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:
Alcohol is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
Craving, or a strong desire or urge to use alcohol.
Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
Recurrent alcohol use in situations in which it is physically hazardous.
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.
Tolerance, as defined by either of the following:
- A need for markedly increased amounts of alcohol to achieve intoxication or desired effect
- A markedly diminished effect with continued use of the same amount of alcohol.
Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for alcohol (refer to criteria A and B of the criteria set for alcohol withdrawal)
- 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.
- 1-866-926-4196 for Bellwood Health Services in Toronto, ON
- 1-587-602-0266 for EHN Sandstone, in Calgary, AB
- 1-866-946-4806 for Edgewood Treatment Centre in Nanaimo, BC
- 1-866-965-4345 for Clinique Nouveau Départ in Montreal, QC
Recovery allows journalist to end nightmares and live dreams
By Jeremy Hainsworth
One sentiment I heard early on at Edgewood sticks in my head.
“Religious people fear hell; spiritual people have been there.”
It resonated with me. I have come to realize that hell exists between my ears – if I don’t live a spiritual life.
I bounced between extremes. On one hand, I was anxious about the future. On the other, I repeatedly tried to change the past, to fix mistakes, to change relationships gone wrong.
I was doing it all in my head and it was torture. So, to fix it, I increasingly numbed myself out.
Added to that was the sense – I remember it as far back as grade three – that I was somehow an outsider, that I did not belong. I was alone.
As for feelings and emotions, I didn’t seem to have any. It was as if I’d not received the full package of emotions as everyone else. I was cold, close relationships scarce.
The using began innocently enough – a few beers and joints with friends at 17. By 18, I was at university doing what students do. The drinking increased, smoking pot an almost-daily thing. Despite the fact I was more included in activities, if I was not the centre of attention I felt unwanted, unneeded.
Intimate relationships eluded me despite a growing circle of good friends, one of whom became my closest friend and using buddy for 35 years.
At 20, I began working on a thesis, ironically about American Beat poet Allen Ginsberg. He was one of the Sixties proto-hippies, one of the psychedelic gurus. I told myself I could not be intellectually honest writing the paper if I didn’t try LSD. I loved it.
And, truth be told, I also enjoyed the elitism of the ivory tower, the “I’m better than” status I believed it bestowed on me.
The guy with whom I had fallen in love and I bought LSD on the steps of BC Supreme Court. That night, under Gustav Dore’s print of the famous tilting-at-windmills Don Quixote, my beau told me I was the devil.
The relationship was an exercise in futility, two people beset by demons. Yet, I returned to it again and again for 17 years with the same results. Agonizing frustration followed by angry exchanges.
I would spend the next 23 years tilting at the windmills of my mind, fogged in a cloud of alcohol, pot, LSD, MDA, MDMA, cocaine, crack cocaine and, finally, heroin.
As a teen in the late Seventies, my musical interests turned as I was introduced to the rebellion of punk. The speed of the music, its anger captured me. I was an avid concert-goer once I hit Vancouver. With that came alcohol and drugs, more and more alcohol and drugs.
I could not see it, but life was becoming unmanageable.
Most of my friends were graduating and pondering law school or well-paying jobs. I had a thesis that was late.
I took a job as a dishwasher and found an apartment in Vancouver’s West End. The restaurant staff was a ready-made party and I joined right in. The kitchen manager, a musician, introduced me to Vancouver’s underground scene. I fit right in with these misfits, spending my nights in smoke-filled bars filled with mohawked punks, music pounding, drink and drugs flowing freely. But, I was arrogant.
Some of the folks from that restaurant remain close friends today. Some are in recovery. They still joke about my aloofness, my intellectualizing.
My close friend had quit university and gone to work in a trendy clothing store. The social scenes of our workplaces dovetailed perfectly.
I remained obsessed with my beau, although the fights continued. I did not have the sense to walk away. I was repeatedly emotionally abused, and I allowed it. I thought it was normal. I clung to a fantasy for dear life and drank and drugged away my pain.
Under threat from my professor, I finished my thesis and graduated from UBC with honors.
I took off to Europe for four months, thinking I could escape the failed relationship and substance abuse. When I returned, I moved into a house with my beau, my best friend and others. It didn’t last.
I moved downtown with people from the restaurant. The party continued.
I applied to write the law school admissions test. I drank all the way through the prep course. I couldn’t stop. My score was not good.
In 1989, I entered journalism school, immediately gravitating to the hard drinkers. We rejected the old student party spot and fell in with the hard-drinking regulars at Vancouver’s press club. I thought this was normal.
Upon graduation, I took a job at a newspaper in Prince Rupert. I was shown my desk. As I cleaned it out, I found a bottle of vodka.
“This is perfect,” I thought.
I was there two and a half years before I was promoted to run the daily paper in Dawson Creek. As I left Prince Rupert, one friend opined the bar owners would be distraught because their profits would fall with my departure.
