Drug and Alcohol Addiction


person taking pillsWith the opioid epidemic making headlines every week, it’s understandable to be worried about the risk of addiction if you or someone you love has been prescribed opioids. However, you must remember that opioid medication does play a vital role in the management of chronic pain for certain individuals. It does these patients a disservice when a misunderstanding of addiction results in unnecessary withholding of opioid medications.

Chronic Opioid Use as a Last Resort

Although opioids are often used to control short term pain from surgery or injuries that are expected to fully heal within a specific period, this type of use is considered low risk. The primary concern in terms of addiction is the chronic use of opioids over an extended period of time.

According to the American Academy of Pain Medicine, chronic opioid therapy (COT) is only appropriate for use if the patient suffers from moderate to severe pain and more conservative measures have not been able to provide sufficient relief. This might include:

  • Non-opioid pain relievers
  • Physical therapy
  • Transcutaneous electrical nerve stimulation (TENS)
  • Ultrasound
  • Therapeutic massage
  • Chiropractic care
  • Mind-body techniques such as mindfulness meditation

Although the perception of pain can be subjective, there is no doubt that living with chronic pain greatly affects one’s quality of life. Pain limits the ability to engage the activities of daily living and increases a person’s risk for developing anxiety and depression. For this reason, healthcare professionals must struggle to find a middle ground between limiting access to addictive opioids and providing relief to sufferers of chronic pain.

Dependence Isn’t Necessarily Addiction

The term dependence means that the body has physically adapted to having a steady supply of a substance in the system. When the substance is no longer being used, withdrawal symptoms such as headaches, nausea, vomiting, diarrhea, fatigue, and restlessness can occur.

Dependence and addiction are often used interchangeably in reference to opioid painkillers, but it’s important to note that the two are not always the same. Although someone with an addiction is likely to also be dependent upon the opioid medication, it’s possible to be dependent without being addicted.

Dependence can occur whenever a medication is being taken for a long period of time, even if it is used precisely as prescribed and isn’t considered addictive. For example, patients can develop a dependence when they take antidepressants to treat chronic depression even though these medications aren’t thought of as addictive. If they wish to stop or switch to a different drug, tapering the dose helps to minimize the severity of withdrawal symptoms.

Distinguishing Between Tolerance and Disease Progression

Tolerance refers to the need to increase a dosage of a substance to experience the same effects due to prolonged use. Tolerance is often thought to be a warning sign of a substance use disorder, but chronic pain patients may confuse tolerance with disease progression. For example, someone taking opioids to cope with cancer pain may require higher doses due to the progression of the cancer even if he or she takes the medication as prescribed. Osteoarthritis is another of a condition where pain levels can be expected to increase over time as the disease progresses.

It can be difficult for the layperson to determine the difference between a patient developing tolerance and someone who is experiencing more pain due to disease progression. This is why careful monitoring of opioid use is necessary.

Seeking a Substance Abuse Evaluation

The fact that someone has been using opioids for a long period of time doesn’t necessarily mean he or she has developed an addiction, but a substance abuse evaluation is in order if any of the following apply:

  • Lying about the severity of symptoms to obtain more medication
  • Seeing multiple doctors to increase availability of opioids
  • Borrowing, stealing, or illegally purchasing medication
  • Becoming defensive or angry when asked about opioid use
  • Mixing opioids with alcohol or other addictive drugs
  • Decreased performance at work or school due to opioid use
  • Withdrawing from family and friends to spend more time using opioids
  • Feeling powerless to control opioid use

It is important to remember that addiction can affect people of all ages, races, and socioeconomic backgrounds. It’s not a weakness or a character flaw. In fact, this form of a substance use disorder is considered unintended addiction because sufferers often originally took their medication exactly as prescribed.

If you or someone you love needs help treating opioid addiction, St. Joseph Institute for Addiction provides a peaceful and serene environment in which to take the first steps towards recovery. Detox, counseling, holistic treatments, and access to aftercare resources provides clients with the tools they need to set a foundation for lasting sobriety.  

