Category: Addiction

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Depression in Recovery: Do You Have Low Dopamine Tone?

By Amy Dresner 09/10/18 – for The Fix

I just felt like shit and slept as much as I could. I showed up to work. I kept my commitments. I spoke when asked to, but I felt more than unhappy. I felt like I just didn’t care.

(The Fix does not provide medical advice, diagnosis, or treatment, nor does anything on this website create a physician/patient relationship.  If you require medical advice, diagnosis, or treatment, please consult your physician.)

I just came out of a six-week depression. That might not sound very long, but when you’re in hell it feels like forever. Good news: I didn’t bone any 25-year-old strangers; I didn’t cut myself; I didn’t get loaded; I didn’t smoke or vape although I really, really wanted to. I didn’t even eat pints of Ben and Jerry’s while binge-watching I Am A Killer. I just felt like shit and slept as much as I could. I showed up to work. I kept my commitments. I spoke when asked to, but I felt more than unhappy. I felt like I just didn’t care. I didn’t return phone calls. I didn’t wash my hair. Suicidal thoughts bounced around my head, but I ignored them like I do those annoying dudes with clipboards outside Whole Foods.
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Rebuilding Your Life After a Relapse

If you have recently relapsed on your path toward sobriety, you know how emotionally challenging this can be. After a relapse, people can feel tremendously guilty, sad, and anxious. That being said, recognizing the severity of a relapse means that you understand the severity of your addiction. By understanding that your relapse was a misstep and not emblematic of your strength, resolve, or self-worth, you are better able to work toward forgiving yourself and moving forward. The following article suggests steps you can take to set yourself back on the path of recovery after a relapse.

Seek Professional Help

While you may be hesitant to tell someone about your relapse, talking to a professional can prove invaluable. It is important to understand that asking for help shows courage and commitment — you should not feel embarrassed about this. Addiction professionals are experienced working with individuals at every step of the recovery process and have encountered other individuals in a similar situation. For many, a good first contact is someone you have already worked with such as a counselor, sponsor, or group therapy leader. If you do not have a specific individual to reach out to, consider calling an addiction hotline for immediate support. Generally, addiction help hotlines are staffed by trained crisis care professionals who can offer immediate guidance and refer you to nearby resources.

Talk to Friends/Family

Building a strong support network is an integral component of the recovery process. Sharing your thoughts and feelings with another individual can reduce stress (especially work-related stress, which often acts as a trigger for substance abuse), anxiety, and sadness. Telling a loved one about your relapse also has the power to keep you accountable for certain actions. Sharing can also strengthen your relationship with certain key individuals and allow you to develop a system to prevent future relapses. For example, some people find it helpful to phone a friend/family member when they are feeling the need to engage in their addictive behavior. Lastly, an empathetic ear can remind you that you are not in this alone and strengthen your commitment to sobriety.

Forgiving Yourself

A relapse can often evoke feelings of intense shame, fear, and guilt. You may feel as if you failed yourself, your family, and your journey because of a certain action. While self-blame is very common after a relapse, it is important to work towards forgiving yourself in order to move forward. Addiction in general often stems from feelings of inferiority and low-self confidence. Blaming yourself for a relapse can intensify these feelings, thereby making another relapse more likely. Feeling ashamed about what you did can lead to increased substance usage rather than sobriety. Recognizing a relapse for what it is — a mistake — is fundamental towards moving forward.

Moving Forward

While moving forward after a relapse can feel overwhelming, consider thinking of this as an opportunity to adjust your sobriety strategy. Take some time to reflect on what circumstances and emotions led to your relapse. Once you recognize the elements that lead up to your relapse, you can begin to develop a strategy to prevent similar situations in the future. During this period of self-reflection, be honest with yourself and ready to take precautions to prevent a future relapse. Many individuals in addiction recovery find exercise and healthy eating to be highly beneficial. Physical activity and healthy, whole foods can increase dopamine levels, thereby helping you feel happy and relaxed. As you start to feel better, you are also likely to gain more self-confidence which has been linked to successful recovery.

The path towards recovery is just that — a path. Addiction recovery is not a finite destination, and it is possible to make mistakes along the way and still be successful. If you have recently relapsed, consider following some of the aforementioned steps. Lastly, always remember that you are not in this alone — there is always someone to listen, guide, and help.

Photo Credit: Pixabay

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Schools are taking on the fentanyl crisis but drug curriculum a patchwork

By the age of 19, Jordan Miller was already addicted to drugs and reaching out to his parents for help. By 24, he’d taken a deadly cocktail of oxycodone pills — enough to stop his heart.

