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How Our Occupational Therapists Help Trauma Patients

Most of us take for granted our ability to complete the most basic steps associated with self care and social engagement. We never really consider that brushing one’s teeth, taking a shower, or having even the briefest social interaction with a stranger may be an emotionally strenuous task for some individuals. Naturally, when a person suffering from post traumatic stress disorder (PTSD) tries to explain the difficulty they experience executing daily tasks, it is not uncommon for them to be met with objections or to have their issues dismissed and be told to simply “get over it.” This advice is in no way helpful to the firefighter who is triggered by the sound of their own children crying, after witnessing children dying in a fire while on the job. And this certainly does nothing to assist the war veteran who relives moments on the battlefield everytime they hear the sound of aircraft overhead. From the decades of research on PTSD, one thing is abundantly clear—avoidance is not a viable option. Enter occupational therapy.

What Is Occupational Therapy?

Occupational therapy is a form of treatment for individual suffering from addiction or mental health disorders that interfere with their ability to perform daily tasks associated with living a normal, healthy. Occupational therapy focuses on three main areas:

Occupational therapists will often try to restore a patient’s self-confidence by breaking down big tasks into smaller, more manageable subtasks for the patient. This approach prevents the patient from feeling overwhelmed and gives them a sense of achievement by proving a series of small wins that bring them incrementally closer to achieving a big goal.

Symptoms of Post-Traumatic Stress Disorder

The biggest commonality among first responders, veterans, and survivors of abuse with post-traumatic stress disorder (PTSD) is that it impairs their abilities to move forward after the traumatic event. PTSD symptoms create severe psychological limitations that promote self-destructive behaviors. Through repetition, these behaviors become habits that an individual will feel unable to control, much less stop. PTSD symptoms are usually grouped into four categories:

In his book, The Evil Hours: A Biography of Post-Traumatic Stress Disorder, David J. Morris describes the aftermath of trauma as follows:

Trauma destroys the fabric of time. In normal time you move from one moment to the next, sunrise to sunset, birth to death. After trauma, you may move in circles, find yourself being sucked backwards into an eddy or bouncing like a rubber ball from now to then to back again. … In the traumatic universe the basic laws of matter are suspended: ceiling fans can be helicopters, car exhaust can be mustard gas. 

Understanding Your Emotions Helps Manage Symptoms

Our emotions are an important part of our individual growth and development. They can help us with everything from situational awareness to establishing healthy relationships. Distinguishing between an appropriate emotional response and a dysfunctional one can be a challenge for individuals with post-traumatic stress disorder (PTSD). Our occupational therapists teach patients principles and skills to help them better understand their emotions:

The process of working with occupational therapists is both collaborative and goal oriented, making it easy for patients to track their progress.

The Wise Mind: Balancing Emotion and Reason

When we are in our emotional mind, our actions are predominately based on our emotions and how we are feeling. Our response to stress or triggering situations is extremely reactive as we abandon logic, fact, and reason when our emotional mind has taken over. An example of your emotional mind taking over is when you overreact to a situation because it triggers a negative memory of a similar situation; your fear that something similar to your memory may happen again drives your overreaction, even if it is actually extremely unlikely.

We would all like to believe that we operate from our reasonable mind, however this is not always the case. The reasonable mind is the part of us that is based solely on logic and rational information. It gathers and interprets empirical information from our observations and forms beliefs and opinions based on that information. If drives actions that are are cool, controlled, and strategic. The reasonable mind is very useful in crisis situations. Many military personnel and first responders can tell you, being able to access the reasonable mind when you need it can be the difference between life and death. The reasonable mind is excellent for planning and evaluating big life decisions, however, it is possible to overdo it and fail to recognize and consider the significance of our emotional signals. Overuse can create habits such as minimizing our feelings, and compartmentalizing events that could be pivotal to our development by diminishing our emotional connections to them. Such habits could lead to depression, burn out, or feeling numb.

The wise mind is the integration of the reasonable mind and the emotional mind. It is a functional blend of strategic thinking guided by healthy emotional awareness. It is the capacity to consider past experiences, current perceptions, and theoretical knowledge, to arrive at a constructive understanding of one’s present situation. Our occupational therapists teach our patients techniques to make the wise mind more easily accessible and available to help them manage their trauma symptoms.

Problem Solving: Barriers and Strategies

Problem solving can be difficult for the average person on any given day. It requires us to use all aspects of our mental capacity to analyze a particular set of circumstances and available choices, and then produce a solution. An ideal solution would not only satisfy our immediate need, but would also be consistent with our long-term goals. This process can be extremely difficult for individuals suffering from mental health or substance use disorders as they may not trust their own judgement and or accuracy in assessing a situation.

Barriers to Effective Problem Solving

The first step that our occupational therapists take with patients is to help them identify common barriers to solving problems quickly and effectively, including the following:

Strategies for Effective Problem Solving

Occupational therapist also teach patients a range of effective problem-solving strategies that can be used in different situations, including the following:

Subjective Unit of Distress Scale and Coping Strategies

It can be very difficult for those suffering from substance use and mental health disorders to clearly recognized and understand how they are feeling at any given time. Occupational therapists provide patients with tangible metrics to help them the recognize, isolate, and react appropriately to negative stimuli. The Subjective Unit of Distress Scale (SUDS) works as an emotional gauge, and is a crucial part of therapy. The SUDS protects patients from their more destructive emotions by teaching them practical ways to distract themselves from what they are feeling. The objective is to turn this distraction, which may be unusual to the patient in the beginning, into their habitual response to extreme stressors.  

