Addiction is a complex disease that affects not only the mind but also the body. That's why addiction treatment must address an individual's whole body health. The holistic addiction treatment model takes into account the whole person - their physical, emotional, and spiritual well-being - rather than just treating the addiction itself. It recognizes that addiction is a complex issue that affects all aspects of a person's life and that successful treatment requires a comprehensive approach that addresses all of these aspects.

One key aspect of the holistic addiction treatment model is integrating exercise and nutrition into the treatment program. Exercise and nutrition can play a crucial role in supporting recovery from addiction. Exercise can help to improve physical health by promoting cardiovascular health, increasing muscle strength, and reducing the risk of chronic diseases such as obesity, diabetes, and heart disease. It can also help to alleviate symptoms of depression and anxiety, which are common co-occurring disorders among people with addiction.

Nutrition is also an essential component of holistic treatment. A healthy diet can help to support physical health, reduce the risk of chronic diseases, and improve mental health. Many people with substance use disorders have poor diets or unhealthy eating habits. Incorporating nutrition education and healthy food choices into addiction treatment can help to improve overall health and support recovery.

This article will examine how malnutrition and substance abuse go hand in hand. We’ll also cover the positive health benefits of exercise and eating a well-balanced, healthy diet, especially for those in the early stages of addiction recovery.

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The Importance of Exercise in Early Recovery

Exercise can be an effective tool in addiction recovery. It provides a range of physical, mental, and emotional benefits that can help individuals in the early stages of recovery manage the challenges and stressors that come with sobriety. Many treatment centers incorporate exercise into their programs for this very reason.

Substance abuse changes your mind and body chemistry. Even after treatment, you may still feel depressed, anxious, and sensitive to major stressors. But physical activity can help you shift the tide on those negative emotions. 

In one study, regular swimming reduces the voluntary consumption of morphine in opioid-dependent rats. In another study, access to a running wheel reduces the self-administration of cocaine in cocaine-dependent rats.

Another small study analyzed an exercise program provided to 38 participants with substance use disorders. These participants agreed to participate in group exercises thrice weekly for 2-6 months. 20 participants finished the program. And in the follow-up a year later, 5 had maintained sobriety, and 10 said they had reduced their substance abuse.

Here's how exercise can help addiction recovery: 

Exercise programs may include various activities like yoga, walking, swimming, or weightlifting, tailored to the individual's needs and interests.

The Importance of Nutrition in Early Recovery

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Nutrition also plays a crucial role in early recovery from drug and alcohol abuse. Drugs and alcohol abuse can cause various nutritional deficiencies and digestive issues that can lead to both physical and psychiatric disorders. Therefore, it is essential to maintain a healthy and balanced diet to support the recovery process.

Here are some ways in which addiction can affect nutrition and diet:

Maintaining a balanced diet with whole foods, including complex carbohydrates, fruits, vegetables, lean proteins, and healthy fats, can provide the body with the necessary nutrients to support recovery. It is also crucial to avoid processed and sugary foods as they can lead to inflammation and other health problems. Healthy eating habits can:

Supplements may also be necessary to address specific nutrient deficiencies. Consulting a health care professional, like a nutritionist, can help determine your nutritional needs during recovery. 

Addiction is a complex disorder that results from a combination of genetic, lifestyle, and environmental factors. The role of genetics in addiction has been widely studied over the last few decades, and research has shown that certain genetic factors contribute to an individual's susceptibility to addiction.

One of the most studied genetic factors in addiction is the presence of specific variations in genes that encode proteins involved in the brain's reward system, such as dopamine and serotonin receptors. These variations may affect how these proteins function, leading to alterations in the brain's reward circuitry, which can result in addiction. Other genes linked to addiction include those involved in stress response, impulse control, and decision-making.

For example, researchers have identified specific genes that may influence an individual's response to drugs and alcohol, including genes that affect the metabolism of drugs, the neurotransmitter systems involved in reward and pleasure, and the stress response system. And while research in this area is still ongoing, some genes linked to addiction or protection against addiction include:

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Moreover, family studies that include siblings, fraternal twins, identical twins, and adoptees suggest that as much as 50% of a person's risk of becoming addicted to alcohol, nicotine, or other drugs depends on their genetic makeup.

Research on the human genome reveals that humans are 99.9% identical on a genetic level. But the 0.1% variation is critical as it's responsible for the differences in their sequence of DNA bases. These differences contribute to visible variations like hair color and height and invisible traits like protection from or increased risk for diabetes, stroke, heart attack, and addiction. 

Other Risk Factors for Addiction

Genetics is just one factor that contributes to addiction, and the influence of genetic factors can vary depending on an individual's environment and life experiences. Furthermore, not everyone with a family history of addiction will develop substance abuse disorder. People without genetic risk factors still have a risk of developing an addiction. Here are some other factors that contribute to addiction: 

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How the Knowledge of Genetic Influences Can Inform Addiction Treatment Approaches

Genetic research has provided a better understanding of the complex interplay between genes and diseases like addiction. Today, mutations like BRCA 1 and 2 that predispose patients to a high risk of ovarian and breast cancer serve as crucial medical tools in assessing one's risk of severe diseases. Researchers can now unravel the genetics of single-gene disorders like breast/ovarian cancer, sickle cell anemia, cystic fibrosis, and addiction.

Understanding the genetic basis of addiction makes it easier to identify individuals who are more susceptible to addiction. By using genetic testing to identify these variations, healthcare providers can better evaluate a person's unique addiction risks. But this is an area that needs more research.