His mother, Leslie McBain, has told the heartbreaking story of her son’s overdose at every high school in British Columbia’s Gulf Islands region over the past two years.

“My message is one of safety. If you decide to do this, here’s how to stay safe,” she said.

It’s a refrain she repeats to students over and over again: never use alone, always carry naloxone, watch out for your friends at parties and know how to recognize an overdose.

‘More we need to do’: Overdose deaths in Vancouver surpass last year’s total
Drug education in B.C. schools changing to reflect overdose crisis
As the spread of opioid-related overdose deaths in Canada continues to move east, more and more kids will likely hear warnings like McBain’s when they head back to school this fall.

But while a front line in the fight against the overdose crisis has opened up in Canadian classrooms, where students go to school seems to affect how they learn about the risks associated with contaminated substances.

Western schools lead country
Predictably, Canada’s westernmost provinces and territories — those hardest hit in Canadian authorities’ battle against fentanyl — have been active in updating their school programming to reflect the continuing crisis.

British Columbia’s Ministry of Education has added modules on overdosing to its Grade 6 and high school curriculum, and several larger B.C. school districts have programs dedicated to teaching kids about the risks associated with drug contaminants.

Meanwhile, inquiries to provincial and territorial health and education ministries found that Yukon is the only province or territory in Canada to have trained all its school administrators in how to use naloxone and to stock every school with a naloxone kit.

Read more here.

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Giving Up Drinking Changed My Life

A year ago, Cheyne Kobzoff’s life sucked. Hard. Despite a loving wife, two kids, and a great job as a chef at a local restaurant, the lifelong drinker spent every miserable morning trying to remove the creeping thoughts of self-hatred from his perpetually pounding head. But beyond the emotional damage, Kobzoff’s rampant boozing had also caused his belly to balloon into a Santa-like situation. (The beard didn’t do him any favors either.)

So on March 23, 2016, the 33-year-old decided to up and quit cold turkey. Shortly thereafter, he started running, too, realizing that it might help curtail some of the anxiety he was feeling. Kobzoff eventually found himself running distances he never thought possible, and dropped several pants sizes as a result. He’s now a full 53 pounds leaner.

Kobzoff, who lives in California, recently posted the above before-and-after photo to Reddit, proclaiming that one year without alcohol has made him “1,000 times happier.” The post blew up. We asked him how he finally got sober—and why his friends may or may not hate him now that he’s “healthy.”

Congrats on losing your gut, but why’d you have to lose the beard?
I was pretty sad to see it go. I had it for about a year and a half, but it just got too much to maintain every day. I was also really interested to see what my face would look like after I lost a bunch of weight.

I bet your wife was stoked when you shaved.
Actually, she really grew to love it, so she was pretty scared when I came into the bedroom after I cut it off. Same with my kids. My 3-year-old daughter freaked out. But I guess she won’t really remember me with a beard anyway.

Or a belly. Did you have a rock bottom moment where you finally decided to quit drinking?
Not really—it sort of built up over time. Alcoholism runs in my family, so I started drinking when I was 15. It was normal to go drinking every weekend, which eventually turned into every day.

Did you consider yourself an alcoholic?
I guess so, but I don’t think it was something I was really ready to admit. I do admit it now, but it feels weird to say it. I just know that I can’t drink. I would be scared that if I did, I’d go back into the same cycle.

I just didn’t like who I became. I didn’t like what it did to my body. I had actually tried quitting two years ago—the day after I went to a wedding, drank everything in sight, and threw up for 24 hours. But I only quit for a month. I gave myself that finish line of 30 days, and just went back to drinking even more. I’d get up to a 12-pack a night, and then my wife would come home and I’d have a glass or two of wine with her. I just felt so crappy every morning on my drive to work.

So I gave myself an arbitrary quit date: March 23. That was three days after my son’s birthday, which I knew would be a big party atmosphere. And that was it. I just stopped drinking.

You wrote on Reddit that you initially replaced all your drinking with eating whatever you wanted—which, honestly, sounds pretty fun.
I went to town on sweets, for sure. My body was missing all that sugar. I just went through bags of candy. Starburst, jelly beans, and anything sour. I also went to soda, which was a big calorie replacement for the beers. That lasted for about a month.

When you started running, right?
Well, I drank to cure my anxiety. But my anxiety didn’t really go away after I stopped. One day I was mowing the lawn and I was engulfed in anxiety, and I just felt this urge to run. I didn’t act on it, but the next night I felt the urge again, and I went. I put on my shoes, ran out the door, and went a mile down the road and back. I had no idea what I just did . . . but it felt good. And then I came inside gasping for air.