In Dawson Creek, I showed up for work with hangovers at least twice a week. The publishers and I would head for the Legion Monday, Wednesday and Friday. Ironically, we called these drinking sessions meetings.
I was again promoted, this time to Vancouver, to become senior editor of the newspaper chain. I was presented with a framed front page of the newspaper. On the back, one staff member, who now has many years of sobriety, had written, “Strength, Courage, Wisdom.” It took me another nine years to understand what had been passed to me with that inscription.
After 18 months in Vancouver, I was sent east to help keep the Calgary Herald running during a strike. For the scabs, the company ran open bar tabs.
I volunteered to be a court reporter, opening the gates that would put psychological scars on top of psychological scars. Day after day, I listened to tales of man’s inhumanity against man. My belief was that I could somehow put the stories in a closed box in my brain and forget about them. I was wrong.
The situation began to go south, and as I worked with some of the worst and best co-workers I have ever endured, my using turned to crack cocaine. I first used it in a drunken blackout. I do not remember doing the crack. All I knew the next day was that I wanted more. And more. I spiraled downhill. I was fired.
Moving back to Vancouver, working part-time for Canada’s national news service and part-time freelancing, my drug use went from once a week to daily. By the end, everything else was secondary to using.
I used in the bathrooms of my office building. On the floors above were federal drug prosecutors. I carried drugs and paraphernalia through FBI checkpoints. I thought the rules did not apply to me. I was special. I continued down my path of covering brutal crimes.
I was now working for an international news service. I covered the gruesomeness of the Robert Pickton serial killer case. I sat through testimony of the bombed Air India 747 — the plane falling apart, jet engines slicing into the passenger compartment, people still alive plunging miles to slam into the hard Atlantic Ocean.
Again, I thought I could put those details in that box in my head and forget them. I could not.
My head was filled with horror. I drank and used heavily to forget it. But it was all still there in the morning as I headed back to court for more.
As one Edgewood counselor said to me, “Addicts love chaos. You love chaos more than most addicts. Journalism is chaos. You chose the most chaotic form of it and then the most grim. Did you choose that or did your addict choose it?”
Mind blown. I was dumbfounded.
“What have I done?” I asked myself.
In July 2006, I met another addict and fell in love. He was wonderful, an artist with a love of abstracts, a passion for Van Gogh. That October, he vanished. Abandoned again, I thought.
Not so. He was in treatment and on restrictions.
At his first opportunity, he invited me for dinner. It was a trick. I went to my first Narcotics Anonymous meeting that night.
I read How It Works. I said the Serenity Prayer with my arm around his shoulder. And, for the first time, I said to other people, “Hi, I’m Jeremy. I’m an addict.”
My partner went in and out of the program and rehabs. Each time out, it was “just one more.”
On May 12, 2007, his “just one more” was the last one. He overdosed and died. It was the worst day of my life. A beautiful soul snuffed out. My heart shattered. A family devastated.
I went berserk. My using went through the roof. I drained my bank accounts. The people I used with became scarier. All I cared about was getting loaded.
Finally, my family said “enough.”
I was removed from Vancouver as I waited to get into Edgewood.
My mum asked me, “If you haven’t used drugs in two weeks, why do you need to go to treatment?”
In a moment of clarity, I responded, “The drugs aren’t the problem. I’m the problem.”
My journey into the unknown began.
I was terrified. I rebelled against Edgewood, tried to fix the program, bitched about unfair rules. Then came acceptance. I realized I could not do this on my own. I learned that surrender was needed.
I began to listen. I began to see and hear how the experience of others could benefit me, how my experience could benefit others.
I learned why “we” is the first word in Step One. What we can’t do alone, we can do together. I learned how to ask for help. I learned to express my feelings instead of going straight to anger when I wasn’t getting my way. And I learned a program of recovery I can practice every day. I still do not do it perfectly.
Life is not without its challenges. I have to live with people every day and it’s not easy. They don’t do what I want them to do. My best friend from UBC residence continued to use, refusing to get into recovery, despite his two closest friends being years clean and sober. He told me A.A. had stolen his friends. He died alone on April 2, 2016, surrounded by drugs.
It was left to me to tell our friends and arrange a memorial dinner. His family held no funeral. I did not use. I reached out for help.
Another close friend died of cancer in November 2016. I did not use. I reached out for help.
I sat on her bed in the hours before she died and held her hand. I made an amend. I thanked her for being a huge part of my life. I kissed her and told her I loved her.
So, what has all this given me?
I have regained the trust of my family and friends. Friends ask me to look after their most precious things – their children. That is trust. For the most part, I have peace and serenity in my head. There are no voices calling my name.
And, I live my dreams. I have crossed Asia on the Trans Siberian Railway from Beijing to St. Petersburg via Mongolia. I have been skydiving in New Zealand. I have fished for piranha in the Amazon. In Moscow, I made a point of going to see my first original Van Goghs on the anniversary of my partner’s death. A photo was taken of me with one of the paintings. I sent it to his mother.
