Relapse Prevention: Substance Use Disorders

Relapse Prevention: Substance Use Disorders Relapse Prevention: Substance Use Disorders

By: Julia Keys

The road to recovery from substance abuse can be long and difficult. There may be many times when those recovering are tempted to just give up. However, there are many different strategies for when individuals are in a place where they feel ready to quit all the progress they made. Relapse is part of recovery, but it should be avoided and treated carefully.

Most people think that relapse starts when the addict starts using again, however relapse can start much earlier than that. There are three stages of relapse: emotional relapse, mental relapse and physical relapse.  Emotional relapse starts when one is thinking about using. Although they have made no real attempts at obtaining any substances, the thought of using is very tempting. During mental relapse one has decided to use again. Physical relapse is when you contact your dealer, obtain substances, or use substances.

When preventing relapse it is important to seek many different types of support. Studies show that those recovering who see therapists alongside any inpatient or outpatient detox programs have faster recovery rates than those who do not seek additional treatment. Therapists can help those in recovery come up with personalized strategies to prevent them from relapsing.

If you or a loved one is struggling with substance use or recovery from substance abuse, do not hesitate to seek help by contacting Arista Counseling & Psychotherapy, located in New York and New Jersey to speak to licensed professional psychologists, psychiatrists, psychiatric nurse practitioners or psychotherapists. To contact the office in Paramus NJ, call (201) 368-3700. To contact the office in Manhattan, call (212) 722-1920. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Sources:

https://www.psychologytoday.com/us/blog/where-science-meets-the-steps/201312/preventing-relapse-among-addicted-youth

https://www.addictionsandrecovery.org/relapse-prevention.htm

Source for Picture:

https://www.bing.com/images/search?view=detailV2&id=F86C5ECD05E0D6595A3D9A0588384D10CCA60F4B&thid=OIP.idNVRUm7p8tdl-M-0iQdzgHaE8&mediaurl=https%3A%2F%2Fwww.thenationalcouncil.org%2FBH365%2Ffiles%2F2017%2F09%2Froad-to-recovery.jpg&exph=334&expw=500&q=the+road+to+recovery&selectedindex=4&ajaxhist=0&vt=0&eim=1,2,6

 

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The Opioid Epidemic: How to Spot the Difference Between an Addiction and Physical Dependency

The Opioid Epidemic: How to Spot the Difference Between an Addiction and Physical Dependency

By Crystal Tsui

In a paper written by Turner et. Al (2017), Opioid Use Disorder: Challenges During Acute Hospitalization, discussed the difference between drug addiction and physical dependency. Addiction is described as a disease. It occurs when a drug produces chemical changes in the brain that enforces the medication to be more desirable. When a person is addicted to a certain drug, they start to build a higher tolerance meaning that they would not feel the effects of the drug with the same dosage. This would make them want to increase the dosage each time just to experience the same effect, which can be dangerous and lead to an overdose. The 4 C’s are the beginning signs of addiction. They are:

  • Craving
  • (loss of) Control
  • Compulsion
  • (using despite) Consequences

A few physical signs of substance abuse includes:

  • Track marks
  • Abscesses
  • Pinpoint pupils
  • Blood in their vomit
  • Chronic cough

There are 3 types of opioid consumers we should be aware of; these include patients with chronic pain, patients who are on medication-assisted treatment and stable, and those who are self-medicating. If you or anyone you know has an opioid addiction, they should be met with warmth and compassion. A caring individual, like you, can help an addict seek the help they need, such as medication–assisted treatment or detoxification.

Individuals who are physically dependent on opioids are a different story. They are usually patients with chronic pain and have become dependent on opioids to relieve pain. However, they don’t feel the desire to take the medication for any purpose other than to relieve their pain. They wouldn’t feel the need to have their dosages increased constantly because the dosage of opioids does not change the effects of relieving pain.

This article is to help define the difference between an addiction and being physically dependent on opioids. This is not an exhaustive list.

If you or someone you know has a drug addiction, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Citations:

https://www.rivermendhealth.com/wp-content/uploads/2017/09/opioid-epidemic.png

Opioid Use Disorder: Challenges During Acute Hospitalization, Turner et al. (2017).

