhile, obstructive sleep apnea affects an estimated 22 million people in the US.
Modafinil can cause a decrease or increase enzyme activity in the liver that can eliminate the effects of other drugs through metabolism. For some medications, this means a decreased level of efficacy, while for others this can mean an increased level of toxicity. Notably, among the drugs with reduced effectiveness when taking with modafinil include hormonal contraceptives.
Though modafinil was originally approved as a medication for narcolepsy, prescribing trends have shown a shift in how the drug is being used in clinical practices. An investigation published in the Journal of the American Medical Association (JAMA) found that, over time, physicians have also started prescribing modafinil off-label as a treatment for attention deficit/hyperactivity disorder (ADHD) and schizophrenia. Throughout the study period, which lasted from 2002 through 2009, the number of patients receiving modafinil increased nearly ten-fold. Ultimately, the researchers determined that most prescriptions written for modafinil are for off-label indications.
Modafinil: The “Smart Drug”
Many people believe modafinil can enhance cognitive ability, and thus perceived intelligence, in healthy individuals. This has increased the drug’s abuse potential – especially among students.
Anecdotal reports have suggested many students abuse modafinil in an effort to keep up with their peers in academic settings. The rising costs of education and increasing competition for scholarships, in part, fuel these competitive addictions. Factors like these are unlikely to go away, so the scientific and health communities have been taking a deeper dive into finding out how to address these types of addictions.
Beyond competition, other stresses that can cause students to turn to modafinil to help them perform better academically include:
Bad sleeping habits
Full schedules and course loads
Poor eating habits
A case published in the Journal of Pharmacology & Pharmacotherapeutics shows that, though it is rare, people can become physically dependent on modafinil. The patient, a 44-year-old man, reported that he started consuming more modafinil tablets to increase the effects derived from the drug. He did this in order to keep up with his shift work schedule and ultimately developed a dependence. He claimed to experience symptoms of worsening of lethargy, tremors of hands, anxiety and erratic sleep hours when he did not take modafinil in high doses.
In general, reasons for abusing prescription drugs can include:
To get high or otherwise feel good
To lower appetite
Peer pressure to fit in or to be social
To perform better in school or at work
To be legal, since prescription drugs aren’t prohibited there is sometimes a false sense of security in using them versus a stimulant like cocaine
To feed an addiction
Act-Alike, Sound-Alike Modafinil Drugs
Modafinil is one member of a drug family consisting of similar medications used to increase energy levels and improve focus and alertness. This family of drugs is called eugeroics. It is important to know the differences between them and what they are used for:
Modafinil vs. Armodafinil
Modafinil and Armodafinil are closely related drugs that are used to increase energy levels and improve focus and alertness. Armodafinil is actually a more potent version of modafinil introduced to the market several years afterward. It binds differently to receptor sites within the brain and body versus modafinil, and while the standard Modafinil dosage is 200 mg, people only need 150 mg of Armodafinil to get the same effects.
Modafinil vs Adrafinil
Modafinil is significantly more potent than adrafinil. Lower doses of modafinil are needed to achieve the same level of effectiveness. Modafinil also acts more rapidly than adrafinil, which must be processed by the liver before it takes effect. While the World Anti-Doping Association has banned both adrafinil and modafinil as performance enhancing drugs, right now adrafinil is unregulated and is available without prescription in the majority of countries.
Provigil vs Adderall
Adderall is FDA-approved to treat ADHD, while Provigil is prescribed for ADHD in an off-label capacity. Adderall is also available in both immediate-release (IR) and extended-release (XR) formulations, and is generally cheaper than Provigil. Most notably, Adderall is a Schedule II drug, which means it has a high potential for abuse that can lead to psychological or physiological dependence, while Provigil is a Schedule IV drug, which indicates a low potential for abuse or dependence.
The Effects of Modafinil Abuse
Despite the reputation as a “safe” stimulant, there have been no long-term studies on the safety profile for modafinil. Dr. Nora D. Volkow, Director of NIDA, authored a piece published in JAMA that says modafinil has the same effect on the dopamine centers of the brain as cocaine, methamphetamines and amphetamines. This, she suggests, means that modafinil is as addictive as those substances because it forcibly triggers the brain to release the particular neurotransmitter (dopamine) that is typically associated with feelings of euphoria and pleasure. Under normal circumstances, the brain reabsorbs dopamine after some time, but powerful medications can force the brain to continually pump out dopamine. Increased levels of dopamine can have several effects on the mind and body.
Modafinil has effects that are similar to medications like Ritalin or drugs like cocaine in that it increases dopamine levels, however it does not have nearly the same strength as either of these other stimulants. The potential side effects of modafinil include:
Nausea or vomiting
Running or stuffy nose
Several investigations have compared modafinil and cocaine through several different lenses. A study published in the European Journal of Neuroscience found that modafinil enhances the effects of cocaine when the two drugs are taken together, while another study published in the journal Psychopharmacology found that modafinil has the potential to be a good treatment for cognitive function improvement in people who have had substance use disorder.
Studies have also linked modafinil dependence and hyperactive sexuality. Research published in the journal Clinical Psychopharmacology and Neuroscience showed increased and prolonged use of modafinil at higher-than prescribed doses can lead to hyperactive sexuality disorder due to increased concentration of dopamine.
