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insomnia and binge drinking insomnia and binge drinking

Insomnia, Binge Drinking, and Cognitive Behavioral Therapy

Written by dev on . Posted in Addiction & Substance Use Disorder, Addiction Treatment.

What is the link between insomnia and binge drinking?

When you ask people about the challenges associated with quitting alcohol, one thing you hear often is “I can’t get to sleep without drinking.” When you ask people who begin drinking again after they try to stop – known as relapse – they often cite insomnia as one of the factors. In fact, research shows that around half the individuals diagnosed with alcohol use disorder (AUD) – formerly known as alcoholism – also have insomnia. Depending on what study you read, the number may be as low as 36 percent or as high as 72 percent.

Whether it’s 36 percent, 72 percent, or somewhere in between, experts agree that insomnia, alcohol use disorder, and relapse are related phenomena. Over the past twenty years, researchers have conducted experiments to try to unravel this relationship, and solve the problem of insomnia-related relapse. Several studies indicate that therapeutic interventions such as cognitive behavioral therapy (CBT), classes on sleep hygiene, and medication can reduce insomnia and help prevent relapse.

A recent study conducted at the University of Missouri-Columbia took a different approach. Rather than analyzing the effect of therapeutic intervention on the behavior of people with insomnia in recovery from AUD, they analyzed the effect of a specific therapeutic intervention – cognitive behavioral therapy (CBT) – on young, active binge-drinkers with a high risk of experiencing alcohol-related harm.

Finding a Path Around Stigma – Insomnia and Binge Drinking

The National Institute on Alcohol Abuse and Alcoholism (NIAA) defines binge drinking as “drinking more than four alcoholic beverages (women) and five alcoholic beverages (men) on one occasion.” This Missouri study focused on people aged 18-30 who reported binge drinking at least once in the month before the study began. The goal of the study was to find a way to reduce the harm associated with excess drinking by targeting the related phenomenon of insomnia without addressing the binge drinking directly.

In an interview with Science Daily, study author Mary Beth Miller, Ph.D., explained the approach:

The potential for insomnia treatment to influence alcohol-related consequences has significant implications for the prevention and treatment of alcohol use among young adults. Given the stigma associated with mental health issues and addiction, it’s crucial to identify other forms of treatment that either influence alcohol outcomes or open the door to alcohol-related treatment.”

The reasoning is rock-solid. Despite decades of awareness efforts and public advocacy campaigns to reduce stigma around alcohol use disorder and the treatment of alcohol use disorder, stigma around addiction and treatment still prevent people with drinking problems from seeking treatment. While we don’t have detailed information about why every person who needs treatment does not seek treatment, we know that a significant treatment gap exists. We also know stigma around treatment contributes to the treatment gap.

To learn more about the treatment gap and stigma, please read our article Alcohol Use Disorder in Adults: The Treatment Gap.

With regards to the effect of CBT on insomnia, and the knock-on effect on alcohol related harms, this Missouri study yielded important results. They indicate Dr. Miller and her team may be onto something important.

The Effect of Improving Sleep on Young Binge Drinkers

The study involved 56 participants who were divided into two groups. One group received five sessions of cognitive behavioral therapy (CBT) for insomnia. The other group received a single session on sleep hygiene. The CBT group received instruction on subjects such as sleep diaries and relaxation techniques. In contrast, the sleep hygiene group received instruction on how to create a consistent bedtime routine and arrange their sleeping space to improve their sleep environment.

Here’s what the researchers found:

  • CBT group:
    • 56% decrease in the severity of insomnia symptoms
    • Moderate improvement in sleep efficiency: more hours asleep in bed
    • Moderate reduction in drinks per week
    • Reduction in negative consequences of drinking
  • Sleep hygiene group:
    • 32% decrease in the severity of insomnia symptoms
    • No reported improvement in sleep efficiency
    • Moderate reduction in drinks per week
    • Moderate reduction in negative consequences of drinking

These results are modest, we admit. However, they contain an easter egg of sorts. The 56 percent reduction in the severity of insomnia symptoms for the CBT group is an important finding. We’ll return to that in a moment. The big picture takeaway is that the idea behind the study – discover a way to reduce alcohol harm that doesn’t involve stigma – showed itself as valid and worthy of further pursuit. Both groups reduced drinks per week and negative consequences of drinking. That’s a positive finding. But here’s where it gets interesting. They did it by addressing their sleeping patterns. They didn’t address their alcohol consumption directly. That’s a new development in the treatment of alcohol use disorder.

Cognitive Behavioral Therapy, Sleep, and Alcohol-Related Harm

Now we’ll talk about the specific data around insomnia. The cognitive behavioral therapy (CBT) group showed a 56 percent reduction in the severity of insomnia symptoms. We see this as an important data point for two reasons. The first is related to relapse. If insomnia is a significant driver of relapse, and CBT for insomnia reduces the severity of insomnia symptoms, it follows that CBT for insomnia for people in recovery from AUD may help them prevent relapse.

Let’s be clear.  The study authors do not say that. But we see that potential in the data.

The second reason is that CBT had a positive effect on the sleeping and drinking patterns of people who are neither in recovery nor receiving treatment for alcohol use disorder. This is another piece of evidence in support of the holistic, integrated model of AUD treatment.

The integrated model advocates treating the whole person. It doesn’t focus solely on the disorder. In the case of these 56 people between the age of 18 and 30 who reported binge drinking at least once in the month before the study, this means that treating an aspect of their overall wellbeing – sleep – had a positive effect on their drinking. It also led to an overall reduction in the number of drinks per week. Finally, it led to a reduction in the negative consequences of drinking.

This is good news and offers a novel entrée to the treatment of problem drinking in young adults. By sidestepping any question of stigma or fear of treatment, it offers young binge drinkers a potential pathway to reducing alcohol consumption. In addition, it may, in the long run, point them in the direction of seeking support for problem drinking, and help them take their first steps toward recovery.

If you need help with the detox process, The Ridge offers an inpatient rehab facility in Cincinnati and the outpatient and partial hospitalization treatments you can enroll in.

Is Alcoholics Anonymous Effective? Is Alcoholics Anonymous Effective?

