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What Causes Alcoholism? Common Causes, Risks and Symptoms

Alcohol is easily one of the oldest and most common recreational substances, dating back as far as 7000 BC — and historians surmise that alcoholism is likely to have gone back just as far. But what is it and what causes alcoholism? Those suffering from this affliction can be thankful that these questions are being asked — and more importantly, researched. For the great majority of the time alcohol has been available to humans, over-indulging was seen as a choice or — worse yet — a weakness of moral character. Thankfully, we now know beyond a shadow of a doubt that alcoholism (also known as Alcohol Use Disorder or AUD) is, in fact, a disease. Like any disease, there are often root causes, factors that increase the risk of acquiring it, and recognizable symptoms we can look out for.

Alcoholism

What Makes Alcoholism a Disease?

Early suggestions that alcoholism could be a disease were met with derision and even accusations of making excuses for alcoholics. While this is incredibly unfortunate and much continued suffering occurred as a result, it’s easy to see why the uninformed are often so quick to dismiss the idea. On the surface, it doesn’t seem like what the average layman would classify as a disease — and further, those suffering from it are the first to deny that anything is wrong. However, as research began, it quickly became clear that alcoholism showed blatantly disease-like traits, which led the American Medical Association (AMA) to recognize it as a primary disease in 1956. This was further cemented by a report released by non other that the U.S. Surgeon General in 2016.

Firstly, it was soon shown that there is a clear neurobiological component to alcoholism. Research uncovered the fact that this and other substance abuse disorders were driven by changes in the brain that occurred due to repeated use of alcohol or drugs. Unknown to the user, the brains pleasure centers are gradually becoming less sensitive to the rush of dopamine released with the consumption of alcohol. This means that more must be consumed to obtain the same pleasure. In short, what we know as ‘building up tolerance’ has a very real biological cause. (This also affects the user’s ability to experience pleasure from other activities.)

The question of “why can’t they just stop when it starts to get out of control?” was also answered by medical research. Nefariously, alcohol abuse also disrupts normal prefrontal cortex activity — the part of the brain that controls judgment and decision-making. These issues point to another decidedly disease-like characteristic — a progressive nature. Slowly but steadily, the disease progresses until, if left unchecked, it reaches a point where it is almost impossible to control and possibly becomes fatal.

Alcoholism also shares many traits with another class of diseases — obsessive/compulsive disorders. While certainly distinct from conditions such as obsessive-compulsive disorder (another disease that was not considered such for a long time), there is a clear component of obsession within alcoholism. The thought that the user musthave a drink is unrelenting — until, of course, the drink is taken.

What Are Alcoholism’s Causes and Risk Factors?

In another similarity with other diseases, the potential causes of alcoholism are numerous, sometimes difficult to prove unequivocally, and vary from person to person. A number of studies have suggested that there are hard and fast biological causes; one such study provided evidence that a failure to clear away a certain substance that inhibits signalling around neurons in the central amygdala could be to blame. Such studies are far from conclusive — however, there are a few things that are widely agreed to be the most common risk factors.

  • Stress—This has long been known to be a risk factor for alcoholism. As with any psychoactive substance, alcohol provides an escape from stressful situations, jobs and the like. This is why in professions recognized as high-stress occupations, such as medicine or construction, alcoholism rates are unusually high. Ironically, alcohol abuse has been shown to increase the release of cortisol – the same hormone our adrenal glands release when we are stressed! The fact that the disease remains in the minority of all populations and occupations, however, tends to support the fact that there are generally interconnected factors.
  • Mental Health Issues—Depression, anxiety, and other mental health problems are commonly seen in those suffering from alcoholism. As with stress, alcohol can seem to be a temporary solution – though we know it just exacerbates the problems. With already compromised brain function, alcoholism is especially dangerous in those with mental health issues. Making things more complicated is the fact that mental health issues can actually be the resultof alcohol abuse. This is why it is important to receive treatment from knowledgeable professionals who are experienced in treating such cases.

Mental Health

  • Family Environment/Social Culture— In certain societies, the imbibing of alcohol is far more tolerated than in others. The same can be said for families and households. Once again, this may not be a problem at all for for many, but for those with other factors predisposing them to addiction, these environments put them at great risk. This also partially explains the high incidence of alcoholism amongst those in the service industry, such as bartenders, servers, chefs, restaurant managers etc.
  • Beginning to Drink at an Early Age— This is a risk factor for a number of reasons. Perhaps the most simple is this makes drinking alcohol ‘the norm’. Those who then progress to the stage of suffering from alcoholism will be even less likely to recognize it — and be better able to hide it from others. Secondly, those who begin to drink at a veryearly age (pre-puberty) are at a huge risk. Science has shown the human brain is still developing well into our 20s and possibly even our 30s. Therefore, beginning to drink when the brain is its most malleable and continuing through its developing years can have disastrous effects. Lastly, the aforementioned rewiring of the pleasure centers that we know as ‘tolerance’ has been observed to be quite extreme in certain individuals who began drinking at an early age — thus the risk of regularly overindulging and falling further into alcoholism is increased.
  • Early/Continued Social Isolation—Studies have shown that isolation, especially early in life, can increase the risk of alcoholism. This is not only due to observations made of those afflicted — controlled lab studies have shown test subjects such as rats to increase their alcohol intake when isolated. Taken out of their naturally social state, the young rats became stressed and anxious — states we now know to be risk factors.
  • Shyness/Low Self-Esteem— It is a known fact that alcohol lowers inhibitions — and for many, this is one of the appealing features of the drug. Those that feel too awkward to interact with others often find themselves easily chatting after a few drinks. However, it is quite different in the case of those that are “chronically shy” – what we now know today to be Social Anxiety Disorder (SAD). These individuals, if untreated, find it literally impossible to interact with others, or in the worst cases, even leave their house. If alcohol seems to alleviate this situation, it is not uncommon for this crutch to quickly become an addiction.
  • Drinking in ‘High-Risk’ Numbers—The National Institute on Alcohol Abuse (NIAA) has defined high risk drinking as more than 14 drinks a week for men, and 7 for women, and more than 4 drinks in any given day for men, while the number for women is 3.

