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May

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.

Distract yourself.

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.

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May

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.

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Sep

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.

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Apr

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.

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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.

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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.

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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.

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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.

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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.

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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.

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Mar

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).

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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.

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Latest Posts

Jun

A Quarter of US Children Have a Parent With Substance Use Disorder, Study Finds

Nearly 19 million children in the United States have at least one parent with a substance use disorder (SUD), according to a new study published in JAMA Pediatrics on May 12. A significant number of those children have a parent whose SUD is moderate or severe as opposed to mild, the study finds.

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Witnessing a parent misusing drugs and alcohol as a child is considered an "adverse childhood experience" (ACE) that can have long-term negative impacts on health and well-being. ACEs are common. About 64 percent of adults in the United States reported they had experienced at least one type of ACE before age 18. Nearly one in six adults reported they had experienced four or more types of ACEs.

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"Children exposed to parental SUD are more likely to develop adverse health outcomes than their peers without parental SUD exposure, including early substance use initiation, substance-related problems, and mental health disorders," wrote study authors Sean Esteban McCabe, Vita McCabe, and Ty Schepis. "We aimed to estimate the number of US children living in the same household as at least one parent or primary caregiver with a DSM-5-defined SUD."

As Rhitu Chatterjee reported on NPR, "the new study used data from the 2023 National Survey on Drug Use and Health, a federal survey that estimated the prevalence of substance use and mental health disorders based on the most updated criteria in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). The national survey is managed by the Substance Abuse and Mental Health Services Administration, but the team in charge of the survey was let go as part of the recent reduction in force. It is unclear how the cuts will affect the future of the survey."

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"If one-quarter of kids in the US have a parent with a substance use disorder, that tells us that every day in our clinics we are encountering many, if not dozens of families that are affected by substance use disorders," Dr. Scott Hadland, chief of adolescent medicine at Massachusetts General Hospital told NPR. "We need to be poised and ready to help support those families."

"The study's main finding is significantly higher than previous estimates (7 million in a study originally published in 2022), which had relied on diagnostic criteria from the DSM-IV," reported Chatterjee. "The new study also estimated how many children have a parent with a moderate or severe addiction as opposed to mild."

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McCabe and his team found that 7.6 million US children have a parent with a moderate or severe SUD, and 3.4 million live with a parent dealing with multiple substance use disorders. The authors also found that more than 6 million children have a parent dealing with both a substance use disorder and a co-occurring mental health condition.

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"These estimates are incredibly important to understand the scope of parental substance use disorder in the United States," Davida Schiff, a pediatrician and addiction physician at Massachusetts General Hospital, told NPR. Dr. Schiff pointed out that a majority of the parents (12 million) had alcohol use disorder. "While alcohol is more socially acceptable in our society, the study points to a need to pay greater attention to a rising number of children exposed to parental alcohol use disorder."

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Adverse childhood experiences and other lifetime traumas are regularly encountered by addiction professionals. The strong correlation between addiction and trauma, especially childhood trauma, is well known.

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Addiction is truly a family problem.

NRT Behavioral Health Chief Clinical Advisor Dr. Michael Barnes is a foremost expert in family system disorders and trauma. The Trauma-Integrated Care Model, developed by Dr. Barnes and used at NRT Behavioral Health treatment programs, emphasizes the importance of identifying trauma and substance use in family systems. Because parental substance use disorder exposes children to physical and psychological danger and increases their risk of developing SUD in later life, addressing the effects of these problems on all family members is key to stopping generational cycles of behavioral health disorders. Family programming is a central part of treatment at NRT Behavioral Health programs. It focuses on educating clients and family members and helps families create recovery-supportive lifestyles and home environments.

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Recognizing how families experience, normalize, and perpetuate substance use is vital to reducing high rates of SUD in America's rural communities. Close-knit families that spend more time together and are more isolated from other community members can inadvertently create an internal culture that makes using substances to self-medicate mental health disorders more acceptable. Ensuring that rural community members can access high-quality treatment is one way to address this problem. Helping individuals address anxiety, depression, loneliness, and other psychological problems through therapy and psychiatric medications can reduce their perceived reliance on alcohol and substances to reduce their symptoms. Sometimes, when one family member gets help, other members become more willing to accept help and to change their relationship with substances.

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If you or a loved one is experiencing problematic drinking or drug use, we may be able to help. Please call us for a free and confidential conversation at (720) 807-7867.

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Jun

Marijuana is Bad for Your Heart

Marijuana causes heart problems — A new study led by UC San Francisco researchers has found that chronic cannabis use, whether smoked or consumed in edible form, is associated with significant cardiovascular risks.

The report, published in JAMA Cardiology, found that people who regularly used marijuana in either form had reduced blood vessel function comparable to tobacco smokers. Vascular function in those who used cannabis by either means was reduced roughly by half compared to those who did not use it.

Decreased vascular function is associated with a greater risk of heart attack, hypertension, and other cardiovascular conditions.

"There is a popular belief that marijuana smoke is harmless," wrote Mohammadi, Navabzadeh, Jiménez-Téllez, et al. in their study. "However, marijuana smoke contains many of the thousands of chemicals contained in tobacco smoke, along with fine particles that contribute to cardiovascular morbidity and mortality. As cannabis legalization increases, it is crucial to understand the public health and clinical implications of marijuana use."

The researchers recruited 55 people between October 2021 and August 2024 who were outwardly healthy and either regularly smoked marijuana or consumed edibles containing tetrahydrocannabinol (THC), the primary psychoactive compound found in cannabis.

Along with decreased vascular function, marijuana smokers had changes in their blood serum that were harmful to endothelial cells, which form the inner lining of all blood and lymphatic vessels. Those who took edibles containing THC, however, did not display these changes in blood serum. It's unclear how THC damages blood vessels.

"This study enhances the understanding of the potential risks to vascular health linked to cannabis use and provides more evidence that cannabis use is not benign," the researchers concluded.