So there it is – my experience. What does it tell me?
It tells me that I lived to use and used to live. It tells me that one is too many and a thousand never enough. It tells me that recovery one day at a time is the truth. That gives me strength.
I accept that something in my head wants to kill me. To keep that at bay, I need to practice a program of recovery. That means telling the truth, if only to my sponsor so he can call bullshit when I need it most. It means doing the steps on a regular basis and going to meetings. I see others doing it and see it working in their lives. That gives me hope.
Yes, the monster still sits in my head waiting. If I ask for help and do the work, that monster is going to wait a long, long time. And, I’m OK with that.
Will AA’s 12-Steps Work For Me?
Written By: Brent Lloyd, BSW, MA, Clinical Manager, EHN Calgary Outpatient Clinic
A Touch of Controversy
Questions about the effectiveness of the 12-Step Alcoholics Anonymous and whether it’s a bonifide approach to addressing recovery from addiction still remain. These questions can create uncertainty about whether or not the 12-Steps program is right for you or if it will work.
Authors, such as Dr. Lance Dodes who published a few years ago, “The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry” used key studies to support his opinion that AA didn’t work.
In the last couple of years, new research studies demonstrate that the 12-Steps do work and help people remain in recovery. A study published this year in the Journal of Health and Human Services Administration looked at the effectiveness of the 12-Steps in helping someone remain abstinent after they’d been through a substance abuse treatment program at the one year mark and five year mark. The results found that “12-Steps or self-help program have a higher success than cases not in a program for the 1-year follow up… Comparing the percentages we can conclude that the probability that an individual relapses is smaller for those who are part of the 12-Step program.”
My Point of View
Before we get started, let’s first look at how open and willing we are to look at both pros and cons of Alcoholics Anonymous. Easier said than done. I believe we all have biases and that does not have to be a negative thing as long as we are willing to be honest about how and why we came about these biases.
For instance, I have met and had the privilege of hearing how scores of people in recovery from addiction whom now speak highly of AA, but at the beginning were angry, defiant and skeptical about this approach. I was one of them.
I have found that when wanting to get high our drunk I would go to any lengths to make this happen. I learned that I needed to be earnestly willing to put in at least half that energy. That’s where AA became the chief reason that helped not only solve the drinking problem I had, but my emotional, health, spiritual, physical and emotional.
Essentially, you need to participate on a regular basis and “work” the 12-Step program if you want to see results. Recently, in Drug and Alcohol Dependence, a study looked at the recovery benefits of the “therapeutic alliance” among 12-Step mutual-help organization attendees and their sponsors. The results from this study showed that almost 69% of participants that had a sponsor, remained in contact with them and had a strong sponsor alliance were “significantly associated with greater 12-Step participation and abstinence, on average, during follow-up. Interaction results revealed that more sponsor contact was associated with increasingly higher 12-Step participation whereas stronger sponsor alliance was associated with increasingly greater abstinence.” 
Let me be clear. AA is not a cure all. Those words are from the AA big book. I would humbly ask any person struggling with addiction to look at all options, many people who have recovered via the AA route will tell you themselves that they had tried many approaches before going through the doors of an AA meeting.
You Be The Judge
In conclusion, only you can answer the question is AA right for me. However, before you rule it out as an option, please give it an earnest evaluation. Recovery is not for the faint of heart and walking through any recovery program requires one to look within. Not an easy task when we put down our mood altering chemicals. I am bias- yes. However, 19 years of ongoing recovery has inspired me to remember where and why I am sober. I would not be where I am today without this life changing fellowship of AA.
Regards, Brent Lloyd, BSW, MA, Clinical Manager, EHN Calgary Outpatient Clinic
Brent is a registered social worker with a degree from the University of Victoria and a Master of Arts in Leadership from Royal Roads University. With several years of experience as a counsellor in both inpatient and outpatient settings, Brent is passionate about guiding and assisting individuals and their loved ones through the struggles of addiction.
-  Gamble, J., & O’lawrence, H. (2016). An overview of the efficacy of the 12-step group therapy for substance abuse treatment. Journal of Health and Human Services Administration, 39(1), 142.
-  Kelly, J. F., Greene, M. C., & Bergman, B. G. (2016). Recovery benefits of the “therapeutic alliance” among 12-step mutual-help organization attendees and their sponsors. Drug and Alcohol Dependence, 162, 64.
Challenging Those Addiction Symptoms That Can Linger After You Stop Drinking
“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:
- Low self-esteem
- Can’t live in the moment.
- “I don’t like myself.”
- “What do they think of me?”
- “Am I good enough?”
- “Nobody understands me.”
- “You don’t get it.”
- Tomorrow I’ll smarten up.
- I don’t fit in.
- Maybe I can control it?
- One isn’t going to hurt…or is it?