There are other risk factors as well, but one is more hotly debated and suspected by many of being the most important of all – we would not be surprised if it is the very one on the tip of your tongue as well.

Is Alcoholism Hereditary?

Hereditary

When the discussion about alcoholism being more complex than a choice made by individuals began, a major topic of debate was whether there was a hereditary component to the affliction. Those who believed it was a disease argued that, like many diseases, it most certainly was hereditary, while opponents of the theory argued that, if there was any correlation between family members, it was simply due to children copying their elder relatives. Through decades of studies, we now know that both of these things are true. Certainly, being in an environment where immediate or non-immediate family members visibly suffer from alcoholism is a risk factor for young people — one that increases exponentially when other factors are present. However, science has shown strong evidence that there is a genetic component to the disease as well.

After many years of work, medical researchers published a paper in 2012 reporting that they had found as many as 11 pairs of genes that could be associated with developing behaviors we would generally recognize as alcoholism. These include a gene mutation that causes the aforementioned discrepancy in the levels of a certain inhibitor (gamma-aminobutyric acid, also known as GABA) that works with neurons in the amygdala. In affected individuals, the intake of alcohol does not reduce the amount of GABA in the same amounts as in unaffected individuals. As a result, drinkers will feel the effects of alcohol less, and as they generally feel less impaired, have the potential to drink more — and more often. As a genetic mutation, this will be passed down through generations.

On the other had, there are also genes that may predispose a person to drink lessand therefore be at a lower risk of alcoholism. These include a gene variant most commonly found in East Asians that causes flushing, nausea and heart racing when alcohol is ingested. Due to the unpleasant sensation, affected persons are far less likely to drink, much less drink in excess. In yet another case of connectivity, any of the 11 genes found were associated with other neuropsychiatric disorders including bipolar disorder and anxiety.

How Do I Know If I Am an Alcoholic?

Man Wondering

Like any person suffering from a disease, alcoholics display symptoms. As alcoholism has both mental and physiological components, so to do the symptoms present as both behaviors and physical reactions. Some of the former include:

  • Drinking alone
  • Drinking large volumes at a time (binge drinking)
  • Routinely ignoring personal and professional responsibilities
  • Engaging in behavior that can be detrimental in terms of safety, health, finances or legality
  • Poor eating habits
  • Erratic sleeping habits
  • Becoming extremely defensive or agitated when drinking habits are brought up
  • Loss of interest in activities previously considered important
  • Poor personal hygiene
  • Extreme emotions, often at inappropriate times or in inappropriate settings
  • Inability to control alcohol intake
  • Consumption of alcoholic drinks one does not enjoy, or objectively unpalatable sources of alcohol, such as mouthwash

As the disease progresses, physiological symptoms may also present, including:

  • Intense cravings for alcohol
  • Experiencing tremors following a binge drinking episode
  • Increased recovery time from drinking episodes and more intense hangovers
  • Alcoholic Ketoacidosis
  • Cirrhosis
  • Withdrawal Symptoms, including:
    • Tremors
    • Nausea
    • Vomiting
    • Sweating
    • Agitation
    • Insomnia
    • Alcohol Withdrawal Delirium or Delirium Tremens— The most severe type of withdrawal, which — in addition to all of the above — also includes extreme confusion and delirium, hallucinations, delusions, involuntary and painful muscle contractions, erratic breathing and heart rate, and even seizures which may prove fatal.

Where Can I Get Help?

First, it is important to note that there is no simple ‘cure’ for alcoholism. It is an infamously complex disease, with — as we’ve seen — numerous risk factors, causes and symptoms. The key to continuous recovery — and it is indeed a continuous process — is treatment by knowledgeable, experienced, caring and compassionate professionals who are able to help you identify the many likely root causes of your addiction and have the expertise to best treat all aspects of the disease.

At Riverside Recovery Center in Spokane, Washington, our mission is to do just that. We provide a host of specialized programs to help each individual discover how to change their life for the better. To further increase the chances of continued recovery, we offer family programs as well. We even provide resources for employers to be better prepared to assist in recovery, and legal support services to reduce the stress from legal issues that may have arisen due to addiction. If you or someone you know is suffering from alcoholism and/or other addictions, we urge you to contact Riverside Recovery Center today. Beginning with a complimentary consultation, we can get you or your loved one on the road to a better life.

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A Comprehensive Oxycontin FAQ

What Is OxyContin?

Oxycontin FAQ

OxyContin is the most well-known brand name of the drug Oxycodone. Oxycodone is an opioid medication, which is prescribed for the relief of moderate to severe pain. It is usually taken orally, with both immediate release and controlled release versions available. In certain markets, it is also available as an injection or administered intravenously. Some oxycodone medications combine the opioid with other drugs (e.g Percocet contains oxycodone and acetaminophen) while others are pure oxycodone.