Is Alcoholics Anonymous Effective? Stanford Scientists Weigh In

Written by dev on . Posted in Addiction & Substance Use Disorder, Recovery.

Is Alcoholics Anonymous Effective? 

Disordered use of alcohol is a significant problem for millions of people worldwide, and – because of adjacent factors such as costs to the healthcare system, job loss, violence, and drunk driving – it’s also a significant public health concern.

One of the best-known methods for treating alcohol use disorder is Alcoholics Anonymous (AA). Millions of people around the world use AA for support and guidance as they seek a path to sobriety.

Founded 80 years ago, AA – comprised of the familiar twelve steps, and characterized by the acknowledgment of powerlessness before alcohol – is now a worldwide presence. The organization has local chapters around the globe, and is depicted in popular culture so often that it’s probably the first treatment method that comes to mind for people who want to quit drinking.

But scientists and medical doctors didn’t create AA. The method itself, as well as its underlying philosophy, was developed by two men: Bill Wilson and Bob Smith. They created AA because of their own problems with drinking. Despite these humble origins, millions of people rely on AA year after year to get and stay sober.

Because of this, AA often faces skepticism within the medical and scientific community. How can a method devised by two non-scientists be so effective? Is AA really as effective as its reputation would suggest? Or is it merely a popular approach with unverified or exaggerated results? Is there, in fact, any hard science that indicates AA is a legitimate treatment for alcohol use disorder (AUD)?

The Stanford Study

Scientists at Stanford recently examined those questions in a study that compared AA with other methods of treatment, including motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT).

To conduct the study, Dr. Keith Humphreys – a professor of psychiatry and behavioral sciences – and his colleagues first determined how to evaluate the effectiveness of the methods in question. Alcohol use disorder (AUD) is a complex phenomenon. What outcomes constitute success? And how, for the purposes of the study, would they define the costs of AUD?

The most obvious desired outcome is a change in behavior of the participant seeking treatment. Did AA lead to abstinence more often than other methods? Was it more reliable than other methods? And were there other measurable outcomes to consider?

Increased Abstinence and Lowered Health Care Costs

For the purposes of their study, the scientists decided to focus on measurable data sets to define success. These included:

  • The duration of time that subjects refrained from drinking alcohol
  • The amount they reduced their drinking overall if they didn’t abstain completely
  • Their health care costs

The investigators looked at data from over 27 different studies, with a total of over 10,000 participants, ranging in age from 34 to 51.

The data showed that AA is an effective intervention for promoting abstinence. They also found that the twelve-step method is likely a factor in reduced healthcare costs, reducing the incidence of alcohol-related violence, accidents, and other consequences of heavy or disordered alcohol use.

What Makes AA Effective?

We need more data for a conclusive analysis, but one aspect of twelve-step programs and the AA approach that appears to help people is the meeting-based structure. Dr. Humphreys and colleagues concluded this element of AA is a key to its success in changing behavior.

That sounds simple, but the group approach is based on behavioral science.

AA meetings reinforce social structures that allow members to support each other in all aspects of recovery. These include examining their behaviors, making changes, and creating and sticking to new habits. Humans are social creatures. Social interactions have a profound influence on behavior. Support from peers can range from practical advice, such as simple tips on how to have fun without drinking, to emotional support, to genuine fellowship.

Why does this simple support from ordinary people work so well?

According to the Stanford study, it’s about our development as a species. Humans evolved over millennia to communicate and learn from each other’s experiences. Hearing from someone who’s been there, knowing that they faced similar challenges and struggles – and succeeded in overcoming them – provides a dose of optimism.  Often, it can make the difference between staying sober and relapsing.

A final note: the Standford study showed therapeutic methods such as motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT) worked in treating AUD, too. That supports research that shows a multi-modal approach to addiction treatment – often called integrated treatment and/or holistic treatment – is the most effective path to long-term, sustained sobriety. In fact, most well-regarded treatment programs use the integrated approach. They combine individual therapies like CBT with group therapy, and lifestyle changes, which include diet, exercise, and mindfulness techniques. With the added benefit of community support programs like AA, these full-spectrum, holistic programs achieve the most favorable outcomes for people seeking long-term sobriety.

The Ridge offers the detox process and inpatient rehab facility to help you start your journey towards recovery.

heavy drinking and marriage heavy drinking and marriage

Heavy Drinking, Alcohol Use Disorder, and Marriage

Written by dev on . Posted in Addiction & Substance Use Disorder, Addiction Treatment.

The presence of a drinking problem or an alcohol use disorder (AUD) can cause significant harm to any human relationship, including marriage. Decades of research show that for newlyweds and long-married couples alike, disordered alcohol use such as heavy drinking or binge drinking can lead to a host of negative consequences. In 2009, the journal Clinical Psychology Review published a review of over sixty studies on the effect of alcohol on marriage.

Here’s what the study concluded:

“There is an overwhelming amount of evidence for the conclusion that spousal alcoholism [AUD] is maladaptive, and that heavy and problematic alcohol use is associated with lower levels of marital satisfaction, higher levels of maladaptive marital interaction patterns, and higher levels of marital violence.”

That study lays the foundation for a data-driven, evidence-based understanding of the specifics of how alcohol affects marriage. More recently, a long-term research effort conducted by scientists at the Research Institute on Addictions (RIA) at the University of Buffalo examined the prevalence of alcohol use and its associated problems among married couples in the U.S. They published their research in a series of articles in 2013-2014. While much of their data and conclusions are not a surprise, there are some notable observations that are important for the general public to understand.

Alcohol Abuse Ruins Mairrages

One takeaway from the research on alcohol and marriage is that in a majority of cases, moderate alcohol use does not cause significant problems. Observable and quantifiable trouble appears most often in couples where one spouse or both report heavy alcohol use and/or patterns of binge drinking.

Different Types Of Alcohol Abuse And Their Effects On Marriage

Before we go any further, let’s look at how the experts at The Substance Abuse and Health Services Administration (SAMHSA) and the National Institute on Alcohol Abuse and Alcoholism (NIAA) define moderate, binge, and heavy drinking:

Moderate Alcohol Consumption

  • 1 drink a day for women and 2 drinks a day for men.