In addition to identifying individuals who are more susceptible to addiction, the knowledge of genetics can also inform addiction treatment approaches through pharmacogenetics. Pharmacogenetics studies how an individual's genetic makeup affects their response to medications. By tailoring addiction medications to an individual's genetic makeup, healthcare providers can improve treatment efficacy and reduce the risk of adverse side effects.

What to Do If you have a Genetic Predisposition to Addiction

If you have a genetic predisposition to addiction, taking proactive steps to manage your risk and prevent addiction is essential. Here are some things you can do:

  1. Educate yourself: Learn as much as you can about addiction and its genetic components. Knowing your risk can help you be more mindful of your behavior and take steps to manage your risk.
  2. Be honest with your healthcare provider: If you have a family history of addiction or suspect you may be struggling with it, it is essential, to be honest with your healthcare provider. They can help you evaluate your risk and provide addiction prevention and treatment resources.
  3. Practice self-care: Engage in activities that promote physical and mental health, such as regular exercise, healthy eating, and stress-reducing techniques like meditation or yoga.
  4. Avoid triggers: Know your triggers and avoid situations that may increase your risk of addiction.
  5. Seek professional help: If you are struggling with addiction, seek professional help from a healthcare provider or addiction treatment specialist. Treatment can help you manage your addiction and start the path to long-term recovery.
  6. Get support: A robust support system can help prevent addiction and promote recovery if needed. This can include family members, friends, or support groups.

Remember that having a genetic predisposition to addiction does not mean that you will automatically develop an addiction. Taking proactive steps to manage your risk and getting help if needed can reduce your chances of addiction and help you live a healthy, fulfilling life.

Mental health and addiction issues often go hand in hand, and many people suffer from both. When you have a mental health disorder and substance use disorder at the same time, it is referred to as co-occurring disorders. Co-occurring conditions can be very difficult to manage, as each disorder often significantly impacts the other.

The Substance Abuse and Mental Health Service Administration estimates that about 9.2 million adults in the United States have a co-occurring disorder. Yet, only 7% of those individuals receive treatment for both issues. A whopping 60% of individuals with co-occurring disorders do not receive treatment for either issue. This is a growing concern when it comes to overall public health.

Understanding Co-Occurring Disorders

Co-occurring disorders, also known as dual diagnosis or comorbidity, refer to the simultaneous presence of a mental health disorder and a substance use disorder in an individual. This means that an individual may struggle with drug addiction and an underlying mental health condition such as bipolar disorder, depression, anxiety, PTSD, trauma, etc.

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Research has shown that people with mental health disorders are more likely to develop a substance use disorder, and people with substance use disorders are more likely to develop a mental health disorder. In fact, roughly about 50% of people with severe mental illnesses are affected by substance abuse and vice versa. This is because individuals may turn to substances as a form of self-medication to cope with their mental health disorder symptoms. Substance use may also worsen existing mental health symptoms or lead to new mental health problems.

The Dangers of Self-Medication

Self-medication is one of the main issues surrounding co-occurring disorders. People self-medicate to attempt to numb or cope with the symptoms of their mental health disorder, such as feelings of sadness or worthlessness. However, this is a risk factor for substance abuse and addiction.

Self-medication can also mask the underlying mental health issue, making it difficult for individuals to access the appropriate mental health services. This further perpetuates the cycle of substance abuse, making it even harder for individuals to break free from addiction.

Here are some ways people self-medicate:

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Recognizing a Dual Diagnosis

The signs and symptoms of a co-occurring disorder vary depending on the abused substance and mental condition. For example, marijuana abuse and depression could look very different from the signs of alcohol abuse and schizophrenia. 

That said, here are some questions you can ask yourself to help determine if you or a loved one may be struggling with comorbidity:

If you answered yes to any of these questions, you may have a dual diagnosis and should consider seeking professional help.

Diagnosing Co-Occurring Disorders

Co-occurring disorders can be challenging to diagnose and treat because the symptoms of the mental health disorder and the addiction tend to overlap. This makes it difficult to determine which condition is causing which symptoms. In some cases, the symptoms might vary in severity, making a patient receive treatment for one disorder while the other disorder remains untreated. People may also be less likely to seek help if they struggle simultaneously with both issues.

But the good thing is that many treatment facilities and professionals (like psychiatrists, psychologists, and therapists) specialize in treating comorbid conditions. These healthcare professionals are experienced in diagnosing and treating substance use and mental health disorders. They will perform a comprehensive assessment that includes physical exams, psychological evaluations, mental health screenings, and substance use assessments to determine the primary and contributing conditions.

Treatment for Co-Occurring Disorders

Once a dual diagnosis is established, the healthcare provider will create a treatment plan that integrates both mental health and substance abuse treatment co-currently. Addressing these comorbid disorders at the same time ensures the best outcome. 

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With integrated treatment plans, the same practitioner offers both substance and mental health interventions in an integrated manner. The goal is to treat the person as a ‘whole,’ not just two separate issues. This treatment addresses the underlying causes of addiction, such as depression and anxiety, while providing strategies to help deal with cravings and overcome the physical aspects of addiction.

Integrated treatment often involves specialized therapies such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational therapy, and trauma-informed psychotherapy. Each type of therapy helps address the underlying issues contributing to addiction while promoting healthy coping skills and emotional regulation. These therapies can be offered in individual or group settings.

According to SAMHSA, co-occurring disorders are treated in a stage-wise fashion with different services provided at different stages: engagement, persuasion, active treatment, and relapse prevention. At each stage, a team of professionals provides services that address mental health and substance use disorder.

After treatment, the patient is encouraged to attend support groups, such as Narcotics Anonymous (NA) and Alcoholics Anonymous (AA), to maintain sobriety. Additionally, they are encouraged to use the skills and techniques they learned in therapy, such as mindfulness and stress management, to help them cope with triggers and handle cravings.