How Long Does OxyContin Stay in Your System?

There are many factors that dictate how long OxyContin remains in your system — as a result, the answer will differ from person to person. An important fact to recognize is that the drug will stay in your system far longer than you stop feeling its effects. Generally, OxyContin is claimed to provide pain relief for up to 12 hours. However, when abused, the ‘high’ is much shorter. Taken orally or smoked, the high lasts about 2 to 6 hours, while the effects of snorted OxyContin can last as little as 20 minutes.

The amount of time Oxycontin can be detected in the system, however, is greater by many magnitudes. In general, after being taken, the drug can be detected in the blood up for up to 24 hours; in saliva for 1 – 4 days; in urine for 3 – 4 days; and in hair follicles an astounding 90 days (3 months). These are all estimates, however, because the true length of time the drug stays in any one individual’s system depends on a host of factors. These include the person’s race, age, genetic makeup, body mass, overall health condition and specific illnesses, level of physical activity and the volume of OxyContin consumed, among others.

Perhaps the most important factor, though, is the person’s metabolism rate. As with all drugs, the rate at which it is metabolized varies from one individual to another. This figures heavily into the danger of overdose — in some people, OxyContin can metabolize so slowly that a single dose that will barely affect one user will result in toxicity high enough to result in a fatal overdose for another.

This is actually important information to know when it comes to recovery. For instance, there is an excellent treatment called Vivitrol that has proven to be a very effective tool in opioid addiction recovery. However, it is imperative that all traces of OxyContin or other opioids are out of the system before beginning this treatment.

What Is the Difference Between OxyContin and Oxycodone?

As previously mentioned, OxyContin is actually a brand name and specific preparation of the drug Oxycodone. Oxycodone comes in many forms and under many brand names. However, over time, OxyContin has become a proprietary eponym — the brand name has become a general way to describe the class of drug oxycodone. This has proven to be extremely dangerous — OxyContin tablets can be many times more powerful than other oxycodone-containing drugs. On many an occasion, overdoses have occurred due to users who are used to a weaker preparation of the opioid taking OxyContin in similar doses as they would the other drug.

Who Makes OxyContin?

Big Pharma

The makers of OxyContin are the pharmaceutical company Purdue Pharmaceuticals L.P., better known as Purdue Pharma. The privately owned company was founded in New York, New York in 1892, and is now headquartered in Stamford, Connecticut. The company is focused on pain management medication, and it is best known for their production of OxyContin and MS Contin. Their medications contain opioids such as oxycodone, codeine, fentanyl, hydrocodone, and hydromorphone.

The company has been the source of much controversy, and have had numerous lawsuits levied against them charging deceptive marketing and misleading the public about their products’ risk of addiction. In addition, cities and states have sued Purdue Pharma demanding millions in compensation for their costs in treating the epidemic of abuse of their products. Purdue Pharma has likely paid out close to $1 billion in fines and settlements including a record-breaking $630 million fine in 2007 — however, critics complain that this is just a fraction of the more than $31 billion dollars in revenue acquired since introducing the drugs in question.

How Long Does OxyContin Last?

OxyContin has a shelf life of 3 years.

3 Year Shelf Life

What Does OxyContin Look Like?

OxyContin pills are, for the most part, very innocuous in appearance. The most iconic image of the drug is the 10 mg variant, a plain white round pill with “OP” stamped on one side and “10” on the other. However, there are a slew of differing dosages, and it is wise to be familiar with them all and their distinct appearances. Older pills are stamped with “OC” on one side, and the dosage on the other. Newer, crush-resistant pills have an “OP” on one side instead of “OC.” The following list includes dosages not readily or no longer available, for completeness’ sake.

  • 5 mg – Light Blue, Round
  • 10 mg – White, Round
  • 15 mg – Grey, Round
  • 20 mg – Pink, Round
  • 30 mg – Brown, Round
  • 40 mg – Yellow, Round
  • 60 mg – Red, Round
  • 80 mg – Green, Round
  • 120 mg – Purple, Round
  • 160 mg – Blue, Oval

All pills are coated due to OxyContin’s ‘control release’ formula — and with the new pills, a tamper-proof coating is also added.

What Is in OxyContin?

In terms of active ingredients, OxyContin contains only the drug oxycodone. However, all pills contain additional inactive ingredients including butylated hydroxytoluene (BHT), hypromellose, polyethylene glycol 400, polyethylene oxide, magnesium stearate and titanium dioxide. Furthermore, the different strength pills contain different coloring agents. For example, the pink 20mg pill contains polysorbate 80 and red iron oxide, the yellow 40mg polysorbate 80 and yellow iron oxide and the green 80mg hydroxypropyl cellulose, yellow iron oxide and FD&C Blue #2/Indigo Carmine Aluminum Lake.

How Addictive Is OxyContin?