Occupational Therapists Help Patients Get Back to Their Lives Faster and Better

Recovery from post-traumatic stress disorder is a difficult process that requires hard work and commitment from the patient. Occupational therapists help facilitate this process and allow patients to return to their normal lives more quickly, with effective coping skills, useful habits, practical knowledge, and effective problem-solving strategies.

Call Us for More Information

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

Integrated Treatment of Substance Use Disorders and Concurrent Post-Traumatic Stress Disorder (PTSD) Is The Most Effective Approach

Post-traumatic stress disorder (PTSD) can develop after an individual has been exposed to a traumatic event such as death, serious injury, or a threat of harm to themselves or to others. When exposed to such events, it is normal to feel intense fear, helplessness, and horror, but in most cases, these feelings are eventually resolved—but, unfortunately, not always. Some people experience long-lasting and intrusive symptoms such as disturbing flashbacks, heightened states of arousal, mood disturbances, and avoidance of memories about the event. These are the symptoms associated with PTSD.

Post-traumatic stress disorder (PTSD) is more common than you might think. An estimated 1-in-10 Canadians will experience PTSD at some point in their lives. Certain populations are at higher risk of developing PTSD because they are more likely to experience traumatic events. Members of the military are often seriously injured, witness the death or injury of others, and have their lives seriously threatened. Many veterans returning from Iraq and Afghanistan report being targets of enemy gunfire, knowing someone who was injured or killed, or even having to handle dead bodies. Such experiences can have a lasting effect on an individual’s mental and emotional well-being.

There appears to be a bi-directional causal relationship between developing post-traumatic stress disorder (PTSD) and developing a substance use disorder. People with PTSD experience persistent and disturbing psychological symptoms, which make them more likely to use alcohol or drugs as coping mechanisms. Conversely, people with substance use disorders are both more likely to experience traumatic events and less likely to be able to process them effectively.

Compared to either disorder alone, concurrent post-traumatic stress disorder (PTSD) and substance use disorders are associated with worse mental and physical functioning, and higher levels of psychological distress. When these two disorders are concurrent, the negative effects can be quite severe: they can impair a person’s ability to work, to maintain healthy relationships, and to maintain a positive outlook on life. As a result, people with concurrent PTSD and substance use disorders will often experience rapidly deteriorating physical and mental health, and should therefore get treatment as soon as possible.

There are several treatment options available for individuals with concurrent post-traumatic stress disorder (PTSD) and substance use disorders, including both medical therapy and psychotherapy. Historically, treatment focused on resolving the substance use disorder first, before proceeding to address the PTSD. However, the historical approach risks exacerbating a patient’s PTSD symptoms: when a patient with PTSD narrowly focuses on trying to resolve their substance use disorders, they are likely to be confronted with challenges and discomfort for which they are not yet adequately prepared. Today, however, most clinicians recognize that patients’ substance use is closely related to their PTSD symptoms. Hence, at EHN Canada, we believe that the most effective treatment approach is through integrated treatment programs that address both disorders together.

EHN Canada’s integrated treatment model acknowledges the fundamental interdependence between post-traumatic stress disorder (PTSD) and substance use disorders. Therefore, we address the two disorders at the same time, usually within the the same treatment program. Substance use disorders are conceptualized as tools—albeit highly dysfunctional ones—that people use to try to manage their PTSD symptoms. We educate patients and provide them with a new, healthier, and more effective set of tools, early on in their treatment programs. This reduces the likelihood that a patient’s PTSD will compromise their recovery from their substance use disorders. Our conviction that the integrated treatment model produces superior outcomes is also supported by patients’ attitudes: research has found that patients with concurrent PTSD and substance use disorders report an overwhelming preference for the integrated approach.

Post-traumatic stress disorder (PTSD) and substance use disorders have a complex interrelationship. EHN Canada treatment programs teach patients how to recognize and manage their symptoms and triggers. We also help patients create solid recovery plans that serve to guide their long-term behaviour changes. EHN Canada’s individualized treatment programs also push each patient to discover their own unique strengths and skills. We encourage and support our patients to further develop these abilities to support their successful recoveries and recovery maintenance. Patients complete EHN Canada treatment programs having developed functional and adaptive coping strategies, as well as assertiveness and effective communication skills. They walk out our doors ready to face the world, full of optimism, and eager to get back to their relationships, families, friends, and careers.

Call Us For More Information About Our Programs

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

How Healthy Eating Can Help You With Addiction Recovery

Written by Munis Topcuoglu, Editor at EHN Canada.