Co-occurring disorders are complex conditions that require integrated and comprehensive health services. With the right combination of therapies, medications, and peer support, individuals can recover from mental health disorders and addiction.

Methadone has been used to treat people with extreme pain for decades and has been approved by the Food and Drug Administration to treat opioid addiction. According to SAMHSA, methadone can help people with opioid use disorder reduce their cravings and withdrawal symptoms, stay in treatment longer than those who are not taking it, and lower their chances of using illegal opioids.

However, some are still skeptical of its effectiveness in treating opioid addiction, citing the potential for misuse and abuse. They think that methadone can quickly become a replacement addiction and that it can still be used to get high. But proponents, who include top addiction professionals, argue broader use of methadone could help address the current opiate overdose epidemic in the US. They advocate for easier access to methadone treatment for opioid addiction, citing its potential benefits in helping people manage cravings and withdrawal symptoms. 

This article will explore both sides of the argument and discuss the risks and benefits of using methadone as an addiction treatment.

What Is Methadone?

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Methadone is a powerful drug used for pain relief and opioid use disorders. It is a synthetic opioid, but unlike other opioids, it has been approved by the FDA to treat opioid addiction. It is one of the three medications approved in the US for opioid addiction treatment.

The drug works by binding to and blocking the opioid receptors in the brain, thus reducing cravings and preventing withdrawal symptoms. It is typically administered once a day at room temperature, though some people require more frequent doses. Methadone is available in liquid, powder, and tablet forms.

Methadone is extraordinarily effective if the standards of any epidemic are considered. A study found that those receiving the drug were 59% less likely to die of an overdose than those who did not receive it. 

How OUD Patients Receive Methadone

Methadone is used as part of a treatment program for opioid use disorder. Those receiving the drug to treat opioid addiction must receive it under the care of a qualified healthcare provider.

This provider prescribes the medication and supervises its use. After a period of stability, some people may be able to take the medication home and administer it themselves. However, this is an option only after they've gone through frequent tests and counseling sessions.

The duration of methadone treatment varies depending on the individual and the severity of their addiction. But the National Institute on Health recommends a minimum of 12 months. Some patients may need long-term maintenance. But those who are getting off the drug should work with their healthcare provider to gradually taper off the medication to avoid any life-threatening methadone withdrawal symptoms.

The Controversy Surrounding Methadone in Addiction Treatments

Methadone has long been controversial in the addiction treatment world. While advocates are proposing a significant expansion in access to the drug, the providers of methadone for addiction treatment are warning that caution should be used when prescribing the medication.

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The primary concern for those who oppose expanded access to methadone is its potential for misuse and abuse. While methadone is effective for treating opioid addiction, allowing doctors to prescribe it to anyone could lead to low-quality care, abuse, and overdose on methadone itself.

At the moment, patients need to visit a methadone clinic each day for a single dose. They also need to be a part of an opioid treatment program and go through frequent drug tests, take part in counseling sessions, and prove that they've had opioid addiction for over a year. 

Opponents of expansion strongly believe it's essential that methadone treatment is accompanied by counseling and other services that opioid-trained professionals are qualified to offer. They also point to worrying statistics about methadone-related overdose. A recent estimate by NIDA found that methadone is involved in 3% of opioid-related overdoses.

On the other hand, advocates argue that methadone can be prescribed responsibly, with adequate monitoring and oversight. They point out that the benefits of broader access to methadone outweigh the potential risks. And that the risk of overdose is too high and that methadone can help treat addiction, reduce cravings and prevent long-term health problems caused by opioid addiction. According to the proponents, the opioid crisis has reached a level where any measure taken to reduce the number of overdoses is worth exploring.

Those in favor of expansion don't see why increasing access should be a problem considering any healthcare provider can prescribe methadone for chronic pain treatment. They argue that strict regulation is only imposed on addiction treatment, which makes little sense and is a sign of the discrimination and stigma faced by OUD patients. Currently, no other drug is as restricted for approved use (opioid addiction), yet it has few restrictions when prescribed for pain management. 

It is worth noting there have been fewer methadone-related deaths even after significant restrictions were lifted during the COVID-19 pandemic. The lift allowed "stable" patients to bring home their weeks' worth of methadone doses instead of going to a clinic every day for an amount.

Methadone Safety

Methadone is a safe and effective treatment when taken as prescribed. Patients should work closely with their healthcare provider to find the correct dose and frequency of administration that works for them. Patients should also take precautions when taking methadone, such as:

Common Side Effects of Methadone

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Some common side effects of methadone include:

Pregnancy or Breastfeeding and Methadone

Methadone is generally considered safe to use during pregnancy. However, it will likely cause harmful side effects to a developing fetus and should only be used when the benefits outweigh the risks. Breastfeeding women should consult their doctor before taking methadone, as it can be passed to the infant through breast milk. 

Drug Addiction Treatment

For people with opioid addiction, many facilities offer comprehensive drug addiction treatment programs. These treatment plans include counseling, support groups, medical monitoring, and other therapies designed to help patients gain control of their addiction and begin the journey toward recovery.

California Sober is a trending term that was popularized by singer-songwriter Demi Lovato. The singer released her song, California Sober, after a near-death opioid overdose in 2018. In her interview with CBS News, Lovato said she best identifies with the term California Sober.

But what exactly does the term California Sober mean?

While traditional sobriety is defined as abstaining from any drug or alcohol, the California Sober approach is about using certain drugs in moderation.