Oxycontin is incredibly addictive — it has been called one of the most addictive drugs in history. Critics point out that one of the main problems with OxyContin is that even when used as suggested, the drug can throw the user into the throes of addiction. When it was released, one of the main selling points was OxyContin would relieve pain for up to 12 hours thanks to its controlled-release formula. This was an unheard length for serious pain relief, and the pills sold in droves. However, it soon became clear that this number was inflated for individuals in many circumstances. As a result, legitimate users would need to take pills more often for pain relief. Soon, shorter and shorter periods of pain relief would be joined by intense cravings for the drug — and the once-responsible user would now be addicted. There is also another danger for legitimate users — those not given proper guidance who attempt to immediately stop taking the drug when it is no longer needed may find themselves experiencing withdrawal symptoms. To alleviate these terrible symptoms (discussed below), they may go back on the drug – and soon become completely addicted.

That attraction to OxyContin as a recreational drug lies in its opioid nature. When taken in situations where there is no pain, the drug does not bind to the pain receptors in the brain as designed. Instead, it creates a euphoric high, much like another opioid: heroin. And while swallowing a single tablet may provide this rush the first few times, an individual soon builds up a tolerance, and the relatively small amounts released over time no longer provide the high being sought. More drastic methods of delivery must then be found — and in its original formula, OxyContin was shockingly easy to abuse in this way.

By simply chewing the old OxyContin tablets, it’s controlled-release system was destroyed, providing a much quicker and more intense effect. Crushing or grinding the tablet created a fine powder perfect for snorting, and it could also be dissolved in water and injected. Abusing the drug in this way not only provided powerful highs, but also intense addictions and withdrawal symptoms that ensured a cycle of use to satiate both cravings that were impossible to ignore and terrible withdrawal symptoms. And while the new formula has made crushing them into powder and dissolving them more difficult, abuse of the pills continues due to the severity of the addiction they create. One of the most difficult habits to ‘kick,’ opioid addiction generally requires treatment at experienced opioid addiction treatment centers.

What Is OxyContin Prescribed for?

Lower Back Pain

OxyContin is prescribed for the management of moderate to severe acute or chronic pain. Common uses include post major surgery pain, pain due to major traumas and cancer pain. Some professionals argue that its use should be avoided for anything other than cancer-related chronic pain, as there is a high potential for dependence or outright addiction. Some studies suggest powerful opioids like oxycodone can cause unrelated pain sensitivity.

What Are the Side Effects of OxyContin?

As a pure form of the drug, the side effects of OxyContin are the same as that of oxycodone, which include:

  • Nausea
  • Vomiting
  • Constipation
  • Somnolence (sleeping for long periods)
  • Dry mouth
  • Itchiness
  • Sweating dizziness

Serious overdose-related symptoms such as:

  • Low blood pressure
  • Slowed heart rate
  • Respiratory depression
  • Complete circulatory collapse and respiratory arrest
  • And death

What Are the Symptoms of OxyContin Withdrawal?

While alcohol and benzodiazepine withdrawal are generally considered more ‘dangerous,’ opiate withdrawal is still recognized as a truly unpleasant experience. Its symptoms include:

Insomnia

  • Insomnia
  • Muscle aches
  • Nausea
  • Fever
  • Vomiting
  • Diarrhea
  • Extreme rhinorrhea (runny nose)
  • Lacrimation (runny eyes)
  • Dysphoria (a prolonged and inexplicable sense of unease)
  • Piloerection (goosebumps)
  • And more

Experts take pains to point out the practice of referring to opiate withdrawal as comparatively mild is a dangerous one, as people can and have died during unsupervised opiate withdrawal, mostly due to dehydration following severe vomiting and diarrhea. A person’s mental state during OxyContin withdrawal is always of concern as well.

What Are Some OxyContin Street Names?

Names OxyContin is referred to by include:

  • Oxy
  • Ox
  • OC
  • C
  • Oxycotton
  • Cotton
  • Kickers
  • Blues
  • References to mg strength (i.e. “20”, “80” etc)
  • Hillbilly Heroin

What Are Some Important OxyContin Statistics?

By the early 2000s, officials were already scrambling to try to contain what would soon come to be known as ‘The Opioid Crisis.’ Letters to OxyContin maker Purdue Pharma and the Federal Government showed real desperation as medical professionals and state officials talked about seeing a rate of addiction and overdose “never seen before.” Sadly, it has only gotten worse, especially among younger individuals, as statistics throughout the years clearly show.

  • A Blue Cross Blue Shield analysis of its members found that from 2010 to 2016, the number of people diagnosed with an addiction to legal and illicit opioids climbed 493 percent.
  • In 2006, the DEA reported doctors wrote 7.6 million prescriptions for OxyContin and similar controlled-release products.
  • The 2013 National Survey on Drug Use and Health showed that people aged 18-25 were the most likely to report ever having abused oxycodone (9.9%).
  • The Monitoring the Future Survey, funded by NIDA, found that about 1 in 30 high school seniors has abused OxyContin at least once.
  • A 2007 report by the Office of National Drug Control Policy said that prescription drug abuse is the second most common kind among 12- to 17-year-olds (after marijuana). Of these prescription drugs, OxyContin and Vicodin are the most popular.
  • Nonprescription OxyContin use jumped from 4 percent in 2002 to 5.2 percent in 2007 among 12th graders.
  • The New York Times reported that NY experienced an 82% rise in prescriptions for OxyContin in 3 years.
  • One Florida network of privately owned pain clinics sold $40 million in oxycodone pills over the course of 2 years.
  • The Substance Abuse and Health Services Administration reported that in 2010, 182,748 visits to emergency rooms across the United States were the result of use or misuse of oxycodone products including OxyContin.
  • The New England Journal of Medicine published a 2012 study that found 76% of those seeking help for heroin addiction began by abusing pharmaceutical narcotics, primarily OxyContin.
  • From 1995 to 2001, the number of patients treated for opioid abuse in Maine increased by 460%.
  • From 1997 to 1999 a 400% increase in the number of chronic hepatitis C cases was reported in the same state (widely attributed to intravenous opioid use).
  • In Eastern Kentucky, there was a 500% increase in the number of patients entering methadone maintenance treatment programs from 1995 to 2002, about 75% of whom were OxyContin dependent.
  • Prescription opioids are now ahead of cocaine and heroin as abused drugs, second only to marijuana.
  • In 2001, OxyContin had become the most frequently prescribed brand-name opioid in the United States for treating moderate to severe pain. By the next year, mortality rates from drug overdose had climbed dramatically, and unintentional overdose deaths from prescription opioids had surpassed those from heroin and cocaine nationwide.
  • More than two dozen states, cities and counties have sued OxyContin maker Purdue Pharma, the latest being Colorado, who reported 373 pharmaceutical opioid painkiller-related deaths last year.