Binge Drinking

  • Alcohol consumption that brings blood alcohol concentration (BAC) up to 0.08 g/dl. That means:
    • 4 drinks in about 2 hours for women
    • 5 drinks in about 2 hours for men
  • Consuming 5 or more alcoholic beverages on the same occasion on at least 1 day in the past 30 days.

Heavy Drinking

  • Binge drinking on each of 5 or more days in the past 30 days

Now let’s look at the prevalence of these drinking patterns among married couples in the U.S. This is data reported by the research team at the University of Buffalo:

  • 79% report neither partner meet criteria for heavy drinking
  • 4.0% report both partners meet criteria for heavy drinking
  • 12% report only the male partner meets criteria for heavy drinking
  • 5.0% report only the female partner meets criteria for heavy drinking

Those statistics introduce a consistent trend throughout all the research – yes, all the research over the past several decades – that indicates a gender difference in heavy drinking. According to the data, the male partner in a married couple is more likely to engage in heavy or binge drinking than the female partner. Another notable fact emerges here, as well. The consequences of alcohol use differ when both partners drink heavily and/or have a clinically diagnosable alcohol use disorder (AUD).

We’ll return to that fact in a moment. To read and understand the criteria and risk factors for AUD, please consult this NIAA resource page .

Now let’s take a closer look at the core findings from the research we’ve been talking about.

The Negative Effects of Heavy Drinking on Marriage

The Research Institute on Addictions (RIA) team examined several key metrics: marital satisfaction, domestic violence, aggression, divorce, and the number of positive and negative interactions between married partners.

Here’s what they found:

  • Marital satisfaction
    • Heavy drinking, problem drinking, and AUD in one or both partners were associated with lower marital satisfaction, as compared to marriages where neither partner reported heavy drinking, problem drinking, or AUD.
    • Stronger associations between lower marital satisfaction and drinking problems appeared when the male partner reported the problem drinking patterns.
    • Weaker – but still present – associations were noted when the female partner reported the problem drinking patterns.
  • Domestic violence
    • Alcohol use was identified as a contributing factor in domestic violence for perpetrators and victims
      • Physical aggression is three times more likely to occur when the perpetrator consumes alcohol
      • Physical aggression is twice as likely to occur when the victim consumes alcohol.
    • Alcohol use was identified as a contributing factor in verbal and psychological aggression between married partners
      • Verbal aggression is twice as likely to occur when either the victim or perpetrator consumes alcohol within four hours prior to the reported aggression
  • Divorce
      • Alcohol and/or substance use are among the top reasons identified for filing for divorce:
        • They’re the 3rd most common reason cited by female marriage partners
        • They’re the 8th most common reason cited by male marriage partner
      • Alcohol and/or substance use is one of the most common reasons married couples cite for seeking marriage counseling
  • Interactions
      • More negative interactions than positive interactions appeared in married couples when one marriage partner reported alcohol dependence or AUD.

These statistics clarify – with numbers – the negative effects of alcohol on marriage. Findings like these are helpful when discussing alcohol and marriage, because it’s easy to make blanket statements like “too much drinking ruins a marriage.” Although that may feel true and seem obvious – and is true in many cases – historical research data does not support that statement. It’s also not what the results from RIA studies say.

So, what do the results say?

Different Drinking Habits Cause Problems

We start this section with a heavy qualification. We do not condone excess drinking in any form, for anyone, ever, whether they’re single, married, in a serious long-term relationship, a common-law domestic partnership, or dating. Issues of marriage, divorce, and alcohol and/or substance use and misuse can be highly charged. They’re often accompanied by complex relationship histories. They can be extremely emotional for everyone involved.

That’s why we stick to facts, derived from data, obtained from reliable scientists working in good faith to understand complex topics that have real ramifications for real people in the real world. If you suspect that you or your spouse is battling with drinking problems, its worth taking a look at our latest findings.

With that said, here’s what the RIA researchers found with regards to the following metrics:

  • Marital satisfaction

    • Marriage partnerships in which both marriage partners report heavy alcohol consumption report higher levels of marital satisfaction than marriage partnerships in which one marriage partner reports heavy alcohol consumption and the other does not.

  • Divorce

    • Marriage partnerships in which both marriage partners report heavy alcohol consumption are less likely to end in divorce then those in which one marriage partner reports heavy alcohol consumption and the other does not.
    • 50% of marriage partnerships in which only one partner reported heavy alcohol consumption end in divorce.
    • 30% of marriage partnerships in which both partners reported similar alcohol consumption ended in divorce.

  • Interactions

    • Marriage partnerships in which both partners report having AUD report more positive interactions than partnerships in which one partner reports AUD and the other does not.
    • Marriage partnerships in which both partners report having AUD report a higher ratio of positive interactions to negative interactions than partnerships in which one partner reports AUD and the other does not.

Now you can see why we qualified the data before sharing it. This is tricky territory.

As the study authors say,

“The difference makes the difference.”

The data shows that for marriage partnerships in which both partners have similar drinking habits, those partnerships do not experience the same negative consequences as marriage partnerships in which partners have contrasting drinking habits.

Alcohol Abuse And It’s Effect on Children

Research identifies the presence of an alcohol or substance use disorder in the home as an adverse childhood experience (ACE). ACEs are a form of trauma. They’re a complex phenomenon by themselves. We’ll now offer a thumbnail version of what we think people reading this article should know about ACEs.

Researchers from the Centers for Disease Control (CDC) identify the following ten types of ACEs:

  1. Physical abuse
  2. Emotional abuse
  3. Sexual abuse
  4. Physical neglect
  5. Emotional neglect
  6. Mental illness in the family
  7. Witnessing domestic violence
  8. Divorce
  9. Having a relative incarcerated
  10. Alcohol and/or substance abuse in the home

The scientists who first identified ACEs published scores of peer-reviewed papers on the long-term consequences of ACEs. Taken together, these studies show that when individuals accrue four or more ACEs, they’re at increased risk of experiencing:

  • Impaired neurodevelopment
  • Social, cognitive, and emotional problems
  • Chronic disease, disability, and impaired social productivity

In addition, children exposed to four or more ACEs are at increased risk of engaging in risky behaviors. These include alcohol use, drug use, and early sexual activity. In terms of chronic medical conditions, exposure to four or more ACEs increases the risk of developing:

  • Cancer
  • Diabetes
  • Heart disease
  • Depression

With regards to the negative effect of AUD among parents on their children, the research clearly indicates the presence of AUD – when combined with three or more other ACEs – increases the risk of those children developing a wide range of biological, social, psychological, and emotional problems when they reach adolescence and adulthood.

