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Friday, March 24, 2017

Recovery: A New High

“It’s up the mountain or it is down into the grave.”

The hardest thing for anyone with first-hand experience of addiction is recovery. The hooks and snares of the disease are so powerful that even amid true despair (e.g. loss of friends, family and home) one will still have a desire to use. In many cases, physical dependence is so strong that to stop using means terrible withdrawal symptoms. Without assistance, relapse typically occurs within the first couple days of trying to quit.

While the disease of addiction is extremely difficult to recover from, it is possible. But it requires hard work day in and day out. It demands that one essentially throw everything you think you know out the window, and adopt a new set of principles and traditions. Recovering addicts and alcoholics must themselves to use muscles, both physical and mental, that they didn’t even know they had. At times it is painful, every part of you wants to quit recovery and have you return to the paradoxical comfort of one's disease. But those who are determined to live life one day at a time and never drink or drug again, appreciating the fact that this is life or death, will push forward into the unknown.

In many ways, recovering from a disease that is trying its best to kill you, is like scaling a mountain. If you are to be successful, one must train on a regular basis to be in the shape required to have a fighting chance of making it to the summit. In recovery, success rests on a daily commitment to stay spiritually fit, failure to do so typically results in relapse at some point. Just like on a mountain, one's environment in everyday life is unpredictable. Things happening in real time require that you have the tools necessary to defend oneself from the elements. On that mountain, what could look like a sudden change in weather, in the real world of everyday life for people recovering from addiction—that can be risky people, places or things.

The mountain analogy may seem corny, trite or vapid. But that doesn’t make it any less true. For serious mountain climbers, such as those who have scaled peaks like Everest, et al, there is an expression that is tossed around sometimes known as the “point of no return.” Simply put, the point of no return is the point beyond which one must continue one's current course of action, because turning back is physically impossible; to turn back would carry a serious risk of injury or death. It could be said that people who battled addiction for years to the point of needing recovery, essentially reach a point of no return. Having to make a choice between life (recovery) or death (active addiction). You either keep climbing in recovery, or you turn back into the abyss.


A New High

Such was the case for a number of recovering addicts living in a homeless shelter in Seattle. A documentary released this year, A New High, chronicles the harrowing story of a former Army Ranger who leads people who want to reclaim their lives from addiction, up 14,400 ft. Mt Rainier. The participants took part in a yearlong addiction treatment program, part of which was preparing them for the climb. The film was directed by Samuel Miron and Stephen Scott Scarpulla.

"I think we all have preconceptions about what 'homeless people' and/or 'addicts' look like,” Scarpulla told The Fix. “Hopefully, this film puts all of those notions to bed. After my first week in the shelter, I quickly learned that addiction doesn't always resemble a guy on a corner with a cardboard box. It can look like your best friend, your neighbor, your boss, your lover. Addiction doesn't discriminate. And the more we recognize that openly in films and media, the more we can combat the stigma and get a clearer picture of truth." 

Please take a moment to watch the short trailer below:

If you are having trouble watching the clip, please click here.

"I don’t think I really understood how personal this film was going to be for many people, nor how life changing the experience was going to be for me," Miron said. "If A New High causes just one conversation to happen that helps just one person feel that it is okay for him or her to ask for help, for me, the film will be a resounding success."


The Journey of Recovery

Naturally, most people's road to recovery will probably not include a mountain over 10,000 feet tall. Yet, at times, in early recovery one may feel like they are on the side of the Matterhorn (not the Disneyland ride). The pains of early recovery are of the utmost importance, especially when you consider that most good things in this world come by way of a struggle, whether that be efforts to earn a degree or working the 12-Steps of recovery to earn back humanity.

Making the decision to seek help for addiction takes enormous courage. But help is available if you would ask of it. If you or a loved one’s life has become unmanageable due to the disease of addiction, please contact Hope by the Sea today.

Wednesday, March 22, 2017

Tanning Addiction and Alcohol Dependence

Not everyone in the United States lives in a climate like Southern California, Arizona or Florida. Climes around the country are far from consistently sunny, much of the year in some places are typified by rain or snow. For those who like to have a copper hue year-round, they usually rely on the assistance of ultraviolet rays via a tanning bed. The practice is somewhat controversial, because it has been associated with various forms of cancer—specifically melanoma. Nevertheless, millions of Americans visit tanning salons, sometimes on weekly basis.