California Sober, or Cali sober, refers to abstinence from all substances except smoking weed or ingesting marijuana. People interpret the exceptions differently, but marijuana is the most commonly cited "acceptable" substance for those who consider themselves California Sober. The term, California Sober, is associated with Michelle Lhooq, who wrote an article on Vice.com explaining how she streamlines her substance abuse to improve her health. The writer stopped using all drugs except marijuana and some psychedelics when she relocated to California from New York.

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In their interview with CBS in her Los Angeles home, Demi Lovato said quitting drug use partially worked well for her. "I am cautious to say that, just like I feel the complete abstinent method isn't a one-size-fits-all solution for everybody, I don't think that this journey of moderation is a one-size-fits-all solution for everybody," she told CBS news. In their case, they replaced opioids with marijuana and alcohol.

But the singer now has a different outlook on things and believes that traditional sobriety is the way to go.

California Sober as a Harm Reduction

Harm reduction seeks to provide users with safer and healthier options to reduce the harm associated with substance abuse. The approach follows principles like: 

  1. Accepting that drug use is part of our world and working to minimize its harmful effects rather than condemn or ignore them.
  2. Providing resources and services to those who abuse substances as well as their communities to help them reduce attendant harm
  3. Understanding drug use as a complex, multi-dimensional phenomenon entails a continuum of behaviors from severe abuse to total abstinence.
  4. Not attempting to ignore or minimize the dangers associated with alcohol consumption or drug abuse.

By most definitions, Cali sober isn't harm reduction. This approach is primarily about replacing substances, like opioids and alcohol, with marijuana as a "softer" alternative. While this may work for some people, it doesn't necessarily change their relationship with drugs. It just shifts it from one substance to another, potentially a more accepted one.

When considering California Sober as a form of harm reduction, it's essential to speak with a medical professional or addiction specialist. They can guide how to safely reduce drug use and provide resources to those who wish to pursue abstinence.

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The Pros of Cali Sober

The main benefit of Cali Sober is that it allows individuals to reduce the risk associated with certain drugs while still getting some of the pleasure they seek. For example, a person who has struggled with alcohol abuse may find that using marijuana in moderation is a less risky alternative. The switch is also common among those who experience hangovers or sleeplessness.

The California Sober approach allows users to escape the strict abstinence-only models of traditional sobriety and gives them more leeway to experiment. This is especially important for those with no behavioral addictions or behavioral health issues like opioid or alcohol abuse. 

Marijuana is an addictive substance but carries fewer risks than drugs like opioids, heroin, cocaine, or fentanyl. It doesn't cause overdose or blood-borne disease and is legal in most states.

Dangers of a California Sober Lifestyle

There are some potential risks associated with the California Sober approach. Some common ones include:

Risk of Developing Cannabis Use Disorder

Finding the right balance between safe drug use and substance abuse can be tricky. According to the CDC, marijuana use can lead to addiction, especially for those who start using at a young age or use it frequently. Other factors like family history, mental health issues, peer pressure, social isolation, and lack of family involvement can also contribute to cannabis use disorder. And like any other substance use disorder, CUD can hurt one's physical and mental health.

Semi-Sober -- Substance Use in Moderation

Semi-sobriety involves setting limits on intake and gradually decreasing the frequency and amount of substance use over a period of time. It is often done with other strategies like lifestyle changes, alternative therapies, and counseling. But since the definition of moderation varies greatly, it's easy for some people to go overboard. For those who have a hard time controlling use, it can be a good idea to cut use completely.

Cali Sober is Open to Different Interpretation

While marijuana is the most commonly used drug in the California Sober approach, some individuals may use other substances like alcohol, tobacco, or even prescription drugs instead. Some may modify it further to use marijuana during the week and hard drugs over the weekend. The lack of rationalization of this approach can increase the chances of relapse. In contrast, the abstinence recovery model requires total abstinence from all mind-altering substances to ensure sobriety.

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Deciding What’s Acceptable Can be Taxing

When following the California Sober approach, one must constantly decide what is acceptable drug use and what isn't. For example, they'll need to figure out things like: 

This can become exhausting and can lead to burnout, which has the potential to create a slippery slope back into addiction.

Address the Root Cause of Addiction

Ultimately, to ensure lasting recovery, people should be guided toward a holistic approach that looks at the underlying cause of addiction. This might include addressing mental health conditions and developing healthier coping strategies for stress or trauma. Treatment options like cognitive behavioral therapy, yoga, and meditation can also help build resilience to cravings.

To summarize, Cali Sober is an increasingly popular approach to sobriety that allows individuals to consume marijuana in moderation while giving up other drugs. However, it's essential to keep in mind that there are some risks associated with this approach, and it should be done thoughtfully. This approach can help individuals find a healthier balance between abstinence and drug use when used responsibly.

If you or someone you know is struggling with addiction, seek help from an addiction specialist. Recovery is possible, and taking the first step can make all the difference.

The number of drug overdose deaths in the United States has skyrocketed in recent years, with opioids leading the way as one of the most deadly and addictive substances. Many even consider it a drug overdose epidemic. According to the CDC, there were approximately 107,000 overdose deaths in 2021. In the same year, SAMSHA identified 141,529 unweighted drug-related ER visits from its analysis of 52 hospitals.

If these numbers are anything to go by, it's evident that addiction is a major problem in the US.

And yet, despite this alarming trend, many US hospitals and emergency departments lack dedicated addiction specialists who can help those suffering from substance or opioid use disorder. This is a glaring omission, especially given how critical an early intervention can be for someone in the throes of addiction.

Without access to addiction specialists on staff, people with substance abuse problems may not get the help they need at a crucial juncture. As a result, they may go through multiple hospitals or ER visits. A lucky few will be connected with a treatment facility while they're still at the hospital.

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For everyone else, they walk out with a phone number to call, or often, nothing at all. Once they leave, many of these people go back to their old habits and never make the effort to call the number they've been given. 