What Does This All Mean?

That depends on the marriage partnership, the individuals involved in that partnership, and the decisions they make with the knowledge they have.

In short, all this information means different things to different families. Therefore, we can’t tell anyone definitively what this marriage and parenting data means for them.

Does Alcohol Abuse Always End In Divorce

The presence of an alcohol use disorder in a marriage does not automatically mean that marriage will end in divorce. Nor does it mean the partners in the marriage will experience physical abuse, verbal abuse, or a disproportionate amount of negative interactions. It does, however, increase the risk for physical and verbal abuse. That increased risk is more pronounced in marriage partnerships in which the marriage partners have contrasting drinking habits, i.e. marriages in which one partner drinks heavily, and the other does not. In those partnerships with mismatched drinking habits, rates of divorce and negative interactions also increase.

The presence of alcohol abuse in a marriage does not mean that children of those parents will grow up to experience all the negative consequences associated with ACEs, either. It does, however, push those children closer to the threshold at which childhood trauma results in adolescent and adult disease and disability.

But no path is written in stone. Humans are resilient and have the ability to experience and transcend adversity of all types. That includes the trauma associated with AUD and ACEs.

Family And Marriage Counseling In Treatment for Alcohol Use Disorder

Associated with all this data on drinking, marriage, and children is the fact that alcohol use disorder is a chronic medical condition that responds to appropriate treatment. A corollary to that fact is that children who experience trauma can learn to process that trauma with the help of a capable adult – most often a therapist – and mitigate the negative effects of experiencing ACEs.

Therefore, married partners that know and understand the implications of AUD in marriage and parenting have options. If they also know and understand that one, or both, partners in the marriage have an AUD, they can seek treatment and support for the AUD. Evidence shows that an integrated treatment model is effective. Integrated treatment includes individual therapy, group therapy, experiential therapy, and family therapy.

This whole person approach can lead to long-term, sustained sobriety. Married parents with AUD in their partnership can seek support for their children, as well. The trauma associated with parental AUD can be mitigated with the help of a qualified, capable adult. The adults most qualified for helping children work through trauma are professional therapists, as mentioned above.

Get Family Therapy For Alcohol Use Disorder At The Ridge Ohio

The takeaway here is that AUD in marriage can have a negative impact on both individuals in the marriage partnership, as well as any children in the family. But that’s not the end of the story. Spouses and parents can take affirmative, proactive steps to recover from AUD and to help their children process any trauma associated with the AUD. A step toward treatment and support is a step toward empowerment and healing for everyone involved. Seeking support and receiving detox treatment are time-tested methods families can use to author their own narrative, write the next chapter of their personal family story, and rediscover the balance and harmony that the presence of an AUD often disturbs.

alcohol use disorder in women alcohol use disorder in women

The Consequences of Alcohol Use Disorder in Women

Written by dev on . Posted in Addiction & Substance Use Disorder, Addiction Treatment, Recovery.

How prevalent is alcohol use disorder in women? What are the consequences?

Alcohol use in the U.S. is common. People serve alcohol at parties, commemorative events, and at home. They include it as an option at occasions as diverse as backyard barbecues and executive business lunches. Adolescents experiment with alcohol, college students often make consuming alcohol a way of life, and adults use alcohol to relax, facilitate social interaction, and reward themselves after a hard day of work or play.

Its prevalence – while innocuous in many instances – can also lead to misuse. The 2020 National Survey on Drug Use and Health (2017 NSDUH) shows the following population-level data on alcohol use disorder (AUD) in the U.S.:

  • Adolescents (12-17): 712,000 (2.8%)
  • Young Adults (18-25): 5.2 million (15.6%)
  • Adults (26+): 22.3 million (10.3%)

Quick math tells us that almost 30 million people in the U.S. meet the clinical criteria for AUD, or what most people think of as alcoholism. Further examination of the numbers shows the rate of AUD gradually decreased for all age groups between 2002 and 2017, then increased between 2017 and 2020. However, additional research reveals an increase in the prevalence of AUD in one group over the same time: women.

A study published by the American Psychological Association (APA) in 2014 explores the differences in the development and consequences of alcohol use disorder in women, and how they differ for women and men. This article summarizes that study and discusses its implication for the treatment of alcohol use disorder in women.

Prevalence of Alcohol Abuse in Women Compared to Men

In general, men experience higher rates of AUD than women. Here’s the data:

  • AUD in men: 24.6%
  • AUD in women: 11.5%

These numbers represent a distinct shift, not only over the past 15 years, as indicated above, but over the past 90 years. In the 1930s, data places the ratio of disordered alcohol use for men, compared to women, at seven to one (7:1). When we fast forward to 2017, we see that ratio close significantly: it now hovers around two to one (2:1). If you’re not used to reading or thinking in ratios, what this means is that about a hundred years ago, seven times more men than women experienced problem drinking. Now – or according to data from 2017 – only twice as many men than women experience problem drinking.

That’s a big change. The specific reasons behind the change are beyond the scope of this article, but it’s reasonable to suggest that the increased reporting of rates of AUD for women mirror their increased ability to participate in all aspects of society, from working, to owning property, to securing equal rights and access to a variety of social, political, and cultural activities that were previously denied them, as Supreme Court Justice Ruth Bader Ginsburg observed, “on the basis of sex.”

What is within the scope of this article, however, is identifying differences in the development and impact of AUD on women compared to men.

We’ll talk about those now.

Alcohol Use Disorder in Women: The Negative Effects

Disordered alcohol use causes severe, lasting, and negative impacts for anyone. Men, women, young people, old people – any person who develops disordered drinking patterns risk damage to their brain and body. The latest research tells us two important things: some of the negative impacts of AUD are more pronounced in women than in men, and AUD develops differently in women, as compared to men.