Did your wife think you were dying?
She was laughing, mostly because I didn’t know that I had to cool down after running. I mean, I had never done anything physical in my life at all. So she told me to go walk around for 15 minutes, and sure enough that helped. Even though I still thought I was going to throw up.

Some people refer to the first couple weeks or months of being sober as the “pink cloud” phase, where you feel unexpected bouts of intense elation. Did that freak you out?
Totally. I would be in a store, standing in line when all of a sudden this overwhelming feeling of being so happy would come over me. I physically felt happy to the point where I’d almost cry. I never felt anything like that before.

Did you break out in song in the middle of the checkout line?
[Laughs] I don’t think so, but I definitely let out more than a couple woo-hoos while driving.

You eventually progressed from running 13-minute miles to running 25-minute 5Ks, and then you introduced lifting into the mix. What’s your proudest fitness accomplishment?
I never used to be able to do sit-ups. But eventually I started deadlifting, squatting, and bench pressing, and before long, I had a six-pack. So I tried to see if I could do some sit-ups, and all of a sudden I could bang out 60. It’s pretty cool to do as many as I want.

You must be driving your friends nuts with this healthy shit.
Yep, I’ve been that guy the entire year. I don’t care, because I’m super happy, but I’m sure I annoy 90 percent of the people I talk to. Mostly I was just super excited about everything that I was learning while getting healthy. I literally had nothing else to talk about besides fitnessand not drinking.

Did you get preachy?
No, I don’t care what other people do. My wife drinks wine, and I’d never tell her she can’t drink because I can’t drink. That would be a dick move.

Are you still a fun hang now that you don’t drink?
I hope so. [Laughs]

Maybe I should ask your friends.
I actually got together with some of my best friends the other week. We went on a trip to Lake Tahoe, and I was kind of worried because they all drink. I just spent the whole time telling them about my year, and it was fine. I think I’m probably better now because I don’t get to that point where I’m totally wasted anymore. I couldn’t have been much fun at that point.

What was your worst drunk moment from back in those days?
The night before I got married, I got shitfaced. I woke up on my wedding day with this bowl next to me with some blood in it. Apparently I tried to pull over a cement trash can, my fingers slipped off, and I just slapped my head on the ground. It’s embarrassing to look at the wedding pictures of me and see my puffy red face and probable concussion.

Do you miss drinking?
I really miss tasting nice craft beer. We have a ton of great breweries around here. And I miss having red wine with a great steak. That kills me.

Small price to pay for not waking up on Sunday mornings and feeling like shit, though.
Oh, it’s pretty awesome. I can stay up late and wake up early and be totally fine. My kids are up at 6:30 am, and I can be up with them if I want to without wanting to barf.

And you wrote that you don’t “stink like a sweet and sour bar mat” anymore. So what do you smell like now?
A sober person? [Laughs] As soon as I stopped drinking, I could instantly smell people who had had just one beer. And I thought, “Oh my god, did I smell like that?” I guess I just smell like my laundry detergent now.

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Deepening “Crisis” In US Reveals One In Eight Americans Are Now Alcoholics

From IFL Science

The “opioid epidemic” continues to be the weight quietly sitting on the shoulders of the US. However, a dramatic rise in dangerously heavy drinking across the country suggests that alcoholism could be a new epidemic hiding in plain sight.

Latest figures show that 12.7 percent of people living in the US have some kind of alcohol-related disorder. That’s nearly one in eight people. These numbers have also increased by almost 50 percent compared to the previous decade, suggesting that the problem is on a sharp rise.

The statistics come from a study, recently published in JAMA Psychiatry, that compared the rates of alcoholism, alcohol use, and binge drinking between 2001 to 2002 and 2012 to 2013 in two surveys of 43,000 people and then 36,000 people, respectively.

Between 2001-2002 and 2012-2013, the number of people who drank alcohol (both problematically or casually) rose by 11.2 percent to 72.7 percent of the population.

Just under a third of people in the US indulge in “high-risk” binge drinking. In keeping with the US dietary guidelines, this was defined as drinking five or more standard drinks for men, or four drinks for women, on any day at least once a week. The rise in binge drinking was particularly noticeable among women (up 57.9 percent over the decade), elderly people, Hispanics, and African-Americans.

The study makes a “compelling case that the United States is facing a crisis with alcohol use, one that is currently costly and about to get worse,” according to one of the study’s authors, Professor Marc A Schuckit of the University of California, San Diego, writing in an editorial statement about the study.