Healthy eating helps you with addiction recovery by allowing your mind and body to work better and heal faster.  It helps you maintain your recovery by supporting your mind and body to function well consistently, thus maintaining your good health. Eating a healthy diet helps you with addiction recovery in a number of specific ways such as stabilizing your mood, improving your focus, increasing your energy, and making you better at resisting cravings for addictive substances and behaviors.  Conversely, nutrient deficiencies can make addiction recovery more difficult by making you more susceptible to depression, distraction, fatigue, and cravings. Substance use disorders can make you are especially vulnerable to nutrient deficiencies, for a number of behavioral and biological reasons—but healthy eating can help correct your nutrient deficiencies and greatly improve your odds of successfully achieving recovery and maintaining it long term.

Healthy Eating Means Getting the Right Nutrients and Calories in the Right Quantities

Your mind and body use up nutrients and energy constantly, so healthy eating requires that you get sufficient nutrients and energy regularly from the foods you eat.  Healthy eating means getting enough of all the nutrients you need to function well and be healthy, but not excessive amounts of any nutrients that would be enough to harm you.  Healthy eating also means getting enough calories (energy) that you need for performing healthy physical activity and maintaining a healthy body weight, but not so much that it would cause you to gain an unhealthy amount of body fat.

There are two main categories of nutrients, macro-nutrients and micro-nutrients.  Macro-nutrients are basic building blocks and energy sources for your body; you must get them in relatively large amounts, such as 10’s or 100’s of grams per day.  In comparison, micro-nutrients have specialized functions in your body; you need them in much smaller amounts, such as micrograms or milligrams per day.

Macro-nutrients

The three macronutrients are protein, fat, and carbohydrate.

Protein

Protein is used for building and repairing all the cells in your body.  It is especially important for muscle and connective tissue, but is also necessary for producing hormones and neurotransmitters.  Proteins are composed of amino acids. There are some amino acids that your body needs but cannot produce: these are called “essential amino acids.”

Fat

Fat is a preferred energy source, but is also essential for your nervous system, building cell membranes, and producing hormones.  There are some fats that your body needs but cannot produce: these are called “essential fatty acids.”

Carbohydrate

Carbohydrates are an optional energy source.  Appropriate carbohydrate intake depends on your physical activity levels and your genetics.  Excessive carbohydrate intake can disrupt your metabolism, cause you to gain unhealthy body fat, and lead to diabetes and cardiovascular disease.

Micro-nutrients

The two main groups of micro-nutrients are vitamins and minerals.  Vitamins are organic molecules and minerals are chemical elements.  Each vitamin and mineral has specialized roles within your body and they are all required in small amounts for your mind and body to function properly.  Your body cannot produce vitamins or minerals.

Essential nutrients and healthy foods

Essential nutrients are nutrients that your body requires to function properly but cannot produce, they are the following: essential amino acids, essential fatty acids, vitamins, and minerals.  Since your body cannot produce them, you must get them from the food you eat.

Healthy eating means getting all the essential nutrients that you need.  Therefore, healthy foods are foods that contain high amounts of essential nutrients; they are usually whole, unprocessed, and fresh.  In contrast, unhealthy foods contain low amounts of essential nutrients and are often refined, processed, and contain preservatives.

Addiction Makes It Difficult to Eat Healthy, Often Resulting in Nutrient Deficiencies

Addictive substances and behaviors can make healthy eating more difficult in a number of ways.  They can also prevent you from getting enough nutrients despite a normally healthy diet. When you don’t get enough of a particular essential nutrient in your body, you develop a nutrient deficiency.  Addictive substances can interfere with healthy eating and cause nutrient deficiencies in the following ways.

Reducing your appetite

When your appetite is reduced and you regularly eat less food, you might not get enough nutrients and energy even if the foods you eat are normally healthy foods.

Increasing cravings for unhealthy foods

When you have cravings and eat a lot of unhealthy foods, it can be difficult to get all the nutrients you need, since unhealthy foods contain low amounts of essential nutrients.

Reducing how well you absorb nutrients

Getting enough nutrients requires that you absorb the nutrients from food in your digestive system.  Since some addictive substances can reduce your ability to absorb nutrients, you might not get enough nutrients even if you have a normally healthy diet.

Depleting nutrients in your body

Getting enough nutrients means that the amount of each nutrient you get equals the amount your body uses up.  Some addictive substances can cause your body to use up nutrients in much larger quantities than normal, or they can destroy nutrients in your body.  When either of these happens, you might not get enough nutrients even if you have a normally healthy diet.

Reduce your motivation to eat healthy

Staying motivated to eat healthy requires maintaining the belief that healthy eating will produce positive outcomes for you.  It also requires the confidence that you will succeed at healthy eating long enough to experience those positive outcomes. Addiction can make it more difficult to maintain a positive outlook on the future and can also negatively affect your confidence.

Take your attention and energy away from your goal of healthy eating

Especially when you first start, healthy eating requires that you pay careful attention to choosing the foods you eat.  Shopping for and preparing healthy foods also usually requires more time and energy compared to unhealthy foods. Addictions can be distracting and take your attention away from healthy eating.  They can also get in the way of healthy eating by draining your time and energy.

Nutrient deficiencies and too few calories

As described above, recovering addicts often do not eat healthy and do not get enough nutrients and calories.  If you are a recovering addict, you may have nutrient deficiencies that are harming your mind and body in ways that make getting sober and staying sober much harder.  A caloric deficit (eating too few calories) can also make getting and staying sober much harder.