According to the American Psychiatric Association, symptoms of sex addiction involve recurrent and intense sexual fantasies, urges and behaviors over a period of more than six months associated with the following criteria:
Excessive time spent on fantasies and urges, including planning for and engaging in the behavior
Repeatedly engaging in these fantasies and urges as a response to certain mood states – namely anxiety, depression boredom, irritability or stressful life events
Failure to control or significantly reduce the recurrence of sexual fantasies and urges despite an expressed desire to do so
Repeated engagement in sexual behavior without regard for the risk for physical or emotional harm to self or others
Clinically significant personal distress or impairment in social, work or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges, and behaviors
Recognizing Modafinil Misuse and Abuse
It is important to be able to recognize the signs and symptoms of prescription drugs like modafinil. These can include:
Stealing, forging or selling prescriptions
Taking medications in higher doses than prescribed
Dramatic mood swings
A notable increase or decrease in the amount of sleep one gets
Bad decision making
Behaviors that indicate being high, such as being unusually energetic or sedated
“Losing” prescriptions on a consistent basis to make the argument to have them refilled more quickly
“Doctor shopping,” which is a term used to describe when a person goes to more than one doctor to try and get multiple prescriptions
Addiction is not just a physical problem – it is also a mental one. Addiction is not a choice, and addressing this disorder requires a careful and compassionate approach. In the best-case scenario, you can help someone recognize addiction in themselves so that they seek treatment willingly. In other cases, loved ones may have to push an addict to seek rehab for their condition.
Have a Problem with Modafinil? Here is What You Need to Do
The allure of modafinil for some people can be very high, as it does not have the same stigma as some of the other more notorious stimulants on the market. Nevertheless, the drug can be dangerous and addictive, and if you or someone you love is facing modafinil addiction it is important to get help right now.
Addiction and recovery from prescription drug abuse is not a journey anyone should have to go through alone. Admission coordinators and compassionate staff can answer any questions you have over the phone or during a scheduled consultation. You can find out more about how continued use of the drug can negatively affect your life and what the next steps should be in getting your life back on track and free from effects of modafinil abuse.
Thankfully, the symptoms of withdrawal from modafinil are not major. People detoxing from modafinil can expect to experience the following symptoms:
Issues with concentration. People report having “poor focus” once they stop using modafinil. In the vast majority of cases, these focus issues are just a result of having experience enhanced cognition for a long time and not remembering what normal functioning feels like. This cognitive slowing is usually temporary.
Feelings of depression. Although not common, some people feel an antidepressant effect while taking this drug – so naturally, stopping the medication can bring on depressive symptoms.
Fatigue and Sleepiness. Modafinil is primarily used as an anti-fatigue agent, so stopping use of this drug can cause excessive tiredness during the withdrawal phase. Those who take the drug for narcolepsy will likely experience sleepiness after discontinuation.
Low levels of energy. Modafinil generally provides energy boosts for people, so not taking the drug can result in low levels of energy for the first few weeks after discontinuation.
Shortness of breath. Some people who discontinue modafinil report shortness of breath as a symptom.
There are several factors that can influence the intensity and duration of withdrawal from modafinil (Provigil), including:
Time span. Withdrawing from modafinil will largely depend on how long the person has been taking the drug. Withdrawal symptoms will be stronger for people who have been taking or abusing the medication for years versus people who have only been abusing the medication or a few months.
Dosage. Modafinil reportedly does not have additional therapeutic benefits beyond a dose of 200 mg per day, although some people take up to 400 mg each day. The higher the dosage, the more likely you are to experience withdrawal effects.
Method of discontinuation. Going cold turkey (sudden discontinuation) from a medication produces different effects than tapering. If the medication has served as your wakefulness agent for an extended period, you have definitely become accustomed to the drug. If you have been taking the drug for several years, you will likely experience withdrawal symptoms if you go cold turkey. Tapering is typically recommended to help avoid suffering from withdrawal symptoms. A medical professional should ideally advise on how to reduce the dose over time.
Therapy and Counseling for Modafinil Abuse Recovery
Once the immediate physical effects of detoxification are handled, it is time to get to work building a sustainable recovery. Addiction is a chronic disease that can be treated with the right combination of behavioral treatments and, if needed, medications to help manage symptoms associated with the detoxification process. Prescription drug counseling helps to address the underlying issues that may have caused you or your loved one to turn to drug abuse in the first place.
Some people may be surprised to learn that addictions may have not have anything to do with physical dependence. Incorporating counseling into a recovery plan can have many benefits. Different therapy types you can expect to be included in your recovery form modafinil abuse and addiction include:
Couples and family therapy
Cognitive behavioral therapy
Many people falsely believe that going through treatment once is enough to fully kick an addiction. This is a dangerous misconception. Drug rehab is an amazing first step, but it should not be considered the final step. Addiction cannot be fully cured, and recovery is a lifelong process.
Abuse and misuse of prescription medications, including modafinil, is becoming of the fastest growing health epidemics in the US due to the high potential for abuse and lethality. Getting treatment for yourself or a loved one is no easy task, but it could become one of the best decisions you will ever make in your lifetime.
The United States is deeply entrenched in a substance abuse epidemic, and Nampa, Idaho is no exception. Alcoholism, illicit drug addiction and opioid abuse are affecting everybody from all states, all communities and all families. An area of the state called Treasure Valley, encompassing Nampa, Boise, Caldwell and Meridian, is the epicenter for drug activity. More than 33% of the state’s total population lives in Treasure Valley, so it is logical that much of the drug abuse, addiction and drug-related crimes occur here.
The American Psychiatric Association describes addiction as a mental disease characterized by compulsive substance use despite known consequences. People with addiction issues are intensely focused on using their substance of choice to the point where use is all-consuming. Pursuit of the substance guides almost every life choice, and people with addiction typically have distorted judgement, decision-making skills, memory, learning, and behavior control skills.
Idaho is a large state with a smaller population than most other states, which might make you think that it is immune to the drug crisis taking over the urban areas of the rest of the country. The truth, however, is that the drug crisis is just as bad. Unfortunately, despite the prevalence of substance abuse the state receives less federal funding to help combat the epidemic when compared with larger, more populous states.
