Do Drugs and Alcohol Permanently Affect Your Brain?
We’ve all heard clichés like “alcohol kills brain cells” or “drugs fry your brain.” Watching someone who’s under the influence of drugs and alcohol, few of us are inclined to doubt it. However, the idea that a period of heavy substance use can leave you mentally damaged for life is also terribly discouraging. If you’ve struggled with drugs and alcohol, the following can give you some idea of how that might have affected your brain.
Most effects are temporary.
First of all, the vast majority of effects from most drugs only last as long as the drugs are in your system. If you drink too much, you can sleep it off. The next day or two might be rough, but you’ll be okay before long. Our bodies are pretty good at maintaining equilibrium, so individual episodes of drinking or drug use typically won’t have lasting effects except perhaps in extreme circumstances, like an overdose. It turns out that the anti-drug scare tactics of the 1980s and 1990s largely backfired, so it’s not a good idea to overstate the dangers of isolated drinking or drug use. It’s worth noting, however, that substance use does have a larger effect on the developing brain and people who experiment with drugs and alcohol at a younger age are more likely to have substance use issues later in life.
It may take months for your brain chemistry to rebalance.
A bigger concern than isolated use is developing a tolerance, which is another way of saying developing a dependence. This is when your body is so used to the presence of drugs and alcohol that it compensates in order to bring you back to equilibrium. Once you’ve developed a dependence, you need drugs or alcohol in your system to feel normal — and when you quit, you will probably notice some emotional and cognitive effects.
Exactly what those are depends on what substance you’ve recently quit. If you’ve quit drinking, you’re likely to experience irritability and insomnia. If you’ve quit cocaine, you’re likely to feel lethargic and unable to focus. While the effects of the drugs themselves might wear off pretty quickly, the effects of withdrawal might hang around for a while. Acute withdrawal typically only lasts about a week or two, but many people experience post-acute withdrawal syndrome, or PAWS. Symptoms of PAWS often include emotional numbness, depression, trouble concentrating, and lack of motivation. These are thought to be caused by changes in your brain’s dopamine system, which is related to motivation, reward, and goal-seeking behavior. This typically lasts a few months, but some people report symptoms lasting up to 18 months.
The long-term effects of addiction aren’t entirely clear.
There’s still quite a bit of discussion in the scientific community over whether addiction permanently changes your brain. We know that addiction does appear to cause some structural changes in your brain. As noted above, some of the most important changes have to do with the dopamine system. The dopamine system is designed to reward behaviors that keep us alive and help the species propagate. However, drugs and alcohol can throw this system into overdrive — especially among people with the right genetic predisposition.
This overclocking of the dopamine system has downstream effects, too. In your prefrontal cortex, there’s a region that becomes sensitized to stimuli that might lead to substance use. We call these stimuli “triggers,” and they are a direct result of the dopamine system realigning your brain’s priorities.
There is also a region of the prefrontal cortex that is primarily in charge of inhibiting behaviors — a sort of mental brake — and this region becomes weaker as addiction progresses. The result is that after a certain period of addiction, you have a brain that is completely bored with anything other than substance use, is extremely sensitive to the possibility of substance use, and is less able to inhibit behavior related to substance use.
Much of the debate around this subject relates to whether this structural change can go back to normal. It’s possible that some people’s brains were never “normal” to begin with. As noted above, there’s research showing that some brains are just wired to respond more strongly to drugs and alcohol. However, we do know that the dopamine system will gradually respond more normally to other stimuli over time and that the prefrontal cortex can change its structure in a matter of weeks using techniques like mindfulness meditation. In other words, we don’t know for sure whether your brain can ever return to some pristine, pre-addiction state, but it can certainly get much better.
Damage from long-term, heavy use may be permanent.
There are a few cases where brain damage from substance use may be permanent. Inhalants, for example, are extremely damaging to the brain. There’s also a condition called stimulant psychosis, which is usually temporary but may be permanent in a small percentage of cases. Korsakoff syndrome, also called “wet brain,” is typically caused by decades of heavy drinking and results in severe memory impairment, confabulation, and apathy. Probably the most common concern in terms of mental impairment is early-onset dementia. A large study¹ of more than a million patients in France found that alcohol use disorder was the single biggest cause of early-onset dementia.
Brains are more resilient than we used to think.
The good news for anyone recovering from addiction is that our brains are extremely adaptable and resilient. Even people who have had strokes that would have been debilitating 20 years ago are able to regain much of their original function. As recently as ten years ago, most neuroscientists believed the adult brain didn’t create new neurons, but now we know it does and that exercise promotes this function. In general, our brains will typically figure out a way to do what we repeatedly ask them to do and new methods and technologies can help them heal even faster.
It’s normal to worry that maybe you’ve abused your brain so much that it will never work quite right again. In some cases, your brain might have undergone some permanent changes, but our brains change anyway, whether we’ve struggled with substance use or not. The important thing to know is that brains are adaptable and they can always get better. At The Foundry, we use a variety of evidence-based methods to help our clients heal and create better lives. To learn more, explore our website or call us today at 1-844-955-1066.
Five Challenging Activities to Try in Addiction Recovery
When you’re recovering from addiction, it’s a great idea to pick up a new interest, hobby, or activity. These do several good things for you. Perhaps most importantly, especially early on, they give you something to do.
Too much boredom and restlessness are not good for recovery, and having a new pursuit gives you something to do. Also, if it’s something you enjoy — which it should be — it gives you something to look forward to every day; a sense of direction or focus. Finally, when you learn new skills and see them improve day by day, it increases your sense of self-efficacy: the feeling that you are in control of your life.
