Archive for October, 2017

A Look at Pennsylvania's Opioid EpidemicNationwide, the opioid epidemic killed more Americans in 2016 than the wars in Vietnam and Iraq combined. On October 26, 2017, President Donald Trump officially declared the opioid crisis a national public health emergency.

The Roots of a National Crisis
The term opioid is used to refer to substances that act on the opioid receptors in the brain to create morphine-like effects. The opioid epidemic refers to the abuse of prescription pain medications as well as illegal street drugs like heroin. Often, people begin their addiction with prescription pain medication and progress to illegal street drugs when it becomes too difficult to obtain their pills by doctor shopping or borrowing from friends and family members.

Prescription opioids play a vital role in managing chronic pain for people who suffer from serious medical conditions, but have a high potential for abuse when they are not taken precisely as prescribed. Many experts believe the opioid epidemic began in the late 1990s and early 2000s when doctors began shifting away from encouraging physical therapy, biofeedback, and exercise or meditation as the first response for pain management to writing prescriptions for opioids. Often, the patients who received these prescriptions were not fully aware of the risk for dependency and addiction until it was too late.

Opioid Addiction in Pennsylvania
To get a sense of the scale of the problem Pennsylvania is facing, consider the following statistics from 2016:

  • Prescription pain medications like Vicodin and OxyContin were responsible for 1,775 overdose admissions in the state of Pennsylvania, compared to the 1,524 admissions for heroin. However, hospital admissions for heroin overdose in Pennsylvania have quadrupled since 2010. Statistics for emergency room visits are not available, but these numbers are thought to be even higher.
  • Opioid pain medication overdoses are most common among people age 50 and over, with 60% of admissions falling in this age group. In comparison, about 70% of the admissions for heroin overdoses were patients between 20 and 39 years old.
  • Philadelphia admitted 47 per 100,000 residents, making it the center of the state’s opioid epidemic. However, rates in several other countries, including both rural Beaver and suburban Delaware, also topped 40 admissions per 100,000 residents.
  • Fatal overdoses in Pennsylvania rose 37% from 2015 to 2016, with 13 people dying of an overdose each day. In total, 4,632 Pennsylvania residents lost their lives as victims of drug overdoses in 2016. This is nearly four times the number of residents who died as the result of fatal traffic accidents, with about 85% of the overdoses attributed to opioids.
  • Fentanyl was found in about two-thirds of Pennsylvania drug fatalities in 2016, while heroin was found in about half. The overlap is due to the fact that many cases included victims who had taken both drugs. Fentanyl is often added to heroin, with or without the user’s knowledge.

What’s Been Done to Fight the Epidemic
Governor Tom Wolf has made fighting the opioid epidemic a top priority of his administration. In the 2016 to 2017 state budget, he secured an overall total of $20.4 million to fight opioid abuse. These funds allowed DHS to create 45 Opioid Use Disorder Centers of Excellence to provide care for approximately 10,100 people who are currently unable to access treatment through other means.

Expanded efforts have been made to provide access to naloxone, a medication designed to quickly reduce the effects of opioid overdose, for law enforcement, first responders, schools, and others who are likely to encounter overdose victims. Training for administering this vital medication is provided regularly at several locations throughout the state as well as in a convenient online course.

To reduce the availability of prescription medications for potential misuse, the Department of Drug and Alcohol Programs, in partnership with the Pennsylvania Commission on Crime and Delinquency, the Office of the Attorney General, the National Guard, and the Pennsylvania District Attorneys Association, has implemented a prescription drug take-back box program with 580 take-back boxes across all 67 counties. In 2016, participation in the program allowed for the destruction of approximately 124,336 pounds of no longer needed prescription drugs.

How St. Joseph Institute Is Helping
As the leading treatment and detox center in Pennsylvania, St. Joseph Institute is committed to providing Pennsylvania residents with the care they need to overcome opioid addiction. Our personalized treatment programs focus on healing the mind, body, and spirit–offering counseling, opportunities for spiritual development, and a chance to address co-occurring conditions like anxiety and depression as you prepare to take the first step towards a brighter future.