THE RISE OF HIGH-POTENCY THC

Cardiovascular issues are not the only risks associated with cannabis use, of course. Many well-meaning Americans have internalized the propaganda of the well-organized cannabis industry, suggesting that cannabis products can cause no harm and may even mitigate specific health problems such as glaucoma or anxiety disorders, despite a distinct lack of scientific evidence for such claims. In an astonishing turnaround, cannabis went from a dangerous gateway drug to a wellness product in a matter of decades.

Foundry Front Range Managing Partner Ben Cort has been raising awareness of the commercialization of cannabis products for years. In his 2017 book Weed, Inc., he explained how the potent products the marijuana industry is selling in the 21st century are a far cry from the weed people smoked in the 1970s. "The average cannabis product sold in Colorado in 2020 had a THC content of 69 percent," says Cort. "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," he wrote in Weed, Inc. In other words, cannabis products have been weaponized. Cort's 2024 follow-up book, "Weed Inked," contains further evidence that high-potency THC products are harmful to personal and public health.

Chronic cannabis use is associated with an increased risk of developing a substance use disorder (SUD) and can induce psychosis.

Cannabis Use Disorder (CUD) is a growing problem nationwide. Studies indicate increasing rates of cannabis use disorder following the legalization and commercialization of cannabis in recent years. Cannabis use disorder poses specific health challenges, including hyperemesis, psychosis, paranoia, and—as the UCSF study confirms—heart health risks.

FOUNDRY FRONT RANGE TREATS CANNABIS USE DISORDER

Foundry Front Range has specialized expertise in treating cannabis use disorder. Cannabis, which is stored in fat cells, can remain in the body and cause psychoactive effects long after a person stops consuming it. This can lead to residual effects of cannabis that must be stabilized before clients are ready to engage in treatment programming. Specialized medical attention may also be required to help people experiencing severe CUD side effects, like nausea or psychosis, feel stable and comfortable.

Because 58-plus percent of people with SUD have more than one substance use disorder, treating the effects of cannabis use disorder can be even more complex. Patients with cannabis use and at least one other substance use disorder are more likely to need more clinical attention and medical resources. They may also have home environments or relationships that make substance use seem permissible or supported, requiring family programming and education about how to build recovery-supportive environments.

Continuing care planning, which ensures that individuals have a specific ongoing care plan after completing treatment, is crucial for allowing them to navigate the fragile period of early recovery safely. As this article suggests, cannabis use disorder and other substance use disorders increase the potential for chronic health problems. With growing evidence that cannabis can affect the heart and blood flow, cardiological assessment may be advisable during and after substance use disorder treatment.

With some of the most experienced clinicians, a modern and well-equipped clinical facility, and leading experts in addiction medicine, Foundry Front Range represents a good treatment option for people experiencing Cannabis Use Disorder. To learn more, visit www.foundryfrontrange.com or call (720) 807-7867.

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Sep

The Weaponization of Cannabis Products

“A strange thing has happened on the path to marijuana legalization. Users across all ages and experience levels are noticing that a drug they once turned to for fun and relaxation now triggers existential dread and paranoia,” wrote Malcolm Ferguson, an assistant editor at The Atlantic, in August. Like other journalists, Ferguson is beginning to realize what many addiction professionals have known for many years. Cannabis products in the United States have been weaponized on an industrial scale.

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“In 2022, the federal government reported that, in samples seized by the Drug Enforcement Administration, average levels of tetrahydrocannabinol, or THC—the psychoactive compound in weed that makes you feel high—had more than tripled compared with 25 years earlier, from 5 to 16 percent. That may understate how strong weed has gotten. Walk into any dispensary in the country, legal or not, and you’ll be hard-pressed to find a single product advertising such a low THC level. Most strains claim to be at least 20 to 30 percent THC by weight; concentrated weed products designed for vaping can be labeled as up to 90 percent.”

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NRT Behavioral Health™ managing partner Ben Cort has been raising awareness of the commercialization of cannabis products for years. In his 2017 book Weed, Inc., he explained how the potent products the marijuana industry is selling in the 21st century are a far cry from the weed people smoked in the 1970s. "The average cannabis product sold in Colorado in 2020 had a THC content of 69 percent," says Cort. "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," he wrote in 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." “Weed Inked,” Cort’s recently published “Weed, Inc.” follow-up, discusses how many of the predictions about the harmful effects of high-potency THC product commercialization and industrialization have come to pass.

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The consequences of making this largely unregulated psychoactive product available through legalization and commercialization have been devastating.

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“In the past few years, reports have swelled of people, especially teens, experiencing short- and long-term ‘marijuana-induced psychosis,’ with consequences including hospitalizations for chronic vomiting and auditory hallucinations of talking birds,” reported Ferguson. “Multiple studies have drawn a link between heavy use of high-potency marijuana, in particular, and the development of psychological disorders, including schizophrenia, although a causal connection hasn’t been proved.”

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The wider public remains largely unaware of these significant risks. In May, the number of Americans who use cannabis daily was reported to have surpassed the number who drink alcohol that frequently for the first time in the history of the United States. As the Associated Press reported, it is “a shift some 40 years in the making as recreational cannabis use became more mainstream and legal in nearly half of US states.”

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In 2022, an estimated 17.7 million people reported using marijuana daily or near-daily compared to 14.7 million daily or near-daily drinkers, according to an analysis of national survey data. In 1992, when daily cannabis use hit a low point, fewer than one million people said they used marijuana nearly every day.

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“Cannabis is in and alcohol is out”—a preference change likely driven by Gen Z, Nikki Battiste reported for CBS News in May. The cannabis industry has mostly succeeded in convincing large numbers of Americans—particularly young people—that their potent products are harmless if not beneficial for their well-being. As a consequence, millennials and Gen Z tend to think of alcohol as harmful and marijuana as healthy.

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After years of promoting cannabis as "medication" (although the evidence for its efficacy is mostly anecdotal) and downplaying the risks of marijuana use, the cannabis industry is close to achieving another goal. In May, the federal Justice Department proposed reclassifying the drug, saying the change would recognize marijuana’s “medical” uses and suggesting it had less potential for abuse than other illicit drugs.

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For now, however, the federal government continues to classify cannabis as a Schedule I controlled substance with “no currently accepted medical use and a high potential for abuse.” Any reclassification is not expected before the November election.