By Dana Hinders

To learn more about our programs, please visit our website.

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Poverty and addictionThe relationship between addiction and poverty is complicated. Lower income people are slightly more likely to struggle with drug or alcohol abuse, but this doesn’t necessarily mean that poverty causes addiction. In some cases, financial troubles are the result of a substance use disorder.

Poverty Increases Addiction Risk Factors

There are several ways in which financial struggles increase the risk of a person developing a substance use disorder:

  • Poverty increases stress. Stress is well recognized as a risk factor for substance abuse and relapse after treatment. Worrying about how to afford shelter, food, and other basic needs causes a tremendous amount of stress. When you’re struggling to make ends meet, there is a great temptation to turn to drugs or alcohol to temporarily escape from your problems.
  • Poverty increases feelings of hopeless. When meeting daily expenses is difficult, dreams of attending college, buying a home, opening a business, or traveling the world seem impossible. Feeling as though you are powerless over your own future creates a vulnerability to substance abuse.
  • Poverty decreases self-esteem. In a culture that values material possessions and financial success, being poor can feel like a moral failing. This can lead to feelings of guilt, shame, and diminished self-worth. According to Psychology Today, people struggling with low self-esteem have an increased vulnerability to developing substance use disorders.
  • Poverty decreases social support. Having the emotional support of friends and family helps people cope with difficult situations in their lives. However, lower income adults are less likely to have strong social support networks simply because they are expending all of their energy on trying to survive from day to day. For example, a UCLA survey found that lower income adults are less likely to be married even though they value marriage just as much as their higher income peers.
  • Poverty decreases access to healthcare. Although the number of uninsured adults has decreased in recent years, the Henry J. Kaiser Foundation found that 45 percent of uninsured adults lacked coverage simply because the cost was too high. Despite the fact that most of these individuals had at least one working adult in the family, 1 in 5 admitted to foregoing recommended medical treatment due to cost. Access to preventative health care is also severely limited for members of this group. Untreated mental health conditions or chronic illnesses that are poorly controlled can lead to the use of drugs or alcohol to self-medicate symptoms.

One frequently cited example of how poverty affects addiction risk is the Appalachian opioid epidemic. Stretching from the Southern Tier of New York to northern Alabama, Mississippi, and Georgia, the Appalachian region of the United States has struggled with widespread poverty since the early 1900s. The majority of the available jobs are physically demanding, carrying a high risk of injuries despite their relatively low wages. Residents who begin taking opioids to cope with chronic pain from their employment-related injuries often find themselves spiraling into addiction. The effects of substance abuse make it nearly impossible to keep working, thus perpetuating financial struggles.

Addiction Can Cause People to Slip into Poverty

It’s important to remember that people with substance use disorders don’t necessarily develop an addiction simply because they are poor. Someone who is solidly middle class can easily slip into poverty as the result of an untreated drug or alcohol addiction.

As an addiction develops, it becomes increasingly likely that a person will have problems performing at work. This might include arriving late, missing shifts, failing to meet project deadlines, or getting into arguments with colleagues. Eventually, this can lead to job loss.

Being terminated for performance issues will make it harder to find another job. This increases the overall stress in the person’s life and provides an incentive to engage in criminal activity to fund continued substance abuse.

Middle class individuals can also slip into addiction-related poverty by selling assets or dipping into retirement savings to buy drugs or alcohol. Untreated addiction impairs judgement and critical thinking skills, which can lead someone who is normally very financially responsible to burn through decades of accumulated wealth in just a short time.

Promoting Recovery by Treating the Root Causes of Addiction

No two people with substance use disorders are exactly alike. To promote a lasting recovery, it’s vital that treatment plans address the underlying issues contributing to addiction. This could include providing job skills training, affordable housing resources, or access to community-based assistance programs for low-income individuals in addiction to detox and substance abuse counseling.