There's a clear need for hospitals to do better when it comes to addiction treatment. So why is it that so many don't have addiction specialists on staff?

Hospitals Have Specialists On Call For Lots of Diseases — But Not Addiction. Why Not?

If you go to a hospital with a kidney problem, you'll likely be seen by a nephrologist. If you have a heart condition, you'll be seen by a cardiologist. But if you're struggling with addiction, chances are you won't see an addiction specialist.

Only a few hospitals have someone who specializes in addiction medicine on staff. A majority of hospitals focus on primary care. Addiction is left untreated.

This is a problem because addiction is a disease requiring specialized care. Without access to an addiction specialist in ERs, people with substance use disorder are often left at the mercy of whoever happens to be on call. This could be a general practitioner, an ER doctor, or even a social worker, most of whom have very little training in physiology, medications, and other aspects of treatment.

Reasons Why Hospitals are Slow to Hire Addiction Specialists

For years, addiction prevention and treatment services have been delivered separately from other general and mental health care services. Drug and alcohol abuse has traditionally been viewed as a criminal or social problem. As such, prevention services were not typically considered a responsibility of health care systems. For this reason, those struggling with substance use disorders have had access to only a limited range of treatment options that were generally not covered by insurance. 

In a nutshell, most hospitals don't have specialists because:

For a long time, addiction has not been seen as a medical problem but rather a social or psychological one. Some medical staff still see it as a moral issue and not something that requires formal medical treatment. This attitude can make it hard to justify dedicating staff and resources to addiction treatment.

Additionally, many hospitals are already understaffed and overstretched, so it could be difficult to add another specialist.

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And finally, there's the question of reimbursement. Addiction treatment is notoriously underfunded, and many insurance companies don't cover the cost of specialized care. Hospitals can find it hard to recoup the cost of hiring an addiction specialist.

The Lack of Proper Care Exposes Addiction Patients to Overdose Risk

NPR shared a story of a 63-year-old heroin addict, Marie, who was admitted to Salem Hospital, north of Boston, for COPD. The next day, she was told she was ready for discharge after the doctor had confirmed that her oxygen levels were good. But the woman was experiencing heavy withdrawal symptoms and could not move. She didn't want to leave the hospital but felt like she had no choice.

Sadly, most hospitals would still let her go despite her pain and condition. Sometimes, she'll be issued a list of detox programs or rehab centers to call. But more likely, she'll be sent on her way with no real plan or hope for recovery.

This is a typical story of what's happening in many US hospitals. Marie was lucky to have found a doctor who administered her some medications that helped. But every day, people with addiction walk into ERs across the country only to be discharged without real help or support.

This is dangerous because it increases the likelihood of patients relapsing and overdosing. In fact, research shows that patients have a higher chance of overdosing within a few days or weeks of being discharged from the hospital.

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The Importance of Having an Addiction Specialist in Hospitals

An addiction specialist is a medical professional specifically trained to diagnose and treat patients with substance use disorders. These specialists can provide critical support to patients who walk into the ER for various reasons but have an underlying addiction problem. Salem Hospital is one of the few hospitals that has succeeded in naming addiction as a specialty and hiring people with training in the disease. 

And despite reservations from some staff, the addiction specialists get overwhelmed many days with referrals - a clear sign of the need for their services. The trend is similar in five other Massachusetts hospitals that added addiction specialists in the last three years. These facilities are funded by HEALing Communities study. Addiction specialists can help patients in several ways, including:

Addiction specialists are vital in helping patients get the treatment they need. They can also refer them to a reputable treatment facility for specialized care. Hospitals can provide a much-needed service to their communities by having these professionals on staff.

According to the National Institutes of Health, effective integration of addiction prevention, treatment, and recovery solution across healthcare systems can help address drug abuse and related issues. This is also the most promising way to improve access to and quality of treatment.

People try drugs or alcohol for a variety of reasons, ranging from curiosity or boredom to social pressure or mental health issues.  For some people, trying drugs or alcohol is a one-time event that doesn't lead to further use. For others, though, drug or alcohol use can become a substance use disorder, defined as a chronic and relapsing brain disease that is characterized by compulsive drug seeking and use despite harmful consequences. 

But what drives people to try drugs and alcohol in the first place? There are several reasons, but some are more common than others.

Peer Pressure

Peer pressure is one of the leading causes of drug use among young people. Whether it takes the form of subtle suggestions or outright coercion, peer pressure from family and friends can exert a powerful influence over our decisions and behaviors.

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Teens are especially susceptible to this type of social pressure, and many will start using drugs at an early age to fit in or feel accepted by their friends. Many young people will try out drugs or alcohol without fully understanding the risks involved.

Mental Health Issues

Mental health issues like anxiety disorders, schizophrenia, eating disorders, bipolar disorders, and depression, can also lead people to start using drugs or alcohol. Numerous studies have listed mental health issues as one of the main drivers of substance use disorders, and vice versa.

Many people with mental health disorders self-medicate in an attempt to numb the pain or ease the symptoms like excessive fear, worry, mood changes, or even suicidal ideation. Others may use drugs or alcohol as a way to cope with difficult life experiences. This can lead to a spiral of drug addiction and mental health problems that is very difficult to break free from.

Trauma

Trauma, especially early childhood trauma, is a major risk factor for developing substance abuse problems later in life. Traumatic experiences like abuse, neglect, witnessing violence, or losing a loved one can have a profound effect on one's mental and emotional health.

For many people, childhood trauma can be long-lasting and far-reaching, and it's often difficult to overcome the damage done in childhood. They may struggle with mental health issues like Post Traumatic Stress Disorder, anxiety, and depression, and turn to may use substances to try to cope with these problems.

