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Wednesday, April 11, 2018

Codependency and Substance Abuse Influence Family Relationships

Most people would agree that loving someone means being prepared to be part of their life during good and bad times. When someone we care about is facing a personal challenge, we step up to do whatever we can to help them. Our hope is that the people we are closest to would do the same for us. This type of interdependent relationship is healthy and a source of strength, but codependency in a relationship is different situation entirely.

What Is Codependent Behavior?

On the face of it, codependent behavior can look a lot like providing support to a spouse, partner, child, or other family member. The difference is that instead of the relationship being one of mutual “give and take," the codependent person “gives” and the other person “takes.”

Codependency may be associated with these behaviors:

  • Attempting to “fix” other people or their problems
  • Difficulty with intimacy
  • Fear of being abandoned or rejected 
  • Guilt
  • Lack of trust in self and others
  • Need for control
  • Perfectionism

Someone who is codependent will place the needs of a loved one above their own. This is not something that they do situationally or in extraordinary circumstances to deal with a crisis. This type of learned behavior can become a way of life.

Codependency and Substance Abuse: Life with an Addict in the Family

No one ever anticipates a situation where they will have an addict in their family. Even though research has shown that addiction is a brain disease and not a character flaw, there is still a stigma to face. Many families still feel some combination of guilt or shame when they realize that a loved one has developed a substance abuse problem.

Early Stages of Addiction
In the early stages of the substance abuse, the person who is becoming more dependent on drugs or alcohol is likely to hide evidence of the existence of his consumption or the amounts consumed. He is likely to deny that there is a problem at all.

During the same stage, a spouse or partner may not immediately want to jump to the conclusion that an addiction exists. Children in the family who notice that a parent or sibling is acting “different” may conclude that they have “done something” to cause the situation.

All family members who notice a change in the family dynamic may alter their behavior to try to improve the situation and restore the family relationships.

Addiction Is Firmly Established
At this point, the addict is drinking or using drugs regularly. She may think that she has things under control; however, her addiction is at the point where cracks are starting to show. She may be missing work or school and having issues getting along with coworkers or supervisors. Financial problems may be starting, as funds are being used to support the addiction instead of paying bills. The addict may be spending less time on family activities and hobbies, as the addiction takes up more of her time.

A parent, spouse or partner who is codependent will go to great lengths to keep up the appearance that everything in the household is working well. They will not discuss their loved one’s addiction with people they consider to be outsiders. In some instances, the subject is not even discussed within the family even though the family knows about it. This enables the addiction to flourish by keeping the addict from feeling the consequences of her actions.

Addict Goes to Treatment
When an addict goes to treatment for his addiction, he is making the positive step to get help for substance abuse. Going to detox and seeking professional drug and alcohol treatment are the first steps toward the goal of long-term sobriety.

If the codependent family members don’t seek help as well, the recovering addict leaves treatment to return to the same family dynamic that existed before he sought help. Family members will continue to behave in the same codependent manner, which will not be the healthiest way to support someone new to recovery.

Family Program at English Mountain

The Family Program at English Mountain Recovery provides support for family members. It allows for healing in the relationship between addicts and those who care for them. One of the main areas of focus is identifying unhealthy patterns and learning new, healthier ones. Healing emotional scars allows the entire family to move forward in a positive manner.

By Jodee Redmond


Monday, March 26, 2018

Opioid Abuse in Tennessee: Issues and Possible Solutions

There’s no question that substance abuse is a major problem in Tennessee. Substance use disorder costs the state $2 billion annually. 

Opioid Deaths in Tennessee

In 2016, the opioid overdose death rate was 18.1 per 100,000 people in Tennessee, representing a loss of 1,186 lives. This figure was higher than the national average, which was 13.3 deaths per 100,000 people. 

Heroin overdoses were responsible for claiming 260 deaths in 2016. This is a significant increase from the 17 fatal heroin overdoses in 2010. 

Between 2010 and 2016, the number of fatal prescription and synthetic opioids jumped from 516 to 739 and 72 to 395, respectively.

Rural Tennessee No Stranger to Opioid Abuse

Rural parts of the state are just as likely as cities to be home to people who get caught up in opioid abuse. This has nothing to do with any stereotypes about rural residents being less well educated than city dwellers. Instead, it speaks to the fact that farming is a very dangerous profession. 

Farming a High Risk Profession for Injuries

The National Institute for Occupational Safety and Health (NIOSH) has determined that farmers are at a “very high” risk for both fatal and nonfatal injuries. This risk extends to family members as well, since they often live and work on the farm. 

