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Help With Addiction and Substance Use Disorders

Curated and updated for the community by APA

Substance use disorder (SUD) is complex a condition in which there is uncontrolled use of a substance despite harmful consequence. People with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day to day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called addictions.

People with a substance use disorder may have distorted thinking and behaviors. Changes in the brain’s structure and function are what cause people to have intense cravings, changes in personality, abnormal movements, and other behaviors. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory, and behavioral control.

Repeated substance use can cause changes in how the brain functions. These changes can last long after the immediate effects of the substance wears off, or in other words, after the period of intoxication. Intoxication is the intense pleasure, euphoria, calm, increased perception and sense, and other feelings that are caused by the substance. Intoxication symptoms are different for each substance.

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  • Aug 31, 2021
Most Teens Who Use E-Cigarettes Have Tried to Quit

More than half of middle and high schoolers who use e-cigarettes said that they intend to quit and about two-thirds had tried to quit during the past year, according to a recent study in Pediatrics.

  • May 17, 2021
Cannabis: Understanding the Risks

At a recent session at the APA Annual Meeting, a panel of psychiatrists addressed many of the common misconceptions around cannabis. With more states legalizing cannabis and changing public perceptions, there is confusion around its safety and uses. At the APA session, Smita Das, M.D., Ph.D., M.P.H., provided an overview of cannabis and its current use. To date, 16 states and the District of Columbia have legalized cannabis for recreational use by adults, and 36 states legalized it for medical use. However, cannabis is still a federal schedule 1 substance (most restricted schedule) under the Controlled Substances Act.

  • Mar 26, 2021
Only One in 10 Youths in Community Justice Systems Who Need It Are Getting Behavioral Health Treatment

Youths entering the juvenile justice system are often identified as needing help for substance use and mental health concerns, yet very few—only one in ten—receive needed behavioral health services, according to a new study in Psychiatric Services, a journal of the American Psychiatric Association.  

What can you do to prevent relapse?

Preventing relapse to substance use is mainly a matter of becoming aware of the triggers to relapse and either finding ways to avoid or cope with them. Triggers can be external, for example being in places where substances are being used. Stress of any kind (job stress, financial stress, arguments with important people) can also be an external trigger. Triggers can also be internal such as craving, depressed mood, anxiety, hunger or fatigue. The key is to anticipate triggers ahead of time so they don’t come as a surprise and use a plan or coping strategy to deal with the triggers. Usually professional help is needed to gain awareness of and plans to deal with triggers to relapse. There are also very good medications for alcohol, opioid and tobacco use disorders that effectively reduce craving and can help prevent relapse. More

I live with pain and I want help, but I’m worried about becoming addicted to pain medication. What can I do?

Opioid type medications that have potential to lead to addiction are only one way, and probably not the best way, to help manage chronic pain. So the best plan is to try all the alternatives first.

Non-medication interventions such as graded exercise programs, physical therapy, mindfulness meditation, yoga, tai-chi and a form of psychotherapy called cognitive-behavioral therapy (CBT) all take some effort but often work very well. Acupuncture may benefit some people living with pain. Many medications that do not have addiction potential can also be helpful for chronic pain. These include anti-inflammatory medications like aspirin, ibuprofen or naproxen; antidepressants like nortriptyline or duoloxetine; or medications often used for seizures like gabapentin or pregabalin.

If you or someone you know does require opioid pain medications to help manage chronic pain, it is reassuring to know that the majority of people who take these medications for chronic pain do not become addicted to them, although anyone who takes these type of medications for more than a few weeks is likely to have some tolerance (less effect of the medication over time) and withdrawal symptoms if the medications are stopped abruptly. More

What resources are available for family members of an individual with addiction?

Al-Anon and Alateen are widely available and free resources for family members. These organizations offer mutual help groups. Members do not give direction or advice to other members. Instead, they share their personal experiences and stories, and invite other members to “take what they like and leave the rest” — that is, to determine for themselves what lesson they could apply to their own lives. The best place to learn how Al-Anon and Alateen work is at a meeting in your local community. Most professional treatment programs also offer family groups to help families support their loved ones struggling with addiction. More

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About the Expert:

Andrew Saxon, M.D.
Professor and Director, Addiction Psychiatry Residency Program
University of Washington
Director, Center of Excellence in Substance Abuse Treatment and Education (CESATE)
VA Puget Sound Health Care System
Seattle, Wash.

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Keith's Story

Keith, a 45-year-old plumber, was referred for a psychiatric evaluation after his family met with him to express their concern about his heavy drinking. Since making the appointment three days earlier, Keith denied having a drink.

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May 13 2021

How Wearables and Apps Can Help Patients Avoid Addiction Relapse

 

Forbes
Before the pandemic, the United States was already in the midst of a national opioid crisis, with nearly 50,000 deaths a year from opioid-related overdoses. The stress of the last year only exacerbated this crisis: The Centers for Disease Control and Prevention (CDC) reports that 13% of Americans either started or increased their use of substances last year. While there is no substitute for rehabilitation counseling, technology — especially wearables and discreet apps on personal devices — can help people struggling with addiction work through vulnerable moments and potentially reduce the odds of relapse.

May 13 2021

Addiction issues aren’t going away: How are you helping your employees post COVID?

BenefitsPro
While the end of the pandemic may finally be on the horizon, the addiction issues are, unfortunately, here to stay. Substance abuse and addiction continue to take a toll on workplaces across the U.S., with nearly 11 million workers across America struggling with a substance use disorder. More than 1 in 4 remote workers reported going to work impaired by alcohol, drugs or both, a rate that is 3.7 times more likely in remote workers than non-remote workers, and 3.5x higher in men than women. There has also been a disruption in routines and increased social isolation, both of which can cause addictions to spiral.

Apr 20, 2021 

New Online Tool Meant to Help Curb Substance Use Disorder Stigma
WV Public Broadcasting

Stigma can impact the quality of clinical care for people with substance use disorder, or SUD. A new e-learning system is meant to help bias among health care professionals. The groups developed online tools tailored to the unique experiences of health care workers around individuals with substance use disorder and the importance of language. The program focuses in part on terminology. The program promotes language like ‘a person with substance use disorder’ rather than ‘addict’ or ‘infants exposed to substances before birth’ versus ‘drug baby.’ The tools are also meant to help reduce compassion fatigue.