Symptoms of Boredom

Boredom is another common reason people first try drugs or alcohol. Teens and young adults often have a lot of free time and can be easily bored. They may start using drugs or alcohol to pass the time or to make their lives more exciting. This can lead to addiction, as people continue to use drugs or alcohol to escape the boredom of their everyday lives.

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Curiosity

Many young adults first try drugs or alcohol out of curiosity. They may have seen their friends using these substances and want to try them for themselves. Others may be curious about the effects of drugs or alcohol and want to experience them firsthand. It's estimated that over 52% of all high school students try illicit drugs, while over 70% drink alcohol by the time they graduate. 

TV, Movies, Music, and Video Games

Popular culture often glamorizes drug use, and this can influence young people to start using drugs or alcohol. TV shows, movies, music, and video games often depict drug use in a positive light, and this can make it seem like a harmless or even exciting activity. Constant exposure like this normalizes drug use in entertainment culture. As a result, teens assume using illegal, and prescription drugs is a normal lifestyle. 

Rebellion

Many teenagers first start using drugs or alcohol as a way to rebel against their parents or authority figures. They may see drug use as a way to defy the rules and take risks. For example, they may smoke cigarettes to show their independence or hallucinogens to escape to a world they deem more idealistic.

Lack of Proper Information About Drugs or Alcohol

Many people start using drugs or alcohol without knowing much about them. They may believe myths and misconceptions about these substances, which can lead them to underestimate the risks involved. For example, teens might be led to believe that marijuana is medicinal and carries a host of benefits. So, they may be more inclined to start using it without understanding the risks.

Lack of Confidence

People who lack confidence or have low self-esteem are also more likely to start using drugs or alcohol. They may use these substances as a way to boost their confidence or make them feel better about themselves. For example, someone who feels shy in social situations may start drinking alcohol to loosen up and feel more confident.

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The above are some of the main reasons people start using drugs or alcohol. It's important to note that not everyone who tries these substances will become addicted. However, drug and alcohol use can lead to addiction, and it’s often hard to break free from this cycle of abuse.

How to Protect Your Loved One From Addiction

As a parent or guardian, there are a few things you can do to help protect your loved one from addiction:

If you suspect your child is using drugs or alcohol, don't hesitate to reach out for help. There are many physical and mental health care resources available to families struggling with addiction. Early intervention is essential to helping your child get on the path to recovery.

Sleep disorders and addiction share a complex and bidirectional relationship. People who suffer from a sleep disorder may be more likely to abuse drugs or alcohol to try and self-medicate and achieve better sleep. For instance, they may use stimulant drugs to compensate for daytime fatigue caused by lost sleep.

In other cases, they may use drugs because of issues like cognitive impairment. Conversely, people addicted to drugs or alcohol may also suffer from sleep disorders due to the negative effects these substances can have on the body and mind.

There is a strong link between sleep disorders and addiction. A review by the Addiction Science & Clinical Practice found that about 70 % of patients admitted for detox had sleep issues before admission, and 80 % of those with sleep problems connect them to alcohol or illegal drug use.

According to the review, the relationship between the two seems to be bidirectional, with chronic or acute substance use disorders increasing the risk of developing sleeping problems. The review also adds that there's evidence indicating that long-term abstinence from chronic drug or alcohol use can reverse some sleep problems. 

One of the most common ailments related to lack of sleep is depression. If you’re wondering whether or not you or someone you know suffers from depression, one way to learn more is to take a depression test. 

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How substance abuse leads to sleep disorders

Addiction is a brain disease. Chronic alcohol or drug use interferes with the brain, changing its chemistry and circuitry. These changes result in compulsive drug use and sleeping problems. Drug and alcohol use disorders can cause short- and long-term sleep issues like insomnia and sleep apnea. 

Substance abuse also alters how a person through their sleep stages - messing up the rapid and non-rapid eye movement (REM and NREM). Generally, substance abuse can lead to:

Here is a quick look at how different drugs affect sleep.

Marijuana  

Marijuana interacts with the endocannabinoid system (ECS) by binding to the cannabinoid receptors responsible for many roles, including regulating the sleep-wake cycle. This explains why more than 40% of those trying to quit marijuana experience sleeping problems. Many others experience sleep difficulty, strange dreams, and nightmares too. 

Opioids 

Opioids like heroin bind to mu-opioid receptors, a body system that’s also responsible for sleep regulation. In fact, the name morphine or morphia, a medical derivative of opium, comes from Morpheus, the Greek god of sleep and dreams. Opioid drugs can induce sleepiness but also derange sleep by increasing transitions between different sleep stages.

Those going through withdrawal from heroin addiction can experience terrible insomnia. Opioids can also regulate respiration and, when taken in high doses, can severely impede breathing during sleep. 

Depressants

Depressants like alcohol may help people fall asleep, but they often lead to disruptions in sleep patterns and can make it difficult to stay asleep. Chronic alcohol use causes:

 

Cocaine and other stimulants

Stimulants like cocaine can make it difficult to fall asleep and cause people to wake up frequently at night. The sleep disturbances like insomnia and hypersomnolence mostly happen during cocaine intoxication and withdrawal. Other stimulants like amphetamine trigger dopamine release.

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During acute administration, they can decrease total sleep time and sleep efficiency and increase sleep latency and the number of awakenings. In the withdrawal phase, there's a drop in sleep latency and a rise in total sleep time and efficiency.