How Can I Recognize the Signs and Symptoms of Addiction?

Addiction Symptoms

Some of the first things to look out for here are the side effects listed above. If someone addicted to OxyContin has not been able to access the drug recently, you will notice the withdrawal symptoms listed above, and in such cases, you should immediately seek medical attention. Other than these physiological signs, there are many behaviors to look out for, including:

  • “Doctor Shopping” attempting to obtain multiple prescriptions
  • Stealing from friends and family members to fund their habit
  • Losing interest in activities previously important to them
  • Poor hygiene
  • Neglecting responsibilities
  • Weight loss
  • Slurred speech
  • Nodding off
  • Claiming to have “lost medication”
  • Other excuses requiring early refills
  • Reduced cognitive ability
  • Impaired judgment
  • Impaired memory
  • Depression
  • Anxiety
  • Suicidal tendencies

If you see any of these symptoms, suspect a loved one may be abusing OxyContin, or are addicted to the drug yourself, please contact us at Riverside Recovery Center today. Offering specialized programs for each individual, and services including family programs, resources for employers and legal support services, we begin with a complementary consultation as the first step to a life free from the pain of addiction.

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Relapse Prevention: Understanding the Urges

There are lots of decisions to make once you decide to enter a drug rehab program. To help make the program a success, you need a relapse prevention plan in place early on. Most relapses occur during the first ninety days in recovery.  But relapse can happen at any time and for any of several reasons. All of these reasons lead to urges in one way or another. Rehab will help you learn the techniques to deal with urges and stay in control of your recovery.

Relapse Prevention

Distinguishing Between Urges & Cravings

Cravings and urges are often referred to as if they were the same thing. Although they both refer to the desire to use your addictive substance, they vary in intensity. You can crave something without having the urge to give in to the craving.

Treatment for addiction always begins with detox and the early withdrawal symptoms that keep so many addicts away. During the first day or two after you stop using the addictive substance, cravings are at their most intense. To the addict, the cravings are comparable to the need for oxygen once your air supply has been cut off. If you’ve ever craved a certain food and couldn’t stop thinking about it until you got it, cravings for drugs and alcohol are similar. But they are many times more intense.

After detox, the intensity of the cravings subsides but they don’t go away. Every person and every substance is different. Sometimes they come in waves, building to a peak before subsiding. Some people can ignore their cravings while others need to develop skills to avoid them. While cravings might be described as the strong desire to have something, urges are the sense of urgency that they have to have it now. As relentless as cravings might be, urges can be unbearable.

How Urges Lead to Relapse

Relapse isn’t something that happens all at once. It starts weeks or months before it culminates into an actual event. Relapse occurs in three phases. Certain “triggers” cause you to experience urges during different stages. Recognizing these triggers and understanding the signs and signals as they unfold can help prevent them from leading you into relapse.

Some of the most common triggers include:

  • Going through withdrawal
  • Post-acute withdrawal
  • Being in places where you used before
  • Being with friends who you used with
  • Things related to your substance use
  • Poor self-care
  • Relationship problems
  • Isolation
  • Believing you don’t have an addiction problem
  • Negative emotions
  1. Emotional Relapse – During the first stage of relapse, you aren’t consciously thinking about using. You are feeling a range of emotions and exhibiting behaviors that signal a future relapse. You might experience anxiety, anger, or mood swings. You slack off from going to therapy and start to isolate yourself from others. You stop eating a nutritious diet and aren’t sleeping well. You aren’t willing to ask for help.

The signs of emotional relapse are the same as those of post-acute withdrawal or the protracted stage of recovery. This period is after the physical symptoms of withdrawal diminish. Now that your brain chemistry is trying to get back to normal, it produces more emotional and psychological symptoms. Understanding these symptoms during withdrawal will help you plan for relapse prevention later on. When you know that you are in stage 1 of relapse, you can change your behaviors and change the outcome.

Make an extra effort to take care of yourself. Plan healthy meals and follow a regular sleep schedule. Engage in an activity that you find relaxing, whether it’s fishing, reading, or taking a yoga class. Better yet, go to class with a friend or family member. Interacting and sharing will help keep you from feeling isolated and allowing your negative emotions to grow.