Healthy Eating Makes Addiction Recovery Easier—Nutrient Deficiencies Make It Harder

There are a number of factors that are essential for addiction recovery and recovery maintenance.  These factors are positively affected by healthy eating and negatively affected by nutrient deficiencies.

Mood and confidence

A positive outlook and confidence in your ability to overcome challenges makes it easier to accomplish difficult tasks.  Healthy eating can help maintain a stable positive mood whereas nutrient deficiencies can make you more vulnerable to anxiety and depression.  For example, research has shown a relationship between folic acid (vitamin B9) deficiency and depressed mood, and also a relationship between thiamine (vitamin B1) deficiency and decreased self-confidence (Ottley, 2000).

Focus and awareness

Focusing on achieving your goals combined with maintaining awareness of yourself and your environment are very useful practices.  Healthy eating can improve your ability to focus and maintain awareness whereas nutrient deficiencies can make you more vulnerable to distractions.  An example is magnesium deficiency, occurring especially frequently in recovering addicts, which has symptoms including confusion and insomnia (Flink, 1985).

Motivation, drive, and energy

Consistent motivation, drive, and energy are necessary for problem solving and overcoming obstacles.  Healthy eating can help maintain high levels of motivation, drive, and energy whereas nutrient deficiencies can cause you to experience more ups and downs that jeopardize your success.  A well-known example is iron deficiency which can cause apathy and abnormal fatigue (Ottley, 2000).

Experience of cravings and ability to resist them

Feeling cravings less intensely and being able to resist them are both critically important.  Healthy eating can make your cravings for addictive substances and behaviors less intense, it can also strengthen your willpower to resist them.  Conversely, nutrient deficiencies can make your cravings more intense and weaken your willpower. One example is a study which showed that alcoholics treated with a traditional therapy combined with nutritional therapy had less alcohol cravings and were more successful at abstaining compared to alcoholics treated with only traditional therapy (Biery et al., 1991).

Too Much of Certain Macro-Nutrients Can Also Make Recovery and Maintenance Harder

Certain macro-nutrients consumed in excess can harm you and make addiction recovery and recovery maintenance more difficult, a few examples follow.  

Carbohydrate: Sugars

Too much sugars (simple carbohydrates) can cause you to have unstable energy levels, intensified cravings, and lower willpower.  Sugar is a reinforcing substance which has demonstrated cross-sensitization with other addictive substances such as amphetamine and alcohol in rodent models (Hoebel et al., 2009).

Fat: ratio of Omega-6 to Omega-3

Researchers believe that a high ratio of omega-6 to omega-3 (two fatty acids) can increase systemic inflammation which contributes to the development of chronic conditions such as arthritis and cardiovascular disease (Patterson et al., 2012) and also depression (Berk et al., 2013).

Protein: (Any)

Some addictive substances cause kidney damage.  If you have kidney damage, there is evidence which suggests that excessive protein consumption can make it worse (Levey et al., 1996).

For Best Results Make Healthy Eating a Part of Your Addiction Recovery Plan

Healthy eating will ensure that the food you eat is helping your addiction recovery and not holding you back.  It will ensure that the food you eat is protecting you from relapse and not increasing your risk.

Healthy eating is challenging for anyone and to succeed you need a clear plan for how you will start eating a healthier diet and for how you will develop habits to keep eating healthy for the rest of your life.  The following list is a good starting point:

However, each individual’s nutritional requirements are different, due to a wide range of factors.  Professional consultation can help you design a personalized plan for your own specific needs and develop a deeper understanding of your unique nutritional requirements.

EHN Canada Facilities Can Help You Eat Healthy, Achieve Recovery, and Maintain It

The comprehensive drug rehab and other treatment programs at EHN Canada facilities include nutrition planning through consultation with our staff dietitians.  Our nutrition planning aims to get you eating healthy with the following objectives for successful long-term addiction recovery:

Please Call Us for More Information

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

Online Treatment and Support

If you’d like to learn more about our online treatment and support options, please call us at 1-800-387-6198 or visit onthewagon.ca.

Further Reading About How Specific Nutrients Can Help Addiction Recovery and Recovery Maintenance

Protein Part 1

Protein Part 2

Fat

Carbohydrate

Sugar (video)

Vitamins & Minerals

References

Berk, M., Williams, L. J., Jacka, F. N., O’Neil, A., Pasco, J. A., Moylan, S., … & Maes, M.
(2013). So depression is an inflammatory disease, but where does the inflammation come from?. BMC medicine, 11(1), 200.

Biery, J. R., Williford, J. J., & McMullen, E. A. (1991). Alcohol craving in rehabilitation: assessment of nutrition therapy. Journal of the American Dietetic Association, 91(4), 463-466.

Flink, E. B. (1985). Magnesium deficiency in human subjects—a personal historical perspective. Journal of the American College of Nutrition, 4(1), 17-31.

Hoebel, B. G., Avena, N. M., Bocarsly, M. E., & Rada, P. (2009). Natural addiction: A behavioral and circuit model based on sugar addiction in rats. Journal of Addiction Medicine, 3, 33-41.  