- But it is different now.
- I feel so much better
- I don’t feel any better.
- I still feel crappy.
- “I’ll stay off the hard stuff!”
- Why does everything always happen to me?
- I never get a break.
- If they don’t trust me, why am I doing this?
- It’s not going to help if I call someone.
- I’m different.
- I don’t care.
- 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.”
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:
- Change your life. You recover by creating a new life where it is easier to NOT use.
- 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.
- Ask for help. That includes doctors, therapists, addiction counsellors and people in recovery. Anywhere that will help your recovery.
- 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.
- 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.
Can You Be Too Old To Start Recovery?
More research has been showing an increase in the number of older people, including baby boomers, overdosing or abusing drugs and alcohol. Perhaps you thought addiction only affected young people or the wealthy? Studies are revealing that substance abuse in seniors is becoming an urgent matter in geriatric medicine. Some seniors are becoming addicted to painkillers or alcohol, and they need help.
At the Edgewood Health Network (EHN), our addiction treatment centres in Canada see people from all walks of life. However, recently we have been seeing a steady increase in older people seeking help for addiction. Some of you may be asking, “Can you be too old to start recovery?”
The Pressures of Life
I sat down with one of the first addiction counsellors at Bellwood Health Services, DR, an incredibly honest and compassionate person who always tells it like it is to clients coming into treatment. DR has worked in several capacities at Bellwood. From marketing, outreach to admissions – he’s done it all. As a person who’s been in recovery for almost 40 years, DR has seen the way factors such as technology, education, and the family unit have changed and perhaps placed enormous pressure on people to “keep up” or get left behind.
“The pace of the world we live in is causing people to create high expectations for themselves and everyone around them. A university graduate versus a trades person is perceived differently now than it was decades ago. The number of people and their concern to stay connected virtually, the immediacy that is expected from others to respond immediately, or the race to enroll your children in everyone else’s kids’ sports or hobbies are examples of stress that people are now experiencing that didn’t exist before. More stress leads people to want to stop the world and just get off. Some people try to relax through yoga or meditation. But there are others who will say it’s too much of a hassle to drive there or that they have no time. So what do they do? They use chemicals. It’s something to help them escape. And they can use it whenever, wherever.”
Nothing Changes if Nothing Changes
Of course, life changes as you get older. Financial circumstances may change, your family can grow or perhaps it gets a bit smaller with the loss of a loved one. If you haven’t reached out and received help for your alcohol or prescription drug abuse, chances are your life has spiraled out of control; you haven’t been handling the changes in your life in a healthy manner and you are still using after several years. DR acknowledges that confronting his disease and getting treatment for alcohol addiction was what he had to do to change his life.
“I think about how blessed I am not to use chemicals or alcohol anymore to escape or handle my problems. We learn through 12 step program, old-timers, and others that you must confront each situation and resolve it rather drug or drink it away, as it will just come back. Recovery modalities have changed and there are many more options since I undertook my alcohol recovery. You still have to work at it ONE DAY AT A TIME and remember to call someone if you need help. Yes, I still do the occasional meeting; not every month or every day, but I drop in and listen. It validates once again that my three bosses back in the beer industry did a great thing by not putting their heads in the sand, but instead confronting me about my disease. I thank God they did. Relapse is always close at hand. If we get away from our program it can be easy to slide down that slippery slope.”
It also helps to be a part of team at an addiction treatment centre when you’re in recovery. “Working in this facility is like going to an AA meeting as it validates that the road of recovery that I chose many years ago was the right one. It cements the choices I have made. Yes, it is wonderful to see the graduates leave. They usually leave somewhat anxious, but if they use the tool kit filled with information and techniques we gave them, it will certainly assist them.”
Some Wise Words About Early Recovery
Early recovery can be a challenge for most people who have just finished treatment. Some say it’s where “the real work begins.” DR recommends avoiding certain places, have an exit plan if need be, and don’t forget to visit your regular support group.
“Avoid places in early recovery that are triggers for you. Examples might be baseball games or dressing rooms from beer league hockey where you might feel pressured to drink to be one of the boys again. There is nothing wrong with saying you are in recovery. Some see it as a very strong point and are proud of you for the accomplishment. If you go to a function early in recovery where alcohol is present, a wedding for example, have a plan to leave. Share it with someone else before you arrive. Let them know that if you are struggling and need to leave, you will give them a sign that you need their support to leave. It could be your spouse, a friend, a business associate, a son or daughter. HAVE A PLAN and follow it. Go to meetings. They are wonderful and a place where you can be thankful for your sobriety. Participate in aftercare, wherever form that might take. It can take place at the doctor’s office, AA meetings, with a therapist, at an addiction centre, etc. I attended the YMCA for 25 years as part of my recovery plan.”
Getting Help if You Are a Senior for Substance Abuse
We asked DR if it was possible to be too old to start recovery.