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Meanwhile, the National Institute on Drug Abuse (NIDA)—one of 27 institutes and centers comprising the National Institutes of Health, which is part of the US Department of Health and Human Services—informs the public on its website that “marijuana use can lead to the development of a substance use disorder, a medical illness in which the person is unable to stop using even though it's causing health and social problems in their life.” A severe cannabis use disorder (CUD) is considered an addiction. “Research suggests that between 9 and 30 percent of those who use marijuana may develop some degree of marijuana use disorder. People who begin using marijuana before age 18 are four to seven times more likely than adults to develop a marijuana use disorder.”

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Cannabis products—especially those with dangerously high THC concentrations—also affect brain development. When people begin using these weaponized THC products as teenagers, the drug may impair thinking, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions.

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A 2022 review study found that higher THC concentrations are now causing more people to become addicted to cannabis. “One of the highest quality studies included in our publication found that use of high potency cannabis, compared to low potency cannabis, was linked to a four-fold increased risk of addiction,” study coauthor Tom Freeman told CNN.

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Foundry Treatment Center Steamboat, part of NRT Behavioral Health, developed a specific treatment track for people affected by cannabis use disorder because the condition poses particular challenges. In 2000, Cort co-authored the first published best practices on treating CUD alongside Dr. LaTisha Bader in a medical text and reference book entitled Cannabis In Medicine and Evidence-Based Approach. He has spent the years since working to educate clinicians and medical professionals in our field on these practices. Many people experiencing cannabis use disorder suffer from extended periods of cannabis-induced psychosis and must be safely housed and medically supervised until their symptoms subside enough for them to engage in treatment programming successfully. Cannabis use disorder treatment is also an area of specialty offered by Foundry Front Range, a comprehensive residential addiction treatment program opened by NRT in August.

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May

US Government Expected to Reclassify Cannabis as Lower-risk Drug

It is a move that has been expected for a long time. After years of promoting cannabis as "medication" and downplaying the risks of marijuana use, the cannabis industry is about to score another victory.

On April 30, US Attorney General Merrick Garland recommended loosening the restrictions on marijuana, a historic shift in federal drug policy that could broaden access to the drug for "medicinal" and recreational use even further and boost the cannabis industries in states where it is already legal.

"Today, the Attorney General circulated a proposal to reclassify marijuana from Schedule I to Schedule III," the Justice Department said in a statement. "Once published by the Federal Register, it will initiate a formal rule-making process as prescribed by Congress in the Controlled Substances Act." On May 13, the Drug Enforcement Administration added its support for reclassification.

The proposal, which the White House has one to three months to review, would recognize the unproven "medical" uses of cannabis and acknowledge it has less potential for abuse than some of the nation's most dangerous drugs. However, it would not legalize marijuana outright for recreational use on a federal level.

The proposed change could nevertheless increase the profits of the cannabis industry dramatically. Unsurprisingly, industry leaders believe that declassifying cannabis altogether, as opposed to reclassifying it, would be even better.

The FDA has approved just one drug, the epileptic seizure treatment Epidiolex, that contains CBD derived from cannabis plants. It has also approved three drugs containing synthetic THC compounds to treat nausea associated with cancer treatment and reduce wasting associated with HIV/AIDS. Like all prescription drugs, these FDA-approved medications are prescribed by doctors to treat very specific medical conditions.

By contrast, “medical” cannabis can only be recommended by doctors to address a range of ailments. Research on other claimed medical and health benefits of marijuana is scant to non-existent, while the negative effects of mass consumption are becoming more and more evident in states that have legalized cannabis. One of those states is Colorado, where Chuck Smith, who leads an alliance of cannabis business executives, described rescheduling as progress.

"The HHS rescheduling recommendation marks a historic step toward federal cannabis policy reform," Smith said. "For over a decade, Colorado has been demonstrating states' ability to effectively regulate cannabis for medical and broader adult use, and it's time for federal law to reflect that reality. State-legal cannabis businesses that create jobs, pay taxes, and provide adults and medical patients with safe and legal access to cannabis deserve to be treated fairly, and this would be a big step in that direction."

Legalization in states across the nation has fueled rapid growth of the marijuana industry, with an estimated worth of nearly $30 billion. Rescheduling cannabis could reduce the tax burden by allowing deductions unavailable for a Schedule I substance. There are fears that rescheduling cannabis could now open the door for large pharmaceutical companies and other major corporations to take over the industry.

NRT Behavioral Health™ President Ben Cort has been raising awareness of the commercialization of cannabis products for years. In his book Weed, Inc., Cort explained how the potent products the marijuana industry is selling in the 21st century are a far cry from the weed people smoked in the 1970s. The reason is the dangerously high THC content of today's cannabis products.

THC (delta9-tetrahydrocannabinol) is the main psychoactive ingredient in marijuana, and THC levels in cannabis products have dramatically increased in the last few decades from less than one percent THC in the seventies to well beyond 15 percent in recent years. And that's just the plants—concentrates can reach much higher levels of THC.

"The average cannabis product sold in Colorado in 2020 had a THC content of 69 percent," says Cort. "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 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 National Academies of Science pointed out that despite a growing acceptance of marijuana in many states, "evidence regarding the short- and long-term health effects of cannabis use remains elusive" and that "no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively."

A 2020 letter from the director of the National Institute on Drug Abuse said, "Marijuana impairs short-term memory and judgment and distorts perception" and, as a result, "can impair performance in school or at work and make it dangerous to drive."

Although it is illegal for Coloradans under 21 to buy, have, or use retail marijuana, and it is a felony for anyone to give, sell, or share marijuana with anyone under 21, teenage consumption and addiction are on the rise.

A 2021 systematic review found that past-year cannabis vaping nearly doubled from 2017 to 2020 in adolescents - jumping from 7.2 percent to 13.2 percent," warned Ty Schepis, a professor of psychology at Texas State University, in a recent article for The Conversation. "A more recent study in five northeastern US states found that 12.8 percent of adolescents vaped cannabis in the past 30 days, a more narrow time frame that suggests potential increases in use. In addition, a 2020 study found that one-third of adolescents who vape do so with cannabis concentrates."