Obviously, it is a massive risk to public health. Alcohol in excess is strongly associated with numerous types of cancer, cardiovascular disease, strokes, liver cirrhosis, and type 2 diabetes, to name but a few. In total it could cost the US economy upwards of $250 billion a year.

The reasons behind these increases were not explored by the study, however, the researchers suspect it’s likely to be “historically rooted in racial discrimination and persistent socioeconomic disadvantage both at the individual and community levels.”

It’s not likely to get better soon, either. “The proposed cuts to the National Institutes of Health budget being considered in Washington in 2017 are potentially disastrous for future efforts to decrease alcohol problems and are likely to result in higher costs for us all,” said Professor Schuckit.

“If the proposed budget prevails, the National Institutes of Health will have serious problems keeping current research going, and it will be difficult or even impossible to fund new research. In addition, most of the problems raised here will escalate further if as many as 23 million people lose health care.”

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Coaching your way to better mental health

For The Star

Mental-health coaches, the first of their kind in Canada, are helping those with depression, anxiety and at-risk drinking

Each day, Antonio was slipping deeper into depression. His parents were ill, he feared being laid off from work and he was unhappy in his relationship, which he had moved to Toronto for.

But when he started thinking about suicide — and at one point two years ago came “really, really close” to taking his own life — he knew he needed help.

“I felt jailed, trapped,” says Antonio, who asked that his last name not be published. “I was in a very dark place.”

He confided in his family doctor, who suggested he participate in the Partners Project run out of the Centre for Addiction and Mental Health (CAMH). It’s a three-year study looking at the effectiveness of a mental-health coach — the first role of its kind in Canada — who calls patients with depression, anxiety and at-risk drinking, the most common mental-health problems in primary care.

Adam Whisler, one of the mental-health coaches, says patient response has been largely positive.

“It’s been really awesome to talk to people who would otherwise be completely isolated or who are very nervous to go and speak with someone in person (about mental health),” he says. “By talking to them over the phone, it can help them drop their guard a bit and feel more comfortable.”

The Partners Project, which started two years ago, is meant to bridge primary-care providers and the larger mental-heath services community.

The way it works is a family physician, or nurse practitioner, refers a patient to the project. A treatment plan is designed by a psychiatrist, who supervises three specially trained mental-health coaches.

It’s the coaches who regularly call the patients, usually weekly for about 20 to 30 minutes, to check in and provide support. The coaches then share the information from those calls with the overseeing psychiatrist, whose treatment suggestions may include medication, different dosages, blood work and referrals for formal therapy. Those recommendations are then given to the patient’s doctor so he or she can implement them.

The program is meant to assist family doctors, who don’t always have the resources when dealing with mental health and addictions issues, and may have limited time for followup and support. It can also prove crucial for those in rural and remote areas, where there are limited mental-heath services.

In Ontario, 1.3 million people suffer from co-existing physical and mental-health illness, and many aren’t getting the treatment they need because the health-care system isn’t designed to focus on both at the same time. That’s according to the Medical Psychiatry Alliance (MPA), which is supporting the study that’s being funded by Bell Let’s Talk.

At first, Antonio was reluctant to participate because he didn’t want to share personal details on the phone with someone he had never met. But he couldn’t afford a therapist and was desperate. So he gave it a try.

“After a few months, I was feeling better and doing better,” he says, noting the mental-health coach helped him set goals, monitored his symptoms and asked how he was responding to his anti-depressants.

“There was continuous feedback between (the Partners team), my family doctor and me. And that was very important. I felt like I was taken care of.”

This kind of integrated care was adopted from similar models in the United States and could become a widespread practice in Ontario. Those overseeing the project say results so far are encouraging.

“Our hope is that this model can assist us in meeting the health-care gaps and increasing access for mental-health services for patients in the primary care context,” says Athina Perivolaris, a senior project manager for the MPA.

Adam Whisler is a mental-health coach, a new role for Canada that involves calling patients once a week to provide support for those dealing with depression, anxiety or at-risk drinking.Adam Whisler is a mental-health coach, a new role for Canada that involves calling patients once a week to provide support for those dealing with depression, anxiety or at-risk drinking. (ANDREW FRANCIS WALLACE)

“If we are able to do that, our hope then would be that we can take this model and have it widely adopted throughout the province.”

The MPA was established in 2014 with funding from the province, an anonymous donor and four partners (CAMH, the Hospital for Sick Children, University of Toronto and Trillium Health Partners). It’s tasked with improving access to better-integrated mental and physical health care in Ontario.

About 150 family doctors, mostly from the GTA, are working with the Partners Project, but researchers are trying to recruit more physicians in rural and remote areas.

