Cutting down on your drinking? Set SMART goals and practice refusing drinks now.

• Someone can set a SMART goal about their drinking to imbibe less.
• It helps to make sure one knows how much booze is in each drink one has.
• One doesn’t have to offer an excuse to reduce or stop drinking, but it helps to be prepared with responses.

It is officially summer! Many of us are finally enjoying some downtime in the sun at cookouts, sporting events, or weekend getaways.

Dry January has long come and gone, but you may have decided to cut back or even stop your alcohol use for a bit longer. If so, you are not alone! More and more people are drinking less alcohol for a variety of reasons. Drinking less can improve one’s physical health in many ways, such as reducing cancer risk, avoiding “empty calories,” and reducing the toxins your body is exposed to on a daily basis. While actively drinking less used to be closely linked to having alcohol-related problems, it is clear that there are any number of reasons that someone may want to reduce drinking in the here and now.

Getting started with SMART goals

So, you may have decided you want to drink less. As a first step, it is helpful to define what that means for you. Having a specific, measurable, attainable, relevant, and time-specific (SMART) goal can help you on this path. For instance, considering how much you want to drink, when, in what context, and for how long can help you clarify what “cutting back” means to you.

When considering how much, think about how much you want to drink in a week versus in a sitting. This could look like setting a goal to drink no more than four drinks in a week and no more than two drinks in a sitting. There is no one-size fits all approach, but a helpful starting point can be low-risk drinking guidelines issued by your local health authority. For example, you can view the guidelines for Canada and the United States using the provided links.

Tips for counting your drinks

When sticking to these limits, it is important to know “What is a drink?” While it is natural to count by the glass, bottle, or can, the actual alcohol content of beverages varies widely. A “standard drink” is an agreed-upon way of measuring one drink based on the amount of alcohol in the beverage. One standard drink is whatever size beverage leads to 0.6 fluid ounces or 14 grams of pure alcohol. For instance, a 12-oz can or bottle of regular beer (5 percent) is one standard drink. But 12 ounces of strong craft beer (9 percent) is nearly two standard drinks! This can give you a sense of how much booze is in your go-to beverages to help you keep count of your drinks.

Simple ways to say “no” to a drink without saying it.

Even though you may have decided you want to drink less, it can still be difficult at first to refuse drinks offered by friends and family. Here are some ideas of how you can say “no” to a drink that is offered to you without using the word “no”:

1. “Thanks, I already have a drink.” Bring your own non-alcoholic drink of choice and perhaps even some extra to share! There are more and more non-alcoholic drinks coming to market, which provides a number of options to partake in drinking-centric festivities without alcohol.
2. “Thanks, but I am good for now.” Express appreciation, but indicate that you do not really feel like a drink right now.
3. “I would love to have a [insert non-alcoholic drink] instead.” Ask for another option that they likely have on hand.
4. “I decided not to drink today because [insert reason], but thanks for offering.” Express appreciation and provide a reason. Reasons are not necessary, but if it is someone that is close to you and you want to share why—go for it! Common reasons are for health, well-being, later plans for activities or driving, or just wanting to fully live in the moment.

You can do this!

These options provide some ideas of how to refuse a drink without saying “no” outright. Remember, you don’t need to explain your reasons for not drinking. The key is to keep it simple and polite. Most people will understand and respect your choice! The more you practice refusing drinks, the easier it will become.

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Self-soothing is defined as an individual’s efforts or capacity to calm themselves while in a state of emotional distress (Wright, 2009). It is a key aspect of well-being as it helps us stay regulated and calm (take the well-being quiz here to learn more about your well-being).

We learn many of our self-soothing patterns when we are babies. It is believed that when we are soothed by caregivers, we internalize this soothing and learn how to do it for ourselves (Wright, 2009). So there are a variety of ways that we might not develop this skill and end up having difficulty self-soothing as adults. Improving our self-soothing skills as adults requires self-insight, the development of self-soothing skills, and the ability to effectively use these skills to return to an emotional baseline.

Here are some specific self-soothing techniques that may help:

1. Listen to Relaxing Music.

Research has shown that relaxing music reduces cortisol, an important stress hormone (Khalfa et al., 2003). If you’re feeling agitated or unable to settle down, calming music might just help change the mood, enabling you to breathe deeper, refocus your thoughts, and nudge negative emotions into remission.

2. Take Some Deep Breaths.

A key part of self-soothing often involves deactivating the sympathetic nervous system. We can do this by activating the parasympathetic nervous system. The parasympathetic nervous system helps stop our fight-or-flight responses and return us to a calm state.

We can easily activate the parasympathetic nervous system by taking a few long, deep breaths. One easy breathing strategy to remember is box breathing. Box breathing involves breathing in for a count of four, holding for a count of four, breathing out for a count of four, and then holding for a count of four. Repeat this box breathing method for a few rounds until you start to feel calmer.

4. Try the “Butterfly Hug.”

EMDR is a therapeutic technique used to help people process trauma. One EMDR technique is the Butterfly Hug. The Butterfly Hug is not considered to be a self-soothing technique in itself, but rather a technique for processing distressing emotions and material often left from trauma. Soothing is what is thought to occur after processing this material. So this technique is not to be used while experiencing negative emotions, but rather it is to help you work through negative baggage that may be causing heightened distress in general.

5. Do Pleasant Activities.

In Dialectical Behavior Therapy (DBT), it is suggested that engaging in pleasant activities is a good way to self-soothe (Linehan, 1993). Indeed, regularly doing an activity we enjoy can help us feel more content, and doing this activity when we’re stressed may make us feel better. Some of my favorite pleasant activities are gardening, spending time with friends, and doing arts and crafts. What pleasant activities help you feel better?