“The first pearls of wisdom would be to mention a story of a graduate from the Credit Valley Alcohol and Drug program who attended AA. I was invited to his birthday party for his recovery. He was celebrating one year sober – 91 years young! You are never too old to be sober. One of my uncles by marriage could not stay sober and attended AA late in his life. He passed away sober. That was all his children ever wanted. He was three years sober. I believe the oldest graduate at Bellwood Health Services was roughly 83.”
If you suspect an older loved one or patient may be abusing drugs or alcohol, Bellwood Health Services can provide a complimentary assessment and provide early intervention. Give us a call or email us to learn more about how we can help.
Research Reveals the Baby Boomer Generation are Increasingly Developing Substance Abuse Problems
Within the last ten years, the face of substance abuse has changed in North America with more treatment centres having to treat a client population that are much older than it used to be. Older adults are increasingly seeking treatment and support for painkiller and alcohol addictions. It was more common for addiction treatment centres to treat people in their 20s and 30s with substance abuse problems several years ago. Treatment and group therapy was focused on people of that age group as they shared certain demographics. Now, treatment providers in the US and Canada, are receiving a wave of seniors with substance abuse problems and having to adjust the way they provide treatment and figure out what motivates our baby boomer generation to get well. So, why the sudden increase in our seniors developing addictions? There are several different factors that may be contributing to reasons why older Canadians are abusing alcohol or drugs.
The Main Triggers for Geriatric Substance Abuse
Loneliness, death, retirement and or health problems are the major reasons why our older generation are developing alcohol addictions, painkiller addictions or, in some cases, eating disorders. According to the Hazelden Betty Ford Foundation, women are more likely to be widows or been through a divorce, to have experienced depression, and to have been prescribed psychoactive medications that are negatively increasing the effects of alcohol. Research also suggests that several baby boomers that were in their early twenties in the 1960s, may have experimented with marijuana and other illegal drugs, are returning to these drugs as a way to cope with loss, stress or loneliness.
In addition to those factors, many seniors are entering retirement homes or those dealing with health conditions, are being prescribed more prescription drugs that have addictive characteristics. Alcohol is also being reported as a substance that is abused more heavily by seniors than it was ten years ago. According to the British Columbia Medical Journal, one in six older adults are self reporting as heavy drinkers. The Canadian Addictions Survey in 2004, stated that 16% of people 55 and older admitted to heavy drinking. Substance abuse has a dramatic impact on the health of geriatric patients, which as a result, changes the way treatment centres provide care for them.
According to the BC Medical Journal, geriatric patients tend to have many medical problems as a result of the abuse in alcohol and the interaction of prescription drugs, such as benzodiazepines and antidepressants. Drugs and alcohol in older adults take longer to metabolize but its effects are felt faster because their bodies don’t carry as much water as they did when they were younger. Healthcare professionals won’t necessarily assess older patients for substance abuse because they don’t fit the common profile of a chronic drinker. A survey of 853 primary care physicians and psychiatrists revealed that only 13% of them used formal alcohol screening tools routinely.
Treatment and Early Intervention
The BC Medical Journal also revealed that early intervention and treatment in older patients works very well and would help geriatric patients avoid serious health consequences. Older patients understand the benefits of treatment such as improved cognition, independent living, improved health and better social connectivity.
It can be difficult to diagnose alcohol abuse or painkiller abuse in older patients as sometimes they can be confused for other health conditions or mental health disorders, such as anxiety, anorexia or depression. Some people may find it difficult to approach a loved one or to try and help an older patient with substance abuse because:
- – They don’t believe older adults can be successfully treated. The mentally that “you can’t teach an old dog new tricks,” may cloud their judgment
- – They excuse the older person’s drug abuse or heavy drinking due to a loss of a loved one
- – They fear they will offend them and as a result get written out of a will
How to Identify a Senior Has a Substance Abuse Problem?
Research states that there are a few signs that may indicate an older person has a substance abuse problem. These can all be signs of other health conditions, but are commonly associated with signs of addiction in seniors:
- – Changes in sleep patterns
- – Lack of personal hygiene
- – Mood changes such as irritability, depression and anxiety
- – Mental confusion
- – Changes in eating patterns (eating more or not eating at all)
- – Falling and injuring themselves more often
If you suspect an older loved one or patient may be abusing drugs or alcohol, the Edgewood Health Network can provide a complimentary assessment and provide early intervention. Give us a call or email us to learn more about how we can help.
It is really just social drinking?
There are social situations that some people attend specifically to get drunk, do drugs or both. Places like bars, clubs, vape lounges and parties. And music festivals. Over the weekend, there were 17 overdoses at the Calgary music festival Chasing Summer. Ten men and seven women were taken to the hospital over Friday and Saturday. Some are in stable condition, some were in serious but stable condition and one woman was in life-threatening condition. While we can’t speculate on what happened in these specific cases, we do know that certain social situations may highlight and/or magnify a possible problem with addiction. So how do you know if you have a problem?