The notion that Colorado is effectively regulating the medical adult use of cannabis seems to provide a partial view of cannabis use within the state by not also acknowledging widely accepted concerns about the negative effects of use and increased underage use. However, the state may only be providing minimal resources when it comes to regulating adult cannabis use, according to Ben Cort’s forthcoming sequel to “Weed, Inc.” The book also talks about how the state’s Marijuana Enforcement Division (MED), which is tasked with regulating commercial cannabis, seems primarily to be a recruiting apparatus to help grow Colorado’s commercial THC industry.

Cannabis misuse by adolescents is dangerous because it can alter the way their brains develop, explained Schepis. "Research shows that the brains of adolescents who use cannabis are less primed to change in response to new experiences, which is a key part of adolescent development. Adolescents who use cannabis are also more likely to experience symptoms of schizophrenia, struggle more in school, and engage in other risky behaviors."

Smart Approaches to Marijuana (SAM) President Kevin Sabet, a former White House drug policy advisor to Presidents Obama, Bush, and Clinton, issued the following statement:

"Politics and industry influence have loomed over this decision from the very beginning. [...] Now, against the recommendations of prior Attorneys General, the medical community, and law enforcement, the Administration unilaterally reversed decades of precedent despite volumes of data confirming marijuana's harmfulness. Moreover, a drug can be taken off Schedule I only if it has accepted medical use—raw, crude marijuana has never passed safety and efficacy protocols. A drug isn't medicine because it's popular."

"Medical and scientific studies, as well as government data, have conclusively linked THC drugs with addiction, psychosis, schizophrenia, depression, anxiety, suicidality, and IQ loss, among other impacts," Dr. Sabet wrote. "The Administration's effort to push through this action in an election year could be perceived as a thinly veiled attempt to reverse polling trends with the principal targets of the pot industry, namely young people."

Ben Cort also believes that the decision is “a reflection of politics rather than medical science. I’ve had several conversations with the nation’s thought leaders and researchers since this recommendation was leaked. They all agreed that there is no science to support the decision, while there are a lot of scientific indicators encouraging a much more careful and deliberate approach.”

“This is a tight election year and somebody did the math on how many swing votes this might pull for the current administration,” says Cort. “We still haven’t learned our lesson as a nation that thoughtless engagement with psychoactive intoxicants doesn’t end well. We still haven’t understood that bad things happen when corporations sell things that have addictive potential.” While groups promoting the purchase and use of THC products continue to get their way, across-the-board decriminalization of drug possession and use has seen some pushback lately.

Marijuana use can lead to the development of cannabis use disorder (CUD), which takes the form of addiction in severe cases. Recent data suggest that 30 percent of those who use THC products may have some degree of marijuana use disorder. People who begin using marijuana before the age of 18 are four to seven times more likely to develop a marijuana use disorder than adults.

At a time when growing evidence suggests that cannabis legalization and commercialization are making potentially dangerous products more available, increasing accidental THC poisonings and other adverse health events, and are not resulting in the promised financial boons to cannabis business owners or states where cannabis is legal, rescheduling could exacerbate these problems.

Regardless of whether rescheduling cannabis changes the way it is sold, the move is likely to reduce further the perceived dangers associated with cannabis use. Research suggests that young adults are more likely to use cannabis after it is legalized because they perceive it as less dangerous.

Rescheduling cannabis could send an even more significant signal to people that cannabis is not harmful, which may further increase its use. The same study suggests that increased use by adolescents and young adults could stimulate cannabis use disorder while making it less likely that they seek treatment.

The behavioral healthcare field is seeing more patients presenting with cannabis use disorder and complex cases linked to high-potency THC use that are difficult to treat. Rescheduling could result in more people than ever before believing that cannabis use is without risks while THC products are more potent than ever, a situation that may lead to more problematic cannabis use with implications for individuals, families, and communities nationwide.

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Apr

Decriminalization—a Failed Experiment

It was supposed to be the panacea for the opioid epidemic. If you decriminalize drug possession and get people with substance use disorder (SUD) into treatment, the crisis will go away. Except, it didn’t.

“When Oregon embarked on a landmark plan three years ago to decriminalize hard drugs, it wagered that a focus on treatment over punishment would create a new model for drug policy around the country,” Mike Baker reported for The New York Times earlier this month. “But after a deluge of overdose deaths and frequent chaos in the streets of Portland, Gov. Tina Kotek signed into law […] a measure to restore criminal penalties for drug possession.”

The new law rolls back a 2020 voter-approved measure by making so-called personal use possession a misdemeanor punishable by up to six months in jail. It also establishes ways for treatment to be offered as an alternative to criminal penalties by encouraging law enforcement agencies to create deflection programs that would divert people to treatment services instead of the criminal justice system.

Measure 110, approved by voters with 58 percent support in 2020, made the personal use possession of illicit drugs such as heroin, cocaine, and methamphetamine only punishable by a ticket and a maximum fine of $100. Supporters said treatment is more effective than jail in helping people overcome addiction and that the decades-long approach of arresting people for possessing and using drugs hasn’t worked.

Farther north, British Columbia became the first province in Canada last year to decriminalize the use of hard drugs as part of its efforts to tackle its deadly opioid crisis. But there, too, the policy is now facing pushback, leaving its future uncertain.

Portugal was the trailblazer for this approach, but the European country has also had second thoughts lately. “Portugal decriminalized all drug use, including marijuana, cocaine, and heroin, in an experiment that inspired similar efforts elsewhere, but now police are blaming a spike in the number of people who use drugs for a rise in crime,” reported Anthony Faiola and Catarina Fernandes Martins in The Washington Post last year.

“Portugal became a model for progressive jurisdictions around the world embracing drug decriminalization, such as the state of Oregon, but [...] some Portuguese voices are now calling for a rethink of a policy that was long a proud point of national consensus. Urban visibility of the drug problem, police say, is at its worst point in decades and the state-funded nongovernmental organizations that have largely taken over responding to the people with addiction seem less concerned with treatment than affirming that lifetime drug use should be seen as a human right.”