In Sum

When we’re feeling upset, it can sometimes be hard to self-soothe. But by using some self-soothing techniques, we actually do have a lot of control over how we feel.

Adapted from an article on self-soothing published by The Berkeley Well-Being Institute.

References

Jarero, I., & Artigas, L. (2016). Instruction for the Butterfly Hug Method.

​Khalfa, S., BELLA, S. D., Roy, M., Peretz, I., & Lupien, S. J. (2003). Effects of relaxing music on salivary cortisol level after psychological stress. Annals of the New York Academy of Sciences, 999(1), 374-376.

​Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. Guilford press.

Wright, J. (2009). Self‐Soothing—A recursive intrapsychic and relational process: The contribution of the Bowen theory to the process of self‐soothing. Australian and New Zealand Journal of Family Therapy, 30(1), 29-41.

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Written by Rowan Lynam

In a stunning 3-minute PSA for the Dove Self-Esteem Project, Dove examines the cost of toxic beauty standards on the mental health of developing minds. The video emphasizes the cascading and long-term consequences children exposed to certain content can form, including developing life-threatening eating disorders.

Mary’s Story

In the ad, we follow Mary, the central focus of the piece, from early childhood to her young teens. We see her go from the uninterrupted joy of her young life to something hyper-fixated and solemn. It begins when she receives her first smartphone, which the PSA draws attention to.

From there, Mary is sucked into the endless stream of beauty and body content online. Not far from her 13^th birthday, she is shown writing in a journal covered in rainbow stickers and “keep out” stickers, outlining her weight-loss goals and her plan to go on WeightWatchers for Adolescents. She plans a detailed workout routine and develops a fixation on her eating habits. We see her standing in front of the mirror, examining her still-developing body from the side to see how thin she is. Then, we see a self-recorded video of her weighing herself and then turning the camera back to see her painfully childish face.

The post This Ad Is Going Viral For Its Important Message on Body Image appeared first on My Blog.

Spring Hill Recovery Center

Millions of people drink (namely beer) on St. Patrick’s Day every year, which began as a day to celebrate the patron saint of Ireland, St. Patrick. People in recovery from drug or alcohol addiction can pursue sobriety by participating in non-alcohol-related activities and getting outside support.

St. Patrick’s Day is one of the biggest drinking holidays of the year. While it’s intended to be a celebration of St. Patrick, a patron saint of Ireland, it’s morphed over time into a day largely centered on drinking beer and spirits.

If you or someone you love are in recovery from drug or alcohol addiction over the festive holiday, you may need to take certain precautions to avoid relapse.

Fortunately, you can enjoy the holiday sober. Here, we’ll discuss the prevalence of drinking on St. Patrick’s Day in the U.S. and provide tips on how to remain sober and focused on recovery.

Why People Drink On St. Patrick’s Day

St. Patrick’s Day falls during the season of Christian Lent, a 40-day season of fasting to prepare for Easter.

Every year on March 17th, Christians began gathering to celebrate the anniversary of St. Patrick’s death in the year 461 AD.

On this day, the restrictions of Lent were lifted and people celebrated by drinking alcohol, eating meat, dancing, and more. This is what spurred the consumption of alcohol on St. Patrick’s Day, a tradition that’s continued to this day.

In America, many people have dubbed Boston as hosting the first St. Patrick’s Day celebration in 1737 when Irish immigrants gathered to celebrate.

From there, non-Irish Americans began to adopt the practices of the holiday, making it into what it is today.

The Scope Of Drinking On St. Patrick’s Day

St. Patrick’s Day is the third most popular day for drinking in the U.S., next to drinking on New Year’s Eve and Mardi Gras, the most popular drinking holiday.

However, it’s the most popular day for drinking beer. According to one survey, there’s a 174% increase in beer sales on St. Patrick’s Day compared to the rest of the year, and a 153% increase in the sale of spirits.

The survey also found that:

• the average number of drinks consumed on St. Patrick’s Day is 4.2
• more than 13 million pints of Guinness beer are consumed on the holiday
• 32% of men binge drink on St. Patrick’s Day

Staying Sober In Addiction Recovery Over St. Patrick’s Day

With so many people donning green clothes and accessories to head out to the bars for a night of alcohol-focused merriment, it can be difficult to get through the day without seeing people drinking.

Social media makes seeing these scenes more accessible than ever, as people post pictures and videos of parties with drinking on apps like Instagram and TikTok.

Though the culture of drinking can be all-consuming, it doesn’t have to be. Whether you plan to spend the holiday in or go out with friends, you can stay safe and focused on recovery.

Here’s how you or your loved one can stay sober this St. Patrick’s Day:

• Find people you trust: If you choose to go out and celebrate with friends on St. Patrick’s Day, choose people who know your recovery journey and can help to keep you accountable.
• Learn about the tradition: If you are a practicing Christian or simply want to know more about the roots of the holiday, spend time learning about the history of St. Patrick’s Day and connect with the traditional aspects of the celebration.
• Go to a parade: You can enjoy the family-friendly aspects of St. Patrick’s Day like a parade, celebrating the day without needing to drink.
• Enjoy Irish foods: Traditionally, St. Patrick’s Day was celebrated with ham and cabbage; however, Irish Americans began a tradition of corned beef and cabbage in the 1700s. Invite friends over and make a traditional St. Patrick’s Day meal together.
• Create a plan: Make a plan for how to handle triggers or difficult situations involving alcohol if you decide to go out. You might choose one person who is aware of this plan and can help you to exit quietly if need be.