1. You choose social situations that allow you to drink or do drugs.
You’re always urging your friends to meet for drinks instead of coffee. Friends who don’t do drugs have fallen by the wayside; you’d much rather hang out with those who smoke pot like you do. And forget going to any dry event. You consistently choose to spend your free time in situations where you can freely drink or use drugs, and are less and less interested in people who don’t do the same.
2. You drink or do drugs at times when most other people are sober.
You might be the only one who cracks a beer before noon at the cottage or the only one having mimosas at brunch. Maybe you like to get high before going to the movies or you drink at work. Fairly often, you’re the only one drinking while everyone else is sober.
3. You use recreational drugs to self-medicate.
You drink to deal with your anxiety or your depression instead of seeing a doctor. Instead of dealing with painful memories, you get high. Your prescription pain medication says twice a day but you frequently use three or four times that amount. Anytime you have an emotional or physical problem, you reach for your favourite substance.
If any of this feels familiar, it might be time to seek some help. We’re here to help our patients get into recovery, and back to enjoying life with a clear mind. You can call us anytime at 1-800-683-0111, or you can email us at [email protected]. You can drop into any one of our clinics in Calgary, Toronto, Vancouver, Victoria or Seattle and see a counsellor.
Seek help before it gets to an overdose. You can still go to music festivals – you might even remember the show this time around.
Spirituality – What’s the Big Deal?
The destructive nature of addiction
By Lee Hausmann, MA, ICCAC
Originally published in the Summer 2015 issue of Moods Magazine, https://www.moodsmag.com/moods/index.php
As an addiction therapist and a person who has been directly impacted by addiction, I have been involved in the treatment of people struggling from this mental health disorder for over 20 years. Addiction comes in many forms: alcoholism, drug dependence, sex addiction, gambling, eating disorders, Internet-based addictions, shopping, relationships, and the list goes on. Whether it’s a chemical dependency or a behavioural addiction, the impact on an individual is devastating. It can affect all areas of life, and if not arrested, can lead to death. The havoc addiction creates, and the slow, insidious destruction that occurs, causes an individual to lose, among other things, their sense of self, their identity and their values. The purpose and meaning of life is clouded over by a lens of despair, self-loathing, fear and emptiness. I have heard many addicts in early recovery speak about the emptiness or void that is felt in their hearts: a feeling of disconnect, soullessness, or spiritual bankruptcy.
Spirituality vs Religion
Often when clients first enter treatment, hearing the word “spirituality” can create a visceral reaction. This word is often misinterpreted and misunderstood. It can challenge an individual’s belief system and conjure up prejudices as they associate the word spirituality with religion and God. Part of my work as a therapist is to try to distinguish between the word “spirituality” and “religion,” in an attempt to open clients’ minds and expand their understanding of this topic. It is important to differentiate between the two. Religion is a specific fundamental set of beliefs and practices generally agreed upon by a number of persons or sects. It is a man-made doctrine. A 12-step phrase states, “Religion is for people that are afraid to go to hell. Spirituality is for people that have already been there.” Unlike religion, spirituality has a wide scope with loose and broad definitions, and is open to interpretation. It is a very personal experience. It can be viewed as a dimension of who we are, the unseen yet vital, animated essence of a person or animal; the intelligent non-physical part of human beings. Whichever way spirituality is defined, there is proof that it is an imperative piece of the healing process if the addicted person is to become well and whole. A person can be both religious and spiritual, however, for purposes of addiction, it is only necessary for people to develop a sense of their own spirituality.
What’s the Big Deal?
Addiction is a complicated, debilitating and destructive mental health disorder that can be fatal, and therefore dictates the need for an equally complex and powerful solution. In other words, the dimension of the solution needs to be equivalent to the dimension of the problem. “There has been an explosion of scholarly and clinical interest in exploring the role that spirituality may play in substance abuse assessment, treatment and recovery (C. Shorkey, M. Uebel, & L.C. Windsor, 2008, 287).” It was reported in Time magazine that from 2000 to 2002, there were more than 1,000 scholarly articles on the relationship between spirituality and mental health, whereas in 1980 to 1982 there were less than 100 articles published on this topic. This growing field of research has substantiated the fact that increased spiritual practices are associated with longer-term addiction recovery. “When individuals experience a “spiritual awakening” as a result of their AA involvement, they are four times more likely to be abstinent than those who reported no spiritual awakening (C. Shorkey, M. Uebel, & L.C. Windsor, 2008, 287).” In my 25 years in the recovery community, the people who have chosen to establish some type of a spiritual practice, such as a daily routine of reflection or meditation, stay clean and sober and begin to positively change their lives. Addiction presents an individual with a choice: life or death? The path of addiction leads to death, but the path of recovery leads to life. And this life of recovery with a spiritual context can begin to include a sense of self, self-worth, self-esteem, self-respect, empowerment, integrity and freedom. And THAT’S a big deal.