There are many possible challenges to take on in addiction recovery. The important thing is to find something you enjoy and something that connects with your values. You may have to try out a few things to find what you like. Here are some suggestions to get you started.
Learn to play an instrument.
Any kind of expression is good for recovery and music has some attributes that make it especially good for some people. First of all, music therapy is an alternative form of therapy that involves many different ways of engaging with music.
It often helps people who aren’t helped much by more conventional modes of therapy. A number of studies have found that it can be particularly effective for treating trauma and depression. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500733
However, the benefits don’t stop with therapy. Several studies have found that the act of making music in itself can improve your mental health. For example, researchers at Oxford¹ have found that singing in a choir can have many benefits, including increasing your feelings of happiness and wellbeing, reducing pain, and even improving your immune system.
Music is good for you because it is a complex activity that promotes social cohesion. Music requires cooperation between many parts of your brain in both hemispheres. It is one of the best workouts you can give your brain and some studies suggest practicing music can even stave off dementia.
No matter what, a certain level of fitness should be part of your recovery plan. Few things are as good for your physical and mental health as daily exercise and emerging research even suggests that it may help prevent relapse.
However, a basic level of self-care is not the same as making sports or fitness a particular interest in recovery. All you really need to be healthy is to walk about 30 minutes a day, but that won’t provide as much of a challenge or motivation as an activity.
For that, you need something that gives you plenty of room to grow — something that requires strength, skill, and stamina. Team sports are a great place to start, because they not only require skill and keep you active, but they also add a social element that holds you more accountable and helps you feel more socially connected — one of the most powerful aspects of a strong recovery².
Even if you never thought of yourself as a sports person (perhaps especially if you never thought of yourself as a sports person), learning a new sport can be a huge boost for your mood and confidence.
As with music, art is a great recovery activity because it emphasizes self-expression. Much of what you go through in life may be hard to put into words, but you still need some way to express it.
Drawing, like dreaming, can be an expression of your inner world. Most of us were encouraged to draw when we were kids, but creativity is discouraged as we get older.
Making art, whether it’s drawing, painting, sculpting, knitting, collaging, or anything else, is often a great way to get back into contact with the parts of your mind that can’t easily express themselves in words.
Learn a new language.
Most people only learn new languages for the sake of practicality. It takes a special kind of person to do it for fun.
However, if you’re that kind of person, learning a new language can be a great recovery activity. For one, it opens up a whole new world that wasn’t available when you were limited to English.
The change of perspective when you can suddenly read a newspaper from Mexico City or Berlin is startling. Perhaps more importantly, a new language connects you to new people.
Language is fundamentally social and even the process of learning a new language can help you build new relationships. Like music, language learning is also great exercise for your brain.
If you’ve been through an addiction treatment program or worked with a therapist, there’s a good chance you’ve already done quite a bit of writing as part of recovery. However, there’s no reason to stop there. Like art and music, creative writing, such as poetry and fiction, can be a way of exploring thoughts and feelings you can’t quite articulate directly.
What’s more, writing is a great way to process what you’ve been through and find meaning in it. Think of all the people who have been through horrible things and then redeemed those experiences by writing about them — from Victor Frankl and Malcolm X to the many excellent recovery memoirs that have come out in the past 10 years or so.
Writing your story is a way to own what you’ve been through and create a story where you’re the hero rather than the victim.
There’s essentially no limit to possible activities to engage in during recovery. The great thing about recovery is that your future is no longer about drugs and alcohol; it can be about anything you want. The more you challenge yourself, the more you’ll grow. At The Foundry, we know that recovery isn’t just about abstinence; it’s about living better. For more information about our treatment programs, call us today at 1-844-955-1066 or explore our website.
- Launay, J. (2015). Choir singing improves health, happiness – and is the perfect icebreaker. The Conversation.
Twark, C. (2018). Can exercise help conquer addiction? Harvard Health Publishing.
Wellness and the New Year
Happy New Year everyone!
Don’t you just love this time of year? A time for new beginnings, a time to dream, to make goals, and turn words into action. A time to let go of the past and to look toward the future! The beginning of the year always feels so fresh and exciting to me, and this year is no exception. Fun things are on the horizon here at Foundry Steamboat, and I can’t wait to share with you what we have planned! To kick off the year, here is what the Wellness Program has been up to in January!
This month our Healthy Habits group focused on Sleep Hygiene. Sleep is so important for not only our physical health, but our mental health as well. Getting quality sleep every night can set the foundation for your day. A good night’s sleep can boost your mood, improve memory, strengthen your heart, bolster your immune system, increase your exercise performance, and improve your productivity and your overall quality of life.
We can all agree sleep is vital to our health, so then what the heck is Sleep Hygiene?! Sleep Hygiene is defined as various practices and habits necessary to have good nighttime sleep quality and full daytime alertness. You might not have good sleep habits if you have frequent sleep disturbances, daytime sleepiness, or it takes you too long to fall asleep.
If you are struggling with Sleep Hygiene, here are a few things you can implement to help you get quality sleep:
∙ Limit daytime naps to 30 min (or avoid them altogether, if you can)
∙ Avoid stimulants such as nicotine or caffeine close to bedtime
➣ You may even need to limit caffeine to before noon in some cases
➣ As little as 10 min of aerobic exercise can improve nighttime sleep quality
∙ Avoid food that can cause indigestion right before sleep
∙ Get adequate exposure to natural light
➣ Exposure to sun during the day and darkness at night helps with a healthy sleep/wake cycle
∙ Establish a relaxing bedtime routine
➣ This helps the body recognize it is time for sleep
➣ Your routine can include warm shower or bath, reading a book, or light stretches
∙ Avoid blue light from phone or TV right before bed (zero screen time 30 min before)
➣ Blue light can make it difficult to fall asleep because it suppresses melatonin production in the body, tricking your brain into thinking it is daytime
∙ Make your sleep space pleasant and relaxing!