Levey, A. S., Adler, S., Caggiula, A. W., England, B. K., Greene, T., Hunsicker, L. G., … & Teschan, P. E. (1996). Effects of dietary protein restriction on the progression of moderate renal disease in the modification of diet in renal disease study: modification of diet in renal disease study group. Journal of the American Society of Nephrology, 7(12), 2616-2626.

Ottley, C. (2000). Food and mood. Nursing Standard (through 2013), 15(2), 46.

Patterson, E., Wall, R., Fitzgerald, G. F., Ross, R. P., & Stanton, C. (2012). Health implications of high dietary omega-6 polyunsaturated fatty acids. Journal of nutrition and metabolism, 2012.x

What You Should Know about Alcohol Use Disorder or Alcoholism:

Alcohol Use Disorder

Alcohol has been and remains the most common substance of abuse in Canada. While the legal age of alcohol consumption is 19 in most provinces, people typically begin experimenting with alcohol in their min-teens and start drinking without incident in their early twenties and beyond. Despite the common place that alcohol holds in our society, there is a continuum of risks and problems associated with alcohol consumption.

Alcohol Use Disorder (AUD) is a recognized medical condition that refers to the regular use of alcohol despite recurrent adverse consequences. To be diagnosed with AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, the current version of the DSM, anyone meeting any two of eleven defined criteria during the same 12-month period receives a diagnosis of AUD. The severity of AUD—mild, moderate, or severe—is based on the number of criteria met.

The Eleven Symptoms of Alcohol Use Disorder (AUD) as per the DSM-5:

  1. Alcohol is often taken in larger amounts or over a longer period than was intended.

  2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.

  3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.

  4. Craving, or a strong desire or urge to use alcohol.

  5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.

  6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.

  7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.

  8. Recurrent alcohol use in situations in which it is physically hazardous.

  9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.

  10. Tolerance, as defined by either of the following:

    1. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect
    2. A markedly diminished effect with continued use of the same amount of alcohol.
  11. Withdrawal, as manifested by either of the following:

    1. The characteristic withdrawal syndrome for alcohol (refer to criteria A and B of the criteria set for alcohol withdrawal)
    2. Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

We Can Help You

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

Challenging Those Addiction Symptoms That Can Linger After You Stop Drinking

photo-1463062511209-f7aa591fa72f“This is WHO I AM! Why are you trying to change me? I stopped drinking!” Sound familiar? Statements like these are examples of what people might say who’ve stopped drinking but continue to behave as if they were still drinking or using. You see, becoming sober is just one part of addiction recovery. This behaviour is commonly referred to as untreated sobriety.

It’s important to recognize this behaviour because it usually presents itself as anger and resentment. These emotions are triggering for your recovery. The anger and resentment are usually a result of not being able to accept that you can no longer use substances to feel better. In essence, what you may be experiencing is grief over the loss of your drug of choice.

We spoke to Kim Holmgren, Addiction Counsellor at Bellwood Health Services to discuss what “dry drunk syndrome” looks like. Kim Holmgren teaches a session on untreated sobriety every few weeks at Bellwood to clients and has been with Bellwood’s clinical team for over three years. Kim Holmgren states, “Although a person may not have used or acted out in years they may still have never had a sober day. So not using or acting out is definitely a part of addiction recovery, but in itself, it is not recovery.” Moving from a stage of loss to acceptance can make all the difference of how you feel. If you’re having a difficult time accepting the loss of drugs or alcohol, this can keep you stuck in a nasty state of bitterness.

Kim Holmgren shared with us a list of symptoms or some things you might say when you have untreated sobriety:

  1. Low self-esteem
  2. Can’t live in the moment.
  3. “I don’t like myself.”
  4. “What do they think of me?”
  5. “Am I good enough?”
  6. “Nobody understands me.”
  7. “You don’t get it.”
  8. Tomorrow I’ll smarten up.
  9. I don’t fit in.
  10. Maybe I can control it?
  11. One isn’t going to hurt…or is it?
  12. But it is different now.
  13. I feel so much better
  14. I don’t feel any better.
  15. I still feel crappy.
  16. “I’ll stay off the hard stuff!”
  17. Why does everything always happen to me?
  18. I never get a break.
  19. If they don’t trust me, why am I doing this?
  20. It’s not going to help if I call someone.
  21. I’m different.
  22. I don’t care.
  23. It’s MY LIFE!

Kim Holmgren states that all these symptoms or sayings are often said by individuals by people who aren’t in recovery too, but the difference is that this type of thinking and behaviour is dangerous for a person who is in recovery. “Those who quit using or acting out and are still angry about it usually wind up living miserable lives and usually make everyone around them feel miserable too. Family members or members from a support group are often the first to notice this behaviour. Some people might argue that their loved one or friend is trying to change who they are despite the obvious. Why pay attention to this? Resentment and anger are one of the worst enemies for a person in recovery! Remember, these individuals are not addicted to the substances. The substances are just a solution. If this behaviour isn’t handled properly, it can come back after long periods of sobriety and is usually the first sign of a relapse waiting to happen.”

Recovery Vs. Abstinence/ Not Acting Out

What does recovery look like versus untreated sobriety? Kim Holmgren explains, “Recovery involves working on all of the problems and issues that led you to use in the first place. It requires major lifestyle changes and developing a support group system. You need to work on yourself and fix what was broken. Plain abstinence does not do any of the things previously mentioned.”