Drug withdrawal and sleep disorders

Withdrawal from drugs can cause sleep disorders like insomnia, or other sleep problems, including restless legs syndrome, strange dreams, or broken sleep. These issues can take a toll on one’s physical and mental health, making a recovery harder. Sleep problems are common when withdrawing from:

How sleep disorders lead to substance abuse

Sleep disorders can also lead to substance abuse. Many people with sleep disorders turn to substances as a way to self-medicate or try and improve their sleep. For example:

 

The dangerous cycle

As discussed earlier, people with sleep may take stimulants like caffeine, cocaine, or nicotine to stay awake during the day and then use alcohol or other drugs to fall asleep at night. Also, those struggling with addiction may disrupt their circadian system and end up with sleep disorders that lead them to use more substances to self-medicated. This can create a dangerous cycle in which they use substances to try and manage their sleep, but the substances themselves make it difficult for them to get the rest they need.

Sleep quality and addiction recovery

People who stop using drugs and alcohol often have better sleep. This happens because they are no longer disturbed by the side effects of those substances. When people get good sleep, they feel better and can concentrate more easily on their addiction recovery.

At the same time, people who sleep better don't need to use substances to cope with their fatigue. So, improving sleep can help break the cycle of addiction.

If you or a family member or someone you know is struggling with a sleep disorder and substance abuse, help is available. There are many treatment options that can address both issues at the same time. With treatment, it is possible to recover from both a sleep disorder and addiction.

As part of an ongoing war on drugs, in November 2020, Oregon became the first state in the US to decriminalize the possession of small amounts of hard drugs. The measure, known as Measure 110, was widely praised by drug policy reform advocates as a progressive step that would help to reduce the stigma around drug use and provide people with drug addiction problems with much-needed treatment.

Measure 110 made personal possession of methamphetamine, heroin, LSD, oxycodone, and other drugs punishable by a $100 fine rather than jail time. This was in a bid to reduce incarceration rates and redirect funds toward addiction treatment programs. These treatment programs would be funded through marijuana tax revenue and savings from decreased law enforcement costs.

The Oregon Health Authority, one of many behavioral health resource networks, announced on September 22 that it had completed awarding the first two years of funding to nonprofits under Oregon's decriminalization of drugs law.

According to OHA, the first round of grants totaled $302 million. Despite this milestone, experts warned that more than just services would be needed to curb the high rates of drug use and resulting societal costs in the state. Keith Humphreys told the Oregon lawmakers that the state should adjust its permissive approach as it encourages drug use without any deterrent.

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"Because the West Coast has an individualistic culture with a tolerance for substance abuse, social pressures to seek treatment are often minimal," said Keith Humphreys, the Founder, and co-director at the Stanford Network on Addiction Policy.

"So, on the one hand, we have widely available and highly rewarding drugs. On the other hand, little or no pressure to stop using them. Under those conditions, we should expect to see exactly what Oregon is experiencing: extensive drug use, extensive addiction, and not much treatment seeking."  (Source)

According to Humphreys, people struggling with addiction hardly seek treatment without pressure from loved ones, health care providers, or the law. He says this should be a concern because the state has lifted the legal pressure to stop substance abuse and seek treatment. Besides, since many people who struggle with use don't work or keep in touch with loved ones, the pressure to quit might not come from those sources, either. (Source)

M110 allows the law authorities to write $100 tickets for personal possession of small amounts of drugs, and the charged person can just call the Life helpline line and have their ticket removed. It all seems very easy to get away with abusing drugs.

But despite that, many people who are issued these tickets still ignore them, according to Dr. Todd Korthuis, the head of addiction medicine at Oregon Health & Science University. By the end of this summer, 3000 tickets were issued, and only 137 calls were made. Even more disturbing is that most callers were not seeking treatment but only screening for legal reasons. (Source)

Good Intentions Behind the Law

The Oregon voters voted in favor of Measure 110, which decriminalized the possession of small amounts of drugs and redirected 110 funds from law enforcement to addiction treatment. The measure was designed to address the state's public health crisis, exacerbated by the COVID-19 pandemic.

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According to proponents of the measure, it would help to reduce the number of those incarcerated for drug-related offenses and redirect funds to much-needed addiction treatment programs. In addition, by decriminalizing drug possession, the measure will help to reduce the stigma associated with addiction and make it more likely that people will seek treatment. 

When the voters passed the ballot measure, they recognized drug addiction and overdoses are a serious problem in Oregon; and that the state needed to increase access to drug treatment. The health-based approach to drug use problems is not only more humane but also effective and cheaper than criminal punishments. Making people criminals because they abuse drugs or struggle with addiction is costly and life-ruining, making it hard to seek treatment. 

On February 1, 2021, the laws regulating controlled substances' possession changed from felonies to Class E violations. Measure 110 is designed to ensure that anyone who wants access, assessment, treatment, and recovery services for substance use gets it.

By all accounts, Measure 110 was set to reduce the pressure on drug users seeking treatment or help. However, going by statistics, it seems to be failing because Oregon has a nearly 20% surge in overdose deaths in the year that ended in April 2022. And according to Dr. Tod Korthuis, Oregon has one of the highest rates of substance use disorders and mental health disorders. Conversely, it ranks the least for access to treatments in the nation.

Humphreys and Korthuis don't fault Measure 110 for the spiking overdose deaths and other drug-related issues. However, they believe these trends have outpaced the state's addiction treatment system.

What Needs to Be Done

Measure 110 is the first of its kind in the United States. The only other country that has tried it successfully is Portugal, which is often cited as an inspiration. Initially, the country had harsh policies led by the criminal justice system. It needed to try something else. So, in 2001, Portugal took a radical step and became the first country globally to decriminalize the consumption of all drugs. 