The reasons why people tan vary, some just like the way being tan looks. For many people image is of the utmost importance, and being ashy or pale is not an acceptable appearance. Concerns about physical appearance can be harmful to one’s health in extreme cases. People often exercise in unhealthy ways to cope with their perception of how they look, whether the flaw exists or not. Left untreated, body dysmorphic disorder (BDD) can wreak havoc on one's life. The DSM-5 categorizes BDD in the obsessive–compulsive spectrum.

There is also a significant number of Americans who suffer from Seasonal Affective Disorder (SAD), commonly referred to as seasonal depression. While the condition can affect people during the summer, it is usually associated with the winter months when natural vitamin D happens to be in short supply. SAD patients will use tanning beds in an attempt to change their current mood.

Tanning Addiction

Aside from the potential for cancer due to tanning, most view the practice as being relatively benign (no pun intended). However, there has been a growing body of evidence suggesting that tanning can become an addiction. There may also be a relation between tanning dependence and other harmful disorders, such as alcohol use disorder.

New research from Yale University showed that people with tanning dependence were six times as likely to be dependent on alcohol, according to a press release from the Yale Cancer Center. People with tanning dependence were five times more likely to show signs of "exercise addiction" and three times more likely to experience SAD. The findings were published in the Journal of the European Academy of Dermatology and Venereology.

"People who are tanning dependent could also be assessed for SAD," said Brenda Cartmel, Ph.D., the paper's lead author and senior research scientist and lecturer in the school's Department of Chronic Disease Epidemiology. "There are ways of addressing SAD other than indoor tanning. Regarding the alcohol dependence association, it may be possible that addressing that behavior could help address tanning dependence."


Focused On Recovery

It is often said in the rooms and centers of addiction recovery that if you're addicted to alcohol, you can also become dependent on another substance or behavior. Many a recovering addict has experienced the pitfall of adopting new addictions in the place of another. It is important that one practice moderation even when an activity is inherently safe. Developing unhealthy relationships with other activities can actually result in a return to the harmful behaviors which brought one to the rooms of recovery in the first place.

It can be easy to put off the work of recovery by focusing on other activities, sometimes in the name of living a healthier life; that in the long run may have a harming effect on both mind and body.

Friday, March 17, 2017

Medicaid Cuts Affect Addiction Treatment

Early last month we wrote about the various efforts of lawmakers to ensure treatment on behalf of the millions of Americans battling with substance use disorder and other forms of mental illness. A small breakdown of pieces of legislation intended to expand access to treatment and life-saving medications (e.g. naloxone and buprenorphine) was provided to illustrate the importance of such bills in response to a nearly two-decade old opioid addiction epidemic.

While the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act are just the latest attempts to provide millions of Americans with the care they need, the Affordable Care Act (ACA) was designed to ensure that everyone had coverage for health care. It wasn’t that long ago when insurers could deny coverage, due to pre-existing conditions such as mental illness, examples being depression or addiction. Under the ACA, millions of people who were historically denied coverage could be approved for coverage via the open market, the exchanges or Medicaid expansion.

Regardless of which way anyone leans politically, it is public knowledge that efforts are underway to dismantle, replace or repeal the Affordable Care Act. A task that has visibly proven to be difficult. It is also public knowledge that millions of Americans could lose coverage under the proposed alternatives to the ACA. So here is where things stand currently, and please keep in mind that this is just a presentation of where it appears things are heading, not a vote of support or a denouement.

Last week, the majority House of Representatives presented the first part of a new healthcare plan. Naturally, there are many different opinions floating around what is now called the American Health Care Act (AHCA). So far, the list of concerns regarding the proposal has been topped by what appears to be a serious change in how Medicaid, which covers some 70 million Americans, will be funded, if the AHCA moves forward. What’s more, it would also affect roughly a million Americans whose mental health disorder treatment is covered under Affordable Care Act's Medicaid expansion, STAT reports. It is worth noting that Medicaid pays for 1 out of every 4 prescriptions for Suboxone (buprenorphine).

The expansion program required that states which jointly funded Medicaid with money from the Federal government, offer strong mental health and addiction treatment coverage for those who enrolled under the expansion. The AHCA would do away with that requirement by 2020. In addition, currently there is an open-ended federal commitment to pay whatever is necessary for Medicaid, under the AHCA states would receive a set amount of money from the Federal government for each person, according to the article. This could lead to Medicaid enrollment cuts and fewer benefits, especially among patients who are considered to be high-cost, such as people living with addiction.