Kim Holmgren does mention in a previous blog post that its not always the person’s fault they weren’t able to accept and move forward in their recovery. “Sometimes people have underlying mental health illnesses that haven’t been addressed yet. Other times, it can be environmental stressors and triggers that are overwhelming for someone who is in early recovery.”

Next Steps

According to Kim Holmgren, one of first things you can do to stop this behaviour and move towards acceptance is to get a sponsor, “Get a sponsor and to talk to them. Ask yourself, where are the anger and the resentment coming from? Acceptance is the first step.” Kim Holmgren also suggested to look at Dr. Steven Melemis, PhD, MD’ five rules of recovery published in his book, I Want To Change My Life: How to Overcome Anxiety, Depression and Addiction:

  1. Change your life. You recover by creating a new life where it is easier to NOT use.
  2. Be completely honest. Addiction requires lying. From this day forward, you have to be completely honest, especially with yourself and your recovery circle. As you get more comfortable, the circle can widen. Honesty is always preferable, except where it may harm others.
  3. Ask for help. That includes doctors, therapists, addiction counsellors and people in recovery. Anywhere that will help your recovery.
  4. Practice self-care. Mind-body relaxation is not an optional part of recovery, it is essential. The practice of self-care during mind-body relaxation translates into self-care in the rest of life.
  5. Don’t bend the rules. Don’t look for loopholes in your recovery (quick fix). No change is no change.

If you need to speak to someone about the challenges you are facing in your recovery, please call us at 1-800-387-6198. It’s important that you start to be honest with yourself and ask for help.

How Do You Know If Someone Is Addicted to Drugs or Alcohol?

Man drinking beer“I drank too much the other night, that won’t happen again!” “I just need one more hit. I’m fine!”  You may have often heard people you care about say these phrases and not think twice about them- until recently. Perhaps, there have been changes in their behaviour that have you concerned.

Changes in behaviour can be a sign of mental illness or addiction. Unfortunately, many people don’t understand what addiction is or how it develops. Addiction is not something that happens overnight. It’s not something you decide to try as you would decide to try Starbuck’s latest Frappuccino.

The World Health Organization (WHO) states that addiction and mental illness affects approximately 10% of the population at any point in time. WHO also reveals that one in four families has at least one member currently struggling with addiction or mental illness. Addiction has no boundaries.

At Bellwood, we’ve seen all walks of life enter our doors and all of them share the same disease. Many of them have lost, or are on the brink of losing so much because their drinking or substance use has spiraled out of control. How do you define addiction? How do you know if someone’s drinking or drug abuse has become a larger problem than previously believed?

Addiction is the inability to stop using a substance despite the negative consequences experienced. People have many different reasons why they become addicted but there is one thing they do share in common. That is the desire to change the way they feel or in some cases, numb the pain. The feelings they get from using alcohol or drugs are what can lead to substance abuse and eventually result in physical and psychological dependence.

Individuals struggling with addiction may:

 

Other common characteristics of addiction include disconnection and isolation. Trauma or previous experiences in a person’s life may have been the reason why the person turned to substances to medicate unpleasant emotions. As a person plummets deeper into the disease of addiction, isolation becomes more apparent.

Do these behaviours sound familiar? If you’re concerned about a loved one’s drug or alcohol use, or perhaps it is yourself that you’re concerned about, Bellwood has an online quiz for alcohol and drug abuse. Responses to these questions may indicate that you need to talk to an addiction counsellor.

  1. Do you ever get drunk or high alone?
  2. Has drinking or using drugs stopped being enjoyable?
  3. Do you find that your choices of friends are selected based on your alcohol/ drug use?
  4. Do you drink or use drugs to cope with your feelings?
  5. Is it difficult for you to imagine a life without drinking alcohol or using drugs?
  6. Do you plan your life around your use of drugs or alcohol?
  7. Do you drink or use drugs to avoid dealing with the problems in your life?
  8. Are you ever not completely honest about your use of drugs or alcohol?
  9. Have relatives or friends every complained that your use of drugs or alcohol is damaging your relationship with them?
  10. Has your use of drugs or alcohol caused problems with motivation, concentration, memory, and relationships, at work or with your health?
  11. Have you failed to keep promises you made about cutting down or controlling your use of drugs?
  12. Do you feel anxious or concerned about how to obtain more drugs or alcoholic beverages when your supply is near empty?

 

Addiction is a disease that affects many people and is often described as a family disease. It’s important that you consult with a professional to get a better understanding of what’s happening with your family member or with someone you care about. Bellwood Health Services is an addiction treatment centre that provides support and treatment options for individuals, family members and employers.

Talking to someone is an important step towards addiction recovery. Give us a call at 1-800-387-6198 or email us at [email protected] to learn how we can get you started on your path of recovery.

Substance Use and Addiction: What Does Work Have to Do With It?

glasses upCould your job be encouraging a substance use disorder?

Addiction can affect anyone, regardless of their job.  But there are certain fields where substance abuse and addiction are more common, and they tend to have a few things in common. Research shows that high stress, low job satisfaction, long hours or irregular shifts, fatigue, repetitious duties, boredom, isolation, irregular supervision and easy access to substances can all contribute to the problem. But what groups are most affected?.  We know that employees in the arts and entertainment, mining and food services are more likely to report heavy drinking in the past month compared to other employment groups. On the other hand, employees working in healthcare and education are the least likely to report heavy alcohol use. 