Substance abuse and addiction can ruin lives, but luckily, there are assistance options for people who are suffering from effects of alcoholism and drug abuse and addiction in the Nampa-area of Idaho. The most important thing to keep in mind is that, regardless of whether you are an addict or if your loved one is an addict, you are not alone. Here are some surprising addiction and substance abuse treatment statistics you may not have been aware of for Idahoans:
Surprising Statistics: Opioid Abuse
Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids like fentanyl, and legal prescriptions like oxycodone, hydrocodone, codeine, morphine and others. Opioids bind with receptors on nerve cells throughout the body and brain, and they can create feelings of euphoria in addition to pain relief. This increases addiction potential, which can lead to dependence and ultimately death.
Data collected by the National Institute on Drug Abuse (NIDA) in 2015 revealed that prescribers in Idaho wrote 76.4 opioid prescriptions per 100 persons, or about 1.3 million prescriptions. In the same year, the average rate of opioid prescriptions written across the US was 70 opioid per 100 persons
Meanwhile, NIDA data also reveal that there were 119 opioid-related overdose deaths in Idaho during 2016. This is a rate of 7.4 deaths per 100,000 persons, which is lower than the national rate of 13.3 death per 100,000 persons. Between 2012 and 2016, the death rates attributed to specific categories of opioids were as follows:
Number of prescription opioid deaths per year increased from 45 to 77 deaths
Number of synthetic opioids (mainly fentanyl) deaths per year increased from 11 to 20 deaths
Number of deaths attributed to heroin rose from 11 to 25 deaths
Nine percent of teenagers in the Nampa area say they use at least one illegal drug every month
According to the National Survey on Drug Use and Health from 2013-2014, 3.9% of people in Idaho older than 12 years old reported nonmedical use of prescription pain relievers. Broken down further, among Idaho high school students, prescription medications, including opioids, are the second-most abused illicit drugs behind marijuana. Between 2008 and 2016, the drug and narcotic violation arrest rate for heroin increased more than 15-fold from 0.03 arrests per 1,000 population to 0.46 arrests per 1,000 population.
Surprising Statistics: Alcohol Abuse
Nationally, alcohol abuse is extremely common due to the social nature of drinking. According to data collected by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) the number of adults who say they have had a drink falls around 86.5%. Of this number, 71% say they have had some amount of alcohol within the last year, while nearly 57% report consuming it during the past 30 days.
Consumption of alcohol can be very dangerous. NIAAA data show that 33% of all visits to the emergency room are related to drinking. For many people, alcohol is considered to be an important element of social activity and celebration. Therefore, it only makes sense that alcohol use disorder (AUD) is extremely common. NIAAA data show that nearly 7% of American adults, or more than 16.3 million people, were classified as having an AUD in 2014. Going further, NIAAA reports that 2.7% of all people between the ages of 12 and 17, or nearly 680,000 people, had an AUD during the same year.
Around 15% of adults in the Nampa area say they have dealt with alcoholism during their lifetime, while 16% of teenagers admit to using alcohol illegally within the last month.
When it comes to Idaho, the Centers for Disease Control and Prevention offers specific data on alcohol abuse as it related to motor vehicle accidents. The National Highway Traffic Safety Administration defines a fatal crash as alcohol-related or alcohol-involved if either a driver or a non-motorist, which is typically either a pedestrian or bicyclist, had a measurable or estimated blood alcohol concentration of 0.01 grams per deciliter or above. Between 2003 and 2012:
712 people were killed in car accidents that involves a drunk driver
The death rate per 100,000 people in Idaho attributable to alcohol is 5.8 for males. No Idaho data are available for females
1.2% of people in Idaho self-report driving after drinking too much
In Canyon County, where Nampa is located, the percentage of driving deaths that involved alcohol was 31% in 2016, which is a steep increase when compared with other counties in Idaho. The rate of driving under the influence (DUI) charges in Nampa and other Canyon County locales was 5.5 per 1,000 persons in 2013.
According to a survey from Department of Health and Human Services, the rate of alcohol abuse among teenagers in Idaho is consistent with the national level data. About 16% of high school students reported having five or more drinks in a row within a couple of hours on at least one day within the previous month, compared with 18% across the US.
Surprising Statistics: Addiction Treatment
Getting addiction help in Nampa may seem like a daunting task, but luckily, there are several options to help you get back on track. In 2012, drug treatment admissions for non-heroin opiates increased to 12% in Idaho. Drug treatment admissions for stimulants including methamphetamine were 39%.
Data from the Department of Health and Human Services’ “Treatment Episode Data Set” (TEDS) from 2004-2014 reveal that in 2014, out of all publicly funded treatment admissions in Idaho that were not funded by Medicaid, 35% of people reported methamphetamine was their primary substance of abuse upon treatment entry. This data is consistent with Nampa-level numbers – The Drug Enforcement Administration (DEA) reports methamphetamine is the biggest drug-related threat to Nampa.
Additionally TEDS data show that the number of people entering treatment for primarily heroin abuse in Idaho has jumped ahead of the number of people entering treatment for prescription drug abuse.
Idaho Counties Take Action
Statistics like these help to expose patterns of drug availability, use, and overdoses trending upward in Idaho. This means that timely and effective education, prevention, intervention, and treatment programs are more important than ever. In April 2018, several counties in Idaho, including Canyon county, signed on with law firms to investigate and pursue legal claims against pharmaceutical manufacturers amid the worsening opioid crisis.
“I first really started paying attention to this early in 2017, and at first I thought this is not an issue for Blaine County because I had not been hearing we had a serious opioid issue that rose to crisis,” said County Commissioner Larry Schoen, who introduced the resolution to join the lawsuit, in an interview with the Idaho Statesman “At a certain point, I began asking various people like the sheriff, the coroner, folks from the hospital, the public health district … ‘Do we have a problem with opioids?’ ”
County commissioners are hoping to get some compensation for the indirect costs of opioid use, similar to the Millennium Fund, which came from the tobacco settlements years ago that continue to generate funds for Idaho and other states.