NIOSH estimates that close to 2.1 million people were working in the US production agriculture industry in 2015. An additional 1.4-2.1 million crop workers are hired each year on crop farms. 

Approximately 100 agricultural workers are hurt in an injury severe enough to result in lost work time. In the years 2008-2010, half of all injuries sustained by crop workers were classified as either sprains or strains. 

Agricultural Injuries Treated with Opioids

When injuries require medical treatment, physicians may decide to prescribe opioid pain medication. Morphine has been used since the time of the Civil War as a pain reliever. Percocet and Vicodin (oxycodone or hydrocodone combined with acetaminophen) have been on the market since the mid-to-late 1970s.

Oxycontin was introduced to the market in 1996 as a long-term pain reliever. At that time, doctors were not aware of the drug’s addictive qualities, only that it was effective. 

For patients who had been injured in agricultural accidents, long-lasting opioid pain medications gave doctors a treatment option that kept patients from having to take pills every four hours. The goal was to keep the patient comfortable while they healed. Doctors would commonly write prescriptions for more medication than a patient might need to ensure that they wouldn’t run out. 

Leftover opioid medications wouldn’t be a high priority for disposal at a pharmacy. Instead, they would likely be left in a medicine cabinet, where they could be easily continued by the patient who had been injured or anyone with access. We already know that most people who develop a prescription medication addiction start by taking medications originally prescribed for someone else.  

The problem of opioid abuse has continued to grow in scope throughout the state. To deal with an issue of this size calls for creative solutions. 

Infrastructure Proposal Calls for More Addiction Training for Primary Care Doctors 

In 2018, Dr. David Stern, the Vice Chancellor for Health Affairs for Statewide Initiatives at the University of Tennessee Health Sciences Center, proposed to state Governor Bill Hasian’s opioid working group that funding of up to $26 million be allocated over six years to fight the opioid epidemic. The government funding would be in addition to third-party funding that Dr. Stern is seeking to put together. 

Dr. Stern’s proposal is to develop a network of healthcare workers in Tennessee who can guide patients to the type of drug treatment that will be best for them. He acknowledges that his proposal will be challenging to put into place, since Tennessee is a state that is already lacking in family doctors.

The idea is to provide training for 10 primary care or family medicine graduates each year by offering a one-year addiction fellowship. Participants in the program would have their medical school loans forgiven (an average of $180,000.00 in 2015) in return for agreeing to take part in a “rural addiction medicine network.” Dr. Stern has asked the state to allocate the funds over the six-year period to fund research and the clinical pilot program to establish the network. 

By Jodee Redmond


Thursday, March 15, 2018

Depression and Addiction: How These Dual Diagnosis Conditions are Alike

When someone is living with depression and an addiction, they are said to have a dual diagnosis. This term identifies that the client has two concerns that need to be addressed and treated. Each one on their own is a serious concern; however, when they are present at the same time, they represent a potentially dangerous combination. For someone in this situation, professional treatment is essential.

How Depression and Addiction are Alike

Major depression is one of the most common mental disorders, according to the National Institute of Mental Health. In the US, 16.2 million adults (estimated) have had at least one episode of depression. This figure represents 6.7 percent of the adult population.

SAMHSA’s National Survey on Drug Use and Health (2014) found that two-thirds of respondents aged 12 and older said they had consumed alcohol in the past year. Of these respondents, 6.4 percent met the criteria for an alcohol use disorder.

The number of Americans using illicit drugs has increased from 8.3 percent in 2002 to 10.2 percent by 2014 (27 million people). Of them, 7.1 million people met the criteria for illicit drug use disorder.

Both depression and addiction carry a stigma.

While most people would likely not have a problem saying to a family member or a friend that they are having a bad day or are in a “blue” mood, they would likely be more reticent about sharing that they have been diagnosed with depression. The word “depressed” is often used socially as a substitute for disappointed or sad, instead of to describe a major mental illness.

Alcohol use is socially acceptable and legal for adults. It’s woven into the fabric of many of our traditional celebrations. At any party, wedding or reception, it’s almost a given that alcohol will be served to guests.

However, very few people would agree with the statement that alcoholism is acceptable or a condition that anyone should aspire to achieve. Families in which alcoholism occurs often go to great lengths to hide the extent of a loved one’s drinking.

When drug abuse occurs, family members are also likely to close ranks and avoid discussing the issue with anyone outside the family unit. There are still people who feel that addicts have “brought it on themselves” and are somehow responsible for their situation.