Clearly, decriminalization has not ended Portugal’s drug problem. Overdose rates hit 12-year highs and almost doubled in Lisbon from 2019 to 2023. Sewage samples in Lisbon show cocaine and ketamine detection is now among the highest in Europe.

It seems that in all three places—Portugal, British Columbia, and Oregon—decriminalization primarily brought drug use out in the open without actually curbing it. So, why didn’t it work?

“Measure 110 did not reduce Oregon’s drug problems,” wrote Keith Humphreys and Rob Bovett in a recent analysis piece in The Atlantic. “The drug overdose death rate increased by 43 percent in 2021, its first year of implementation—and then kept rising. The latest CDC data show that in the 12 months ending in September 2023, deaths by overdose grew by 41.6 percent, versus 2.1 percent nationwide. No other state saw a higher rise in deaths. Only one state, Vermont, ranks higher in its rate of illicit drug use.”

It appears the notion that decriminalization will induce a flood of help-seeking from people with addiction was hopelessly naive. “The replacement for criminal penalties, a $100 ticket for drug possession with the fine waived if the individual called a toll-free number for a health assessment, with the aim of encouraging treatment, failed completely,” wrote Humphreys and Bovett. “More than 95 percent of people ignored the ticket, for which—in keeping with the spirit of Measure 110—there was no consequence.”

Humphreys and Bovett have spent the better part of their careers studying and working on drug policy and were not surprised that “trivial pressure” to seek treatment proved ineffective. “Fentanyl and meth addiction are not like depression, chronic pain, or cancer, conditions for which people are typically motivated to seek treatment. Even as it destroys a person’s life, addictive drug use by definition feels good in the short term, and most addicted people resist or are ambivalent about giving that up. Withdrawal, meanwhile, is wrenchingly difficult. As a result, most addicted people who come to treatment do so not spontaneously but through pressure from family, friends, employers, health professionals, and, yes, the law.”

The reporters contend that Oregon didn’t even need Measure 110 as “a rebuke to the War on Drugs” because Oregon “had never fought such a war.” The state had the country’s “lowest rate of imprisonment for nonviolent crimes. Short local jail sentences for drug possession were permitted, but diversion programs, including drug courts and community supervision with drug testing, were widely used. However, after Measure 110 was passed and the threat of jail time eliminated, the flow of people into these programs slowed.”

Humphreys and Bovett do not advocate a return to severe crackdowns by the justice system. “Many states are far more punitive toward drug users than Oregon was before Measure 110 passed. They overemphasize incarceration of people who use drugs, they do not provide adequate, publicly funded health treatment and health insurance, and they do not use criminal justice productively to discourage drug use (for instance, by using arrests and probations as leverage to get people into drug courts and treatment).”

If these states could be persuaded to dial down their overly harsh criminal-justice approach to approximate what Oregon had before Measure 110, “except with adequately funded, evidence-based prevention and treatment, substantial gains in public health and safety would likely follow,” they feel. “The future of successful drug-policy reform is not greater laxity in states that are already quite progressive in their approach to drug use; it is using criminal justice and public health together in a balanced, pragmatic fashion, as Oregon is now poised to do.”

While the decriminalization of heroin, cocaine, and meth was based on naive assumptions about addiction, at least proponents have not attempted to declare these substances to be harmless or even good for your health. In the case of the legalization and commercialization of cannabis, that is exactly what happened.

In Colorado, cannabis has been legal for “medical” use since 2000 and for recreational use since late 2012. On November 7, 2000, 54 percent of Colorado voters approved Amendment 20, which amended the state constitution to allow the use of marijuana in the state for approved “patients” with written “medical consent.” Twelve years later, that medical figleaf was dropped with Amendment 64, which led to full recreational legalization in December 2012 and state-licensed retail sales in January 2014.

The impact has been widespread and negative. Few people are aware that marijuana legalization is largely driven by well-organized multi-state operators selling unregulated and unsafe commercial products. Foundry Treatment Center Steamboat Managing Partner Ben Cort has been raising awareness of these issues for years. In a webinar last year, Cort explained how the potent products the marijuana industry is selling in the 21st century are a far cry from the "weed" people smoked in the 1970s. The reason is the extreme THC (delta9-tetrahydrocannabinol) content of today's cannabis products.

The average THC content of cannabis products seized by the Drug Enforcement Administration was 15 percent in 2021, up from just four percent in 1995. However, many commercial cannabis products now advertise THC concentrations of up to 99 percent. The potency of the plant is irrelevant because the plant is being converted into products not used on its own. According to Cort, "Rarely, if ever, do we treat an individual who is only using cannabis in anything like its natural form; they use highly concentrated THC produced by extracting THC from the plant."

"There are now users who consume several grams of this unnaturally potent THC daily," says Ben Cort. "I know that because we treat such patients here at our program." The result of the widespread use of these powerful concentrates: "Addiction rates are considerably higher, the higher the potency goes as are negative psychiatric complication."

According to healthcare analytics company Truveta, rates of diagnoses for cannabis-induced disorders were more than 50 percent higher at the end of November 2023 than in 2019. It has been estimated that approximately three in ten people who use marijuana have a cannabis use disorder.

Despite the addiction risk, Colorado is still expanding the availability of cannabis. Since January, retail marijuana stores have been allowed to accept payment for products ordered online. Online ordering became legal in Colorado late last year, but customers still had to pay for their orders in person.

American Heart Association warned last year that marijuana use is linked with an increased risk of heart attack and heart failure. “As more people across the US use marijuana, [...] two new studies suggest its regular intake may damage heart and brain health. In one study, daily use of marijuana raised the risk of developing heart failure by about one-third, even after considering other factors, compared to people who reported never using marijuana. In a second study, older people with any combination of Type 2 diabetes, high blood pressure, and high cholesterol who used marijuana, significantly increased their risk for a major acute heart or brain event while hospitalized, compared to those who reported not using marijuana.”

Legalizing dangerous substances like cannabis because people bought into claims of unproven medical benefits or tolerating the illegal use of heroin and cocaine in the hope that people addicted to these drugs will simply come forward asking for treatment without any encouragement is a path fraught with dangers as it turned out. Addiction is a complex bio-psycho-social disease characterized by the continued use of psychoactive substances or the continuation of addictive behaviors despite negative consequences.