By Dana Hinders

The relationship between binge drinking and alcoholism is often misunderstood. The majority of binge drinkers are not physically dependent on alcohol, but binge drinking is considered a significant risk factor for developing an alcohol use disorder.

What Is Binge Drinking?

Binge drinking refers to consuming large quantities of alcohol in a short period of time. There is some disagreement as to what constitutes binge drinking, but many addiction professionals use the guidelines established by the Substance Abuse and Mental Health Services Administration (SAMHSA). For men, binge drinking is defined as consuming five or more drinks on the same occasion at least once in the last 30 days. Since women process alcohol differently due to their smaller size and different biological makeup, binge drinking for women is defined as drinking four or more drinks at least once in the last 30 days.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), this level of alcohol consumption in a 2-hour span of time is enough to place an average sized person’s blood alcohol content (BAC) at .08. This is the level at which drunk driving penalties apply if you get behind the wheel.

Motivations for binge drinking vary. Binge drinking is most common in social settings, with many people viewing alcohol consumption as a way to have fun and temporarily forget their problems. Teens and young adults may view binge drinking as a way to test their tolerance and rebel against authority.

Moderate drinking is generally considered safe for people with no underlying medical conditions, but binge drinking offers no health benefits. Some of the negative effects associated with binge drinking include:

  • Alcohol poisoning
  • Blackouts
  • Falls
  • Increased risk of motor vehicle accidents
  • Risky sexual behavior with an increased risk of unplanned pregnancy and/or STDs
  • Sexual dysfunction
  • Potential for dangerous interactions with prescription medication

How Common Is Binge Drinking?

According to the Centers for Disease Control (CDC), binge drinking is very common. About 1 in 6 adults in the United States engages in binge drinking 4 or more times per month, consuming an average of 8 drinks in each binge.

Binge drinking behavior strongly varies by age and gender. Men are twice as likely to binge drink as women. People ages 18 to 34 are more likely to engage in binge drinking than older adults.

Surprisingly, binge drinking is more common among upper income adults. People with household incomes of $75,000 or more likely to engage in binge drinking than lower income individuals. However, lower income individuals consume more drinks on average when they do engage in binge drinking.

How Is Binge Drinking Related to Alcoholism?

Binge drinking does not necessarily mean that a person suffers from an alcohol use disorder, although many people who enter treatment for alcoholism have a history of binge drinking.

A formal diagnosis of an alcohol use disorder is made based on the specific problems that drinking causes in a person’s life. This can include:

  • Drinking more alcohol than you originally intended
  • Feeling powerless to stop drinking
  • Experiencing withdrawal symptoms when you are unable to drink
  • Craving alcohol
  • Requiring larger quantities of alcohol to feel impaired
  • Continuing to drink despite experiencing alcohol-related health problems
  • Failing to meet your responsibilities at home or work due to your drinking
  • Lying to friends and family about your alcohol consumption
  • Giving up activities you once enjoyed to spend more time drinking
  • Feeling as though drinking is the only way to cope with stress, sadness, anger, anxiety, or other uncomfortable emotions.

The relationship between binge drinking and addiction is strongest in adolescents, with teens who report frequent binge drinking having nearly triple the risk of developing an alcohol use disorder as adults.

What Type of Help Is Available?

If you believe that your binge drinking may be a sign of an alcohol problem, help is available. Alcoholism is a treatable disease, but you can’t beat it alone.

Treatment for an alcohol use disorder typically includes individual and group therapy to focus on learning coping strategies for handling cravings and managing emotions without drinking. Experiential therapies such as equine therapy, art therapy, or music therapy can also be used to encourage people who have trouble talking about their feelings to process the issues that are contributing to their substance abuse.

It is common for people who suffer from an alcohol use disorder to also meet the criteria for mental disorders such as anxiety, depression, or PTSD. When someone has a dual disease or co-occurring disorder, treating both conditions simultaneously is vital to providing a solid foundation for a sustained recovery.

By Dana Hinders

Understanding the relationship between alcohol and depressionThe relationship between alcohol and depression is deceptive. Since drinking is often a part of social gatherings, it may seem like a few beers would be a great way to take your mind off your troubles. However, alcohol can actually worsen depression symptoms. In some cases, it may even induce depression in someone with no previous signs of a mental health disorder.