The Opioid Epidemic and Drug-Seeking Behavior

The Opioid Epidemic and Drug-Seeking Behavior

By Crystal Tsui

AMA Journal of Ethics states there has been a 300% increase in opiates in the US. What does this mean for the people? Well, drug availability increases when the demands for opiates increase. Long story short, patients with complaints of pain are getting addicted to opiates and are relying on opiates as pain medication when it’s not entirely necessary. Doctors and nurses in the Emergency department are in the frontlines of this epidemic. They see patients with all sorts of complaints, but over 500,000 ED visits are patients with drug-seeking behavior, specifically for opiates. Different types of opiates include:

  • Heroin
  • Oxycodone
  • Percocet
  • Morphine
  • Tramadol

How did the epidemic begin? Doctors and nurses would prescribe their patients opiates just to improve the flow of the ED. However, recently the epidemic has gotten worse. Patients have learned different catch phrases and to over exaggerate their pain to get these opiates. Such as “headaches”, “back pains”, “neck pain”, and even “dental pain”, or rate their pain higher on the scale of 10.

So, how do doctors and nurses know when to give opiates for patients complaining of pain? The answer to the tough question is quite simple, they don’t. Opiates are always a last resort and there are other pain medications out there that treat everyday pain. The most common are:

  • ibuprofen (motrin)
  • acetaminophen (Tylenol)
  • aspirin (advil)
  • steroids

If you or someone you know is addicted to opiates do not be afraid to reach out for help with pain management or drug addiction.

If you or someone you know a drug addiction, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Citation:

https://humantraffickingsearch.org/wp-content/uploads/2018/05/1140-pill-usa-opioids-aarp.imgcache.rev5b2d008604b6e9d3635709395bae1267.jpg

https://www.asahq.org/whensecondscount/pain-management/non-opioid-treatment/

https://journalofethics.ama-assn.org/article/drug-seeking-or-pain-crisis-responsible-prescribing-opioids-emergency-department/2013-05

https://americanaddictioncenters.org/the-big-list-of-narcotic-drugs

Addiction

By: Dianna Gomez

It is more often than not assumed that a person addicted to a substance, whether it be drugs or alcohol, is someone with shallow morals, little motivation, and that if he or she really wanted to, they could simply stop using at any moment. These assumptions show how extremely misunderstood addiction is by our general public, as well as how infrequently this topic is discussed among us. Addiction is a chronic disease that affects a person’s brain chemistry, thoughts, and behaviors. An individual can initially fall into addiction through voluntarily substance use or through necessary use of prescription medication prescribed by a doctor (ex: pain medication for after a surgery). When addiction first begins, the substance affects the reward circuits in the brain which causes feelings of complete euphoria. If a person continues to use the substance, the brain adjusts itself and develops a “tolerance” for it, which causes the individual to not feel the effects of the drug as intensely as they did the first time the drug was taken. This requires the person to have to use a larger quantity of the substance in order to reach the same level of “high” they did before. There are many different ways an individual can naturally be more vulnerable to addiction throughout their lifetime. Two of these main ways include biology and environment.

Biology: the genetics a person is born with can affect up to 50% of their risk for becoming addicted to a substance. This includes factors such as gender, ethnicity, and an individual’s family mental health history.

Environment: the conditions in which an individual is brought up in such as their economic status, family/friends, and quality of life in general also plays a huge role in their vulnerability for addiction. Peer pressure, lack of parental guidance, traumatic experiences with abuse (physical, emotional, sexual) are a few examples of common environmental influences.

If either you or anybody you know suffers from substance abuse or addiction, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can help you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201)-368-3700 or (212)-722-1920 to set up an appointment. For more information, visit us at https://www.counselingpsychotherapynjny.com/.