Treatment Options in Nampa, Idaho
The population of Canyon county, where Nampa is located, is young (30% younger than 18 years of age), diverse (20.5% Hispanic versus 6% in neighboring Ada county), and poor (13.2% live below the poverty line). All of these factors need to be considered when choosing treatment options, but luckily in Nampa there are facilities and programs appropriate for everyone’s needs.
Physically ridding the body of harmful substances is just to first step in making a full recovery from addiction. Addiction is a chronic disease, and many patients require long-term or repeated care to completely stop using and have a sustainable recovery. Overall, addiction treatment must help the person stop abusing substances, stay substance-free and be a productive in their family, job, and society. Treatment modalities can vary based on the individual.
Ashwood Recovery is here to help you and your loved ones overcome addiction, alcoholism and other disorders in a comfortable, compassionate environment. Our counseling program has helped many in our community get their lives back. With locations in Boise, Bellevue and now Nampa, Ashwood Recovery can offer comprehensive services for even more Idahoans. Services offered by Ashwood including:
True or False: Are opioids more effective in treating pain than over-the-counter (OTC) pain medications? Luckily, the answer here is a solid “false.” If you are suffering from chronic or acute pain, OTC pain medications Tylenol and Advil may be just as effective as a prescription painkiller for helping to relieve your pain.
Opioids Are the Number #1 Solution for Pain – But Evidence Does Not Support It
Currently, prescription opioid medications are the number one solution for chronic pain in America. When people go to the doctor complaining of aches and pains, doctors are quick to throw opioid drugs at the problem– often without a detailed description of the risks and dangerous of using the drugs even at their prescribed doses. This explains how such widespread problems have gripped the nation as it relates to opioid addiction.
Despite high prescribing rates, evidence suggests that opioids are not always the only option. A recent study, published in the Journal of the American Medical Association (JAMA), investigated the effectiveness of opioids versus non-opioid medications in treating pain among patients with chronic back pain or hip or knee osteoarthritis pain. Opioids tested included generic Vicodin, oxycodone or fentanyl patches, while nonopioids included generic Tylenol, ibuprofen and prescription pills for nerve or muscle pain. The researchers found that, over the 12-month study period, opioids did not deliver superior results for improving pain-related function. The findings, they concluded, do not support the practice of starting opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain.
Another study published in JAMA similarly found that prescription opioids do not necessarily offer better results when compared with OTC medications, and in particular for acute pain. For adult patients in the emergency department with acute extremity pain, there were no clinically important differences in pain reduction after two hours with ibuprofen and acetaminophen or three different opioid and acetaminophen combination analgesics.
In an accompanying editorial, Demetrios N. Kyriacou, MD, PhD, from Northwestern University Feinberg School of Medicine in Chicago, Illinois, said the investigation offers “important evidence” supporting the use of nonopioid painkillers for selected patients in the emergency room setting.
“The demonstrated effectiveness of the ibuprofen and acetaminophen combination for moderate to severe pain may also translate to outpatient management and other clinical settings of patients with acute pain,” he wrote. “However, this will require future investigations.”
OTC pain relievers are commonly used for treating arthritis pain, headaches, back pain, sore muscles and joint pain. Aspirin, ibuprofen (Advil, Motrin IB), and naproxen sodium (Aleve) are nonsteroidal anti-inflammatory drugs (NSAIDs). These medications are extremely effective because they reduce swelling and relieve pain.
Opioid Misuse and Abuse Kills People Everyday
Determining the necessity of opioids is a critical need given how many people suffer from addiction to these medications. Data from the National Institute on Drug Abuse (NIDA) estimate that between 26.4 million and 36 million people abuse prescription opioids around the world—with more than two million people in the US struggling with addictions stemming from prescription painkillers. Beyond that two million, 467,000 others are thought to be addicted to heroin in America.
It is alarmingly easy to get a hold of prescription drugs, which is a major reason why the epidemic is occurring in the first place. Over-prescribing doctors and inadequate regulations are making it easier and easier for anyone to get their hands on prescription medications and increase the likelihood of abuse. In 2010, more than 210 million prescriptions for opioids were dispensed in America. In that same year the Centers for Disease Control and Prevention (CDC) found that 5% of people in the US age 12 or older used prescription painkillers for reasons other than medical problems. Around 40% of all opioid-related deaths involve a prescription opioid, and these medications are responsible for about 46 deaths each day.
The most common drugs involved in prescription opioid overdose deaths include:
Oxycodone (such as OxyContin®)
Hydrocodone (such as Vicodin®)
Opioid abuse can be devastating for individuals, families and communities. Some of the more common effects that accompany opiate abuse include:
Job loss and unemployment
Chronic Pain in the US: A Pervasive Problem
Chronic pain is one of the most commonly reported health issues in the US. Data from the 2012 National Health Interview Survey show that most American adults have experienced some degree of pain – either acute or chronic – at some point in their lifetime. Drilling down further, about 25.3 million US adults, or 11.2% of the total adult population, reported experiencing pain each day for the preceding three months. Almost 40 million adults, or 17.6% of the entire adult population, say they have experienced extreme pain. People with severe pain are more likely than others to have worse health status overall.
With pain being such a common complaint, it is not surprising that doctors are over prescribing prescription opioids to help people feel relief and live normal lives. Unfortunately, even legitimate prescribing practices can ultimately lead to dependence. With that in mind, the CDC has ramped up efforts to help curb overprescribing.
“We’re trying to chart a safer and more effective course for dealing with chronic pain,” said Dr. Tom Frieden, former director of the Centers for Disease Control said in an interview with the Associated Press. “The risks of addiction and death are very well documented for these medications.”