Addiction is frequently driven by underlying trauma and depression, and simply decriminalizing maladaptive attempts to self-medicate such underlying conditions does nothing to address them. Treating a severe substance use disorder often requires the concerted efforts of the affected individuals, their families, and a team of treatment professionals addressing the root causes of the SUD.

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Mar

When Cannabis Use Kills

Many Americans are not aware of the grave dangers cannabis use can entail. Ever since the nationwide—if not international—movement to promote marijuana as a healthy substance or even as a medication succeeded beyond its wildest expectations, the risk awareness connected to the use of THC (delta9-tetrahydrocannabinol), the main psychoactive ingredient in cannabis, has been steadily eroded.

Twenty-four states (plus Guam, the Northern Mariana Islands, the US Virgin Islands, and the District of Columbia) now allow the recreational use of cannabis, and around a dozen states, plus Puerto Rico, allow the "medical" use of cannabis products. However, the federal government continues to categorize marijuana as a Schedule I drug, a category for substances like heroin and cocaine that have no medical use and a high potential for misuse and addiction. As of this writing, the recommendation of federal scientists and associated reporting indicate that cannabis may be rescheduled to a lower schedule, a move that could further relax cannabis prohibitions.

Addiction—a severe cannabis use disorder—is not the only risk. Marijuana use can also result in acute psychosis and violent behavior with devastating consequences.

In January, Los Angeles television station KTLA reported on a manslaughter case in which a man was stabbed to death by a Ventura County woman after both used cannabis together.
In May 2018, 32-year-old Bryn Spejcher killed 26-year-old Chad O'Melia after taking several hits from a bong filled with marijuana. Spejcher reportedly experienced an adverse reaction resulting in a cannabis-induced psychotic episode. During that psychotic break, she stabbed O'Melia multiple times, eventually killing him. She also stabbed herself repeatedly, officials said.
According to KTLA, police officers arrived the next morning at O'Melia's apartment to find him "in a pool of blood and Spejcher screaming hysterically while still holding a knife in her hands. As officers tried to disarm her, Spejcher plunged the knife into her neck, authorities said."
Officers had to use "a taser and several baton blows before they were able to finally disarm Spejcher," police said. "A long-serrated bread knife was taken from her hands." Spejcher, who had been dating the victim for a few weeks, was found to have stabbed O'Melia 108 times with three different knives.

On January 23, a judge sentenced Spejcher to two years of felony probation and no prison time. She had been out on bail since the 2018 slaying. She had faced up to four years in prison along with sentence enhancements. However, the judge cited evidence and expert testimony, saying the defendant did not know marijuana would have this type of effect on her when she smoked with the victim that night.

Family members of Chad O'Melia expressed outrage at the leniency of the sentence and said they were worried about the broader impact of this ruling.

NOT YOUR PARENTS’ WEED
The core of the problem is that most people don't know that today's cannabis products are largely unregulated and extremely potent. They don't believe that marijuana use can result in psychosis or violent behavior, and they have uncritically absorbed the claims promoted by the cannabis industry of unproven medical benefits of marijuana use for various ailments. Hence, the excuse that a defendant cannot know marijuana would have a murderous effect.
The effect is well known, however. "Cannabis is involved in approximately 50 percent of psychosis, schizophrenia, and schizophreniform psychosis cases," wrote Shrivastava, Johnston, et al. in a 2014 study on the neurobiology of cannabis and psychosis.

A recent article in the Wall Street Journal pointed out that "more frequent use of marijuana that is many times as potent as strains common three decades ago is leading to more psychotic episodes, according to doctors and recent research."

Foundry Treatment Center Steamboat CEO Ben Cort has been warning for years that the legalization of cannabis has been largely driven by well-organized multi-state operators selling unregulated and unsafe commercial products. "The average cannabis product sold in Colorado in 2016 had a THC content of 63 percent," he explained in a webinar last year. In the 1970s, "weed" contained roughly 1–3 percent THC.

"There are now users who consume several grams of this weaponized THC daily," Cort says. "I know that because we treat such patients here in our program." The result of the widespread use of these powerful concentrates: "Addiction rates are considerably higher, the higher the potency goes."

CANNABIS AND VIOLENT BEHAVIOR
"According to research studies, marijuana use causes aggressive behavior, causes or exacerbates psychosis, and produces paranoia," wrote Miller, Ipeku, and Oberbarnscheidt in a 2020 study on marijuana use and violence. They, too, noted that marijuana products are far more potent in THC concentrations than they used to be. "Accordingly, and demonstrated in direct studies, more potent marijuana results in a greater risk for paranoid thinking and psychosis. In turn, paranoid behavior increases the risk for paranoid behaviors and predictably associated with aggressive and violent behaviors."

In their study, Miller et al. presented many case examples, one of which pertained to Nikolas Cruz, who killed 17 students and staff at the Marjory Stoneman Douglas High School in Parkland, Florida, in 2018. "Cruz was diagnosed as developmentally delayed at age three and had numerous disciplinary issues dating to middle school. From a young age, he started consuming marijuana heavily." He would "frequently 'hear demon voices' and would consume large amounts of marijuana to try and silence those voices. He also attempted suicide. During an interview after his mass shooting, he stated that he used a lot of marijuana as well as [the] prescription tranquilizer Xanax."

In May 2017, Richard Rojas purposely drove a car along three blocks of pavement in New York's Times Square, killing a teenager and injuring 22 other people. "Evidence indicates that Rojas was a heavy marijuana user. He admitted to the consumption of spiced-up marijuana right before committing the attack," reported Miller et al. in their study.

The year before, Arcan Cetin carried out a mass shooting that killed five people and injured many others at the Cascade Mall in Washington, DC. "Evidence indicates that Cetin was a heavy marijuana consumer. Further, he had a past of violent behavior, with some incidents including the consumption of marijuana."