➣ Comfy pillows and mattress
➣ Temp between 60-67 degrees for optimal sleep
➣ Can include a noise machine, fan, ear plugs, eye mask, or blackout curtains to create a pleasant sleeping space
∙ Only use bed for sleep and intimacy!
➣ Reading, watching tv, or working from your bed, can make your brain associate your bed with a place of wakefulness, instead of a place to sleep!
Try a few of these tips to see if they improve your quality of sleep. To track their effectiveness, make note of how many nights a week you utilize these tools to see which ones work best for you. Keep in mind, the more you practice them, the better they work! For more information about sleep hygiene visit www.sleepfoundation.org.Happy sleeping!
January Wellness Activity Highlight
This month we took advantage of the sunshine and got outside on our snowshoes around the ranch! At the time of the activity, we had recently had a snowstorm which made the perfect canvas for us to think outside the box and make some art with our snowshoes. The residents and staff got creative out in the hayfield and did a collaborative Snowshoe drawing. This activity was perfect for mindful movement and cardio! The end result was so cool, and we even got aerial photos and a video, thanks to one of our staff members with a drone! You can check out our aerial video by going to our YouTube channel or our social media platforms. We have big plans for our next snowstorm, we can’t wait!
In the fitness aspect of theWellness Program, we focus on functional movement; movements that mimic everyday life. Functional Fitness is a classification of training that prepares the body for real-life movements and activities. It trains your muscles to work together and prepares them for daily tasks by simulating common movements you might do at home, at work, or in sports. While using various muscles in the upper and lower body at the same time, functional fitness exercises also emphasize core stability. Movements such as squatting, reaching, pulling, and lifting will be made easier with functional fitness integrated into your exercise routine.
Some of the benefits of functional fitness include increasing ease of everyday movements; increases flexibility, coordination, balance and posture; helps reduce joint pain; reduces the risk of injury; can be tailored to any ability; and builds muscle. Here at Foundry Steamboat, we incorporate three functional fitness workouts a week.
Below is one of the full body workouts we did this month:
For 12 min, do as many rounds as possible of:
- 5 pull ups (modifications: assisted pull ups, ring rows, or bent over rows)
- 10 push-ups (modification: elevated push-ups)
- 15 air squats
- 20 sit ups (modification: crunches)
- 3 – 5 burpees
That’s a wrap on January for the Wellness Program! Stay tuned for what we have going on in February!
Cait Mowris, Wellness Director, Foundry Steamboat
My Son is an Addict
My son is an addict. It's not the first thing you’ll hear me say if you ask me about my kids. Truthfully, I’ve never said it until now. I usually skirt around the subject, saying my oldest son has had some struggles with drugs and alcohol.Not because I am ashamed or embarrassed, but in my eyes, my oldest son is not one thing. He’s a million things — an amazing living, breathing, walking, talking human being with a "heart so big it could crush this town," to borrow a few words from Tom Petty. (For future reference, my mind is prone to bust out in a song lyric at any time.) Yes, I’m his mother and his biggest fan, but I’ve never liked the smallness a label dictates. I don’t even like to label myself as a writer, songwriter, musician, wife, or any other word that defines a role I play. Instead, when someone asks, I say I write stories and songs and do stuff. That pretty much sums it up.
I’ll be the first to admit that I like to look at the bright side. I see the good in others and especially my children. At times, I’ve been accused of being too damn optimistic. But I’m a believer. I know, that's a label, but it’s also what I do. I believe there is always a way, a solution, a miracle waiting around the corner, and that things will get better. This doesn't mean that behind these rose-colored glasses, life is always beautiful. I've spent many sleepless nights and cried rivers of tears. I've also had times when it felt like my heart was physically being ripped out of my chest. But most times, I try to “keep on the sunny side.” I did tell you about the song lyrics. Right?
Being the mother of a son who is an addict has taught me a lot of things. But first, what is an addict anyway? There is such a stigma attached to the word. When I used to hear the word addict, my mind conjured up the image of a guy lying in a dirty New York City back alley, fighting off rats, surrounded by syringes and needles - thank you,Al Pacino. But now, I know better. Addicts are brothers and sisters, sons and daughters, nieces, friends, acquaintances, and ancestors. Many have very successful careers. Some give TED talks, climb mountains, play big stages, and shine bright…at least for a while. Recently, when my son lost a close friend to addiction, I wrote a song to try and bring some comfort into the raging sea of heartbreak.
Some stars shoot across the sky and light the world on fire as they go by
Some fade out of sight, while others still burn bright and keep on shining,
They just keep shining, I’ll shine on for you, and I’ll shine on for me
- lyric from Shine On
Addiction is painful on all sides. It's not something you can sweep under the rug and talk about later or chalk up to “sowing a few wild oats.” I wish I would have known that a long time ago.Addiction is real. It’s not some phase that people go through with a clear beginning and end. It’s a disease, a dragon that can bare its teeth at anytime. And it runs in my family, in my blood, a gene that can be “on or off.” I didn’t know any of this back then.