The goals of having prescribing guidelines include:
Determining when to initiate or continue opioids for chronic pain outside of end-of-life care
Opioid selection, dosage, duration, follow-up, and discontinuation
Assessing risk and addressing harms of opioid use.
“Evidence on long-term opioid therapy for chronic pain outside of end-of-life care remains limited, with insufficient evidence to determine long-term benefits versus no opioid therapy, though evidence suggests risk for serious harms that appears to be dose-dependent.”
The recommendation calls for non-opioid therapy and non-pharmacological therapy to be first-line treatment options for chronic pain. Instead of selecting opioids by default, providers should only consider prescribing them if the anticipated benefits for both pain and function are expected to outweigh risks.
Signs and Symptoms of Opioid Addiction
Whether an opioid prescription is appropriate or not, it is important to keep an eye out for possible signs and symptoms of opioid abuse so that people get the help they need as soon as they need it. Those who are addicted to opioids often exhibit certain physical signs that you should recognize. These physical symptoms can include:
Unexplained exhaustion or drowsiness
Slow or otherwise labored breathing
Nodding off at random times or even complete loss of consciousness
Over-the-top elation or euphoria
Nausea and vomiting
Insomnia and inability to sleep normal hours
Other than these physical symptoms, there are a few behavioral patterns to watch out for that could indicate opioid addiction. These include:
Visiting several different health providers in order to obtain prescriptions – sometimes referred to as “doctor shopping”
Unpredictable and dramatic mood swings
Discovering empty pill bottles in weird locations or even just having more pill bottles than usual
Unexplained and sudden financial issues
Social withdrawal or general isolation
An increasing inability to do well in school
Inability or unwillingness to keep up with family or social responsibilities
Unfortunately, the long-term effects of opioid abuse can be very harmful for people and cause permanent damage. Some of the long-term health risks associated with opioid misuse and abuse include:
A compromised and weakened immune system, which can leave the body vulnerable to certain dangerous illnesses and diseases
Gastrointestinal and digestive issues, including constipation, bleeding ulcers or bowel perforation
Health issues that relate to intravenous administration, including embolism events or contraction of blood borne illnesses (like HIV or hepatitis C). This occurs when opioids are injected with needles
Dangerous respiratory issues
Kidney and liver damage
Higher propensity for seizures
Damage to memory function
Mental Health and Opioid Misuse and Abuse
One of the common underlying causes for addiction is the presence of a co-occurring mental health issue. This is also referred to as a “dual-diagnosis.” According to the Substance Abuse Mental Health Services Administration (SAMSHA), the National Survey on Drug Use and Health reported that more than 7.9 million people in the US had a co-occurring disorder in 2014 – the most recent year for which this data is available.
Bipolar, anxiety disorders, depression, PTSD, eating disorders, and schizophrenia are among the most common mental health issues implicated in a dual-diagnosis. These disorders can affect individuals in various ways, but the common denominator between these conditions and substance abuse and addiction is self-medication. People who have mental health disorders often self-medicate with drugs or alcohol to find relief from their symptoms.
In most cases, a mental disorder is present before the substance abuse begins – although it is common for people to start using drugs or alcohol before they are officially given a diagnosis. While drugs or alcohol may provide temporarily relief for those who suffer from mental health issues, substance abuse actually prolongs symptoms and makes them worse. It can be difficult for a healthcare provider to determine which symptoms are caused by the addiction and which ones are brought on by the mental health disorder. In addition, someone with a dual-diagnosis will have to battle their addiction and overcome the complications of their illness.
Treatment for Opioid Misuse and Abuse
According to the American Society of Addiction Medicine, “Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”
Addiction and recovery from prescription opioid abuse is not a journey anyone should have to go through alone. Although physical addiction plays a role in opioid misuse and abuse, there are typically underlying psychological reasons why addiction became a problem. Counseling for prescription drug abuse can help people work through their substance abuse problems and maintain a healthy, sober lifestyle for life.
Intensive outpatient programs (IOP) are also a viable option for people working through addiction. Through IOP, you will be assigned a case manager tasked with creating an individualized treatment plan that caters to your individual needs. There is no “one size fits all” method for treating addiction – each person has their own unique story and addiction experts recognize that. Your case manager will conduct an intake assessment to get to know you better so they can devise a plan to support you in your efforts to conquer addiction.
Beyond counseling services, medication-assisted detoxification can help to promote a safe and sustainable recovery for prescription opioid addiction. Vivitrol, a drug targets the part of the brain that cravings stem from, can help someone work through the withdrawal process. Unlike some other treatment medications, the drug itself is non-addictive. Subutex is another opioid-replacement therapy shown to be effective in treating addiction, although it does have addictive potential.
Abuse and misuse of prescription medications, including modafinil, is becoming of the fastest growing health epidemics in the US due to the high potential for abuse and lethality. Getting treatment for yourself or a loved one is, by no stretch of the imagination, an easy task. Nevertheless, it could become one of the best decisions you will ever make for yourself or your loved one.
The wildly popular show Roseanne is one of the most iconic sitcoms in TV history. There is no question that America was clamoring for a reboot for years. According to The Nielsen Company, about 18.2 million viewers watched the show’s premiere – which is a 10% jump from the number of people who tuned in for the 1997 finale.
The behavior of one cast member, however, could have derailed the reboot effort before it even got off the ground.
John Goodman, who plays family patriarch Dan Connor, has been speaking candidly about his struggle with alcohol abuse during the show’s original run (1988-1997). He admits that his alcohol addiction got so bad at one point that he would even drink while on the job.
“I got so lucky, because I was still getting hired for things, but the fact is, I was drinking at work,” Goodman said onSunday Today With Willie Geist. “My speech would be slurred. I thought I was fooling people. My cheeks would turn bright red when I was liquored up. I just looked like a stop sign.”