Find Alcohol And Drug Addiction Treatment In Massachusetts

Our addiction treatment specialists recognize the difficulty of staying sober on major drinking holidays in the U.S. such as St. Patrick’s Day.

To keep yourself or a loved one safe and on track with recovery, consider reaching out to us to learn about our treatment programs.

We offer a range of programs, including access to drug and alcohol detox in Massachusetts, outpatient treatment, inpatient rehab, and more. Call us today to learn more about your options.

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I direct one of the largest addiction research centers in the country, and I study substance use in adolescence. Here’s what every parent needs to know about adolescent substance use:

1. Adolescence is the time when most kids initiate substance use.

It’s when they establish regular patterns of use, that many start to experience consequences. About 15 percent of the population will meet the criteria for a substance use disorder at some point in their lives, meaning that substance use is causing significant harmful consequences. The average age of onset for problems is in the early 20s, so most problems start in adolescence. That’s why we focus so much substance use prevention programming on teens.

2. Adolescents have brains that are wired for risk-taking.

This is a result of the fact that the brain doesn’t develop evenly. The part of the brain that is highly attuned to experiencing reward is fully developed in adolescence. That’s a product of evolution—if our brains didn’t respond positively to food, social interactions, and sex, as a species, we wouldn’t survive very long. Those things make us feel good, and we seek out more of them.

But as we all know, too much of a good thing can lead to trouble. The part of our brain that helps us weigh the consequences of our actions and think about long-term implications isn’t fully developed until the mid-20s. So, teenagers are like race cars without fully functional brakes. Using drugs is a novel experience that adolescent brains crave—and then drugs hijack the reward system by producing feel-good effects. It’s a big part of the reason why most adolescent substance use is risky adolescent substance use. Teens don’t have a glass of wine with dinner; if one drink is good, their reward-primed brains tell them, five drinks must be better! Of course, there is a lot of individual variability in this trait, but developmentally, teenage brains are at a high point for risk-taking.

3. The drugs available to kids today are more dangerous than in the past.

Vaping has risen tremendously in popularity, with one in four youths reporting that they have vaped. Vapes come in fun flavors and are easy to hide; most youth (and parents) do not realize that a single vape can contain as much nicotine as a pack of cigarettes.

Cannabis use is on the rise as most states have legalized marijuana for either medicinal or recreational purposes. Up to 11 percent of youth report using cannabis daily. This is the drug most of us who study adolescent substance use are most worried about presently.

The marijuana available today is nearly 10 times stronger than the marijuana that was available in the 70s, 80s, 90s, and up through the 2000s. Early research is showing potent adverse effects on memory and motivation in kids who use them regularly. The level of THC, the psychoactive ingredient in marijuana, was about 3 percent until the early 2000s; it is now close to 25 percent in the marijuana available today, and up to 90 percent in edibles like gummies! Many parents are unaware of just how different and dangerous this drug is compared to how they remember marijuana. Parents, think of it this way: If marijuana use in your youth was the equivalent of having a beer when your kids use marijuana, it’s more like drinking a liter of vodka.

Fentanyl, a powerful synthetic opioid which can be produced far more cheaply than other opioids, has flooded the drug market as a result of the opioid epidemic. It is the top cause of accidental overdoses, which have grown exponentially over the past several years. The concern now is that it’s not only opioids that are laced with fentanyl; it’s other drugs as well. Increasingly, cocaine, ecstasy, and other street drugs also contain fentanyl, leading to accidental overdoses in youth who experiment.

4. Alcohol remains the most widely used drug in youth.

It is the most available drug, so it continues to be the one most kids use recklessly, leading to injuries, fights, unwanted sexual behavior and assaults, accidents, and death. Well-meaning parents have asked me if, due to the increasing availability of more dangerous drugs, they should instead encourage their child to take the “least-worse” path and stick to alcohol.

There are two reasons this isn’t a good idea. First, it assumes that all kids will use alcohol or other drugs, which is not the case. We don’t want to inadvertently normalize substance use in our kids. Many youth choose not to drink. Rates of alcohol use have fallen steadily over the past decade, with national data showing that only 55 percent of high school seniors report using alcohol in the past year.

Secondly, there is no evidence that when youth use alcohol it deters them from using other drugs. In fact, the opposite is true. Youth who use alcohol are more likely to try other drugs as well. When the novelty of alcohol wears off (remember they have sensation-seeking brains!), they move on to trying other drugs.

5. Parents can make a difference.

Parents, don’t despair! There are actions you can take to reduce the likelihood your teen will initiate substance use or use in risky ways.

• Monitor your kids. Know who they are with, where they are going, what they are up to. Remove easy access to alcohol in your house. Parental monitoring is the number-one thing that research shows reduces substance use in teens. Kids can’t use alcohol and other drugs if they don’t have access. You can make it harder for them to get access. Remember, their brains aren’t in a place to help them make the best choices; you have to make up the difference.
• Talk to your kids about alcohol and other drugs. Ask your child questions about substance use in their school and among their friends. Ask what they think about using alcohol or other drugs. Use this as an opportunity to have a conversation about substance use. Be clear about the rules and expectations in your house, and—this part is key—outline and implement consequences if they are broken. It’s normal for teens to push boundaries, and the unfun part of being a parent is that we have to serve as the referees. But unfortunately, this isn’t a game; your child’s life is at stake.

References

Nicotine vaping now one of the top forms of substance use among teens. (2022). University of Michigan News.