I just kept believing. I believed my son when he said he didn’t leave the pipe in my glovebox. I believed him when he said he was camping in a blue tent on the Colorado River. I even went to the place where he said he was with a care package of food and supplies and a guitar for him to play. There was no blue tent. The other people camping there said they hadn’t seen or heard of him — I believed them, maybe. For a year, I didn’t know where he was. I thought I saw him everywhere — the face of a homeless man in San Francisco, or hitchhiking on the side of the road. I believed I could help. What I didn’t know was that my love wasn’t enough to save him. He needed more than I could offer.
When he did surface again, I got a phone call from jail. Letters followed, and I began to understand. I’ll never forget the first time I went to visit him and saw him behind the glass, dressed in orange. I couldn’t stop crying. I wish I could have held back the tears and offered an encouraging word, but I wasn't that strong. I just bit my lip, tears streaming down my face. He apologized over and over. I didn’t need an apology. I just wanted him to be okay. I studied his letters and tried to read between the lines. When he decided to goto an addiction/behavior modification treatment center, at a cellmate's suggestion, I took him there. The 24 hours between the time he was released from jail and admitted to the treatment facility felt like an eternity. He was so fragile, fractured, and torn.
As his mother, I wanted to take the blame, and for a while, I did. I wasn't a perfect parent. I have a laundry list of things I could have done differently. I tried to mold my children into what I thought they should be. Ouch, that truth still hurts. To top it off, during a crucial time in his life, I walked out on my marriage of 18 years, shattering the illusion I had created of the perfect "Leave it to Beaver" family. I often wonder why children are given to the young, who don’t know what they’re doing. But as I get older, I realize age doesn't matter all that much. I still don’t have all the answers. I know more things, but for the most part, I’m making it up as I go. However, what I do know is that my children never suffered from a lack of love.
So what has all this taught me about addiction? Forgiveness is key. Always. Every day, all day — especially when it comes to forgiving myself. And to never stop believing. Ever.
Trisha Leona Sandora
Words & Music
At Foundry, we know that addiction is a problem that affects every area of your life and therefore requires holistic solutions. We don’t just teach skills to help you abstain from drugs and alcohol; we teach skills to help you live a happier, more purposeful, more connected life. To learn more, call us at (844) 955-1066.
COVID-19: From Our CEO
As coronavirus (COVID-19) continues to gain momentum and impact others across the globe, proactively communicating the safety precautions that we have taken to ensure the safety of our participants and staff is necessary. The evolution of this pandemic has been, and will be, something that we closely monitor and thoroughly heed the instructions given by Centers for Disease Control and Prevention (CDC).
Due to the highly contagious nature of this virus, we felt that our two-tier detox continuum needs to be Highlighted. Two years ago, we partnered with Steamboat Emergency Room (SBER) which has become our first line of defense for situations just like the one our country is currently experiencing. Every participant’s journey with Foundry STARTS here, where they are promptly taken to a private room and immediately seen by medical professionals. During this first phase of our detox and assessment process, they are given a comprehensive physical and thoroughly screened for symptoms of COVID-19 following the strict protocol enforced by the CDC. Once cleared for residential treatment, they are transported to our facility (15 minutes outside of town on a secluded 48-acre Ranch) for the second phase of our detox process, and continued monitoring from members of our medical team for at least 24 hours. Once in our care, the following steps are being strictly enforced by every member of our team at Foundry Treatment Center Steamboat.
1) The clients will have limited "off campus" activities. This means they will not be attending 12 step meetings off campus. They will either take part in an in-house or online meeting, structured by our lead residential managers. Wellness activities will either be on campus or involve limited exposure to those in the community.
2) All staff are expected to immediately wash their hands upon arrival on the Foundry campus with soap and water for at least 20; or use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
3) Throughout their shift, staff are required to frequently maintain CDC standards of hand washing hygiene.
4) Did we mention we are encouraging staff and clients to WASH THEIR HANDS with soap and water?
5) Staff will wipe down the facility at shift exchange with soap and water or wipes. This means the office will be wiped down a minimum 3x per day.
6) During morning opener, clients will be asked if they are experiencing a fever, lower respiratory symptoms, coughing, shortness of breath. If a client endorses any of these symptoms they are to be removed from the milieu and stationed in their room until medical can meet with them to determine next steps. When staff enters a room in which a client may be ill, they will wear a mask and gloves, disposing of the mask and gloves and immediately washing hands once removed.
7) Staff will contact their superior immediately and stay home if they feel ill (fever, respiratory difficulty, cough or just not feeling well) to protect co-workers, clients and the program as a whole.
8) Staff and clients are asked to cover their cough or sneeze with a tissue, throw the tissue in the trash, and wash their hands immediately after.
The SAFETY of our Participants has been and will always be our #1 Priority and will continue to follow the instructions given by the professionals on the front lines of this pandemic.
Why is Group Therapy So Commonly Used to Treat Addiction?
One aspect of addiction treatment most people are familiar with is group therapy. Every film or TV show about addiction and recovery will have a scene where a character either goes to a 12-Step meeting and shares or participates in a group therapy session in rehab. For many people considering treatment, this might seem a bit intimidating. It’s a bit too much like public speaking and on top of that, the subject of conversation may include your worst thoughts, memories, and emotions. It’s no wonder that people are often hesitant to participate. However, group therapy is a staple of addiction treatment for good reasons. What’s more, once people get started, they usually find group therapy helpful, rewarding, and even enjoyable. Here are some reasons why group therapy is so common in addiction treatment programs.