Research indicates the following short-term differences in the effect of alcohol consumption on women, compared to men. Women show:

  • Higher blood alcohol levels when consuming the same amount of alcohol
  • Increased cognitive impairment
  • Increased sedation (sleepiness)
  • Higher levels of impairment (drunkenness)
  • Increased levels of acute, alcohol-related injury
  • Increased risk of sexual assault (as a victim)

Long-term differences in the effect of alcohol use disorder on women, compared to men, include:

  • Increased risk of brain damage and shrinkage
  • Shorter time for brain damage and shrinkage to occur
  • Increased memory impairment
  • Increased cognitive impairment
  • Elevated risk of alcohol-related liver disease
  • Elevated risk of mouth, throat, esophageal, liver, breast, and colon cancer
  • Greater risk of heart disease and cardiovascular complications
  • Increased risk of depression and mood disorders

Pregnancy And Alcohol Use Disorder

Studies also show the negative impacts of alcohol consumption during pregnancy. Risks to newborns of mothers who consume alcohol excessively during pregnancy include:

  • Birth defects
  • Low birth weight
  • Fetal Alcohol Syndrome (FAS), which can cause:
    • Physical deformations
    • Slow growth (before and after birth
    • Defects in major organs
    • Defects in the brain and nervous system
    • Cognitive impairment
    • Social impairment
    • Memory impairment
    • Disrupted emotional development
    • Impaired balance

These elevated risks mean, in a nutshell, that AUD – or simply excessive drinking – has the chance to cause more damage, more quickly, to women than men. The authors of the APA study cited above put it this way:

“AUD appears to be a more severe form of psychopathology in women.”

Alcohol Use Disorder Rehab For Women

There are two more pieces of information we left out – and both are relevant to our discussion. First, following initiation of alcohol use – i.e. their first drink – women develop patterns of disordered drinking more rapidly than men. Second, when women begin drinking during adolescence, the intensity and duration of alcohol use disorder are greater than that found in men who begin drinking around the same time.

Taken together, all this information is critical for primary care physicians, physicians who specialize in women’s health, therapists, psychiatrists, and social workers involved with women’s issues. In other words, anyone directly involved in the health and wellbeing of women should understand the increased physical, emotional, and psychological risks associated with AUD in women compared to men.

Putting this knowledge into action means that medical and mental health professionals can include questions regarding alcohol consumption in any screenings they conduct during regular office visits. These professional caregivers can then act quickly on the information they collect. If women show signs of AUD, doctors and therapists can recommend a drug and alcohol rehab for women and treatment plan sooner rather than later – which can help women with disordered drinking patterns live healthy lives and significantly mitigate the negative short- and long-term consequences of alcohol abuse.

Sources:

https://www.samhsa.gov/data/sites/default/files/reports/rpt35323/NSDUHDetailedTabs2020/NSDUHDetailedTabs2020/NSDUHDetTabsSect5pe2020.htm

Frequently Asked Questions About Dual Diagnosis/Co-Occurring Disorders

Written by dev on . Posted in Addiction & Substance Use Disorder.

What does dual diagnosis or co-occurring illness mean and how common is it in the United States?

The term co-occurring disorder (also referred to as dual-diagnosis) is the term used to indicate a person who has one or more disorders relating to the use of alcohol and/or other drugs of abuse as well as one or more mental disorders.

A diagnosis of co-occurring disorders is made when at least one disorder of each type can be established independent of the other and is not simply a cluster of symptoms resulting from one of the disorders. Either substance use or mental illness can begin first. Some individuals who have mental illness may use a substance as a means of reducing their symptoms. This is often referred to as “self-medicating”.

The term mental health disorder generally refers to mood disorders (depression or bipolar), anxiety disorders (generalized anxiety disorder, panic disorder or social anxiety disorder), trauma or stressor related disorders (PTSD, adjustment disorders), thought disorders (schizophrenia), and other disorders not substance-related or induced by substances. The Diagnostic and Statistical Manual 5 or DSM 5 is the national standard for the definition of mental disorders.

According to the National Survey on Drug Use and Health (NSDUH) approximately 9.2 million adults experienced both substance use disorder and mental illness in 2018.

The NSDUH data for 2018 provides a few general trends worth noting these include; increasing rates of serious mental illness, major depression, and suicidality in young adults and major gaps in treatment received by those affected.

The NSDUH data for 2018 also illustrated increased rates of substance use among those who have mental illness compared to those who have no mental illness. Suicidal thinking and attempts are also higher in those who have substance use disorders and those who have a co-occurring mental illness. Those with co-occurring illnesses have higher rates of relapse.

How can my doctor determine if I have a co-occurring disorder?

It is important to let your doctor know if you are using any substances including herbal or over-the-counter supplements. If a doctor or licensed counselor is unaware of substance use, they may provide an inaccurate diagnosis or treatment.

Your doctor will attempt to determine if the symptoms are caused by a substance, medication (given by a doctor, over the counter, or taken without a prescription), or a general medical condition. In addition to asking questions, your doctor may perform a physical examination and order other tests such as blood work or request to review your previous treatment records.

Your doctor will ask about your history of substance use and mental health symptoms. If a period of sobriety has occurred this can often help in clarifying the diagnosis. For example, If you noticed feeling depressed while using alcohol regularly the feelings of depression could be due to alcohol. If you then stop using alcohol and notice feelings of depression stop this suggests alcohol was the cause of the symptoms. On the other hand, if the cessation of substance use does not alleviate mental health symptoms an independent mental health diagnosis may be the cause.

For many a period of abstinence is not possible or waiting to clarify the diagnosis is not an available luxury and treatment of both is recommended. In these cases working closely with your doctor over time is critical.

What can I do if I think I have either a substance use disorder, mental health disorder, or both?

Speak with your doctor or a counselor. For many individuals, their primary care provider (PCP) or family physician is the first contact made. An individual can also seek an assessment with a psychiatrist or licensed mental health counselor.

Some offices/agencies require appointments made ahead of time while others offer walk-in assessment hours on specified days.

An excellent resource can be found on the Substance Abuse and Mental Health Services Administration or SAMHSA website (link below). This website provides a treatment locator for substance use disorder, mental disorders, or both.

You can also contact your insurance carrier and request a list of providers who accept your insurance. This can also be done online with many companies.