Marijuana and hallucinogen use among young adults reached all time-high in 2021. (2022). National Institute on Drug Abuse.

Synthetic Opioid Overdose Data | Drug Overdose. (2021). Centers for Disease Control and Prevention.

Miech, R. A., Johnston, L. D., Patrick, M. E., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2023). Monitoring the Future National Survey Results on Drug Use, 1975–2022: Secondary School Students. Ann Arbor: Institute for Social Research, The University of Michigan.

Parents & Educators. (2020). National Institute on Drug Abuse.

The post Teen Substance Use appeared first on My Blog.

Pew Trust

Only 10% of all adults with co-occurring disorders received treatment for both conditions in the past year, national survey data show

Policymakers are increasingly focused on justice system interactions with and outcomes for people with either mental illness or substance use disorders.¹ What has received less attention, however, is the extent to which people with co-occurring mental health and substance use disorders (hereafter called co-occurring disorders) become involved with the justice system.

To better understand this issue at the point of arrest, which is the “front door” of the criminal legal system, The Pew Charitable Trusts analyzed data from 2017 to 2019 from the National Survey on Drug Use and Health (NSDUH).² NSDUH is an annual, nationally representative, self-reported survey and the only national data source for trends in the incidence and treatment of behavioral health (which includes mental illness and substance use disorders). The survey also asks respondents whether they were arrested in the past year and, if so, how often.

Pew’s analysis found that adults reporting co-occurring serious or moderate mental illness (hereafter “mental illness”) and substance use disorders in the past year were far more likely to be arrested compared with both those with mental illness alone and those who didn’t experience any mental illness or substance use disorder as defined by NSDUH.

• Adults with co-occurring disorders made up 2% of the U.S. population but 15% (1 in 7) of all people were arrested from 2017 to 2019. Almost half of these individuals had a substance-related arrest, such as drug possession, as the most serious charge.
• More than 1 in 9 adults with co-occurring disorders were arrested annually, 12 times more often than adults with neither a substance use disorder nor a mental illness, and six times more likely than those with a mental illness alone.
  • Women with co-occurring disorders were arrested 19 times more often than women with neither a substance use disorder nor a mental illness and accounted for more than 1 in 5 of all women arrested.
  • Black adults with co-occurring disorders were arrested 1.5 times more often than their White counterparts.

People with co-occurring disorders were also unlikely to receive treatment for more than one disorder, even though research demonstrates that simultaneous, coordinated treatment for multiple diagnoses produces better outcomes compared with separate treatment for only mental illness or substance use disorder.³

• Only 1 in 10 adults with co-occurring disorders (10%) received treatment for both of their conditions.
• About 2 in 5 adults with co-occurring disorders (42%) did not receive either substance use or mental health treatment of any kind in the prior year.
• Black and Hispanic adults with co-occurring disorders were less likely to receive mental health or substance use treatment (47% and 43%, respectively) than White adults (64%).

About 60% of people with a mental illness who were arrested had a co-occurring substance use disorder. NSDUH doesn’t explicitly ask respondents whether these arrests resulted in time spent in jail, so recent national-level data on how many of these arrests led to incarceration is not available. Being arrested and jailed can negatively affect wages, employment, housing stability, physical and mental health, and public safety outcomes, including increasing the likelihood of recidivism.⁴

Researchers have found that communities with more treatment availability may have lower crime and jail incarceration rates, and some jurisdictions are working to divert people with mental illness away from the criminal legal system and into a continuum of community-based care.⁵ However, an increased focus on the needs of people with co-occurring disorders—particularly on integrated treatment for both mental illness and substance use—could make an even larger impact on the number of people entering and cycling back through the justice system.⁶

Adults (ages 18 and older) with past-year co-occurring mental illness and substance use disorder represented about 2% of the population but made up 15% of all adults who reported being arrested in the past year. Those with a mental illness alone made up a similar share of the adult population in general and of those arrested (8% and 9%, respectively). Most adults with a mental illness who were arrested had a co-occurring disorder (60%). Although not shown in the chart, Pew analysis also revealed that adults with co-occurring disorders made up an even larger share (18%) of all those arrested twice or more in a year.

Although not shown in the chart, Pew analysis also revealed that adults with co-occurring disorders made up an even larger share (18%) of all those arrested twice or more in a year.

About 650,000 adults with cooccurring disorders were arrested annually in the years 2017-19. This was more than 1 in 9 of all adults with co-occurring disorders. In contrast, about 1 in 50 adults with mental illness but no co-occurring substance use disorder and about 1 in 100 adults with no behavioral health issues—that is, neither a substance use disorder nor a mental illness—reported a past-year arrest. People with co-occurring disorders were roughly six times more likely to be arrested annually than those with a mental illness alone, and 12 times more likely to be arrested than those with neither a mental illness nor substance use disorder.

For adults with co-occurring disorders, almost half (48%) of those arrested had a drug-related charge but no additional, more serious charge. Only 10% of adults with co-occurring disorders were arrested for a violent offense as the most serious charge. Additionally, 17% of adults with co-occurring disorders were arrested for a property offense.

Individuals responding to the NSDUH indicate which substances are involved in their disorder. In looking at adults with co-occurring disorders, those who reported a methamphetamine use disorder— either alone or in combination with other substances—were the ones most likely to be arrested. Almost 4 in 10 adults with co-occurring disorders involving a meth use disorder were arrested annually. For all substances except alcohol, most of those arrested had multiple substance use disorders—that is, disorders involving two or more substances.