Spirituality as a Practical Matter
Often, spirituality is not a very practical matter, especially in early recovery. There are many deep questions, such as: Why am I here? What is my purpose? Is there more to me than just flesh and bones? These may seem inconsequential when an individual is dealing with more pressing matters, such as earning a living, paying bills, attending to children and trying to stay clean and sober. It can be easy to set spirituality aside, putting it off as something to be done at a later time. This can be a dangerous place for an addict, especially when we bring to mind the fact that addiction is chronic, progressive, and fatal if not arrested. Can spirituality become a practical matter and part of everyday life? Yes, it can. For thousands of years, man has acknowledged that he has an invisible aspect to himself, call it soul, divinity or higher state of consciousness. For addicts, an exploration of the spiritual aspect of her/his nature cannot be ignored, if the individual is to get well. What then, is a spiritual practice, how can it be incorporated into everyday life, and what are the benefits of such an experience?
A Spiritual Practice
When I was a little girl playing in the backyard of my family home in Weston, Ontario, I recall my friends and me digging holes for fun in my mother’s flower garden. As we dug deeper, I began to feel anxiety rise in the pit of my stomach. In my imagination I visualized digging right through the earth to the other end of the world, which was an unknown and frightening place for me. In today’s day and age, this is an absurd idea. We live in a much smaller world today. Countries and cultures are interconnected through trade, exchange of thoughts, culture, sophisticated levels of communication, and globalization. The East meets the West, bringing with it ancient traditional practices of meditation, mindfulness, yoga, and a diverse array of spiritual and mystical practices, writings and philosophies. Therefore, today there is a wealth of information that we can access to help us along this path. How does this actually happen? The following are practices that can create a context in a person’s life to help them begin to grow both spiritually and emotionally:
- Regular practice of meditation
- Quiet time, reflection and journaling
- Regular readings of inspirational literature
- Regular practice of prayer or spiritual affirmations
- Joining a 12-step program and becoming active in that community
- Regular yoga practice
- Regular participation in a church or your preferred spiritually-based organization
Spirituality as a process encourages an individual to live in the present moment, learning from their experiences. Everyday life then becomes a school, a place to expand one’s awareness, change perceptions, recognize the positive and negative workings of the ego, and to begin to find one’s place in this world and one’s connection to oneself.
In early recovery when the fog lifts and clarity begins to unfold, this stark reality can be frightening and frustrating. Resentments that were once drunk away are now coming to the surface. Hurt and pain of the past are no longer repressed. This is where the “work” of recovery through treatment, therapy and 12 step groups, begins the process of clearing the wreckage of the past. With perseverance, commitment and daily spiritual practice, positive emotions such as love, hope, joy, forgiveness, compassion and gratitude can replace the darkness of early recovery. Experiencing positive emotions helps to expand our awareness, change our perceptions, and broaden our lives. The journey of recovery or spiritual and emotional growth is one from dependence on outside sources (drugs and alcohol) to developing inner resources and strengths. There is a saying in the rooms of Alcoholics Anonymous, “It’s an inside job.” A spiritual practice is at the root of these changes, leading an individual to live a life of transparency and integrity, where the insides match the outsides, masks are no longer needed, the facade is gone, replaced by authenticity and genuineness. A transcendence of self into a larger reality is where service to others becomes a common occurrence and a necessary part of an individual life.
If there was one message I would like to communicate to all those individuals in early recovery, it would be to take spirituality seriously as an essential element of recovery. And to keep up the practice until the miracle happens. An excerpt from the Big Book of Alcoholics Anonymous captures this
in The Promises:
“If we are painstaking about this phase of our development, we will be amazed before we are half way through, we are going to know a new freedom and a new happiness, we will not regret the past, nor wish to shut the door on it, we will comprehend the word serenity and we will know peace; no matter how far down the scale we have gone, we will see how our experience can benefit others; that feeling of uselessness and self-pity will disappear, we will lose interest in selfish things and gain interest in our fellows, self-seeking will slip away, our whole attitude and outlook upon life will change, fear of people and economic insecurity will leave us. We will intuitively know how to handle situations which used to baffle us….”
And THIS is a big deal.
The Importance Of Aftercare In Recovery
For those suffering from addiction, the consequences can be devastating. People lose their jobs, damage their relationships with friends and family, and face financial hardship. It becomes cyclical; substance abuse creates these personal difficulties and in turn, they can cause stress and trigger the individual to use more frequently. In other words, abusing substances becomes the individuals primary means of coping with life’s difficulties. When this happens, the environment becomes so toxic that admission into a residential addiction treatment center may be necessary to give the individual a chance at recovery.
Residential treatment offers a safe environment to begin to repair the damage caused by addiction. At this stage, people are very vulnerable and treatment provides a safe place away from triggering situations in which they might relapse. They can focus on healing and recovery. Clients are taught more constructive coping strategies, relapse prevention and grounding techniques. They can then begin to practice and refine these skills without the outside pressure of their environmental stressors.