You’ll See You’re Not Alone
Shame, stigma, alienation, and isolation are among the biggest barriers to recovery for people with substance use disorders. Trauma is perhaps the single element that people with substance use issues have most in common. This could be in the form of childhood abuse or neglect, domestic abuse, sexual assault, or some traumatic event. By some estimates, half of people with substance use disorders also have symptoms of post-traumatic stress disorder, or PTSD.
Addiction is commonly the result of trying to cope with shame. Most people’s instinctive reaction to shame is to try to hide it, bury it, or push it away, but that only makes shame more powerful. The best way to deal with shame is to open up about it in a safe environment, such as individual or group therapy. What makes group therapy especially good for healing shame is that group members quickly learn that they are not alone. Whatever they experienced in childhood, whatever they did during active addiction, there are almost certainly other members of the group who have had similar experiences. Being able to open up about these experiences and know you’re not alone is liberating.
Group Dynamics Give the Therapist Insight into Your Behavior
One of the limitations of individual therapy is that, for the most part, you control what information your therapist has. Even if you aren’t deliberately distorting events that you relate in therapy, you necessarily see things through your own perspective. That limits the information your therapist has to work with. However, in group therapy, the therapist can see how you interact with others. Maybe you have a tendency to be defensive or critical without realizing it. Maybe you are friendly to women but not to men. Maybe you believe you’re hopelessly awkward but in fact are charming. These are things that are far more obvious in real interactions than in the privacy of an individual session.
You Enjoy Social Support
Feeling socially connected is one of the most important parts of a strong addiction recovery. For many people, drugs and alcohol are a way to try to fill a void, which is often caused by a lack of belonging or purpose. There are many different reasons people feel this way and you are likely to find in the group some people who understand.
There are also more concrete reasons social support matters. For one, it creates a greater sense of accountability. People are more likely to show up to sessions, and show up on time, and be engaged if they know other group members are depending on them. In other words, it matters that group therapy is about helping as well as receiving help. Having a connection with the group also makes people a little more reluctant to slip up because they know they will have to tell the group.
Social support has benefits outside of the group as well. One challenge a lot of people face early in recovery, especially as they transition back to regular life, is that they have to distance themselves from friends who drink or use drugs. Sometimes there is stress within the family and they have to work on maintaining boundaries. These kinds of behaviors are easier when you feel like you have people supporting you, even if they aren’t physically with you at the moment.
You Get Many Different Perspectives
Another particular advantage of group therapy over individual therapy is that group therapy gives you many different perspectives. As an expert, your therapist’s perspective may be well informed but your therapist is still just one person. The group will have had many different experiences and will have many different ways of thinking about things. These will sometimes be surprising and illuminating. Problems that seem intractable to you might seem easy to someone else and being open to other perspectives can expand your repertoire of solutions.
You can also get different perspectives on your own behavior. Part of the challenge of resolving interpersonal conflicts is that it can be hard to tell whether we are acting reasonably. Getting feedback from the group is one way to orient yourself and better understand if your attitude is fair. It can also help you understand someone else’s perspective. For example, if you’ve been arguing with your spouse, it’s possible that your spouse can’t explain themselves well and perhaps someone in the group could be a better advocate with less emotional investment.
You Can Practice Vital New Skills
Recovering from addiction is, at its core, about learning a lot of new skills for managing emotions, thinking, and behavior. It’s one thing to know, rationally, how to do these things and another thing entirely to be able to use these skills when they matter. For example, if you tend to explode when you are criticized, that will lead to a lot of unnecessary stress and conflict but it’s also hard to practice responding better in real time. The group is the perfect time to practice these kinds of skills in a safe, moderated environment. If someone gives you feedback you don’t like, for example, it’s a perfect time to practice, perhaps with the help of the therapist, using your strategies for responding more constructively. This is why modalities like dialectical behavioral therapy, or DBT, specifically include group therapy rather than relying solely on individual therapy.
Group therapy can be intimidating at first but most people end up finding it helpful and they even enjoy it. The sense of connection you can find in group therapy is one reason so many people say they’ve met their best friends during addiction treatment. Group therapy heals shame and isolation, it gives your therapist extra insight, it provides social support, and gives you a valuable opportunity to practice new skills. At The Foundry, we use a variety of evidence-based methods, including group therapy and DBT, to provide clients with individualized, holistic treatment. To learn more about our programs, call today at 1-844-955-1066.
Why Cannabis Use Disorder Should Be Taken Seriously
“Marijuana (cannabis) use directly affects the brain — specifically the parts of the brain responsible for memory, learning, attention, decision making, coordination, emotions, and reaction time,” warns the Centers for Disease Control and Prevention (CDC) on its fact sheet. “Long-term or frequent marijuana use has been linked to increased risk of psychosis or schizophrenia in some users.”
Despite these known health risks, 18 states have legalized recreational marijuana. In 2012, Colorado and Washington became the first states to legalize the recreational use of cannabis following the passage of Amendment 64 and Initiative 502. Additionally, 36 states and the District of Columbia currently allow cannabis for “medical” use although the federal Food and Drug Administration (FDA) continues to list cannabis as an illegal schedule I substance “due to its high potential for abuse, which is attributable in large part to the psychoactive effects of THC, and the absence of a currently accepted medical use of the plant in the United States.”
As a result of the continuing normalization of cannabis use, a majority of Americans—including teenagers—perceive little or no risk in using it. Thirty-eight percent of high school students report having used marijuana at least once (although it is only legal for people 21 and older).