These results are in line with other recent Pew research, showing the large and growing issue of people using, being arrested for, and dying from meth use.⁷

Overall, about 2 in 3 (66%) people with co-occurring disorders report that they have an alcohol use disorder. They make up more than half (53%) of all arrests of those with co-occurring disorders due to their overall greater number, even though, as the figure shows, a smaller share is arrested, likely because alcohol is legal for adults to buy and use.

Adult women with co-occurring disorders were almost 20 times more likely to be arrested each year compared with women with no substance use disorder or mental illness. Additionally, they made up more than 1 in 5 (22%) of all adult women arrested (not shown in chart). By comparison, adult men with co-occurring disorders made up 12% of all men arrested.

People with co-occurring disorders frequently report violent victimizations.⁸ Women are two to three times more likely than men to develop post-traumatic stress disorder and are exposed to more highly traumatic events such as sexual abuse, and at a younger age.⁹ Research shows that women in jail with a co-occurring disorder were more likely to have a history of trauma than those women with substance use disorders alone, suggesting the need for trauma-centered interventions to reduce arrests and incarceration.¹⁰

Black adults with co-occurring disorders were arrested at higher rates than their non-Hispanic White or Hispanic counterparts. About 16% of Black adults with co-occurring disorders were arrested annually versus 11% of White and Hispanic adults with co-occurring disorders. (The sample size of other races was too small to report on with confidence.);

Racial and ethnic disparities in arrests among adults with cooccurring disorders were smaller than for those without behavioral health disorders. Black adults without mental illness or substance use disorder were about three times as likely as their White counterparts to be arrested, while Black adults with co-occurring disorders were about 1.5 times as likely to be arrested as White adults with co-occurring disorders.

Relatively few people with co-occurring disorders received treatment for both their mental illness and substance use disorder. Research shows that integrated treatment—which addresses both mental illness and substance use disorder diagnoses and symptoms at the same time within one coordinated service system and set of providers —produces consistently better outcomes compared with separate treatment of each diagnosis or for treatment of only one disorder.¹¹

White adults with co-occurring disorders were the most likely to indicate that they received treatment (as identified in the survey), with almost 2 of 3 (64%) receiving treatment for substance use disorder, mental illness, or both in the past year. Slightly less than half (47%) of Black adults with co-occurring disorders received treatment of any kind, while an even smaller percentage (43%) of Hispanic adults with co-occurring disorders received treatment.

Conclusion

As this analysis showed, adults with co-occurring disorders in the United States from 2017 to 2019 were over-arrested and undertreated. Given that 60% of those who are arrested with mental illness also have co-occurring substance use disorder, focusing on this intersection is important for both policy and practice. In fact, this analysis found that adults with co-occurring disorders were more likely to be involved with the justice system than those with mental illness alone, and few received treatment for both substance use and mental illness. Implementing evidence-based solutions that increase and improve treatment for co-occurring disorders could reduce justice system contact and produce better public health outcomes for those with co-occurring disorders.

Methodology

This brief analyzes self-reported survey data taken by the National Survey on Drug Use and Health (NSDUH) from 2017 to 2019.¹² Pew looked at survey results from multiple years to ensure adequate data sample sizes for analysis. Data from 2020 was available at the time of publication but excluded from this report because NSDUH switched to new definitions that were not comparable to the previous year’s data sets.¹³ NSDUH asked respondents if they were arrested and booked within the past year, and while being booked is often construed to mean going to jail, NDSUH does not survey people in jail or prison or in an inpatient residential treatment programs or psychiatric hospitals, so this analysis of arrest rates for adults with co-occurring disorders is likely an undercount. The definition of mental illness is adopted from NSDUH, which states that “adults aged 18 or older were classified as having any mental illness if they had any mental, behavioral, or emotional disorder in the past year of sufficient duration to meet Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria (excluding developmental disorders and substance use disorders).” The definition of substance use disorder is adopted from NSDUH and is “characterized by impairment caused by the recurrent use of alcohol or other drugs (or both), including health problems, disability, and failure to meet major responsibilities at work, school, or home … based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).” The definition of illicit drugs is adopted from NSDUH and includes “marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, and methamphetamine, as well as for the misuse of prescription stimulants, tranquilizers, sedatives, and pain relievers.”

Pew considered individuals as having a mental illness if they were classified by NSDUH as having a serious or moderate mental illness in the past 12 months; classifications are based on respondents’ self-reported answers and the criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). People whose responses indicated that they had a mild mental illness were included in groups identified as not having a behavioral health disorder. Those identified as having a co-occurring disorder were identified as having both a mental illness (serious or moderate) and a substance use disorder, as classified by NSDUH. NSDUH data shows that an additional 300,000 adults with co-occurring mild mental illness and substance use disorder were arrested each year, though they were not included in this analysis. Although a mild mental illness is defined as having only a mild impact on a person’s functionality, research indicates that treatment can prevent the development of more serious mental illness.¹⁴