Twenty-one-year-old white supremacist Dylan Roof murdered nine black people who were attending a prayer service in Charleston, South Carolina, in 2015. His declared intention was to start a race war. His acts were preceded by years of substance misuse. Reports revealed that Roof's drug use started at the age of twelve when he would smoke marijuana three times a day.
Dzhokhar Tsarnaev and his brother Tamerlan, who killed three people and injured more than 250 in the 2013 Boston Marathon bombing, were heavy marijuana users since they were young teenagers.

In the cases presented by the authors, "one of the recurring conditions that most likely led perpetrators to commit violence was paranoia… It is very likely that marijuana played an active role in these people's paranoia, considering that the chemical composition of the drug has compounds that alter a person's perception of reality."

The authors note that "marijuana intoxication results in panic reactions and paranoid feelings whose symptoms lead to violence. The sense of fear, loss of control, and panic are associated with violence. Also, marijuana use increases heart rate, which may be associated with violent behavior."

When people stop using marijuana, they may experience a variety of withdrawal symptoms, including sleep disturbance, irritability or restlessness, loss of appetite, anxiety, and sweating. "Experiencing any of these symptoms can make a person angry, ranging from mild irritation to violent rage," explained Miller, Ipeku, and Oberbarnscheidt. "Marijuana withdrawal can lead to intimidating violent or bullying behavior, endangering the perpetrator or other people and property."

In the case of Bryn Spejcher and Chad O'Melia, the use of high-potency THC sadly also resulted in a psychotic break and the death of a human being. "We now have concentrated THC products such as oil, shatter, dab, and edibles that have been able to get the THC concentration upwards of 95 percent. There is absolutely no research that indicates this level of THC is beneficial for any medical condition. The purpose of these products is to produce a high, and the increased potency makes them potentially more dangerous and more likely to result in addiction," wrote Elizabeth Stuyt, MD, in "The Problem with the Current High Potency THC Marijuana from the Perspective of an Addiction Psychiatrist."

Foundry Treatment Center Steamboat treats adults experiencing cannabis use disorders and other substance use and co-occurring mental health disorders. While cannabis has long been one of the substances used by people suffering from substance use disorders, Foundry Steamboat clinicians have seen significant increases in the acuity of symptoms arising from problematic cannabis use. High-potency THC products, like other psychoactive substances, pose unique health risks, including the potential to cause or exacerbate paranoia, psychosis, hyperemesis, anxiety disorder, and more. While violence and severe adverse mental health impacts resulting from cannabis use affect a small percentage of cannabis users, it seems that these potential harms should be better known. It is also worth noting that treating cannabis use disorder and its co-occurring mental health disorders can be especially challenging. Patients experiencing psychosis, paranoia, or heightened anxiety related to cannabis use may require more treatment than people not experiencing these conditions.

Despite growing evidence that today's high-potency THC products pose specific health risks, reporting indicates increasing rates of adolescent and teen consumption, and states and the federal government seem likely to reduce further cannabis restrictions to expand commercial access.

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Jan

Why More Potent Cannabis and More Frequent Use Are Contributing to Higher Rates of Psychosis

Some federal scientists have reportedly concluded that "marijuana is neither as risky nor as prone to abuse as other tightly controlled substances and has potential medical benefits, and therefore should be removed from the nation's most restrictive category of drugs."

This astounding recommendation is contained in a 250-page scientific review "provided to Matthew Zorn, a Texas lawyer who sued Health and Human Services officials for its release and published it online," Christina Jewett and Noah Weiland reported for The New York Times in January. An HHS official reportedly confirmed the authenticity of the document.

It looks like federal health officials could soon follow the example of many states and legalize cannabis products for "medical" and recreational use. This momentous volte-face has been expected for quite some time now.

Since the 1970s, marijuana has been considered a Schedule I drug, a category for substances like heroin and cocaine that have no medical use and a high potential for misuse and addiction. Despite this prohibition, proponents of legalized cannabis use have been pushing unproven medical benefits of marijuana use for various ailments.

"Empirical and clinical studies clearly demonstrate significant adverse effects of cannabis smoking on physical and mental health as well as its interference with social and occupational functioning," wrote Svrakic, Lustman, et al. in "Legalization, Decriminalization & Medicinal Use of Cannabis" in 2012. "These negative data far outweigh a few documented benefits for a limited set of medical indications, for which safe and effective alternative treatments are readily available. If there is any medical role for cannabinoid drugs, it lies with chemically defined compounds, not with [the] unprocessed cannabis plant. Legalization or medical use of smoked cannabis is likely to impose significant public health risks, including an increased risk of schizophrenia, psychosis, and other forms of substance use disorders."

According to The New York Times article, the new federal "documents show that scientists at the Food and Drug Administration and the National Institute on Drug Abuse have recommended that the Drug Enforcement Administration make marijuana a Schedule III drug, alongside the likes of ketamine and testosterone, which are available by prescription."

At the same time, the review noted that marijuana misuse does lead to "physical dependence" and "some people develop a psychological dependence." Nevertheless, the review concluded, "the likelihood of serious outcomes is low."

Many addiction experts disagree. "They note that any long-running study of marijuana that the federal authorities have reviewed may not account for the escalating strength and increasingly frequent use of marijuana, which has been tied to psychiatric problems and chronic vomiting among users in recent years," wrote Jewett and Weiland.

For years, there was the promise—ultimately unmet—that marijuana could be used to combat opioid abuse or treat mental health problems, Keith Humphreys, a Stanford health policy professor and a former federal drug policy official, told The Times. "As the science has gotten better in the intervening decades, most of the therapeutic claims about cannabis have been debunked," he said.

A recent article by Julie Wernau in the Wall Street Journal made the same point. "More frequent use of marijuana that is many times as potent as strains common three decades ago is leading to more psychotic episodes, according to doctors and recent research," she wrote.

Few people know that the legalization is largely driven by well-organized multi-state operators selling unregulated and unsafe commercial products. Foundry Treatment Center Steamboat CEO Ben Cort has been raising awareness of these issues for years. In a recent webinar, Cort explained how the potent products the marijuana industry is selling in the 21st century are a far cry from the "weed" people smoked in the 1970s. The reason is the extreme THC (delta9-tetrahydrocannabinol) content of today's cannabis products.