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Speaking about what needs to be done, Humphreys mentioned that Portugal puts heavy legal and social pressure on those abusing drugs to get help. And despite the decriminalization of drugs, one can hardly see people openly using or dealing drugs, as in West Coast cities of the US. That's because they close operations and use court pressure to lead them into treatment. 

"I have spent a lot of time in Portugal, and I know the people who designed their policy," Humphreys said. "Please take it from me; Oregon is not following Portugal's example and will not get its results." (Source)

Humphreys further mentioned the need for harm reduction, which emphasizes engaging directly with addicts to prevent overdose, and transmission of infectious disease, improve physical, social, and mental well-being and offer low-threshold options for accessing addiction treatment and other health care. He recommended solutions like making Naloxone (opioid antagonist) more available to reduce overdose deaths. 

As the prevalence of mental health issues and substance use disorder continue to rise in the United States, the search for new and innovative treatments has become more urgent. One potential therapy that is gaining popularity is psilocybin mushrooms. Psilocybin, the main active ingredient in magic mushrooms, has shown effectiveness in treating alcohol use disorders (AUD).

A clinical study published in Jama Psychiatry found that psilocybin could help people with alcohol use disorders reduce their drinking days. The study participants were given 12 weeks of manualized psychotherapy and were randomly selected to get psilocybin or diphenhydramine during 2-day-long medication sessions at weeks 4 and 8. The results showed that over 50% of the participants who were assigned psilocybin stopped drinking entirely for months or even years.

After 32 weeks of analyzing the 93 participants with alcohol use disorders, researchers discovered that the 48 participants who got psilocybin and psychotherapy had an 83% reduction in their drinking habits within 8 months of their first dose, while those assigned placeboes had 51%. While the exact mechanism of action is not known, it is thought that psilocybin helps to break the cycle of addiction by:

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The safety and efficacy of psilocybin mushrooms as a treatment for alcohol addiction are still being studied, but the preliminary evidence is promising. As a precaution, you should never consume psilocybin mushrooms without the supervision of a trained medical professional. Psilocybin may be riskier in an uncontrolled environment because your experiences may feel extreme. For example, you may feel severe anxiety while under the influence of the drug.

Other common side effects are nausea and vomiting, paranoia, and delusions. In rare cases, psilocybin mushrooms can cause psychotic episodes. Psilocybin mushrooms can also interact with other drugs and medications. For example, they can intensify the effects of antidepressants and anti-anxiety medication.

It is always important to speak with a medical professional before consuming psilocybin mushrooms, especially if you are taking other medication.

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What are psilocybin mushrooms?

Psilocybin mushrooms are a type of mushroom that contains the psychoactive compound psilocybin. Psilocybin is a naturally occurring psychedelic compound that is found in over 200 species of mushrooms. When consumed, it can produce powerful hallucinations and an altered state of consciousness. Some people use psilocybin mushrooms for recreational purposes, while others use them for medicinal or spiritual purposes.

Psilocybin has been shown to be an effective treatment for various conditions, including depression, anxiety, and addiction. It is also being studied as a potential treatment for PTSD and OCD. Although psilocybin mushrooms are legal in some countries, they are illegal in most parts of the world. Possession and consumption of psilocybin mushrooms can lead to jail time and heavy fines.

 

What this means for alcohol addiction treatment

Alcohol addiction is a serious problem that can lead to various negative consequences, including health problems, relationship difficulties, and financial problems. In some cases, alcohol addiction can even lead to death.

According to the National Institute on Alcohol Abuse and Alcoholism, alcohol is a factor in about 95,000 deaths annually in the United States. These deaths are due to various causes, including alcohol-related accidents, liver diseases, and other health complications.

Treatment rates for alcohol use disorder are low (e.g., 7.6% in 2021), and the Food and Drug Administration has only approved 4 AUD evidence-based medications since 1947. 

While these medications can help people with alcohol addiction, they have been shown to be only partially effective. Psilocybin mushrooms have shown promise as a treatment for substance use disorders and could potentially help to reduce the number of deaths due to alcohol addiction.

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Further evidence on the effectiveness of psilocybin is needed

Although the study’s results are encouraging, it is important to note that it's a small study with a limited number of participants. More research is needed to confirm the findings and to determine the long-term efficacy of psilocybin mushrooms as a treatment for alcohol addiction. The study only analyzed 93 participants, and only 50 were given psilocybin as such research needs to be done in a bigger and more diverse population. 

Besides, the study used diphenhydramine, an antihistamine, as a placebo, which is not an ideal substitute for psilocybin. It was also observed that the participants didn’t have serious drinking problems as those who usually enrolled in clinical trials for alcohol use disorders. The clinical trial may have attracted participants who were already managing their condition. Most notably, the researchers didn't include participants with underlying mental disorders like depression so they could establish if psilocybin-assisted therapy treats AUD and not other co-occurring disorders

But patients with severe AUD can benefit from the therapy. This is especially true if the therapy can address other issues that underlie physical dependence and mental disorders. In this case, the treatment will simultaneously address both conditions.

Ketamine is also showing potential as a treatment for alcohol addiction. A group of researchers found that Ketamine disrupts memories to help heavy drinkers stop drinking or cut back. Ketamine blocks the NMDA receptors, disrupting the reconsolidation of memories associated with alcohol consumption. As a result, heavy drinkers who receive ketamine treatment may have fewer cravings for alcohol.

It has also been shown to be an effective treatment for various conditions, including depression, anxiety, and chronic pain.

Psilocybin mushrooms and Ketamine have shown promise as potential treatments for alcohol addiction and some mental health issues. However, more research is needed to confirm the findings. If you or someone you know is struggling with alcohol addiction, many resources are available to help. Never try psilocybin mushrooms or Ketamine outside a clinical setting, as they can be dangerous.

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