Self-care is one of the most important things you can do to prevent relapse during this stage. Some techniques to help reduce cravings and improve your overall wellbeing include:

  • Yoga
  • Mindfulness Meditation
  • Acupuncture
  • Massage Therapy

These techniques are beneficial for relapse prevention by increasing relaxation and stress reduction.

  1. Mental Relapse – To visualize this stage of relapse, think of the depiction of having a devil on one shoulder and an angel on the other. The devil wants you to use, while the angel doesn’t. You might think more about the places where you used to use and the people you shared your addictive lifestyle with. Your past takes on a glamorous appearance in your memories that it never had in real life. You begin to think more about using, hanging out with your old friends, and actively considering relapse. You start lying about what you’re doing and planning your relapse. The urge is getting stronger, making relapse more likely.

During stage 2, you aren’t as worried about the consequences of relapse. This time around, you think you’ll be able to control how much and when you use. You might consider taking “just one drink” or using “just one time.” No one will know you’ve relapsed. When you start having these urges, talk to someone about them. Getting them out in the open is the only way to take control over them. It also helps you when you realize you aren’t alone in the battle against relapse.

  1. Physical Relapse – Getting past the first two stages makes it easier to avoid the third one. If you don’t develop the coping skills to control your urges, you’re more likely to go into physical relapse. Once you take that step and get a drink or use drugs, going back is more difficult. An effective recovery program teaches you to recognize the triggers that lead to urges and relapse.

Why Relapse Is Common

The emphasis that recovery centers, physicians, therapists, and other recovering addicts put on relapse prevention is due to the extreme difficulty of overcoming addiction. Unlike psychological addiction, physical addiction to a substance leads to changes in the brain’s chemistry. It impacts every aspect of your life. There is also the issue of underlying mental or medical conditions that can act as potential triggers.

In comparison to a life filled with pain, depression, bad memories, or trauma, using the substance provides you with a reward, a feeling of euphoria, and the cloud you need to block out the memories. All of the physical, emotional, and mental aspects of addiction are intertwined. You can’t make the decision to stop using and go forward with an addiction-free life. You have to go through the stages and deal with the pain. Sometimes that pain is enough to remind you why you started using in the first place.

Techniques to Help Prevent Relapse

Relapse is common but not inevitable. Everyone has cravings and urges, sometimes years after recovery. When cravings and urges happen to you, be prepared to manage them. Some techniques to help are…

1. Know Your Triggers

Once you know what triggers your urges, the best approach is to try and avoid them. Going to certain places or being around specific people might cause you to start thinking about using. Some triggers are probably unavoidable. But if you know what they are, you can develop strategies for dealing with them when they happen.

2. Engage in a Little Self-Talk

When an urge arises, there’s a good chance you won’t be in the company of someone you feel like confiding in. It’s up to you to use logic and reason to talk yourself out of using. No one knows more about the process you’ve been through than you do. Tell yourself what the potential outcome of using is in comparison to that of staying in recovery. If there are some words of wisdom that you find inspiring, keep them written down and close to you at all times. When you feel the urge to use, read the worlds to yourself. It will help you remember all the benefits of recovery and the future you’re working for.

3. Get Some Exercise

Even if it’s just a walk around the block, the movement will help you resist urges. Regular exercise is also part of self-care and promoting good physical health. It helps you feel strong and makes it less likely that you will use.

4. Engage in Urge-Surfing

Some people deal with urges by disputing them or substituting a different thought or activity. Others run from the situation that triggered them in the first place. Another option you might try is called urge-surfing. Instead of resisting it or trying to stop it, it’s more a matter of acceptance. Accept the urge for what it is. Take a time out to focus on the urge and evaluate the thoughts and feelings you have. Describe what you are thinking, feeling, and sensing.

The reason it’s called ‘urge-surfing” is that urges come in waves. They start to form, build into something big, and then they pass. If you can learn to mentally surf through them without giving in, they will pass.

5. Find New Interests

Build a different life than the one you had while you were using. If you’ve always wanted to start a new hobby, do it now. It doesn’t matter if it’s gardening, cooking, knitting, or horseback riding. Discovering new interests helps distract you from urges and gives you the opportunity to learn something new about yourself. Some hobbies also provide the opportunity to meet new friends with the same interests.

6. Try Behavioral Therapy

Many recovery facilities use behavioral therapy to help patients cope with cravings. Some combine therapy with medication-assisted treatment. During therapy, you will learn techniques that help you whenever urges occur. These techniques rely on visualization, distraction, and redirection.

When you experience an urge, you can distract or redirect your attention to something else. Visualization involves imagining yourself in a place where you feel relaxed and happy. These techniques are ways that you can change your thoughts and put your focus on something besides your cravings until they pass.

7. Reach Out

It’s up to you to take the right steps to go through recovery and fight your cravings and urges. That doesn’t mean you should go through it alone. There are lots of other people out there going through the same thing as you. When urges make it challenging for you to stay on track, reach out. Group therapy will give you a venue for talking about your feelings and sharing with people who understand.

Don’t overlook the importance of maintaining contact with a sponsor. Have someone to call when things get difficult. Having someone to talk you out of giving in to urges is one of your most valuable relapse prevention tools.

8. Participate in an Intensive Aftercare Program

The months after completing a rehab program are the time period in which you’re most likely to relapse. Leaving the program and returning to life as usual is an invitation to relapse. An aftercare program greatly improves your chance of a successful recovery in the long-term. It helps you ease back into your life without giving in to your triggers. The support you receive from an aftercare program will help you stay focused and maintain your sobriety.