Endnotes

1. R. Haneberg et al., Reducing the Number of People With Mental Illnesses in Jail: Six Questions County Leaders Need to Ask (WS Hein, 2017); National Association of Counties, “Meeting the Needs of Individuals With Substance Use Disorders: Strategies for Jails” (2019), https://www.naco.org/sites/default/files/documents/Strategies-for-Jails.pdf.
2. Substance Abusw and Mental Health Services Administration, “Key Substance Use and Mental Health Indicators in the United States: Results From the 2019 National Survey on Drug Use and Health (HHS Publication No. Pep20-07-01-001, NSDUH Series H-55)” (2020), https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR090120.htm.
3. T.M. Kelly and D.C. Daley, “Integrated Treatment of Substance Use and Psychiatric Disorders,” Social Work in Public Health 28, no. 3-4 (2013): 388-406.
4. G. Lopes et al., “Labeling and Cumulative Disadvantage: The Impact of Formal Police Intervention on Life Chances and Crime During Emerging Adulthood,” Crime & Delinquency 58, no. 3 (2012): 456-88; M.H. Esposito et al., “The Consequences of Contact With the Criminal Justice System for Health in the Transition to Adulthood,” Longitudinal and Life Course Studies 8, no. 1 (2017): 57; P. Heaton, S. Mayson, and M. Stevenson, “The Downstream Consequences of Misdemeanor Pretrial Detention,” Stanford Law Review 69 (2017): 711.
5. S.R. Bondurant, J.M. Lindo, and I.D. Swensen, “Substance Abuse Treatment Centers and Local Crime,” Journal of Urban Economics 104 (2018): 124-33; National Association of Counties, “Data-Driven Justice: A Playbook for Developing a System of Diversion for Frequent Utilizers” (2021), https://www.naco.org/sites/default/files/documents/DDJ-Playbook.pdf.
6. National Association of Counties, “Data-Driven Justice: A Playbook for Developing a System of Diversion for Frequent Utilizers,” (2021), https://www.naco.org/sites/default/files/documents/DDJ-Playbook.pdf.
7. The Pew Charitable Trusts, “Methamphetamine Use, Overdose Deaths, and Arrests Soared From 2015 to 2019” (2022), https://www.pewtrusts.org/en/research-andanalysis/articles/2022/08/16/methamphetamine-use-overdose-deaths-and-arrests-soared-from-2015-to-2019.
8. V. Gil-Rivas, J. Prause, and C.E. Grella, “Substance Use After Residential Treatment Among Individuals With Co-Occurring Disorders: The Role of Anxiety/Depressive Symptoms and Trauma Exposure,” Psychology of Addictive Behaviors 23, no. 2 (2009): 303.
9. M. Olff, “Sex and Gender Differences in Post-Traumatic Stress Disorder: An Update,” European Journal of Psychotraumatology 8, no. sup4 (2017): 1351204.
10. C.K. Scott, M.L. Dennis, and A.J. Lurigio, “Comorbidity Among Female Detainees in Drug Treatment: An Exploration of Internalizing and Externalizing Disorders,” Psychiatric Rehabilitation Journal 38, no. 1 (2015): 35.
11. Kelly and Daley, “Integrated Treatment.”
12. Substance Abuse and Mental Health Services Administration, “Key Substance Use and Mental Health Indicators.”
13. Substance Abuse and Mental Health Services Administration, “Key Substance Use and Mental Health Indicators in the United States: Results From the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56)” (2021), https://www.samhsa.gov/data/.
14. Center for Behavioral Health Statistics and Quality, “2019 National Survey on Drug Use and Health: Methodological Summary and Definitions” (Substance Abuse and Mental Health Services Administration, 2020), https://www.samhsa.gov/data/; R.C. Kessler et al., “Mild Disorders Should Not Be Eliminated From the DSM-V,” Archives of General Psychiatry 60, no. 11 (2003): 1117-22.

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News Anchor/Reporter WMUR

MANCHESTER, N.H. —

Newly released figures show that 2022 was the worst year for overdose deaths in New Hampshire since 2017. State officials said there were 434 confirmed overdose deaths, with another 39 deaths still pending toxicology test results. In every overdose death, fentanyl was involved. There have been more than 400 overdose deaths every year in New Hampshire for the past nine years.

People who are recovering from substance misuse say there are different strategies that could help, ranging from setting up recovery centers for the person addicted and their families, increasing awareness about available recovery treatments, and providing medical and emotional support for those going through withdrawal.

“Obviously, the magic solution would be no drugs, no fentanyl, but that’s just not going to happen,” said Jacque Ingersoll, of Farnum Center. Some said it’s important to focus on what motivates people who are addicted to drugs.

“It’s not death that scares the opioid addict. It’s the pain of going through withdrawal,” said Keith Howard, executive director at Hope for New Hampshire Recovery. Howard, who has been in long-form recovery for 15 years, said the state can do better. “All of us are trying our best, but there’s so much more that needs to be done,” he said. Alexander said she got into drugs when she was 10 because her father was addicted. She hopes to one day open a recovery center for families. “Helping more than just the person that’s struggling is key,” she said. Officials said the presence of fentanyl and other powerful drugs has made substance misuse even more dangerous than it was 10 to 15 years ago.

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If you’ve never experienced addiction, it can be hard to understand. Everyone’s experience with addiction is unique. This article is intended to encourage an understanding of people with addiction, not to represent or stigmatize any individual or groups.

 What Is Substance Dependence?

Feeling Apart and Isolated

Imagine, for a moment, that you’ve never really felt comfortable with who you are. It could be because you feel like you’ve failed at everything you’ve tried, or because you were never satisfied with the level of success you did achieve.

It could be because you’ve had thoughts and emotions that make you feel different from other people, particularly if you feel that you aren’t as good or as lovable as others. Or perhaps you were actually told, or shown, that you were no good, worthless, or that you existed just to meet other people’s needs.

Getting Hooked

Then imagine that you have an experience—you drink, take a drug, win a bet or a game, have a sexual experience, overeat, make a large impulse purchase—and suddenly, everything feels great. You feel as if success is easy and right for you, that perhaps others don’t understand, but now it feels good to be alive.

There is finally something you can depend on to be OK. It might be easy to get what feels good: for a person with a food addiction, a quick trip to the corner store and a few dollars can replenish your supply of chips and chocolate.