 

Neurofeedback

Leah Flanzman

There has recently been a great deal of discussion on a psychological treatment called neurofeedback. Neurofeedback assists people in consciously controlling their brain waves by attaching subjects to an EEG machine that extracts various brain-activity components and feeds them back to the patient.  The most common protocols used in neurofeedback training are alpha, beta, theta, and alpha/theta protocols.  The way that you select the placement of electrodes on a patients head depends on their specific brain functions and specific symptoms.  The goal is to allow the subject to assess their progress and adjust their brain waves accordingly to achieve optimal performance.  However, the effectiveness and practicality of the treatment is under debate.

According to the Basic and Clinical Neuroscience journal, many studies conducted on neurofeedback therapy reveal methodological limitations that question its effectiveness. For example, with the alpha treatment protocols, it remains unknown exactly how many treatment sessions are necessary before patients can consciously possess the ability to control their alpha waves.  Once an optimal performance is achieved, it’s difficult to study the long-term effects of these treatments, in other words how long the effects last without feedback.

The pros of neurofeedback are that it’s a safe and non-invasive procedure that has been proven effective in treating certain disorders such as ADHD, anxiety, depression, epilepsy, insomnia, drug addictions, and learning disabilities. Despite this, more scientific evidence of its effectiveness must be conducted before we can consider it a valid treatment.  It’s also important to keep in mind that it’s a very expensive procedure that is not covered by many insurance companies, and is very time consuming to complete.

If you or someone you know thinks they have ADHD, anxiety, depression, or drug addictions, or learning disabilities, the psychologists, psychiatrists, and psychotherapists at Arista Counseling and Psychiatric Services can help.  Contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920.  Visit http://www.counselingpsychotherapynjny.com for more information.

Part 2: Marijuana as Medicine

 

Marijuana Part 2: Marijuana as Medicine

Sam Kwok

Despite the growing use of medical marijuana, under the federal jurisdiction, it is still classified as a schedule 1 drug. Twenty-nine states have legalized medical marijuana; however, each state has its own legislature that creates lists of preapproved conditions that may be treated with marijuana. Though, when comparing these lists, one may notice that the severity of the conditions ranges drastically. For example, California, a state known to have very loose marijuana regulation laws, has a list that include more common conditions such as anorexia, anxiety, depression, migraines, or just “any debilitating illness …deemed appropriate by the physician.” New Jersey, which is considered a moderate state when examining marijuana regulations, has a list that excludes anxiety and depression, but includes more severe illnesses including terminal cancer, muscular dystrophy, and terminal disease where the physician has determined there is less than a year of life left. Despite the differences in severity, under the US law, medical marijuana patients, dispensaries, and government officials that do not enforce the federal laws are all criminals to some extent.

In the early 70’s Nixon began his famous “War on Drugs” campaign, which intended to keep the American public safe from hard drugs. One of these drugs, was marijuana. Almost 50 years later, the same laws are still upheld and little research has been done to update the data. Technology and scientific procedures have updates, so research and laws should be updated as well.

From the little data we do have, we know that CBD, the non-psychoactive ingredient of marijuana has medicinal effects. It is linked to the healthy release (unlike opiates) of dopamine and serotonin which are the “happiness” chemicals in our brain. This may be the reason why in some states, marijuana is used as a treatment for anxiety and depression. Children who suffer from severe forms of epilepsy have shown to have dramatic improvements with the introduction of CBD. The number of seizures that a child has may decrease drastically when treated with CBD oil. Marijuana is also known to help people undergoing chemotherapy treatment. It may not only help patients to regain their appetite through the reduction of nausea, but can also help reduce pain and reduce the body’s urge to regurgitate. Despite the potential of medical marijuana, further research is still barred by the government. Some suggest that the easiest way to completely legalize marijuana is if states vote to create a 28th amendment which would legalize marijuana, but that would still require ¾ of all states to vote in favor. Currently, 30 states have some laws which allow for marijuana to some extent (includes medical and recreational), but 8 more still need to reform for the possibility of a 28th amendment. The nation’s capital, Washington DC has already decriminalized the drug as well. With the current administration, marijuana will not be legalized federally. But with more and more people becoming aware of such issues, even the government will not be able to stop people from getting the medicine they need. It is clear in which direction the US is heading towards in this debate and it is only a matter of time until medical marijuana is legalized in all 50 states.