When Relapse Occurs

In spite of your best efforts, relapse can still occur. It doesn’t mean you’re a failure. Maybe a serious life event caused you to give in to your urges. Maybe you’ve been struggling with other medical or mental issues. Or, maybe you didn’t have a plan for relapse prevention that prepared you for the cravings and urges.

In any case, what’s important is what you do next. Don’t chalk it up to a total loss and let your substance use get out of control again. Go back to treatment and start again. Not at the beginning, because you’ve already made great strides. This time follow the advice listed above. Every time you try, you take a little more knowledge about what it takes to manage your cravings and urges.

If you or a loved one needs addiction treatment, contact Riverside Recovery Center. Our team of physicians and behavioral health clinicians are committed to redefining treatment and recovery. We offer outpatient drug and alcohol rehab that lets you get the help you need without taking you away from your work. If inpatient or residential treatment is indicated, we can refer you to the appropriate clinic. Our goal is to help you have a lasting recovery.

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Staying Sober: Tips to Make it Through Winter

Staying sober is a day-to-day struggle for anyone in alcohol or drug addiction recovery. For some, getting through the winter months offers even greater challenges. Colder temperatures lead to more time spent inside. It isn’t unusual for anyone to feel a little “down in the dumps” during the winter. When those feelings become intense, it could be a sign of seasonal affective disorder (SAD.)

staying sober in winter

What Is Seasonal Affective Disorder and How Does It Impact Addiction?

Seasonal affective disorder is a type of depression that occurs when the seasons change. It can begin right before winter and usually ends once the weather turns warmer. Doctors often treat SAD with light therapy, medications, and psychotherapy. As anyone who has suffered from depression knows, it’s more than a feeling of sadness. Symptoms of SAD include:

  • Feelings of hopelessness or guilt
  • Sleep problems
  • Loss of interest in favorite activities
  • Changes in appetite and/or weight
  • Problems concentrating
  • Loss of energy
  • Thoughts of death or suicide
  • Feeling depressed almost all the time

Where you live can also determine whether you suffer from SAD. People who live farther from the equator develop the condition more often than those who live closer. Some scientists believe this is due to the decreased sunlight during the winter in the most impacted areas.

Other known risk factors include having existing depression or bipolar disorder or a family history of SAD or other forms of depression. Anyone familiar with the challenges of staying sober from any type of addiction already knows the relationship between depression and addiction. People with SAD who ignore their symptoms only get worse. Exacerbated symptoms lead to mental health disorders, feelings of suicide, social withdrawal, and substance abuse. These are many of the same demons you’re already dealing with. That’s why it’s so important not to dismiss your symptoms of depression and get help.

What You Can Do

All researchers don’t agree, but there seems to be a distinct connection between SAD and the lack of exposure to sunlight during the winter. Shorter days with less daylight can affect the activity of serotonin in your brain. People who are most vulnerable to the disorder sometimes produce too much melatonin, causing them to feel sleepy. These two factors combined might affect the body’s circadian rhythms.

Getting a little more sunlight might help you combat the changes in serotonin activity and melatonin. That means opening up the curtains and getting outside and into the sunlight as much as you can.

Exercise is an important part of your rehab. You might have to push yourself to get up and get moving. Once you do, it helps improve your mood. To get the most benefit from exercise, bundle up and go outside. Even if it’s just a brisk walk around the block, outdoor exercise can help you control your SAD symptoms.

Light Therapy

There are lots of light boxes and other gadgets out there to provide you with artificial light. Normally, you sit in front of the light box for between 20 minutes and 1 hour each day. These boxes filter out the dangerous ultraviolet rays while providing you with 10,000 lux of fluorescent light. This is 20 times brighter than the lighting you use inside your home.

If you have bipolar disorder or are at a higher-than-average risk of it, light boxes aren’t recommended. Since they can cause manic episodes, your doctor might recommend a different approach. You don’t need a prescription for a light box. You should still get your doctor’s or therapy team’s suggestions for the best course of treatment.

The Role of Vitamin D

You might know that vitamin D helps build stronger bones by helping the body absorb calcium. But scientists continue to find new ways that this essential vitamin helps keep you healthy. Failing to get enough vitamin D is linked to colon, prostate, and breast cancer. It also increases your risk of heart disease, weight gain, and depression.

People with drug addiction and alcoholism often have vitamin deficiencies, including that of vitamin D. Many rehab centers provide vitamin supplements to help improve the addict’s health. Another way that you get vitamin D is from exposure to sunlight. Keep in mind, people who live the farthest from the equator are least likely to get enough sun exposure to help their bodies produce enough vitamin D. Also, people with darker skin tones don’t get as much sun exposure as those with lighter skin. If either of those factors impacts you, you may want to talk to your doctor about other ways to include more vitamin D in your diet.

During the winter months, everyone is likely to get far less sunlight than they need. Experts recommend getting 30 minutes of exposure without wearing sunscreen. This means exposing your skin to ultraviolet light that can lead to skin cancer.

Another option is to take a supplement during the winter. You may want to have your doctor test your levels and prescribe the right supplements for you. More doctors are paying attention to their patient’s vitamin D levels due to the growing list of benefits linked to the vitamin.