What are some of the treatment options for those with co-occurring illnesses?

The best treatment option for those with co-occurring illnesses is integrated treatment. Integrated treatment refers to a program that can provide treatment for substance use disorder and mental illness.

Treatment may include the use of medication, therapy, or a combination of medication/therapy and self-help groups. The treatment setting in which treatment is provided can vary and is based on the individual needs of the person seeking treatment. Some typical treatment settings include residential treatment, partial hospitalization, intensive outpatient, aftercare and outpatient. It is important to remember that treatment needs can vary over time and an individual may find benefit from transitioning to more intensive treatment during times of symptom worsening. During times of symptoms remission and stability, an individual may opt to reduce the intensity of their services. Always let your doctor or counselor know if you have unmet treatment needs so you can work collaboratively to address them.

Effective treatment realizes recovery does not occur in days but rather in months and years. Those with co-occurring disorders, substance use disorder, or mental illness do not achieve functional improvements or stability quickly but gradually through regular engagement with a consistent treatment program tailored to their individual needs.

The Ridge offers you a comprehensive treatment plan that involves the inpatient rehab facility and detox program in Cincinnati to help you start your journey toward recovery.

References:

https://www.samhsa.gov/data

https://www.samhsa.gov/find-treatment

Substance Abuse and Mental Health Services Administration. Integrated Treatment for Co-Occurring Disorders: The Evidence. DHHS Pub. No. SMA-08-4366, Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 2009.

 

My Child’s Father Is An Addict

Written by dev on . Posted in Addiction & Substance Use Disorder.

When we think the parent-child dynamic in the context of addiction, we almost always think about the parent at their wit’s end trying to get help for their addicted son or daughter. The reality is, however, that it’s often the parents of underage and adult children who struggle with addiction and often wind up impacting their children for years to come as a result. Between alcohol addiction and the escalating opioid crisis affecting baby boomers and older seniors, addiction is a public health issue that doesn’t discriminate based on age.

If the father of your child is struggling with addiction, there is a whole other level of urgency you need to observe in your attempt to get them help in order to ensure the safety and long-term well-being of you and your child while getting your partner or co-parent a second chance at life in recovery. Data from the United States Department of Health and Human Services indicates parental alcohol or other drug use as a contributing factor for child removal increased from 18% to over 35% in the last 16 years. At the same time, while there is obviously no guarantee, a commonly cited body of research suggests that children of addicts are eight times as likely to become addicts themselves.

In order to break the cycle of addiction and protect your child from immediate harm, here are some steps you can take to get the father of your child the help they need.

Make Sure You & Your Child Are Safe

You need to be able to help the father of your child from a position of strength and stability. The reality of addiction is that it puts both the addict and the people they love in dangerous situations, and very often jeopardizes their immediate health and safety. Before you can take steps to help your loved one, make sure your living situation is secure and that you and your child have somewhere to go in the event of escalation. Call a friend or family member, if necessary.

“Tough Love” – Consequence-Based Treatment Motivation

While it may seem initially harsh, sometimes the best thing you can do is show the addicted father of your child what can happen if they don’t get clean. Tell the father of your child as calmly and rationally as possible, without exercising judgment, that you simply can’t put your child at risk by allowing visitation until they get clean. It may be necessary to take legal action in this case. Courts may automatically intervene and mandate treatment, depending on the specific circumstances.

Some Of The Signs That The Father Of Your Child May Have A Drug Problem Include:

  • Increasing irresponsibility regarding care
  • Professional or financial problems
  • Prolonged periods of absence or isolation
  • Erratic, risky and potentially illegal nehavior
  • Lying about whereabouts and other things

If your child’s father is exhibiting these physical indicators or any behavioral signs of addiction, it’s time to get them help.

Engage Them Calmly About Treatment

Before things escalate to the point of consequences; however, try talking to the addicted father of your child about the prospect of getting help for both themselves and your child. Offer to help them in their search for care. If they see that they have a partner in this endeavor, and that they can lean on you for support, they might be more receptive to entering treatment. Help can mean anything from assisting in their search for a treatment center by calling or going online to offering to help cover some of their treatment costs through your insurance if they aren’t adequately covered by their own plan. There is no blueprint for this, but as long you are willing to help, let them know.

Get Others Involved In Their Treatment

Even though your child’s safety and emotional well-being may be tied to their father’s recovery, and you have a tremendous personal stake in their progress, this can’t be entirely up to you. Reach out to his family, close friends, and other important people in his life to try and organize a meeting or intervention. An intervention should be led by an experienced, trained, and qualified professional who can keep the process from becoming overtly emotional, assist with making treatment arrangements, and help your group coordinate the logistics of the meeting. It’s important to make treatment arrangements ahead of time to avoid any of the pitfalls of any second thoughts your child’s father may have.

We’re Ready To Help Your Child Get His Father Back

The Ridge has helped thousands of parents just like you start to reconnect your family through comprehensive alcohol and drug addiction treatment. We offer detox programs and an inpatient rehab facility. Whether you and your child’s father are married, separated, or share parentage in any other model, your child deserves to have two parents who love, support, and show up for them.

Resources:

How To Defend Against Prescription Drug Addiction

Written by dev on . Posted in Addiction & Substance Use Disorder.

Prescription painkillers are necessary for people in unbearable pain after an injury or a major medical procedure, but they have a deadly dark side that has more people seeking drug detox programs by the day. Opioid painkillers are extremely easy to become addicted to and introduce people to a life-destroying habit. Every American needs to know the risks these drugs carry and how to avoid getting hooked.

Prescription drugs are more prevalent now than ever. Enough pills were prescribed in 2010 to keep every adult in the country fully medicated 24 hours a day for an entire month. The number of prescriptions for opioid painkillers has nearly tripled from 70 million in 1991 to 210 million in 2011. Unless Americans happened to experience three times more pain that year than they did twenty years earlier, something is wrong with the frequency of these prescriptions. And the statistics for deaths by overdose back that up, too: deaths from prescription drug overdoses more than quadrupled from 4,030 in 1999 to 16,651 in 2010.