Signs of Depression

Despite being one of the most common mental illnesses, depression is often misunderstood. Clinical depression is more than just having a bad day once in a while. Someone suffering from depression experiences noticeable changes in mood and behavior that significantly affect their overall quality of life.

Signs of depression can include:

  • Anger
  • Irritability
  • Feelings of intense sadness
  • Fatigue and lack of energy
  • Loss of interest in hobbies or socialization
  • Appetite or weight changes
  • Trouble concentrating
  • Feeling like you’re a failure or that you’ve let friends and family down
  • Having thoughts of self-harm or suicide

Symptoms that occur on all or most days for two weeks or more indicate a need to consult a medical professional.

Signs of Alcohol Abuse

Studies indicate that nearly 1/3 of people suffering from depression also have a drinking problem. The link between depression and alcohol addiction is strongest in women and teenagers.

Signs of alcohol abuse include:

  • Believing you need alcohol to relax or feel better
  • Continuing to drink despite negative consequences in your personal or professional life
  • Drinking until you black out
  • Developing an increased tolerance for alcohol, so you require more drinks to feel impaired
  • Feeling powerless to stop drinking
  • Lying about your drinking to friends and family
  • Experiencing withdrawal symptoms such as anxiety, nausea, shakiness, and trembling when you’re not able to drink

Understanding the Relationship Between Alcohol and Depression

Chemically speaking, alcohol is a depressant. A depressant is a substance that lowers neurotransmitter levels, reducing stimulation and arousal in the body.

The majority of people who suffer from both depression and alcohol addiction began drinking as a way to self-medicate their symptoms. However, since the genetic risk factors for both drinking and depression significantly overlap, alcohol abuse can sometimes trigger symptoms in people who weren’t previously depressed.

Other ways in which alcohol can affect depression include:

Fatigue. Drinking regularly can negatively affect your sleep patterns. Fatigue can worsen existing depression symptoms or trigger symptoms in people who are not clinically depressed.

Malnutrition. Alcohol satisfies the body’s calorie requirements, but contains no essential vitamins, minerals, proteins, fats, or carbohydrates. It can also irritate the lining of the intestine, making it more difficult for the body to absorb needed nutrients. Someone who is malnourished lacks the energy needed to complete daily activities

Difficulty regulating blood sugar. When the liver’s resources are devoted to processing alcohol, it becomes more difficult to maintain stable blood sugar levels. This can lead to mood swings, including feelings of anger and irritability.

Folic acid deficiency. Folate deficiency is common in people suffering from depression, but regular alcohol use lowers levels of folic acid in the body.

Lower serotonin and norepinephrine levels. Alcohol can lower levels of these important mood regulating chemicals in the body, which can make a depressed person feel more depressed.

Impaired judgement. Alcohol decreases inhibition and impairs judgement. This can lead to risky behaviors, including self-harm or suicide attempts.

Decreasing effectiveness of medication. Alcohol can reduce the effectiveness of prescription antidepressants while increasing the risk of side effects such as drowsiness and dangerously high blood pressure

Getting the Help You Need

Someone who is suffering from both depression and alcoholism is said to have a dual diagnosis or a co-occurring disorder. In this case, both illnesses must be treated simultaneously. This is typically done with a combination of individual therapy, group therapy, and medication to focus on relieving specific symptoms and addressing the underlying factors contributing to both problems.

According to research published by the National Institute on Alcohol Abuse and Alcoholism, seeking treatment for alcohol addiction can quickly result in an improvement in depression symptoms. “Although it has been suggested that alcoholism and depression are manifestations of the same underlying illness, the results of family, twin, and adoption studies suggest that alcoholism and mood disorder are probably distinct illnesses with different prognoses and treatments. However, symptoms of depression are likely to develop during the course of alcoholism, and some patients with mood disorders may increase their drinking when undergoing a mood change, fulfilling criteria for secondary alcoholism. When depressive symptoms are secondary to alcoholism, they are likely to disappear within a few days or weeks of abstinence, as withdrawal symptoms subside.”

By Dana Hinders

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