You can also add more vitamin D-rich foods to your diet like salmon, egg yolks, and orange juice. There are also vitamin D fortified foods like breakfast cereal and milk. If your goal is to stay sober through the winter, taking vitamin D will help reduce your risk of depression and improve your overall health.

Staying Sober

Stay With Your After-Care Program

One of the hardest things for anyone to do is admit they feel depressed. It’s easier to just stay in bed and not put any energy into getting better. Your recovery isn’t complete as soon as you leave the recovery center. An aftercare program ensures your success at staying sober, even after problems arise.

Some people who develop SAD benefit from certain types of antidepressants. Those patients with bipolar disorder can experience manic episodes that also require treatment. No one has the right knowledge of addiction and can help you more than the therapeutic team who has helped get you this far through your recovery.

Don’t Give in to Feelings of Isolation

A lot of the tips your rehab team gives you for rehab are difficult once you experience the symptoms of SAD. They demand that you take control and get into the thick of things. Allowing yourself to give in to feelings of isolation can cause cravings that, in turn, lead to relapse. Put yourself out there and spend time with the people that matter to you. The more activities you perform with people whose company you enjoy, the easier it is to ignore cravings. It doesn’t matter if it’s your bff, your kids, or other people in group therapy.

About 5% of all people in the U.S. population have seasonal depression. Of that number, 4 out of 5 are women. The percentage varies among different geographic regions. Initially, that doesn’t sound like a big number. Considering there are an estimated 328,953,020 adults in the country, that means about 16,447,651 will develop seasonal depression.

Diagnosis of SAD occurs after two episodes of depression at the same time of the year. Ask your doctor about treatment and also about any preventive measures you can take. If you’ve already experienced symptoms or signs of SAD in the past, you may be able to stop them from returning.

Other Reasons You’re Having Trouble Staying Sober

Rehab isn’t easy. The physical and emotional impact it has on your body and mind is the reason so many people relapse. The symptoms associated with addiction, side effects, and symptoms of SAD are intertwined. But as hard as it might be to get through the winter due to depression, there are many other reasons that people give for relapse.

– Fear of Missing Out

Regardless of the impact they’ve had on you, you’ve chosen your friends, the parties, and the lifestyle that goes with addiction. Many users worry that missing just one occasion will mean missing out on something life-changing. The reality is that it’s really just more of the same. The fear of missing out has led many alcoholics and drug abusers to never take that first step towards sobriety.

– You Can’t Distinguish Between Slowing Down and Stopping

Some people look for the happy medium between addiction and rehab. They believe they can continue their drug or alcohol use in moderation. It’s like being on a diet and finally giving in to a piece of chocolate cake. Except when it’s an addictive substance, there isn’t any getting back on track the next day. There isn’t a happy medium between using and sobriety. There’s only a choice between one and the other.

– The Idea of Sobriety Scares You

For some addicts, the idea of staying sober is terrifying. Thinking about no longer having a crutch when things go bad is more than they can accept. That’s one reason some recovering addicts will tell you they became and stayed sober one day at a time. Sometimes the idea that “I’m not going to have a drink today” is a lot easier to live with than, “I’m never going to drink again.”

– Facing Your Demons

Sometimes the reason that people start using addictive substances is to cover the pain they have inside. They may have mental issues that they can’t deal with. With sobriety comes the return of the demons that led to addiction in the first place. If you’re ready to face your demons, it’s time to find a recovery center that takes your physical and psychological health into consideration.

– Previous Relapses

Many people believe they will either become sober or they will fail. When they relapse, they consider it a failure. An estimated 70% to 90% have at least one minor slip-up, while about half return to heavy use. Often, returning to the same settings and friends where they used before serves as a ‘trigger’ for drug use. Relapse occurs most often during the first ninety days in recovery. A slip doesn’t mean you’re at the end of the road.

Underlying conditions, including depression and anxiety, also contribute to the person’s potential to relapse. But staying with the program and learning to deal with issues before a relapse occurs can lead to lifelong sobriety. After a year of not using, the odds of your staying sober become a lot better.

If you’ve already made a previous attempt at staying sober only to end up relapsing, it doesn’t mean it’s the end. Think about what you’ve accomplished during your recovery. More people experience at least a minor relapse than those who don’t. Gather information from your experience and learn how to keep it from happening again. Sobriety is worth it, no matter how many attempts it takes. Learn your triggers and what causes you to start craving drugs or alcohol again. Get help dealing with mental issues, including the symptoms of SAD.

What to Do If You Have Symptoms of Depression

Seasonal affective depression is a very real threat to anyone’s health and happiness. For anyone who is newly sober, it can also put you at a greater risk of relapse. As we’ve explained here, there are many reasons that people relapse. But there are also many types of depression in addition to SAD. Any person can develop depression at any stage of their life. They can also experience it during any season of the year.

We all feel a little down sometimes. But when you’re sad most of the time, it isn’t normal. Once feelings of sadness begin to interfere with your life, it’s time to seek treatment. Most importantly, you should never ignore symptoms of depression. Whether they are caused by cold weather or something else, they can put your sobriety and your life at risk when they get worse. If you aren’t sure where to go for help, talk to your medical doctor. They can either provide you with the appropriate treatment or give you a referral to a specialist who can help.

It doesn’t have to be your first attempt at staying sober. Getting sober is worth every effort you put into it. Contact Riverside Recovery Center to learn more. We offer drug addiction treatment you can depend on in Spokane, Washington. See why people often call us “Spokane’s best drug rehab center.”