Some states, those who rely heavily on Medicaid to cover the cost of mental health treatment and medications like buprenorphine, have a lot to lose. Medicaid pays for nearly half of those prescriptions in Ohio. Keeping in mind that we are in the throes of an opioid addiction epidemic, the proposed plan could mean that millions of Americans will lose access to coverage for treatment, flying in the face of what CARA and the Cures Act aimed to provide.

Thursday, March 16, 2017

Synthetic Marijuana: Unnatural and Unsafe

synthetic marijuana
The dangers of synthetic drug use have been widely publicized for several years now. Most of us have heard or read horror stories related to synthetic cannabis and “bath salts.” In some cases, people under the influence of the products, which are often marketed as “safe and natural,” commit atrocious acts. It is worth mentioning that the packaging of synthetic drugs often has a label that says, “not fit for human consumption.” A regular paradox, begging the question. Safe and natural for whom?

The use of synthetic drugs has been regularly associated with people below the poverty line, or those who would like to avoid detection with standard drug tests. The products, are both cheap and the chemicals present on the benign plant matter or bath salts do not register in typical drug tests utilized by employers. However, those aspects of synthetic drugs also make them appealing to young people. A trend that has become a growing concern of late.

We have written on several occasions about the dangerous nature of synthetic drugs use, and the potentially deadly side effects that can result from use. Much of the danger stems from synthetic drug manufacturers constant efforts to stay one step ahead of government bans, by way of altering the chemical formula ever so slightly. Thus, creating a substance that has yet to be banned. The U.S. Drug Enforcement Administration (DEA) is in a perpetual state of catch-up when it comes to the ingredients used to make synthetic pot (e.g. Spice and K2).

As you might imagine, young people, despite the fixation on computers and smartphones connecting to the greater world, do not always do their research before making decisions that could have grave outcomes. A new study conducted by the Centers for Disease Control and Prevention (CDC), which compiled data on almost 16,000 high school students, found that about one in 10 high school students has used synthetic cannabis, The Chicago Tribune reports. On top of being asked about both traditional and synthetic marijuana use, the teenagers were also asked about:
  • Other Drug Use
  • Violent Behavior
  • Mental Health
  • Sexual Behavior

 Findings of Concern 

While one in 10 students may not seem like cause for alarm, what synthetic drug use was associated with in the findings is certainly troubling. The research showed that teens who used synthetic marijuana were more likely to have had begun using traditional cannabis before the age of 13, the article reports. Those who had used synthetic marijuana were more likely to have used traditional cannabis 20 times or more in the past 30 days. What’s more, compared to the high-schoolers who only used regular marijuana, teenagers who used synthetic “weed” were:
  • More prone to injury or to engage in violence (i.e. carry a gun or fight).
  • At greater risk of being victims of sexual or physical violence when dating.
  • More likely to engage in risky sexual behavior.
  • At a greater risk of abusing other drugs.
"The findings indicate that students who report using synthetic marijuana are possibly on a very concerning health trajectory, which is particularly serious given that synthetic marijuana use is relatively common among adolescents," said lead researcher Heather Clayton. "While the study does not show that synthetic marijuana use causes these risk behaviors, it's still important for health professionals and school-based substance-prevention programs to focus on strategies that reduce the initiation of marijuana and synthetic marijuana use."

The study was published in the journal Pediatrics.

A Road to Addiction 

It is quite common for those who engage in drugs use and other risky behaviors in adolescence to struggle with addiction in young adulthood. If you or a loved one’s teenage recreational substance use has progressed to a substance use disorder, please contact Hope by The Sea. We can help break the cycle of addiction and provide the skills necessary for relapse prevention.

Thursday, March 9, 2017

Ask Why? Questioning Prescription Opioids

prescription opioids
If you were to take a straw poll among your peers regarding their perception of prescription opioids, you might think that everyone would respond saying that they were concerned about the drugs. If asked why, they would probably respond by saying that they are addictive and carry a high risk of overdose. Such responses would seem typical given the ongoing crisis being seen across the country regarding opioid narcotics of any kind. Every day, around hundred people die from an overdose.

The perceived danger that people have regarding a substance can have serious impact on whether or not someone tries a particular drug. Marijuana is used more than any other illegal drug, due in part to people viewing the drug as being relatively benign. Shaping public perception is of the utmost importance when comes to curbing experimentation, abuse and addiction.

To be fair, prescription opioids while deadly, are extremely effective at treating pain. No other type of drug available compares with opioids' efficacy. One of the major tasks that physicians have is treating pain, so it makes sense that they will prescribe opioids when they are deemed necessary. On the other hand, doctors also have an obligation, that of ensuring the safety of a patient when it comes to the types of treatments they prescribe. A conflict of interest that is glaring, to say the least.