Costar Roseanne Barr recently joined Goodman on Howard Stern’s SiriusXM, where both recounted an instance where she confronted him about his drinking problem on set during production of one of the show’s earlier seasons.
“She was scared for me, but she was more confrontational,” Goodman said. “She’d already had a husband go through the process.”
During the same interview, Goodman said his drink of choice was “anything that was wet and of a certain proof.” He added, “The last four years [of the show] were pretty bad, and I was drinking at work and [Barr] was scared for me. I was ashamed of myself, but I couldn’t stop.”
Alcohol Abuse by the Numbers
It is important to know that alcoholism is an addiction that ultimately leads to disease. The American Psychiatric Association describes addiction as a mental disease characterized by compulsive substance use despite known consequences. People with addiction issues are intensely focused on using their substance of choice to the point where the use consumes their lives. Pursuit of the substance guides almost every life choice, and people with addiction typically have distorted thinking and experience changes in the brain that disrupt their judgement, decision making, memory, learning, and behavior control skills.
Alcohol abuse in the US is extremely pervasive due to the social nature of drinking. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) the number of adults who self-report either past or present alcohol consumption is about 86.5%. Of this number, 71% report consuming some amount of alcohol within the last year while nearly 57% report consuming it during the past 30 days.
With those statistics it should come as no surprise that 33% of all visits to the emergency room are related to alcohol consumption. There is a common misconception that alcohol isn’t a dangerous substance because it’s legal, and since drinking alcohol is a very common element of social activity and celebration, it makes sense that alcohol use disorder (AUD) is extremely common. NIAAA data show that nearly 7% of American adults, or more than 16.3 million people, were classified as having an AUD in 2014. Going further, NIAAA reports that 2.7% of all people between the ages of 12 and 17, or nearly 680,000 people, had an AUD during the same year.
The following are telltale signs and symptoms of alcoholism:
Mood swings, changes in motivation levels or overall attitude even when sober
Drinking first thing in the morning before doing anything else
Having conversations about alcohol cravings
Drinking in secret and hiding empty bottles from people
Reckless behavior, such as drinking and driving, fighting, having unprotected sex or putting themselves or others into risky situations
Lack of impulse control
Inability to quit despite an expressed desire to do so
Repeated episodes of excessive drinking can cause long-term negative health consequences, including:
A physical dependence could form if binge drinking occurs frequently. Higher tolerance and physical dependence can occur without necessarily having an addiction, but a psychological dependence on alcohol is likely to develop. Going to be rehabilitation facility is often the best way to treat alcoholism.
Brain health issues
Unfortunately, some people who engage in binge drinking behaviors for a prolonged period can suffer from brain damage due to structural damage. The parts of the brain responsible for learning and decision-making are especially vulnerable to this type of damage. Ultimately, this damage can work against AUD recovery in the future.
Liver health issues
Most people know that drinking too much can affect healthy function of the liver, and binge drinking is no exception.
Having a high blood alcohol content can put undue stress on the heart. If excessive drinking persists, people may face an increased risk for heart attack and/or stroke.
Ongoing excessive drinking can reportedly cause erectile dysfunction in men. A higher likelihood for risky sexual behavior and lowered inhibitions characteristic of alcohol use can also contribute to higher instances of sexually transmitted diseases.
Entertainment: An Enabling Industry?
John Goodman is most certainly not the only person in entertainment to develop an alcohol issue. The nature of the entertainment industry is bustling, busy and social – which all contribute to an enabling culture. It’s not out of the ordinary for actors and actresses to have a few drinks during an awards ceremony, or for a DJ to drink a bit during a long night working in a club atmosphere. In many other cases, entertainers may just want to enjoy a nightcap after a long and potentially stressful day.
There is no scientific evidence linking substance abuse to a career in the entertainment industry, but some research does suggest certain career paths may affect recreational drinking habits. A 2007 report from the Substance Abuse and Mental Health Services Administration (SAMSHA) on worker substance use and workplace policies and programs found that about 9.4 million full-time workers ages 18 to 64, or 8.2% of the working population, reported illicit drug use in the previous month. Among these workers, about 3 million met criteria for illicit drug dependence of abuse, while 10.6 million were dependent on or abused alcohol.
The report further broke down which industries had the most addiction-prone careers. Arts, design, entertainment, sports and media was ranked third on the top 10 list with about 12.4% of workers struggling with addiction falling into one of these career buckets. The full list of top 10 most addiction prone-careers includes the following:
Food preparation and serving (17.4%)
Arts, design, entertainment, sports, and media (12.4%)
“I got complacent and ungrateful. And after nine years—eight years, I wanted to leave the show,” he explained. “I handled it like I did everything else, by sittin’ on a bar stool. And that made it worse.”
Now sober for ten years, Goodman was lucky enough to not join the ranks of celebrities and entertainers who ultimately succumbed to substance abuse and addiction. This list includes:
Michael Jackson (Age: 50). Cause of death: Acute propofol and benzodiazepine intoxication
Whitney Houston (Age: 48). Cause of death: Cocaine, heart disease, drowning
Heath Ledger (Age: 28). Cause of death: Acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine
Philip Seymour Hoffman (Age: 46). Cause of death: Acute intoxication by heroin, cocaine, amphetamines and benzodiazepines
Amy Winehouse (Age: 27). Cause of death: Alcohol poisoning
Anna Nicole Smith (Age: 39). Cause of death: Acute combined drug intoxication from Methadone, chloral hydrate and three different drugs used to treat depression and anxiety
Chris Farley (Age: 33). Cause of death: Cocaine and morphine overdose
River Phoenix (Age: 23). Cause of death: Cocaine and heroin overdose
John Belushi (Age: 33). Cause of death: Cocaine and heroin overdose
Janis Joplin (Age: 27). Cause of death: Heroin overdose
Jimi Hendrix (Age: 27). Cause of death: Barbiturate intoxication
Cory Monteith (Age: 31). Cause of death: Mixed drug toxicity, including heroin and alcohol
Scott Weiland (Age: 48). Cause of death: A toxic mix of drugs including cocaine, ethanol and the amphetamine MDA
Elvis Presley (Age: 42). Cause of death: Officially attributed to cardiac arrhythmia, however toxicology results showed 14 drugs in his system, including codeine, methaqualone, morphine, meperidine, ethchlorvynol, diazepam and barbiturates
Recovery from Alcohol Addiction
Despite how common addiction is in the entertainment industry, many entertainers avoid seeking treatment out of fear that it may affect their employment status and ability to get jobs in the future. Thankfully, in the majority of cases, people cannot be fired for admitting they have a problem. Going to rehab and keeping a job do not have to be mutually exclusive.