Risk Factors Explained:

There are several factors associated with different types of jobs that may lead to an increased likelihood of problematic substance use. Low employee visibility and isolation can be high risk for substance use and misuse. Jobs that involve a substantial amount of travel, and therefore less direct supervision such as some sales jobs, construction or contracting jobs, can lead to increased substance use.  In addition, social and workplace norms around drinking and drug use can also contribute to the problem. Some work environments are more permissive that others and it has been found that perceived acceptability of drinking by coworkers is one of the strongest predictors of drinking behaviour. In some industries such as the food and beverage service industry, alcohol is easy to acquire right on the job, making it easier to consume. Therefore the normative belief that it’s okay to have a drink while at work, coupled with the easy access to alcohol can make it extremely likely that an employee in a bar or restaurant will consume alcohol while on the job. If the employee works every day, it can become a daily habit that can ultimately lead to it’s misuse and possibly abuse.

Another important contributing factor is the issue of employee stress. Stress can come from various sources including physical hazards or heavy workloads, tight deadlines, low job security and workplace conflict. These factors can lead to an employee feeling little or no control over what happens at work. Jobs that offer very little control, combined with increasing demands, can place the employee at risk for substance use as the alcohol or drugs may be the employee’s form of coping with the demands and stress of the work environment. Therefore employers should be aware of possible stressful situations and should emphasize work/life balance with employees.

What to do?

It is important to note that not all employees working in high risk occupations will go on to develop an addiction. Instead, it is likely that a combination of several causes, including construction-workerindividual factors such as genetics, social, cultural, and mental health issues, places an employee at greater risk for developing a substance use problem. In order to minimize this risk, it helps if employers are aware of the common signs of substance abuse and receive adequate training in how to approach an employee that might need help.

It is also important to establish clear organizational policies about substance use in the workplace. Employees need to have clear expectations about workplace rules and repercussions that would follow should an employee choose to break those rules. Employers should also be aware of how the work environment or job features may lead to maladaptive coping or other unwanted behaviours such as drinking alcohol or using drugs. This knowledge could shape the workplace culture such that employees feel empowered to approach a supervisor when concerned or taking some time to rest and recover when feeling stressed or overwhelmed.

So pay attention to the signs.  Try to minimize stress, isolation and fatigue. Work on creating a culture where health and self-care are more important than drinking and using.

Intensive Outpatient Programs: Early Intervention Can Mitigate the Need for Residential Treatment

sex-addiction

The American Society of Addiction Medicine defines addiction as a primary, chronic disease of brain reward, motivation, memory and related circuitry. Similar to other chronic illnesses such as cancer and diabetes, addiction, if left untreated can develop into a more severe condition over time.  The negative impact of addiction can range from physical and emotional damage, to severe life impairment and even death.  This progression of the disease can occur over many years, however it often begins with use of a substance to induce a desired mood change.  The discovery of this perceived benefit can then lead to the individual’s misuse of the substanceor using to the point of intoxication in order replicate this sensation.  Substance misuse can further progress as the individual exploits this relationship between the substance use and its desired outcome.  This would be considered substance abuse, and the individual may continue to use the substance even despite the fact that it is beginning to interfere with their life, impact their work or personal relationships.   If not addressed, substance abuse can then develop into a substance use disorder. Individuals struggling with a severe substance use disorder often require a greater amount of the substance in order to feel the same effect as the first use, and negative physical symptoms such as withdrawal may occur if the substance use is discontinued. As the illness progresses the difficulty to stop using the substance increases. 

The development of an addiction is often characterized by negative consequences such as DUIs, performance issues at work or family concern. Some of these consequences can serve as warning signs that the substance use is becoming out of control. By recognizing the warning signs and realizing that perhaps one’s substance use has progressed to misuse or even abuse, an individual can be proactive in avoiding the progression of the illness and prevent further negative physical, mental and social consequences. Early detection of the illness however may require insight into the personal problems that fuel the substance abuse.  Help from a professional addiction counselor may be a necessary means of addressing the substance use issue. It is important to get help and there is a range of treatment options available depending on the severity of the problem. For those appropriate, treatment is possible without having to attend a residential rehabilitation program. For example, mild and moderate substance use disorders can be effectively treated within an outpatient context.  One possible option is an Intensive Outpatient Program (IOP).

Components of an IOP include group process and counselling, psycho education on the disease of addiction and recovery, relapse prevention, cognitive behavioural therapy, aftercare planning and substance use monitoring.  The goal of the IOP is abstinence from mood altering substances, and therefore clients will learn to establish relapse prevention tools, but they will also begin to address underlying issues associated with the substance use and bring them to the surface. This can help them understand what is perpetuating the addiction and help to find other means of coping with stress or relationship issues, for example.

Family-SupportdollsAn intensive outpatient program is well suited to individuals who are motivated to address their substance use issues, before they further impact their health and well-being. They are also ideal for individuals who have supportive home environments, with loved ones who will encourage them in their recovery. While addiction is a very serious health issue, the good news is that it can be effectively treated, especially in its early development. Participation in programs such as an IOP, can be an important and meaningful way to address substance use issues before they lead to more severe problems.