If you are struggling with substance abuse or any other kind of addiction, the psychologists, psychiatrists, and psychotherapists at Arista Counseling and Psychiatric Services can help.  Contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920.  Visit http://www.acenterfortherapy.com for more information.

Prescription Drugs and Side Effects

Prescription Drugs and their Side Effects

Emily Ramos

The truth of the matter is that many prescription drugs contain side effects. It is hard to predict whether or not an individual will experience side effects, it depends on how their body reacts to the drug. The good thing is that there are steps an individual can take to reduce the risks. If the side effects persist you can speak with your doctor who can prescribe a lower dosage or a different medication. DO NOT stop taking medication if you experience a side effect, always speak with your doctor. They might have to wean you off of the drug instead of stopping all together. Here’s how you can learn about possible side effects and how to avoid them:

  • Before getting prescribed medicine, ask your doctor about possible side effects that may occur. For example, if nausea is a side effect your doctor may recommend that you eat or drink before taking the medication.
  • Once you start taking medication take note of any symptoms that arise and tell your doctor about them. This will give your doctor a better understanding.
  • Other ways to prevent side effects are to make appropriate lifestyle changes. For example: if a medication causes you to gain weight you will have to pay more attention to your nutrition and incorporate exercise plans.

It may take a few trial and errors before your doctor is able to find a medication that works best for you. That is why it is crucial to be honest with your doctor before and after he or she prescribes medication.

If you or a person you know is struggling with medication, it may be beneficial to contact a mental health professional and receive therapy. The psychologists, psychiatrists, and therapists at Arista Counseling and Psychiatric Services can help. Contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920. Visit http://www.acenterfortherapy.com for more information.

 

Marijuana Part 1: How does it work?

Marijuana Part 1: How does it work?

Sam Kwok

As the most commonly used illicit drug, marijuana has recently blossomed into an estimated $11 billion-dollar industry. Recently there has been a national shift towards the legalization of the drug, which has caused debates from both ends of the spectrum. But how does marijuana work?

Marijuana’s main psychoactive chemical is delta-9-tetrahydrocannabinol, THC for short.  THC is produced by the cannabis plant and its molecular formula is C21H30O2. Anandamide, a naturally existing molecule in the brain, has the molecular formula C22H27NO2 meaning that the relative molecular weight and size of THC and anandamide are similar. Moreover, the 2 molecules have a similar structural layout which allows THC to imitate anandamide’s effects on the brain.

Anandamide is part of the endocannabinoid (EC) system in the body which helps neurons regulate the release of neurotransmitters- the brains way of sending and retrieving messages. Generally, cannabinoids affect the brain by slowing down the transmission of neurotransmitters. When marijuana is smoked, a large amount of THC enters the lungs and into the bloodstream where it can flow into the brain. THC then bonds to the same receptors anandamide normally would to slow down the activity of certain enzymes which reduces the number of neurotransmitters in the brain. Because anandamide does not naturally occur is large quantities, smoking THC overwhelms the brain, and it is this reaction that gives users that “high” feeling.

The other main chemical compound in marijuana is cannabidiol- known as CBD. CBD has been popularized due to its medicinal effects and much of the medical marijuana platform is built upon the usage it. Some laws allow, medical usage of CBD concentrates, but still consider THC as a schedule I drug. Though its molecular formula is identical to THC, it lacks key functional groups and effects the brain differently. This is why CBD has no psychoactive effects. CBD actually inhibits an enzyme used to activate receptors lowering the psychoactive effects of THC. While THC directly effects the brain by bonding to a receptor, CBD indirectly affects the brain by activating adenosine receptors. These receptors have been linked to having anti-anxiety effects and are known to also release dopamine, a naturally occurring chemical in the brain that is linked to pleasant feelings. CBD also activates serotonin receptors which are linked to benefiting sleep, appetite, anxiety, and depression issues.