According to SAMSHA, “the Americans With Disabilities Act (ADA) is perhaps the most important federal civil rights legislation that affects employers when developing and implementing drug-free workplace policies. It prohibits all U.S. employers with more than 15 employees from discriminating against qualified job applicants and employees because of a physical disability.”
Furthermore, “The ADA does not, in any way, prohibit employers from having a drug-free workplace policy, nor does it provide any special protection to individuals who are currently using illegal drugs. However, it does make it illegal for employers to discriminate against recovering alcoholics and drug users who have already sought treatment for their addiction.”
Goodman ultimately received treatment at a specialized facility after reaching to his wife for help. The decision was an extremely wise one, as severe withdrawal symptoms are a major reason why so many people relapse. Additionally, detoxification from alcohol can potentially be deadly. Withdrawal symptoms can include:
Insomnia and/or fatigue
Shakiness, which usually happens in the hands
Sudden changes in blood pressure and heart rate
Unfortunately, many others don’t receive the help they need. In 2015, less than 10% of adults who needed treatment at a specialized facility for their AUD actually received that treatment. Meanwhile, only 55,000 adolescents classified as having an AUD received treatment for their issues at a specialized facility.
Detox is not a treatment, but rather the first step in addressing an addiction issue. Seeking help at an independent, comprehensive outpatient treatment center is the best way to get the tools needed to fight addiction and get back on the right track for a healthy, fruitful life. Look for a facility that offers the right combination of multi-faceted treatment strategies like songwriting, art therapy, equine therapy, adventure therapy and music therapy as well as one-on-one therapy session and cognitive behavioral therapy strategies.
Heroin withdrawal can be a scary process. Maybe you’ve heard stories from opiate addicts that have gone through it. People who detox from opioids often experience intense nausea, stomach cramping, severe anxiety and insomnia among other symptoms. It’s no wonder, then, that the prospect of withdrawing can be quite intimidating.
Once someone is able to overcome the symptoms of heroin withdrawal, however, they’ve jumped one of the biggest hurdles in the recovery process. Making it through detox without relapsing means that the individual has taken one of the biggest steps toward getting clean.
If you’re struggling with heroin addiction and thinking about withdrawal, this article will outline some important information for you.
First Things First—What is Heroin Withdrawal?
Heroin is an opioid. It produces a chemical in the body that sticks to our “opioid receptors”. These are small points in our brain that enable us to feel happy. That is why the drug causes users to feel euphoric for a certain amount of time after they’ve taken it. When someone uses opiates repeatedly, their brain becomes accustomed to the chemical and starts to depend on it.
Heroin also causes the user’s central nervous system to slow down. When opioids stick to the brain’s receptors, the brain sends a signal to the heart, circulatory system, lungs and other parts of the body, telling them that they don’t need to work so hard. This is one reason why someone who uses opiates feels relaxed with the drug in their system. An addict’s body will become accustomed to a slowed-down nervous system, as well, if they use the drug for a long enough period of time.
All of the symptoms felt during withdrawal—the anxiety, the nausea, the rapid heart rate, etc—are a result of the body trying cope with the absence of heroin. The brain may go haywire as it attempts to recalibrate itself without opioids. The user’s body might hurt as their nervous system starts to operate at the correct speed. The nausea and vomiting that we associate with heroin withdrawal occur as the body attempts to flush the remaining chemicals out.
Can You Die From Heroin Detox?
Heroin withdrawals themselves will not kill you. Unlike detoxing from benzos or alcohol, quitting opiates rarely results in death. If done properly and with supervision, the detox process can go safely and smoothly.
The deaths that do occur for a few reasons that aren’t related to heroin withdrawals themselves. If an individual relapses before (or shortly after) completing detox, they can face fatal consequences. Once an addict flushes enough of the drug out of their system, their tolerance will decrease and they won’t be able to use the quantity of the drug that they may be accustomed to.
Other people die during heroin withdrawal due to self-harm. Because the process can be painful and disorienting, some addicts develop the need to hurt themselves during detox.
It is for both of these reasons that detoxing from heroin in a rehab facility or addiction treatment center is highly recommended. Not only will the staff provide support and help to prevent a relapse, but medical professionals will be on site to make sure you’re safe. They will also work to make sure you stay hydrated which, as you’ll learn in this article, is one of the keys to making opioid withdrawal as easy as possible.
Common Symptoms and Signs
The symptoms of heroin withdrawal are different for everyone. The severity of side effects will depend on how long they’ve been addicted, how often they’ve used the drug and how much of it they’ve consumed.
Symptoms come in two forms: physical and psychological. Physical side effects will usually only occur during the heroin withdrawal process itself. Once the addict has finished flushing the drug out of their system, it is unlikely that they will continue to experience these effects.
Some common physical withdrawal symptoms include:
Vomiting and diarrhea
Chills and goosebumps
Muscle and joint pain
Hypertension (This may be a long-lasting side effect if caused by the heroin use itself. Those who are prone to heart problems and take opiates are always at risk of developing hypertension).