With that in mind, it is vital that doctors turn to alternative forms of pain relief before relying on prescription opioids, per recommendations from the Centers for Disease Control and Prevention (CDC). While there is existing evidence showing that primary care providers are curtailing the willingness to prescribe such drugs for the treatment of acute pain, the NPR-Truven Health Analytics poll found that 57 percent of adults say they have been prescribed an opioid painkiller at some point, compared with 54 percent in 2014 and 50 percent in 2011, NPR reports. Perhaps most disturbing, the new poll showed that only 35 percent of those taking opioids had concerns about the drugs, compared to nearly 50 percent among those not taking prescription opioids.

The latter findings are important, and highlight the need for patients to ask their doctor, “Why are you prescribing me opioids, given their addictive and deadly nature?” Acute pain is temporary, and the risks associated with using opioids probably outweigh the benefits of relief. The survey indicates that 74 percent of opioid prescriptions were for acute pain, compared to nineteen percent who said they received opioids for treating chronic pain.

"Ask why," says Dr. Leana Wen, an emergency physician and commissioner of health for the City of Baltimore. "Often, other alternatives like not anything at all, taking an ibuprofen or Tylenol, physical therapy, or something else can be effective. Asking 'why' is something every patient and provider should do." 

The Truven Health Analytics®-NPR Health Poll surveys approximately 3,000 Americans every other month. The goal is to determine the attitudes and opinions on a broad spectrum of healthcare issues.

Tuesday, March 7, 2017

Expanding Access to Life-Saving Naloxone

A growing number of lawmakers are in accord with health and addiction experts regarding the value of addiction treatment in America. As we quickly approach the end of a second decade rife with opioid addiction, it is of the utmost importance that effective measures be taken to provide help for people living with addiction. Last year, we saw the passing of two bills which addressed opioid addiction in America, the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act. Hopefully, the legislative acts will result in more Americans receiving the help they desperately require.

It is worth noting that the clear majority of people with any form of mental illness do not receive any type of treatment, especially those living with a substance use disorder(SUD). Channeling more resources towards the field of mental health would not only help the afflicted, it would have a beneficial impact on society. We must never forget the countless family members of addicts who have been touched by the disease.

Given that addiction is a progressive disease whose ends are always the same: jails, institutions, and death. It is vital that everything be done to mitigate the risk of anyone of those three terrible outcomes. On top of expanding access to addiction treatment services, the legislation passed last year aims to provide greater access to the life-saving opioid overdose reversal drug—naloxone. Commonly sold under the brand name Narcan, naloxone has saved thousands of lives in recent years and will continue to so. The caveat, of course, being that the drug be both affordable and accessible with little effort, i.e. without a prescription.

One organization who has lent its full support to expanding naloxone access is the Clinton Foundation, a nonprofit which has championed several great causes around the world over the years (i.e. HIV/AIDS). Tackling the American opioid addiction epidemic is one of the organization’s main goals today. It is a cause that is important to Chelsea Clinton who serves as vice chair of the foundation. The former “first-daughter” wrote an editorial published by the BBC, in which she called for increasing access to naloxone.

“We’re working with partners to make naloxone widely affordable (and at times free) and accessible to EMTs, police officers, educators, and community first responders, so that they know how to use naloxone and are ready to use it whenever needed to save someone’s life – at a school, in a park, on a street, in a home,” writes Clinton. She added: “No one should die of an opioid overdose in 2017 in America, or anywhere – as in all areas where we know how to prevent such deaths, we have an obligation to save lives and work toward zero.” 

Such efforts are ever important, given the fact that a few naloxone manufacturers have decided of late to dramatically raise the price of the drug. For instance, the pharmaceutical company Kaleo, who makes the naloxone auto injector Evizio, raised the price for two doses from $690 in 2014, to $4,500. If no one can afford the drug, lives with be lost needlessly.

Friday, March 3, 2017

Alcohol Use and Social Rejection

Deep down we all have a strong desire to feel a part of, rather than apart from. Humans are, by design, social animals. We require others to not only get by in life, but to better understand ourselves and how we fit into the grand design of life. It is somewhat of a paradox that many begin using drugs and alcohol to feel a sense of togetherness with our fellow peers, yet the very substances that give people the sense of oneness with our fellow man are the same things that end up completely isolating you from the rest of society. While drugs and alcohol separate you from others, they do in many cases leave you with one relationship—rather than another being, it is a relationship with the disease of addiction.