Neither one is a sign of weakness.

People who are living with depression aren’t weak. They are living with a brain disorder due to a chemical imbalance in the brain. Other factors at play determine who will develop symptoms of depression, such as a person’s genetic makeup and the life events they experience. We know that if there is a family history of depression, a person is more likely to develop symptoms at some point during his or her lifetime. Experiencing a number of stressful events may trigger an episode of depression, although it’s not a guarantee that everyone who is under a lot of stress will become depressed.

Certain medications can cause symptoms of depression. For this reason, it’s important to review possible side effects of any new drugs being prescribed for you or your family members with your doctor or pharmacist. Patients living with chronic medical conditions, such as cancer, diabetes, epilepsy, Parkinson’s disease or rheumatoid arthritis are at higher risk of becoming depressed.

Addiction is not a sign that someone has a character flaw or that they are lacking in morals. It’s a brain disease that changes the way someone thinks and reasons. Once an addiction takes hold, keeping it fed becomes a prime motivator for the affected person.

It’s virtually impossible for an addict to simply decide they are going to stop using through sheer willpower. In the vast majority of cases, more help and support are needed to achieve the goal of a sustained recovery.

Depression and addiction are treatable

When a client seeks help at a drug and alcohol treatment facility for a dual diagnosis of depression and addiction, the good news is that both conditions respond well to treatment. At English Mountain Recovery, each client is evaluated individually, and an appropriate treatment plan is devised to treat the depression and substance abuse at the same time.

By Jodee Redmond



Thursday, March 1, 2018

How Yoga Helps with Healing from Addiction

Addiction is a chronic disease affecting the brain and how it functions. Those in recovery need to adopt strategies that will help to rewire the brain to adjust to a chemical-free lifestyle. Taking up yoga can help you learn to calm your body and minds, handle stress, and learn new coping methods.

Addiction and the Numbing of Emotion

The heart of addiction is the drive to numb emotion. Addicts may turn to drugs or alcohol as a way to cope with past traumas. They could also start using substances as a means to deal with mental health issues. This type of self-medicating is quite common among people living with anxiety, depression, bipolar disorder, Post-traumatic Stress Disorder (PTSD) and schizophrenia. 

Someone may not immediately recognize these mood or mental health issues when symptoms first start. Instead of seeking medical attention, they may use alcohol or drugs as a way to control their symptoms. Chemicals only mask the symptoms of the mental illness and can even make them worse over time. 

With repeated exposure, a person can develop an addiction to drugs or alcohol (or both), and have a mental illness as well. A person in this situation has a co-occurring disorder; they have two concerns that require treatment.

Yoga Forces Participants to Slow Down and Become Self-Aware

When someone is in the midst of an addictive lifestyle, much of their time is spent acquiring their drug of choice, consuming it and experiencing the altered state the drug creates. The addict comes down from the “high” and has to find more of the drug. The cycle continues. The addict has to be constantly active in feeding their addiction, to keep it going. 

Once a client enters a drug rehabilitation facility and starts doing the work needed to stay sober, the atmosphere is different. There is no more moving quickly to get high and push emotions away. 

Practicing yoga helps people slow down so that they can get in tune with their bodies, perhaps for the first time. The movements are not meant to be performed quickly, but rather in a slow, controlled manner. Even breathing is controlled, and participants learn to listen to the sound of their breath while holding a pose. 

Yoga Encourages Relaxation

People in addiction recovery, no matter how long they have been sober, can always benefit from stress relief. Practicing yoga helps those in recovery learn how to better handle their stress so that it doesn’t trigger a slip-up or relapse. A relaxed body also heals more quickly from physical, emotional, or mental illness. 

Yoga Creates a State of Mind Favorable for Mindfulness

Mindfulness is paying attention to what is happening in the present. When someone is being mindful, they aren’t focused on the past (these events are finished) or the future (it hasn’t come to pass). Any thoughts are observed, without judgment. 

This state of mind is something that anyone can do. It is a way to cut down on focusing on irritations and stressors that happen throughout the day. It keeps stress levels down, which is one of the key factors in helping to combat cravings and urges to start drinking or using again. 

Yoga Workouts are Easily Accessible

Most communities have at least one yoga studio led by a licensed yoga teacher. But yoga videos are also online and on certain cable channels. Yoga can be learned from books and DVDs as well. If you’re new to yoga, and if your doctor approves your practice of yoga, it will be helpful to learn from a teacher until you feel comfortable enough to practice independently. 

By Jodee Redmond