Although these drugs have medical legitimacy, it’s essential to remember that they’re still opioids. The euphoric, painless sensation they cause is very easy to get addicted to. The brain will shut down the natural production of pleasure-causing chemicals in response to the unnaturally large amounts the drug causes the brain to release, forcing a person to seek more of the drug. When a person runs out of legally obtained pills, they’ll likely try to buy them through less-than-legitimate means, which can run up to $100 per pill. Many then switch to the much cheaper and much more potent heroin. People in this situation often never would have willingly tried heroin and never thought they’d end up struggling with addiction, especially since the pill that got them hooked wasn’t an illicit substance, but medication recommended by their doctor. With this kind of risk present for literally anyone prescribed an opioid painkiller, education and preparation are key!

So, how can you avoid having you or a loved one fall into addiction if you need a painkiller because of a medical condition? The best bet is to communicate your concerns with your doctor. See if there are any non-addictive, non-opioid methods of dealing with pain. If not, make sure you and your doctor agree on a limited amount of refills and a safe schedule for taking the pills. Consider having a trusted family member make sure that the drugs are only taken at the correct times in the correct dosages. These precautions are especially important since addiction usually begins when people can get their prescription refilled many more times than necessary and start taking the pills for the euphoric high rather than pain relief. If you see anyone starting to abuse painkillers in this way, act immediately and look for an inpatient drug rehab center. Don’t wait for their addiction to get worse.

A less direct action, but no less important, is to be an advocate in your community for safe, effective opioid control. By raising awareness, you’ll force doctors and pharmacists filling prescriptions to be more accountable for their actions, and gain public support for more treatment options for prescription opioid addicts.

What Is Casey’s Law?

Written by dev on . Posted in Addiction & Substance Use Disorder, Addiction Treatment.

My Loved One Is Abusing Drugs or Alcohol and I Am Afraid They May Hurt Themselves. What Can I Do?

If there is an immediate threat of harm to themselves or others call 911. Often families or friends turn to involuntary treatment because they feel that they have exhausted all other options. After all, the person who is abusing substances is hurting themselves, causing family strife, and harming others to continue using. If the person is treatment-resistant or does not see their substance use as a problem it leaves loved ones in a state of hopelessness and fear. This is OK and normal. Most people have little or no experience with substance abuse or treatment options, so they don’t know where to turn.

There are solutions beyond involuntary treatment that are more effective. An informal intervention by a neutral third party is one way to help ease a person into the realization that treatment is the best course of action. Formally structured interventions are another way to go. Making things difficult for the person suffering from addiction by strategically cutting off resources is another effective approach. At The Ridge, we are experienced with treatment-resistant individuals and can use our resources to assist in helping your loved one make the best choice.

What Is Casey’s Law?

Casey’s law is a piece of legislature passed in Ohio and Kentucky that allows loved ones to petition the court for involuntary addiction treatment.

What States Have Casey’s Law?

As of October 2019, only Ohio and Kentucky have active versions of Casey’s law with versions in the works in Georgia and West Virginia. Civil commitment for substance use or involuntary substance use treatment laws, such as Florida’s Marchman Act or Kentucky’s Casey’s Law exist in 37 states.

These laws are rarely used as an option because they can be complex to undertake, unclear, or are simply not known in the state. Also, once the process of involuntary commitment begins, a person suffering from substance use disorder may decide on their own to attend treatment.

How Do I Use Casey’s Law or Another Civil Commitment Law to Court Order My Loved One Into Treatment?

For Casey’s law specifically, there are a series of legal steps that must be taken including filling out a petition and filing it with your local district court. There are fees involved with this filing and the process can take 14 days or longer. Additionally, two or more qualified health professionals must also agree that the person will benefit from treatment. Find out more about the specific steps for Kentucky here: https://odcp.ky.gov/Stop-Overdoses/Pages/Caseys-Law.aspx and for Ohio: http://caseyslaw.org/caseys-law-oh-steps/

What Are My Options If I Cannot Use Casey’s Law Where I Live?

If there is an immediate threat of harm to themselves or others call 911. If the individual’s substance use is creating imminent harm, your local jurisdiction may have a version of a “civil commitment” or “involuntary treatment” law that includes substance use. These laws vary greatly from state to state. Here is an interactive map that can help guide you to your own area’s laws and regulations: http://lawatlas.org/datasets/long-term-involuntary-commitment-laws

Our Family Has Been Through So Much, What Is Next for Us?

The fact remains: if an individual does not want help forcing treatment may not change their mindset. That does not make it any easier for the loved ones involved but there is always hope for the person suffering from the disease of addiction.

Find out which inpatient rehab centers can treat their specific type of substance use disorder.

Find out how they treat the disease of addiction, get specific, ask for staff credentials and treatment methods. Are they licensed in the state? Are they Joint Commission or CARF accredited? Is there detox offered if necessary? Is the treatment residential, outpatient, or partial hospitalization?

Determine what the financial impact will be, so you are ready. Check with local treatment centers to see if they accept your loved one’s health benefits, what the copay or out of pocket amounts are and, what the self-pay rate is. Are they in-network or out of network? Are there payment plans available?

Find out if your loved one needs detox services and what agencies provide those services. Again, find out the cost of detox services ahead of time.

Tour your local facilities and see what the environment is like, get an idea of what the center offers in both amenities (comfort) and clinical treatment (effectiveness). Here is a great resource for how to find the right treatment center: NAATP Treatment center selection guide. Remember effective treatment may be offered at a facility outside of your immediate area.

There are solutions beyond involuntary treatment. An informal intervention by a neutral third party is one way to help ease a person into the realization that treatment is the best course of action. Formally structured interventions are another way to go. Making things difficult for the person suffering from addiction by strategically cutting off resources is another effective approach.

The Bottom Line

Casey’s law and other civil commitment tools are one avenue to pursue when it comes time to get your treatment-resistant loved help. However, there are other less cumbersome, less expensive and effective avenues which you may not have considered. The Ridge can help navigate these questions for you and also can provide the residential treatment your loved one may need when they are ready.

Sources:
http://caseyslaw.org/
https://drugfree.org/learn/drug-and-alcohol-news/many-states-allow-involuntary-commitment-addiction-treatment/
https://www.naatp.org/naatp-treatment-selection-guide
http://lawatlas.org/datasets/long-term-involuntary-commitment-laws

Protecting Pain Patients In The Midst Of An Opioid Epidemic

Written by dev on . Posted in Addiction & Substance Use Disorder.