The road to addiction often begins with feeling disconnected with others. Since most people are introduced to mind altering substances by another person, it can be easy to begin equating the use of drugs or alcohol with feeling like you belong to something greater than yourself. It is a misconception that does not lead to a healthy relationship with other beings, but rather an unhealthy relationship with substance use.

Sure, there is a time at the beginning of the slippery slope towards addiction when using drugs and alcohol makes one feel like you have found what was missing all along. Unfortunately, the very things that ends up filling the hole deep inside are, in fact, trying to kill you. It is a realization that one usually only comes to with hindsight. Those who come through to the other side of addiction into active recovery, often become acutely aware of how toxic the desire to fit can be, a desire that leads to inviting the wolfs of substance abuse in the front door. What’s more, those same people often realize that they didn’t desire to feel OK with their peers, as much as they desired to be comfortable with themselves. Learning how to be comfortable in one’s own skin is one of the main pillars of addiction recovery.

Social Rejection and Alcohol

Just to give you an idea of how much relationships with others can impact one’s own life, a new study suggests that social rejection can lead to increased substance use, the Research Society on Alcoholism reports. The organization points out that earlier research indicates that rejection by one’s peers was found to be associated with increases in negative emotions, distress, and hostility. The new study, Social Rejection and Alcohol Use in Daily Life, sought to determine the role that social rejection played in alcohol use. The findings were published in the journal Alcoholism: Clinical and Experimental Research.

The researchers found that rejection from friends, spouses or family members leads to significant increases in alcohol use, according to the report. However, the correlation was not found when people experienced rejection from acquaintances or strangers.

Together in Recovery

If you have ever been to a meeting of recovery, such as a 12-Step program, you probably noticed from the "get go" how friendly and welcoming everyone was to you. There is a good chance that more than one person came up to you hoping to have a chat, or they invited you to have coffee with some of the group attendees. Simply put, those with some recovery time under their belt understand the value of inclusion when it comes to long-term sobriety. Addiction is the embodiment of feeling rejected by the world forced to live in the mire of solitude, whereas recovery is the epitome of communal togetherness. A fraternal community of like-minded people making a commitment every day to be a-part of something bigger than themselves.

For those who are new to recovery, the importance of accepting the unsolicited invitations for friendship by those in the program cannot be overemphasized. You may find yourself suspicious, but we assure you that their efforts to include you into the recovery community are not only genuine, they are a necessary part of living a spiritual life free from drug and alcohol.

Wednesday, March 1, 2017

Preventing Suicide On Facebook

The use of social media websites and apps can be mentally draining. Checking-in to see what your friends and family are up to on a day to day basis can be a bit overwhelming. You may even find yourself on Facebook asking yourself from time to time, ‘what good is any of this?’ To be sure, social media sites like Facebook can prove to be an invaluable resource for those who want to keep in touch with people from their past, giving you a window to the lives of others, who you’d otherwise be in the dark about. You can also use social media to discern how your loved ones are doing health wise, both physically and mentally.

While the majority of what people talk about on social media sites is trivial in nature, there are times when people use these platforms to express negative feelings about themselves. Potentially waving a red flag that could result in friends coming together to assist their loved one get the help they need. As you are probably aware, it would be an onerous task to scan all your Facebook friends' timelines looking for signs of trouble. Let’s face it, some people have thousands of FB friends.

The people working at Facebook seem to understand how their platform can be used to avert catastrophe. Last summer, the company launched a suicide prevention tool. FB users could use the tool to flag the posts of their friends that are indicative of depression and suicidal thoughts. A team working at the company would then review flagged posts and advise the "flaggers" about how to talk with the friend they were concerned about.

Taking the mission to save lives one step further, the social media giant is working on helping people with mental illness without a friend even needing to flag a post. Facebook is testing the use of artificial intelligence (AI) algorithms they created that identify potential warning signs in users' posts and the friends’ comments, BBC reports. The algorithm tests will be used only in the U.S. initially.

After the tool identifies posts of concern, it will be reviewed by a team of humans to determine its validity, according to the article. If the team confirms that a user is at risk of self-harm, the “social network” will reach out to them and suggest helpful resources. The use of AI to prevent suicide is actually just the tip of the iceberg, please watch the short video for more information on the novel methods being employed at Facebook:

"Their ongoing and future efforts give me great hope for saving more lives globally from the tragedy of suicide," said Dr Dan Reiden executive director of Save.org, which is involved in the initiative. "The opportunity for prevention, even with Facebook Live, is better now than ever before."
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