While residential treatment is a necessary first step, recovery really consists of using coping, grounding and communication tools in “real life” situations. Without prior experience practicing these newly acquired tools, the recovering addict is susceptible to return to past behaviours and may relapse. Therefore, early recovery is a time of transition and one where aftercare support becomes vital to long term behaviour change. Continuing care is an active way the individual can build on the foundation of recovery that he/she has established in residential treatment.
There are many support systems available to individuals in early recovery. Aftercare supports can consist of self-help groups such as Alcoholics Anonymous, individual counselling, or outpatient groups run by addiction treatment organizations. Furthermore, these meetings take place throughout the day and into the evening, making them easier to attend. Also, with the latest technology trends there a variety of aftercare meetings available online.
Attending aftercare benefits the participants by giving them the ability to share their experiences using active coping skills in real life situations. Individuals may receive feedback on how they can improve these skills going forward or receive reinforcement that they are progressing well. Another benefit is the opportunity for the individual to belong to a community that they can relate to – one that is supportive, but will also hold each other accountable when needed. For example, aftercare can help individuals come to a realization that they may be on a risky path of returning to their previous behaviours. These groups also provide members with the opportunity to pass knowledge onto others who are beginning their journey of recovery. Imparting knowledge and experiences onto newcomers can help reinforce an individual’s commitment to abstinence and a life of wellness.
Research has also demonstrated the importance of aftercare. Studies have found that regular aftercare participation is one of the best predictors of success following treatment. For example, a long-term follow-up study spanning 40-years, found that those who were able to maintain longer periods of abstinence were attending 20 times as many meetings as those who were not able to maintain abstinence. Bellwood’s own outcome research has demonstrated that 83% of those who engaged in two or more regular aftercare supports were high recovery (continuously abstinent or achieved at least 95% reduction in substance use) at six-months follow-up from residential treatment.
There are many different forms of aftercare, but it is important to remember that attending any form of aftercare is an improvement over leaving the treatment center overconfident. Recovery requires continuous work on the skills learned in treatment and is a lifelong process. As the Chinese philosopher Laozi once said ‘a journey of a thousand miles begins with a single step’ and each week of successful engagement in support, is a successful step on the road of recovery and lifelong wellness.
Managing to stop using alcohol or drugs can be a major milestone in the life of someone struggling with an addiction. However, remaining abstinent from substances is only a part of recovery. After quitting, a person can be in a state called “Untreated Sobriety,” or as it is often called, “Being A Dry Drunk.” This means that while the person is no longer using substances, they still manifest many of the thoughts and behaviors as if they were still in the midst of their addiction. Unable to use drugs or alcohol to cope with their emotions, people with untreated sobriety often feel a sense of anger or resentment due to the fact that they had to give up the one thing that seemingly made them feel better.
Addiction often serves a purpose whether as a coping mechanism, or as a means of escape or avoiding boredom. If the underlying emotional needs are not being addressed, simply removing the substance is not enough. Recovery is not about going back to the way things were before the addiction reared its head. The person has to uncover the reasons for picking up a drink in the first place. Chemical dependency is often a symptom of a larger issue, similar to an iceberg where most of the problems are underneath the surface.
It is also important to consider the psychological ramifications of letting go of a certain way of life or routine. What happens when we give up or lose something that has been a huge part of our lives for a long time? Something that we believe made us happier? We begin to grieve. Grieving the loss of alcohol or drugs can be as powerful as losing a loved one. If the person does not begin to actively work through this grief to get to the acceptance stage, relapse is a lot more likely. Very often people get stuck in the anger stage asking: “Why me?” or “Why can’t I have just one?” This type of thinking is what can precipitate relapse. This is why it is important to ask for help and guidance, learn about the disease of addiction and begin to explore personal reasons for using substances.
Recovery is about progress and many make it through the process to the final stage. They can finally accept the loss and with the help of others, grow through the experience and move on. Others never make it through and remain stuck, feeling angry, bitter and resentful. They may not have used drugs or alcohol for a while, but are hanging on for dear life, “white knuckling it”, and screaming in anger, “I HAVE QUIT!” all the while feeling miserable. How long can this go on before drugs and alcohol looks like a good option again?
It is important to note that it is not necessarily the person’s fault if they were not able to progress in their recovery. Some people may have underlying mental health issues that have not been addressed. Other times, environmental stressors and triggers may be too overwhelming especially for someone who is early on their path to recovery. That being said, it is important to be mindful of how recovery is being approached. Recovery is about making changes that go beyond staying sober. It is about feeling good about life and the ability to meet life challenges rather than feeling deprived. Getting to the acceptance stage by quitting AND being in recovery, is what makes life beautiful again.
By: Kim Holmgren, Recovery Counsellor &
Iryna Gavrysh, Research Assistant