Prescription painkiller overdose is one of the leading causes of death in America right now, affecting millions of lives.

According to the Centers for Disease Control:

  • In 2012, health care providers wrote 259 million prescriptions for opioid pain medication, enough for every adult in the United States to have a bottle of pills.
  • Opioid prescriptions per capita increased 7.3% from 2007 to 2012, with opioid prescribing rates increasing more for family practice, general practice, and internal medicine compared with other specialties.
  • From 1999 to 2014, more than 165,000 persons died from overdose related to opioid pain medication in the United States.
  • In 2013, on the basis of DSM-IV diagnosis criteria, an estimated 1.9 million persons abused or were dependent on prescription opioid pain medication.

There is no question that prescription opioids are being abused by many who claim to have a pain disorder. These addicted individuals visit several doctors for the same conditions in order to obtain multiple prescriptions. They fake illness or injury to get drugs. They falsify prescriptions and buy painkillers from the black market. They manipulate the system in order to get the drugs they are addicted to. In fact, nearly 30% of patients prescribed opiates had no recorded pain diagnosis, according to the CDC.

Lives are being ruined and lost because of prescription opiates. In order to combat this epidemic, several laws and practices have recently been put into place. There are now stricter regulations for doctors who prescribe controlled substance, more comprehensive reporting required by pharmacists who fill the prescriptions, and more data collected on patients who are taking the medications. However, because of the increased security surrounding prescription painkillers, many who legitimately need pain medication for severe and chronic pain are sometimes unable to get the medications they need. The question remains, to what extent are we as a country willing to negatively impact pain patients in order to stop painkiller abusers and addicts?

CDC Recommendations For Opioid Prescription

The CDC published its guidelines for prescribing opioids in 2016, in an effort to help doctors, pharmacists, and even insurance companies aid in curbing unnecessary opioid prescribing and abuse and addiction. However, the CDC’s publication is simply a guide and is not mandatory, but because of some overzealous following of these suggestions, and fear of the growing opioid epidemic, some pain patients find it difficult and even impossible to get the pain relief they require. Below are some examples of the struggle pain patients face trying to get the medication they legitimately need to manage pain, according to a study published in Science Direct.

  • Twenty-six states have passed laws that impose mandatory limits on the prescribing or dispensing of opioids for acute pain from surgery or an injury.
  • Some pharmacies have placed restrictions on opioid prescriptions they will fill, limiting numbers of pills dispensed as well as denying prescriptions with dosages stronger than the CDC’s dosing guide.
  • More than half of the pain patients surveyed (56 percent) reported disruptions in care or outright abandonment by their physicians.
  • Some physicians are being red flagged for overprescribing, some even losing their licenses or facing criminal charges for overprescribing. Some physicians are now leery to prescribe at higher levels, even when necessary, in order to avoid scrutiny from the DEA or state medical boards.
  • The state of Oregon is considering a proposal that would end coverage for opioids for many chronic pain patients on Medicaid. The original proposal would have forced pain patients to taper off their dose of painkillers in 12 months. Since its original consideration, last August, officials in Oregon have scaled back their proposal, to taper patients to 0 “when appropriate” based on the individual’s needs.

See the CDC guidelines here.

Pain Patient Statistics

According to the CDC report:

  • The 1999–2002 National Health and Nutrition Examination Survey estimated that 14.6% of adults have current widespread or localized pain lasting at least 3 months.
  • Based on a survey conducted during 2001–2003, the overall prevalence of common, predominantly musculoskeletal pain conditions (e.g., arthritis, rheumatism, chronic back or neck problems, and frequent severe headaches) was estimated at 43% among adults in the United States.
  • Most recently, an analysis of data from the 2012 National Health Interview Study showed that 11.2% of adults report having daily pain.
  • On the basis of data available from health systems, researchers estimate that 9.6–11.5 million adults, or approximately 3%–4% of the adult U.S. population, were prescribed long-term opioid therapy in 2005.

Reinterpreting The Guidelines

Some people wonder if the changes in prescription regulations are even helping. The rate of prescribing opioids has dropped every year since 2011, and still, opioid overdose deaths have continued to skyrocket during that same time frame.

Risks associated with denying prescription painkillers to pain patients include a loss of productivity, inability to function, medical decline, and increased risk of suicide. Individuals are losing their livelihoods and even their lives because they are unable to deal with chronic pain day after day.

The American Medical Association has recently pushed back against the misapplication of the CDC’s guidelines. At its meeting last November, the AMA adopted a series of resolutions describing its stance.

“Our AMA affirms that some patients with acute or chronic pain can benefit from taking opioids at greater dosages than recommended by the CDC Guidelines for Prescribing Opioids for chronic pain and that such care may be medically necessary and appropriate.

Our AMA advocates against the misapplication of the CDC Guidelines for Prescribing Opioids by pharmacists, health insurers, pharmacy benefit managers, legislatures, and governmental and private regulatory bodies in ways that prevent or limit access to opioid analgesia.

Our AMA advocates that no entity should use MME thresholds as anything more than guidance, and physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing opioids at a quantitative level above the MME thresholds found in the CDC Guidelines for Prescribing Opioids.”

Finding The Balance

So, what should be done? Prescription painkillers are addicting, and even when used as prescribed at first, can cause dependence and eventually addiction and drug-seeking behavior. First of all, we need to create better awareness of the dangers of any type of drug use. Doctors should try alternative forms of treatment whenever possible, and for those who require prescription opioids, they should be prescribed with care. Patients should be monitored closely for dependence and signs of abuse while on the medication, and patients should be screened for addiction prior to going on the medications.

On the other hand, physicians should be trusted enough to know which patients need more pain relief and should be allowed to prescribe based on the individual’s needs. Finding the balance between necessary pain relief and drug-seeking behavior is difficult, but if medical facilities take the CDC’s recommendations as just that and not requirements, we will provide more options for patients who desperately need this pain relief.

If you’re addicted to painkillers, you might need a detox program that can be monitored through residential or outpatient treatment facilities. Contact us now for more details.