The health risks connected with cannabis use are real, however, notwithstanding years of promoting it as a medicinal remedy. “Researchers know that prolonged and heavy cannabis use can alter brain circuitry. However, the specific pathophysiological mechanisms are yet unclear. In terms of addiction, tetrahydrocannabinol (THC) is the primary molecule responsible for the reinforcing properties of marijuana,” report Jason Patel and Raman Marwaha in Cannabis Use Disorder.
THC, acting through cannabinoid receptors, activates the brain’s reward system, which includes regions that govern the response to healthy pleasurable behaviors such as sex and eating. Like most other drugs that people misuse, THC stimulates neurons in the reward system to release the signaling chemical dopamine at levels higher than typically observed in response to naturally rewarding stimuli. The surge of dopamine teaches the user to repeat the rewarding behavior, helping account for marijuana’s addictive properties.
According to a research report of the National Institute on Drug Abuse (NIDA), “THC is able to alter the functioning of the hippocampus and orbitofrontal cortex, brain areas that enable a person to form new memories and shift his or her attentional focus. As a result, using marijuana causes impaired thinking and interferes with a person’s ability to learn and perform complicated tasks. THC also disrupts the functioning of the cerebellum and basal ganglia, brain areas that regulate balance, posture, coordination, and reaction time. This is the reason people who have used marijuana may not be able to drive safely.”
Cannabis use can induce significant behavioral or psychological changes such as impaired motor coordination, euphoria, anxiety, hallucinations, a sensation of slowed time, impaired judgment, increased appetite, dry mouth, and even tachycardia.
In his 2015 book Marijuana, psychiatrist and addiction specialist Kevin Hill listed three popular myths: that cannabis is not harmful, that it cannot lead to addiction, and that stopping the use of marijuana cannot cause withdrawal symptoms.
Cannabis or marijuana use disorder is common in the United States, is often associated with other substance use disorders, behavioral problems, and disability, and goes largely untreated, according to a 2016 study conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health.
Approximately a third of cannabis users develop a clinically diagnosable cannabis use disorder (CUD) at some point in their lives. A major study published in Oct 2020 updated the number of users developing an addiction from 10 to 30 percent, a change that is most likely driven by higher potency use. People who begin using marijuana before the age of 18 are four to seven times more likely to develop a cannabis use disorder than adults.
“Often, patients who use cannabis heavily will report that it helps them with anxiety or insomnia irrespective of whether they have a common comorbid diagnosis such as general anxiety disorder, social anxiety disorder, posttraumatic stress disorder, or attention-deficit hyperactivity disorder,” reported Kevin Hill and Arthur Williams in 2019. “Although the short-term benefits of using cannabis may help with anxiolysis or treating early insomnia, in general cannabis, especially via rebound withdrawal symptoms, can worsen these underlying conditions over time (much like how patients with heavy alcohol use often develop worsening anxiety and irritability).”
We need to emphasize that today’s marijuana is much more harmful than it used to be. Cannabis products are now vastly more potent than the “reefers” of the 20th century.
In the seventies, joints averaged a THC concentration of about one percent, close to the natural levels of the cannabis plant. In the early nineties, the typical THC concentration had increased to three percent. Now it often exceeds 30 percent. In addition to that, cannabis is used in an extremely concentrated form called hash oil or wax. So-called “dabbing” refers to the inhalation of concentrated THC products created through butane extraction. Butane hash oil (BHO) can reach incredible concentrations of over 50 percent—that is 50 joints of the seventies rolled into one!
The legalization of the recreational use of cannabis products in recent years has also led to the commercial production and sale of incredibly potent drugs that bear almost no resemblance to 1970s vintage joints. “To say that we have legalized weed is misleading,” Foundry Steamboat CEO Ben Cort explained in a 2018 TED talk. “We’ve commercialized THC.”
The relentless commercialization has had consequences. Advertising and location of cannabis retailers influence adolescents' intentions to use marijuana, according to a 2020 study in the Journal of Health Communication by Washington State University researchers who conducted a survey of 13- to 17-year-olds in Washington State to find out how marijuana advertising and the location of marijuana retailers influence adolescents' intentions to use the drug. Their research shows regular exposure to marijuana advertising on storefronts, billboards, retailer websites, and other locations increased the likelihood of adolescents using marijuana.
Watch "Surprising truths about legalizing cannabis," a TedTalk delivered by Foundry Steamboat CEO Ben Cort. https://www.youtube.com/watch?v=SmqtPaMMVuY
And the billboards are advertising ever more powerful products. “Concentrates are everywhere and are not just being used by the fringe; they are mainstream and they are what many people picture when they talk about marijuana,” Cort wrote in his 2017 book Weed, Inc. “You are going to think some of this must be talking about hardcore users on the edge, but it’s not; concentrates are everywhere and have become synonymous with weed for this generation of users.”
The higher the concentration of THC and the more frequent the use of such products, the higher the risk of addiction. The current edition of the Diagnostic and Statistical Manual of Mental Disorders or DSM-5 used by psychiatrists in the United States lists—analog to other substance use disorders—eleven criteria for cannabis use disorder:
- Cannabis is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control cannabis use.
- A great deal of time is spent in activities necessary to obtain cannabis, use cannabis, or recover from its effects.
- Craving, or a strong desire or urge to use cannabis.
- Recurrent cannabis use results in failure to fulfill role obligations at work, school, or home.
- Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis.
- Important social, occupational, or recreational activities are given up or reduced because of cannabis use.
- Recurrent cannabis use in situations in which it is physically hazardous.
- Cannabis use continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
- Tolerance, as defined by either: (1) a need for markedly increased cannabis to achieve intoxication or desired effect or (2) a markedly diminished effect with continued use of the same amount of the substance.