For a person with an addiction to heroin, maintaining a habit can cost a lot of money, entail significant risks, and involve interactions with people you can’t trust. But compared to the emptiness of what you felt before, investing in the chance that you could again feel good about yourself and about being alive is what matters.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Experiencing Consequences

Sure, those around you don’t understand why you’re doing what you are doing. But this just makes you want to spend time with people who do understand, whose addictions make them feel exactly the way you do. You don’t even need to talk about it with them—between you, there is already an understanding. With them, you don’t feel like an outsider, but like a member of a secret club.

There is a steep price to pay for addiction. You may put on or lose weight, experience health problems, lose a lot of money, and destroy relationships. But your reasoning may be that nothing made you feel happy in the past anyway, and, at least for a short time, your addiction does.

The more people criticize you, the more you want to seek comfort in that good feeling you get from your addiction. The more others lecture you about what you should be doing with your life, the more convinced you are that they don’t know what they are talking about.

Sure, you wish what they were saying was true, but underneath, you know that a normal life was never for you. Except you long for a normal life.

You wish that you could take satisfaction in the things that seem to make other people happy, such as graduation, a career, and a family. But to get those things, or to experience them the way you want to, you would have to believe in yourself and that self-belief has always eluded you.

Wanting to Recover, But Feeling Stuck

Most people with addiction struggle with a double life. You try to keep your addiction hidden from most people, most of the time, even when it is quite obvious to those around you.

You have a hard time admitting to yourself that you are a person with addiction because no matter how fleeting, it gives you that brief moment when everything feels okay. You want to free yourself from your addiction and not end up back where you started, with all the losses you have built up while you have been struggling.

Recovery is possible for every person with addiction. But facing the problems that caused the addiction in the first place is scary.

It’s difficult to cope with the deep dissatisfaction with your life and to take responsibility for how your behavior affects other people. It means learning how to experience a gentler sense of pleasure in the small things in life and coping with the many challenges and imperfections of life, without retreating back into your addiction. Which means accepting being human, just like everyone else.

https://www.verywellmind.com/understanding-an-addict-21927

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One of the most frequently asked questions regarding substance abuse is, “what causes addiction?” While there’s no clear answer, there are several risk factors that affect the likelihood that a person will experience addiction during their lifetime.

A family history of addiction, having a mental health disorder, peer pressure, lack of family involvement, and a genetic predisposition are all common risk factors associated with substance abuse and addiction. But another risk factor, one that’s often overlooked, is trauma—especially trauma that occurs during childhood.

Emotional abuse, rape, sexual assault, the death of a loved one, being the victim of a crime or accident, and catastrophic natural disasters are all examples of traumatic events that may have an impact on substance abuse and addiction.

But how much do these events impact the likelihood of developing an addiction? And is there a way to prevent substance abuse later in life after an individual has experienced trauma?

How Trauma Affects the Brain

Biology and genetics play a critical role in brain development, but the human brain also has the ability to respond and adapt to environmental stimulation. As the brain grows and matures during childhood, it creates, strengthens, and occasionally discards neural connections. Every experience a child has, whether positive or negative, affects the brain in some way.

While most experiences cause the brain to develop in a way that’s beneficial, negative experiences can impede the brain’s development. Specifically, negative experiences during childhood, such as trauma, are believed to cause certain anomalies in brain structure that can result in cognitive, behavioral, and social impairments. According to data published by The National Child Traumatic Stress Network, one in four children experiences at least one potentially traumatic event before turning 16.

Is There a Correlation Between Trauma and Substance Abuse?

Although experiencing trauma doesn’t mean a person will develop an addiction, research suggests there’s a significant, undeniable link between trauma and substance abuse.

Researchers at the University of Texas studied 32 teenagers, 19 of whom had been maltreated during childhood but had not been diagnosed with a mental health disorder. The other participants served as the control group and had no history of any major childhood trauma or psychiatric problems. All of the teens were followed up every six months for approximately three and a half years. The researchers found that nearly half of the children who experienced trauma developed depression, an addiction, or both during the study. The comparison between the two groups showed that the rate of developing an addiction or mental health disorder in the maltreated teens was three times higher than in the control group.

But it’s not just childhood trauma that has an impact on addiction. A report issued by the National Center for Post-Traumatic Stress Disorder and The Department of Veteran Affairs showed a strong correlation between trauma and addiction in adults as well. Some of the significant findings of the report include:

• Sources estimate that between 25 to 75% of people who survive abuse and/or a violent trauma develop issues related to substance abuse.
• 10 to 33% of survivors of accidents, illnesses or natural disasters report having a substance use disorder.
• A diagnosis of post-traumatic stress disorder (PTSD) increases the risk of developing a substance use disorder.
• Male and female sexual abuse survivors experience a higher rate of drug and alcohol use disorders compared to those who have not survived such abuse.

Can Addiction Be Prevented After Trauma?

Not every person who experiences a traumatic event will develop an addiction to drugs or alcohol, which makes it difficult for experts to say whether it can truly be prevented. However, people who don’t seek help when dealing with traumatic experiences are more likely to turn to drugs or alcohol as a coping mechanism, which can lead to a substance use disorder over time.

Perhaps the best way to prevent substance abuse after a traumatic event is to ensure that the individual seeks some form of treatment, such as therapy with a licensed professional. Addressing the underlying trauma and the feelings associated with that trauma can help prevent a person from turning to drugs or alcohol in the future to cope with their emotions.