Since marijuana is still illegal federally, there has been little research on long term effects on the brain. Several studies have shown that marijuana use during a child’s developing age may have irreversible damaging effects to the brain. Marijuana has also been known to have harmful effects when mixed with other drugs such as alcohol. Users of the drug have also been known to have a higher chance of becoming to addicted to other drugs as marijuana is a gateway drug. However, majority of the research are inconclusive and more research must be done to make definitive conclusions.

If you are struggling with substance abuse or any other kind of addiction, the psychologists, psychiatrists, and therapists at Arista Counseling and Psychiatric Services can help.  Contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920.  Visit http://www.acenterfortherapy.com for more information.

 

Cause of ADHD

Isabelle Kreydin

ADHD stands for attention deficit hyperactive disorder. It’s typical symptoms are easily distracted, has trouble organizing tasks, is forgetful, fidgets, squirms, or is restless, talks excessively or has trouble staying quit, always seems on the go, and sometimes can be impulsive and act without thinking or interrupt.

It’s really important to educate oneself about this disability because despite hard work and great efforts, it may be hard to stay focused on a certain goal and it may be difficult to be around students and coworkers whom can function normally without their body and brain working in a different function to distract them.

ADHD is frequently confused for being caused by external environments. However, it is the result of low or imbalance levels of chemicals in the brain, specifically neurotransmitters. The two specific neurotransmitters that are implicated in ADHD are dopamine, and norepinephrine. These specific chemicals that carry messages in the brain are related to hyperactivity, inattention and impulsiveness.

Fortunately, there has been medications made that are known to work to avoid consequences associated with the symptoms of ADHD, such as poor academic performance, difficulty in academic performance, trouble in peer relationships, low self-esteem, etc.

These medications target these neurotransmitters and allow ones to control their symptoms better throughout the duration of the day. They are best combined with learning strategies and behavior modification, in the school, home, and academic environments. It’s important to try the medicines and see which one is best to help, since everybody’s chemical makeup is different and has a different reaction to certain medicines. Examples of these are Adderall and Mydais.

If you or a person you know is struggling with a narcissistic personality disorder, or any personality disorder, it may be beneficial to have them contact a mental health professional and receive therapy for their illnesses. The psychologists, psychiatrists, and therapists at Arista Counseling and Psychiatric Services can help.  Contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920.  Visit http://www.acenterfortherapy.com for more information.

Gambling Addiction

By: Heather Kaplan

Gambling is defined as playing games for a chance to either win or lose money. One who is a compulsive gambler is someone who is unable to resist their impulses to gamble. This leads to severe disturbances in their personal and social lives. The urge to gamble becomes so great that this tension can only be relieved by more gambling. One who exhibit such behavior can be classified to have a gambling addiction. Unfortunately, many gambling addicts are not aware that they have a problem. They only begin to realize the severity of the issue when they hit ‘rock bottom’.

There are various symptoms that indicate that someone is a compulsive gambler. One who has a gambling addiction usually progresses form occasional to habitual gambling. He begins to risk more and more money, which can lead to both financial and personal instability. Someone is said to have a gambling addiction if four (or more) of the following have been demonstrated in the last twelve months:

1. Needing to gamble progressively larger amounts of money to feel the same (or more) excitement

2. Having made many unsuccessful attempts to cut back or quit gambling

3. Feeling restless or irritable when trying to cut back or quit gambling

4. Preoccupation or excessive thoughts (planning next gambling venture, thinking of ways to get more money to gamble with)

5. If the person is using gambling to escape problems of distress, sadness or anxiety

6. Gambling larger amounts to try to recoup previous losses

7. Lying about the amount of time and money spent gambling

8. Relying on others to borrow money due to significant gambling losses

Gambling addiction is a significant problem in the United States, impacting 1-3% of adults, men more often than women. Various complications can arise from having a gambling addiction. Those with such gambling behavior often have problems with alcohol and other substances. These people also tend to have financial, social, and legal problems. Those with gambling addictions are also at higher risk for considering or attempting suicide.

If you or a loved one is exhibiting any of the eight behaviors listed above, you may be at risk for developing a gambling addiction. The licensed psychologists, psychiatric nurse practitioners and psychotherapists at Arista Counseling & Psychotherapy are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/