- Withdrawal, as manifested by either (1) the characteristic withdrawal syndrome for cannabis or (2) cannabis is taken to relieve or avoid withdrawal symptoms.
The DSM-5 specifies three levels of severity for substance use disorders such as CUD. Two or three criteria indicate a mild cannabis use disorder, four or five indicate a moderate CUD, and six or more criteria indicate a severe cannabis use disorder.
According to Patel and Marwaha, cannabis misuse can also lead to a number of marijuana-related issues such as cannabis-induced sleep disorder, cannabis-induced anxiety disorder, or cannabis-induced psychotic disorder.
Sadly, people presenting with CUD do not enjoy the same support from society as people with other substance use disorders, says Cort. “If you go to your doctor saying ‘I need to get off the bottle’ or ‘I need to stop shooting dope’ you can expect encouraging words and specialist referrals. If you say ‘I’m smoking too much weed’ you often only get a ‘so what’ kind of shrug.” Many doctors think that cannabis use is fairly harmless, if not beneficial.
“We even encounter people in treatment whose CUD had been dismissed as ‘only weed’ because our society does not recognize cannabis as an addictive substance,” says Cort. In treatment, Foundry Steamboat has to prepare clients for a trigger-rich environment with ubiquitous “pot shops” and billboards advertising cannabis products—especially in Colorado.
When Do You Need More Than the 12 Steps to Beat Addiction?
AA and the many mutual-aid programs they’ve inspired have been helping people get sober since 1935. Working the 12 steps is a time-tested method for quitting alcohol and drugs, and millions of people are now staying sober one day at a time. The social support of mutual aid meetings like AA is especially important, which is why most people go to meetings even after completing professional treatment programs. However, it’s important to remember that 12-Step meetings are just one approach to recovery. Everyone has different needs when trying to overcome addiction. For many people, AA or NA will be all they need. Others may require more help. The following are some reasons you might need something more than your neighborhood 12-Step meeting.
When You’re Facing a Tough Detox
You don’t have to be sober to attend a 12-Step meeting; you only need to want to be sober. Unfortunately, beyond possibly offering some helpful advice, your 12-Step group won’t be able to help you detox. Sometimes, you will be able to tough it out at home, but other times that might be too difficult or too dangerous to attempt. For example, people trying to quit opioids often have a hard time making it all the way through detox because the withdrawal symptoms get too intense. It can be hard to take care of yourself when you’re experiencing what many have said feels like the worst flu you’ve ever had.
If you’re detoxing from a serious drinking problem or a benzodiazepine addiction, your life may even be at risk. Severe alcohol detox, DTs, can come on without warning and lead to death in a small percentage of cases.
It’s hard to know when you might need a medical detox and when you can do it at home. It’s always a good idea to consult with your doctor before deciding. If you have any medical conditions, especially cardiovascular issues or pregnancy, a medical detox is typically a good idea. If you’ve had a difficult time detoxing in the past, it’s likely the next time will be tough too. In general, the longer and more heavily you’ve been drinking and using drugs, the harder detox is likely to be.
When You Have Comorbid Health Issues
As noted above, if you have any medical conditions, it’s best to detox under medical supervision. However, medical issues can continue to be a challenge even after acute withdrawal symptoms have subsided. Many people starting in recovery have problems related to malnutrition, weak immune systems, and other issues related to substance use. Spending some time in a residential treatment program can help you avoid complications and restore your health more quickly. You get healthy meals, plenty of sleep, a bit of exercise, and easy access to medical care, should something go wrong.
When You Have a Co-occurring Mental Health Challenge
Perhaps the most common problem that mutual-aid groups aren’t well suited to deal with is mental health issues. According to the National Institute on Drug Abuse, at least half of people with substance use disorders have co-occurring mental health issues, such as major depression, anxiety disorders, PTSD, ADHD, personality disorders, schizophrenia, and others. Many of these conditions require specialized care and medication. That’s far beyond the support that a mutual-aid meeting can provide.
Trying to get sober without diagnosing and treating co-occurring mental health issues is extremely hard and probably won’t succeed for long. For most people with co-occurring disorders, the mental health issues are the main driver of their substance use. Mental health issues and substance use each tend to make the other worse, so only treating the addiction is not likely to solve the problem for long.
When You Have Trouble Sticking with a Program
Mutual-aid programs can be very effective in helping you to stay sober if you keep going. The problem is that most people don’t keep going. They may go to a few meetings but that’s all. One study¹ found that only about 10 percent of people who go to AA meetings keep going for three months. Some of the features that make AA attractive, such as free attendance, anonymity, and open doors, also make it easy to quietly disappear.
When you invest in a professional treatment program, you are far more likely to stick with it. For one thing, you may actually be in residence, perhaps far from home, so you’re less likely to just stop showing up. You can leave, of course, but your level of commitment is much higher, especially if you’re paying to be there. What’s more, the staff and other clients are more invested in your success. People will definitely notice if you don't show up for group therapy or other activities. You also form connections to others more quickly in treatment and that social bond creates an incentive to stay engaged.
When You Don’t Fit In
There are many effective approaches to addiction recovery, but unfortunately, some people who have succeeded through 12-Step meetings don’t always see it that way. Some groups are fairly rigid and dogmatic, which can put people off. Since 12-Step groups aren’t centrally organized, there is a lot of variation among meetings. However, if you’re in a place without many options, you might have trouble engaging with a group where you don’t feel welcome or comfortable. You may have to explore other options.