By working to heal the mind, body, and spirit, St. Joseph Institute helps clients move towards a future free from the burden of addiction. With personalized care, you can regain control of your life.

 

By Dana Hinders

To learn more about our programs, please visit our website.

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dentist officeDuring your next dental appointment, you may be asked about more than your brushing and flossing habits. A recent survey found that 77 percent of dentists now perform substance abuse screenings as part of routine exams.

Why Are Dentists Are Worried About the Addiction Epidemic?

Dentists may not be considered primary care providers, but dental health plays a key role in your overall physical health. This puts dentists in a unique position to fight substance abuse.

Dentists often see patients who have tooth decay due to substance abuse issues. For example, methamphetamines are a leading cause of tooth decay and tooth loss. Alcohol abuse is a primary risk factor for oral cancer. Tobacco use leads to gingivitis and tooth loss.

Addressing the risk of substance abuse is also important because dentists are the second leading prescriber of prescription opioids. This puts them at risk of inadvertently starting someone on the path towards addiction or feeding the habit of someone who already has a full blown opioid use disorder. Drug interactions could be another potential concern, since prescription opioids given for pain relief after a dental procedure could have dangerous interactions when combined with alcohol or illegal street drugs.

What Do Substance Abuse Screenings Look For?

Substance abuse prevention efforts often start the moment a patient walks into the office. Staff members may be looking for signs of potential problems such as:

  • Poor personal appearance, including bloodshot eyes
  • Slurred words, unsteady movements, or other signs of current intoxication
  • A history of broken appointments
  • Repeated requests for unusual prescriptions based on a self-diagnosis
  • Dramatic complaints of severe pain not in line with the issue the patient is being seen for
  • Someone who arrives near closing time seeking opioid prescriptions with the promise to return for an appointment the following day

In addition to a more informal evaluation, the dental hygienist may ask the following questions:

  • How often do you consume alcoholic beverages in a typical week?
  • Have you used tobacco products such as cigarettes or smokeless tobacco in the past three months? If yes, how much and how often?
  • Have you used marijuana more than five times in your life? If yes, when was the last time you used marijuana?
  • Have you felt you should cut down or otherwise control your drinking or drug use?
  • Do you get angry, upset, or annoyed when people ask you about your alcohol or drug use?
  • Do you feel guilty about your drinking or drug use?
  • Have you ever needed a drink or used drugs immediately in the morning to calm your nerves or get rid of a hangover?

Female dentists are more likely to believe addiction screenings are part of their professional responsible than their male counterparts, with 61 percent of women and 52 percent of men conducting screenings.

Age is another factor in how dentists perceive the importance of addiction screening, with 62 percent of dentists over the age of 53 and 47 percent of dentists under the age of 53 conducting screenings.

What Happens Next?

Although the rise of addiction screenings at the dental office should be encouraged, screening people at risk of substance use disorders is only a small part of the battle.

A 2013 study in the Journal of the American Dental Association reports that most dentists who screen patients for substance abuse do not provide referrals to counseling or follow up with patients who exhibit warning signs of addiction. Despite their concern for the well-being of their patients, they feel unqualified or not prepared to offer more extensive drug use prevention services.

Providing continuing education opportunities and additional training to help dentists refer at-risk patients to the appropriate resources would be a cost-effective way to tackle the public health concerns associated with substance use disorders. Until then, however, it’s up to each individual to look out for the signs of addiction and urge friends, family, neighbors, colleges, and others in need to the appropriate evidence-based treatment programs.

Based in Port Matilda, Pennsylvania, St. Joseph Institute for Addiction provides detox and counseling to address the issues contributing to substance use disorders. Our faith-based approach views addiction as physical disease in need of treatment for the mind, body, and spirit. This allows for a solid foundation of sobriety, setting the stage for a future free from the burden of addiction.

By Dana Hinders

To learn more about our programs, please visit our website.

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