Help is Available

You didn’t wake up one morning and decide to become addicted to drugs or alcohol. If you’ve experienced a traumatic event at one point in your life, there’s a chance you’re using drugs or alcohol to cope with those feelings and experiences, even if you don’t realize it. You don’t need to feel embarrassed, upset, or frustrated with yourself forever. Help is available, and by accepting treatment, you can begin to deal with your trauma, overcome your addiction, and live a happy, fulfilled life in recovery.

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Addiction can be a very lonely experience that drives a wedge between a user and the world around him. By contrast, companionship is very important in recovery. Friends and loved ones offer a reservoir of support and inspiration to someone who is relearning how the world works. The role of peers in addiction recovery cannot be understated. Relationships take on new meaning in a post-treatment life.

The Importance of Friends

Even beyond the extent of recovery, friends provide many mental health benefits. Friends are valuable for support and counsel. According to the Mayo Clinic, friendships increase a sense of belonging and purpose, boost happiness, help with self-confidence and self-worth.¹

Of course, not all friendships are good ones. A bad friendship can have negative effects such as an increase in stress or anxiety. Some friendships can make you feel “in competition” with others.² It is important to pursue as many healthy friendships as possible.

Friendship and Addiction Recovery

The same is true for friendship dynamics after treatment. If peers cannot adapt to a patient’s sobriety (if they still insist on drinking or using around her, or by being dismissive or critical of the patient’s new lifestyle), then such peers could easily push their “friend” into relapse.It may even be a requirement of recovery for the patient to break off ties with old friends and contacts.

The struggle of having to leave old friends (and maybe even family members) behind is one that is shared and understood by the other people in the group. This can give rise to a sense of solidarity; the worst thing for a newly sober patient is a feeling of loneliness. When someone provides support to an individual in recovery, healing takes place.

Friendship and Relapse Prevention

Relapse is a very real possibility in recovery. Many addicts have fallen off the wagon because they have tried to do too much too soon: pursuing relationships, starting new jobs, setting goals, and more. While these ideas are good in theory, they need to be balanced and staggered. Doing too much too soon is a recovery pitfall. A newly sober addict who feels like she can take on the world might very easily find herself overwhelmed, stressed, frustrated, and exhausted. And just like that, the right combination of factors for a relapse line up.

But this is where having peers in addiction recovery can help. These men and women have been through recovery before, and they may have even made the same mistake as the patient. Recovery friends understand that recovery is very much an ongoing process, and even the good things in life need to be spread out.

As much as friends are there to support and encourage, they are also there to say “no” and to offer warnings or corrections. Contrast this with the kind of “friends” who would encourage the patient to keep drinking and using drugs, even when it is evident that a substance use problem exists.

Sober Activities

While support groups are important, other activities in life should support a life of sobriety. For example, sober exercise peers give the patient a focus in his new life by helping him to enjoy a productive past time without the pressure or expectation to consume alcohol. Such a network can help guide everyday life. Of course, such a system is not just found in exercise. Sober groups can form for any number of activities:

• Yoga, other fitness classes
• Dancing
• Hiking, climbing
• Kayaking, canoeing
• Musical pursuits
• Cooking classes
• Art

All of these pursuits offer a goal of some kind — to reach a target weight, to master an art form, or simply to learn a skill you did not previously possess. A friend offering a simple invitation to a yoga or other fitness class can make a person in recovery feel that his presence and companionship is valued and desired.

The Importance of Fun

A perception exists that once an individual gets clean, he is no longer fun to be around. This thought process may even be a source of friction between the former addict and friends who do not understand the changes made as a part of recovery. As useful and valuable as sober activities are, the importance of having fun cannot be overstated. Recovery does not have to be a military march to health. After a while, the most rewarding activities can become monotonous, and familiar disgruntlement and frustrations start to set in.

This is where the right kind of peers can really make a difference. There is no reason that simple, basic fun should be compromised because of a sober lifestyle. Discovering new hobbies and interests should be a part of a recovery program, but doing something purely recreational with peers is an essential part of healthy living.

“Negotiating Non-Drinking Identity”

College has often been considered a place where young men and women go to find their identity away from home. Many students may find this inspiring, but the first steps of independence and liberty can be overwhelming. With the almost universal presence of alcohol on most college campuses, sober friends can help a person in recovery steer clear of tempting people and situations, without feeling like they are missing out on enjoying their college years.³

Notwithstanding the importance of fun, people in recovery still need discipline and control in their lives. To lead a healthy life, free of alcohol and drug abuse, it’s necessary to change habits and regulate unconscious emotions that both drive and support abuse.⁴

How Can a Sober Person Stay Sober?

Being sober has many challenges, and despite all of the strategies that may be in place, an individual might still find himself in a situation where alcohol is flowing. This is obviously not an ideal place to be, but there are still ways to resist temptation in such a way that feels empowering and genuine.

One way to do this might be to take a mental inventory before going to the event. Being mindful of what you’re feeling will help you control those emotions before you’re given the choice to drink or abstain. Being mindful of where you are emotionally will eliminate the surprise factor and empower you to make the healthy choice when someone asks you what you would like to drink.

Sharing your thoughts with an understanding friend can help you take ownership of what you are feeling. Once you have ownership of your emotions, no one can take them away from you.

Confidence is another key factor to consider when approaching risky environments. Some ideas to implement include: touching base with a sobriety sponsor, going to a meeting, or bringing a sober friend to an event to help stay accountable.⁵

Through these methods, friends can play a vital role in ensuring long-term addiction recovery and sobriety. With support from understanding friends and family, people in recovery begin to see their new lifestyle of health and sobriety as rewarding, fun and full of possibilities.

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