Twelve-Step meetings like AA and NA can be a great option for many people who want to get sober, but sometimes meetings alone are not enough. If you might face a hard detox, have co-occurring mental health issues, have had trouble sticking with the program, or you just don’t feel comfortable with the available groups, you might need something more. At The Foundry, we use the time-tested 12-Step principles combined with evidence-based modalities for treating co-occurring issues. To learn more, call us today at 1-844-955-1066 or explore our website.
How to Feel Better by Ending Rumination
You probably know the feeling: you’re a bit bored at work or home, or maybe you’ve just gotten into bed, when some thought pops into your head and you can’t let it go. Maybe it’s something embarrassing you did when you were a child or something you’re worried might happen at some undefined point in the future.
Maybe you start replaying a conversation, thinking about all the things you should have said. The next thing you know, you’ve been rehashing these thoughts for 20 or 30 minutes, perhaps even longer. You haven’t gotten anything done, you haven’t slept, and now you feel more depressed and anxious than you did before.
This is rumination and it’s strongly associated with mental health issues such as depression, anxiety, and PTSD. When you’re recovering from a substance use disorder, ruminating definitely doesn’t help, but it’s also a hard habit to break. The following tips can help you quit ruminating and feel better.
Learn to recognize rumination.
Like other bad habits, you can start ruminating without even being aware of it. You quickly get swept up in your thoughts and are not aware of what your mind is even doing.
If you want to stop ruminating, then you have to learn to notice when you’re doing it. This is a skill called metacognitive awareness — being aware of what you’re thinking about. The first step is to label rumination whenever you catch yourself doing it.
It’s important that you do not scold yourself when you realize you’ve been ruminating. Instead, congratulate yourself for noticing: “Ah, there’s rumination again, good catch!”
Notice your rumination triggers.
Noticing rumination is only the first step. Your real goal is to better understand what’s causing it.
Rumination typically has triggers, just like any bad habit. That is, it doesn’t come out of the blue but rather is caused by something you hear or see — or even a particular train of thought.
When you catch yourself ruminating, notice what you’re ruminating about and notice what triggered it. For example, maybe you were reading an article that mentioned a topic you recently argued with someone about or that reminded you of a bad decision you made, perhaps years ago.
You will probably notice there are only a few topics you get stuck ruminating about and your triggers are likely things closely related to these topics. Once you are aware of your triggers, you can be more vigilant about falling into the rumination trap in the first place.
Our minds are very associative and once you fall into the rumination trap, it’s hard to get out just by trying to force yourself to think of something else. If you’re sitting or lying in the same position, in the same room, trying to do the same task, you’ll probably keep getting drawn back into the rumination.
Although rumination has negative outcomes, it is also more interesting to your mind than whatever you’re supposed to be doing because your mind thinks it’s solving a problem. If someone were running toward you and yelling, you would definitely pay attention to them even if you’d rather not have to deal with that situation.
Rumination is similar, except the threat you’re preoccupied with might be far in the past or a hazy possibility in the future.
To get out of that rut, you may have to change more than your focus. You might have to get up and walk around for a while, switch to a different task, go to a different room, or do something that demands more attention than whatever you’re ruminating about.
Maybe get some exercise or play a video game. The more you ruminate on a particular topic, the deeper that groove gets in your brain.
That means you fall into that rut more easily and have a harder time escaping. Distracting yourself will limit rumination and help keep that groove from getting much deeper.
Write down your thoughts.
Writing down your thoughts helps with rumination in several ways. First, it helps you recognize when you’re ruminating, identify your triggers, and distract yourself, as discussed above.
When you write about rumination, you’re automatically enlisting some of your metacognitive awareness. Second, when your mind ruminates, it believes it’s solving a problem, except that it never gets very far.
It just keeps rehearsing the initial steps. Typically, it’s gotten hold of some insight it doesn’t want to forget, so it gets stuck in a loop.
Writing down your thoughts commits them safely to paper so your brain can stop rehearsing it. Writing it down also helps you actually make progress thinking through the problem instead of repeating the first few thoughts.
This helps you process whatever it is you’re ruminating about. If it’s something you’re worried about happening in the future, it can even lead you to some concrete steps that might help you solve the problem and worry less about it.
Practice mindfulness meditation.
Mindfulness meditation is one of the best ways to expand metacognitive awareness, since it’s essentially a practice of spending 20 or 30 minutes a day just watching thoughts and emotions rise and fall in your mind.
With practice, you learn to avoid getting swept up in your thoughts. Mindfulness meditation also helps moderate activity in the brain’s default mode network, which is active during rumination.
Remember that it takes practice.
Finally, keep in mind that getting rumination under control will take practice and persistent effort. Rumination is a habit, probably one that you’ve been doing for years.
Breaking it for good will probably take months. The good news is that every time you catch yourself ruminating and take some definite action to stop it, you’re also sparing yourself a lot of pointless anxiety and self-criticism. After a while, you will notice rumination gradually diminish.
When you’re recovering from addiction, it’s crucial to look after your mental health. Anxiety, depression, PTSD, and other mental health issues are common among people recovering from substance use disorders and they are all conditions highly associated with rumination. Awareness is key, followed by action.
At The Foundry, we know that recovery begins in the mind. That’s why we use cognitive behavioral therapy, dialectical behavioral therapy, mindfulness meditation, and other treatment modalities to help our clients become emotionally resilient. To learn more about our treatment options, call us today at 1-844-955-1066 or explore our website.
Call today to get started on your journey or if you have any questions.(844) 955 1066