As part of the study, patients are placed in one of two groups: one that keeps getting usual care and another that receives usual care, plus the extra phone support from a mental-health coach.

In some cases, the study’s researchers identified serious problems with patients, such as PTSD, drug use, mania and psychosis, which had been missed by family doctors.

“Even when physicians detect some distress, they do not necessarily have the time to find out what the problem is,” says Perivolaris.

Dr. Charles King of Village Family Health Team in Toronto welcomes the extra support and has referred about 35 patients to the project.

“The idea is that you want to actively manage depression, anxiety and at-risk drinking. Typically a lot of people fall through the cracks with those problems.”

Whisler has a bachelor’s degree in psychology and sociology, is a former youth worker and does mental-health research at CAMH. In order to participate in this project, he and the other coaches received special training that includes symptom-monitoring and how to speak with patients so they better understand their symptoms.

For those with mild to moderate symptoms of depression and anxiety, regular chats with a mental-health coach may be sufficient, says Whisler. Coaches can help them with life skills and goals so their situation doesn’t worsen and require formal therapy.

“From a system-level perspective, that makes a massive difference in reducing wait times for psychiatrists and psychologists and also reducing the cost to the overall health system.”

For Antonio, regular phone sessions with a mental-health coach — a “comforting and reassuring” voice — made all the difference.

“I’d probably be gone had I continued on that destructive path.”

He’s now putting many of the skills he learned during their discussions to good use. For instance, he recently broke up with his partner — something he says would’ve pushed him over the edge a couple of years ago — but he’s managing.

“I’m not exactly 100-per-cent OK . . . but I’m not where I was.”

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Louis Theroux: Drinking to Oblivion: BBC2 alcoholism documentary promises to be a sobering experience

For The Independent

If you think you have a drink problem, you know someone who does, or who may have, then I beseech you to watch Louis Theroux: Drinking to Oblivion. It will be, almost literally, a sobering experience, not to say an unpleasant one. Indeed, although there are mercifully few properly medical scenes to unsettle the squeamish, the conversations with mostly healthy-seeming and normal-looking alcoholics featured will be some of the most upsetting things you will witness on your screen for a very long time indeed. In case you thought there might be, there are no laughs.

In this one-off documentary, Theroux wisely tones down his usual contrived faux-naive personality and plays things about as straight as he can manage. The techniques he used to devastating comic effect with, say Ann Widdecomble or the last Paul Daniels and Debbie McGee (and which worked rather less well with the cunning Jimmy Savile), are abandoned in the fact of abject human suffering. Every alcoholic is a human being, after all, and they all have their own stories to tell, and they are not always sad. The fact that this drug has destroyed their jobs, their relationships and their health doesn’t make these characters any less complex than those fortunate enough to be able to stay sober for more than couple of days. But there is one common theme in their outlook, an almost friendly relationship with death, an outcome accepted with equanimity. In and out of detox at Kings College Hospital in south London, there seems an almost cheerful acceptance, even when relatively sober, that the booze is killing them and more than a hint that they would almost welcome the end. It is a suicidal kind of mind-set, and, as I say, makes for an excruciating hour of non-entertainment. Maybe it won’t cure anyone, and maybe all it will do is confirm what you already know about a friend, loved one or acquaintance who is losing control, but the stories are informative as well as terrifying. Theroux has never used his journalistic gifts for a greater good.

Not quite as dark, though dramatically under-lit, is Flowers, a new Channel 4 ‘black’ comedy. It is plenty of strangeness in it, as well as the utterly unstrange Olivia Colman playing another on-the-brink middle class middle aged woman in a difficult relationship. There’s an unexplained Japanese lodger with an unhealthy interest in extreme manga; a chap who has invented a “cheese fumigator”, which explodes with predictably smelly consequences; dementia; suicide; inappropriate sexual behaviour; a fantasy novelist; open marriages; and a “magic snake”.

Anyway, Flowers, a sort of suburban Gormenghast for our times, will run at 10pm every night throughout the week from Monday 25 April (with a double bill), culminating with the show’s finale on Friday, 29 April. The whole of the astonishing series will then be available on All 4.  It will run on Channel 4 at 10pm every night throughout the week from Monday 25 April (with a double bill), culminating with the show’s finale on Friday, 29 April. It isn’t as bleakly brilliant as Julia Davis’ Camping over on Sky Atlantic, but it shares some of the same morbid attractions. There’s an awful lot of that on the telly right now, I must say.

Hope > Vision > Action | Copyright 2019 ©. All Rights Reserved. Some images from Pixabay.