As it was pointed out above, each of these side effects is a sign that the body is expelling opioids from its system. While they may not be pleasant, the physical symptoms of heroin withdrawal signal that the user is getting the drug out of their body and therefore making huge strides toward a healthy recovery.
Some of the psychological side effects of heroin withdrawal include:
Agitation and restlessness
Lack of focus
Inability to feel pleasure
The psychological aspects of heroin withdrawal can last much longer than physical symptoms. This is due, in part, to the fact that heroin use itself causes psychological side effects. While the addict will probably feel cravings during detox, for example, it is likely that they will experience cravings from time to time even after they’re clean.
Similarly, the anxiety and depression that result from heroin withdrawal can be side effects of the addiction itself. While these symptoms may diminish as the user works through recovery, it is normal for addicts to cope with these emotions for years after they become sober.
How Long Does Heroin Detox Take?
The withdrawal timeline will vary depending on the addict. Mental and physical health, as well as the addict’s age, will have an effect on the length of the detox process. Generally, however, withdrawing from opiates doesn’t take much longer than a week.
A typical timeline looks like this:
Days 1-2: The addict can start to experience withdrawal symptoms within twelve hours of their last dose. Those who use the drug chronically may start to feel side effects in as few as six hours. At first, the addict will feel irritated and anxious. They will probably consider relapsing to ease their anxiety. Additionally, they will start to experience nausea, diarrhea and other feverish symptoms. It will be uncomfortable, but those who are able to make it through this time period without relapsing will be in a much better position to handle the rest of the detox process.
Days 3-5: The severity of physical symptoms will peak and then decrease. The addict might still feel nauseous and cramps, but it is likely that they won’t feel as much pain as they did earlier in their withdrawals. It is likely that the user will still experience cravings, anxiety, and restlessness due to the lack of the drug in their system. They will probably, however, be able to think much more clearly than they had been able to for the previous few days.
Days 6-7+: Physical symptoms will probably have passed entirely at this point. Anxiety may fluctuate and the user might start to feel depressed. If the addict is withdrawing from heroin in a detox facility, they will probably be transferred to their inpatient rehab program. Those who detox at home on their own should consider seeking further rehabilitation support in the form of drug counseling or group therapy at this point.
Does Heroin Withdrawal Cause Seizures?
Unlike detoxing from alcohol and benzos, heroin detox does not usually cause seizures. There are rare cases in which, due to dehydration, the user’s body become chemically imbalanced and mineral deficient, leading them to experience a seizure. While the research is not exactly clear as to why this occurs in some people but not others, it is possible.
Addicts can decrease the risk of a seizure by remaining hydrated throughout the entire process. They can also make sure that they stay well-nourished by eating small number of nutrient-rich foods. High-fiber foods like whole grain bread or green vegetables will provide the addict with some form of nourishment and speed up the metabolism as well. This will ensure that the digestive system keeps functioning properly and that the risk of a seizure isn’t present.
Avoiding Dehydration During Withdrawals
There are two key aspects to a successful heroin detox: avoiding relapse and staying hydrated. Hydration is important during the initial stages of recovery, as the addict’s body will lose a lot of water very quickly. As the body attempts to flush out the leftover byproducts of opiate use through vomit, sweat, and stool, the water in the user’s body will go with it. Dehydration can cause withdrawal symptoms to feel much worse. Without water to expel, the body will take much longer to flush the drug out of its system.
Detox professionals prevent dehydration using a number of withdrawal management methods. They will most likely provide the addict with a cup of ice water to sip periodically throughout the process. In extreme cases, it may be necessary to hydrate the addict using intravenous methods.
Is There Any Medication for Withdrawals?
There are a variety of treatment drugs designed to make the heroin detox process easier. Some addiction treatment centers prescribe Subutex (buprenorphine), for example, which supplies the addict with a small amount of opiates to help fight off withdrawal symptoms. Some opioid replacement drugs are shown to greatly decrease the risk of a relapse, particularly during the earliest stages of detoxification.
Heroin withdrawal treatment drugs should only be used under the supervision of a medical professional. Medications like Subutex can present a number of risks and therefore should not be taken without a doctor’s instruction. The intention of these drugs is to act as an aid to the addict during the detox process, not to replace heroin entirely. A doctor, therefore, will make sure that the addict is tapering off of their replacement drug at a healthy rate and ensure that they are safe in doing so.
Can I Detox from Heroin at Home?
While it is possible to go through heroin withdrawals at home, most addiction treatment professionals don’t recommend it. The detox process is most successful when the addict goes through it under the supervision of a doctor or specialist. Someone who detoxes in a professional facility is far less likely to dehydrate. They will also have access to resources and medications that will make the process go much smoother.
Furthermore, the temptation to relapse is not present in a detox center. When the patient is on campus at the treatment facility, they won’t have access to opiates that can feed their craving. Withdrawals can be intense and those who try to quit on their own are far more likely to seek out a dose once the symptoms become too harsh.
The most valuable aspect of detoxing in a rehab center is that the addict will be only a few steps from inpatient rehabilitation. This makes the transition from detox to rehab as easy as possible. Once they enter the rehab program, they’ll receive counseling and support from addiction professionals as well as other addicts. While it may be possible to detox from home, there is no real treatment at home.
Heroin Withdrawal—The First Step Toward a New Life
Let’s face it—no one is excited to go through heroin withdrawals. The process is unpleasant and even painful for many people. However, it is a necessary aspect of treatment and one of the earliest steps toward a drug-free life. Once the symptoms start to dissipate after a day or two, you’ll be that much closer to sobriety.
If you or someone you know is battling with an opiate addiction and needs help with recovery, it may be time to reach out to a detox facility or treatment professional. They’ll be able to advise you on what the addict needs to do in order to go through heroin withdrawals safely.