WHO Report Declares Alcohol Kills 1 Person Every 10 Seconds

Addiction has become one of the most critical health problems facing our species.

A new study released last month from the World Health Organization (WHO) reveals that alcohol kills 1 person every 10 seconds. The study states that alcohol was the reason that 3.3 million deaths occurred in the world in 2012 and that 16% of people who drink alcohol alcohol binge drink. In addition, not only does risky alcohol consumption lead to addiction, it also puts people at a higher risk for developing more than 200 different disorders. Shekhar Saxena, head of the WHO’s Mental Health and Substance Abuse department, has stated that these numbers actually translate into 1 death every 10 seconds.

Several people who work in the addictions field were probably thinking the same thing I was. Well, that’s no surprise. What was alarming to me was the number of deaths that were accounted for alcohol only! Many of you may be discovering in your practice or in the workplace that the odds of finding someone with merely an alcohol problem is becoming quite rare.

Individuals are dabbling into prescription drugs and street drugs as well as developing other dangerous compulsive behaviours such as sex addiction, eating disorders and problem gambling. Finding the proper treatment for individuals who are facing concurrent disorders has become one of the major and important missions for healthcare professionals across the world.

What does this data tell us?

The WHO continues to be an authority for health within the United Nations system. The purpose of WHO is to provide guidance and direction on global health matters, set health standards, communicate evidence-based policy options, as well as monitor and assess health trends. In essence, they are a legitimate source of statistical data and have the resources to clinically confirm how countries are responding to global health problems.

The fact that the WHO’s report states that 3.3 million people died in 2012 because of alcohol, means 3.3 million people drank excessively and severely to the point of causing bodily harm to themselves or to others. No one sets out to develop heart disease, cancer or addiction. Yet, the reality is addiction has become one of the most critical and detrimental health problems facing our species.

How did this happen? Why didn’t we save more lives?

Addiction is a Primary Healthcare Problem

I believe there are a number of people who don’t think addiction is still a serious problem in today’s world. Several healthcare authorities and associations do tremendous work to help prevent our youth from developing addictions, from binge drinking, and to prevent individuals from driving while under the influence. So why would these problems still exist and at such a prevalent rate? The reason is because numerous individuals do not view addiction as a primary health care issue. It is still viewed as a social and economic issue.

What is the definition of primary health care? According to Health Canada, “primary health care refers to an approach to health and a spectrum of services beyond the traditional health care system. Primary Care is the element within primary health care that focuses on health care services, including health promotion, illness and injury prevention, and the diagnosis and treatment of illness and injury.”

Addiction is an illness and it’s been acknowledged by medical authorities across the globe. It has been and continues to be a primary health care problem that affects everyone. Yet, primary healthcare professionals struggle to find treatment for their patients because many countries have failed to provide its citizens one of the major components to primary healthcare- and that is proper treatment of addiction as an illness.

The Major Gap – Building Awareness to Providing Treatment

As I mentioned earlier, several preventative and awareness campaigns are published frequently every year on the dangers of alcohol abuse and drugs which are fantastic for those who have no history of abuse, no trauma, no major health problems, no financial issues, and has a dependable support network, as well as has a great foundation for handling life stresses.

Some individuals may have the knowledge and be blessed to not have such issues, have the right people in their life, as well as be open to discussing their problems. Yet, several individuals unfortunately face or have faced such challenges and do not know how to manage and pull through. These individuals thus turn to unhealthy behaviours or substances to cope with the pain, despite the negative consequences, and thus are beyond the awareness campaign. These people are in need of medical and psychological treatment.

What You Can Do

If you know someone who may have an alcohol problem or any other behavioural problem and are struggling, the most important thing you can do is acknowledge the problem and offer a helping hand. We need to stop creating campaigns that accusingly point finger at individuals who clearly have the disease of addiction and change the words we use to stop the stigma that has been around for decades. We need to show these individuals through our actions and words that it is understood that addiction is an illness and that it is important to seek treatment for it. Just as you would seek Chemo for cancer or get insulin for your diabetes, people who need addiction recovery need professional treatment to treat their disease.

The sooner we acknowledge addiction treatment and the several benefits of it on the economy, the workplace, the family unit, and the judicial system, the closer the world will be at achieving the WHO’s voluntary global target to reduce harmful alcohol use by 10% by 2025.

References

Health Canada. (2012) About Primary Health Care. Retrieved from: https://www.hc-sc.gc.ca/hcs-sss/prim/about-apropos-eng.php

Thomspon Reuters (2014). The Knowledge Effect: World Alcohol Consumption. Retrieved from https://blog.thomsonreuters.com/index.php/world-alcohol-consumption-graphic-of-the-day/

World Health Organization. (2014) Global Status Report on Alcohol and Health 2014. Retrieved from https://apps.who.int/iris/bitstream/10665/112736/1/9789240692763_eng.pdf?ua=1

Time Magazine (2014). Alcohol Kills 1 Person Every 10 Seconds, Report Says. Retrieved from: https://time.com/96082/alcohol-consumption-who/