The Cannabis sativa plant has over 480 constituents, with THC being the main psychoactive ingredient. "The average cannabis product sold in Colorado in 2016 had a THC content of 63 percent," Cort said. He doesn't like to talk about the plant anymore because the people treated at Foundry Treatment Center Steamboat for cannabis use disorder (CUD) have not been smoking the pot passed around in the 1970s; they are using high-potency commercially produced cannabis-based products.

According to healthcare analytics company Truveta, rates of diagnoses for cannabis-induced disorders were more than 50 percent higher at the end of November than in 2019, "The trend is contributing to the broader burden of caring for people who developed mental health and addiction problems during the pandemic," Wernau reported.

Symptoms of serious mental disorders, including schizophrenia, often emerge in adolescence. While cannabis cannot be definitively isolated yet as the only culprit in any particular case, a growing body of evidence seems to support this conclusion. Large studies show a clear link between frequent and more potent cannabis use and higher rates of psychosis, particularly in young users, Yale University psychiatrist Deepak D'Souza told the Wall Street Journal.

Even one psychotic episode following cannabis use was associated with a 47 percent chance of developing schizophrenia or bipolar disorder, a 2017 study published in the American Journal of Psychiatry showed. The risk was highest for people 16 to 25 years old and higher than for substances such as amphetamines, hallucinogens, opioids, and alcohol.

The Wall Street Journal cited the example of Dr. Karen Randall, who moved to Pueblo, Colorado, for a job in an emergency room more than a decade ago after working in Detroit for 18 years. She thought it would be like retiring early. She bought a ranch where she could ride horses in an area locals now call the Napa Valley of Cannabis. "I see more psychotic people here than I did in Detroit," she told the Wall Street Journal. "We're just making this huge population of people who we can no longer fix." Dr. Randall is right, we can 'no longer fix' these issues in an acute setting like an emergency department. Individuals affected by the type of THC-induced psychosis she sees need long-term care.

Cannabis use disorder (CUD) is a potentially serious condition frequently requiring treatment. Sadly, people presenting with CUD do not enjoy the same support from society as people with other substance use disorders, explained Cort. "If you ask your doctor for help because you drink too much alcohol or because you can't stop using opioids, you can typically expect encouraging words, immediate action, and specialist referrals. If you ask your doctor for help because you are concerned that you are using too much THC, you may only get a shrug or a simple recommendation to cut down." Many doctors, especially those who have not graduated recently from medical school or received new training in cannabis use disorder, think that cannabis use is relatively harmless or poses few risks. Some doctors believe that cannabis may be less harmful than using alcohol or medications to cope with stress symptoms and anxiety.

"At Foundry Steamboat, we treat patients whose cannabis use disorder had been dismissed as 'only weed' because our society does not recognize cannabis as an addictive substance even though it is objectively demonstratable as such," Cort said. In treatment, Foundry Steamboat has to prepare clients for a trigger-rich environment with ubiquitous "pot shops," billboards advertising cannabis products, and family systems and friend groups in which cannabis use is considered normal.

Foundry Treatment Center Steamboat offers men's residential treatment and telehealth for adults of all genders experiencing substance use and mental health disorders and offers specialized treatment for cannabis use disorder. Treating cannabis addiction can be complex and prolonged compared to the treatment for other types of substance use disorders. Some people presenting with a cannabis addiction experience lengthy periods of psychosis and hyperemesis syndrome, which may require lengthy periods of supervised stabilization before clients are mentally and physically able to safely engage in treatment.

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Dec

Why Cannabis Is Not a Good Treatment Option for Anxiety

The USFood and Drug Administration (FDA) has not approved the use of cannabis as a treatment for any medical condition. However, after a long legalization campaign, most states now allow "medical" use of marijuana to treat pain, nausea, and other conditions. Twenty-three states, theDistrict of Columbia, and Guam have fully legalized the drug for recreational use as public support for legalization rose rapidly—despite marijuana being illegal at the federal level.

Cannabis sativa (the marijuana plant) contains many active compounds. The best known aredelta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the primary ingredient in marijuana that makes people "high."

Today, many Americans believe in the unproven health benefits of cannabis, but few people know about the danger of addiction and other health impacts of marijuana use. The FDA continues to classify cannabis as a Schedule I controlled substance "with no currently accepted medical use and a high potential for abuse." Recent research estimates that approximately three in ten people who use marijuana have cannabis use disorder (CUD). For people who begin using cannabis products before the age of 18, the risk of developing a marijuana addiction is even greater.

Among the many risks and possible side effects of "medical" marijuana, the Mayo Clinic lists

increased risk of heart attack and stroke, potential for addiction, hallucinations or mental illness, and withdrawal symptoms.

FoundryTreatment Center Steamboat CEO Ben Cort has raised awareness of these health risks for years. In a recent webinar forHarmony Foundation, Cort pointed out that the THC levels in cannabis products have dramatically increased in the last few decades from less than one percentTHC in the seventies to well beyond 40 percent in recent years. And that's just the plants—concentrates and other products can reach 99 percent THC.

Cort doesn't really want to talk about the plant anymore because the people who are treated at Foundry Treatment Center Steamboat for CUD have not been smoking the pot passed around in the 1970s. "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 2017book 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." Cort will publish a new book in 2024 that focuses, in part, on the wide-ranging effects of expanded cannabis commercialization since the release of his first publication.

One group of individuals regularly self-medicating with cannabis is people with anxiety. "Lots of people with anxiety are counting on cannabis's ability to treat their symptoms," wrote Andrea Petersen and Julie Wernau in the Wall Street Journal in October. But "there's a problem: The science shows that it probably doesn't help, and it may make those symptoms worse."

The cannabis industry is promoting its products as helpful for anxiety because it's a very lucrative market. "Anxious consumers have turned to weed and edibles for relief as treatments for their ailments have become harder to find," wrote Petersen and Wernau. "The number of available and affordable therapists badly lags demand, and traditional medications don't work for everyone."

Petersen has personal experience with anxiety issues and cannabis use. In her 2017book On Edge – A Journey Through Anxiety, she used that experience and her expertise as a health reporter to explore the nature of anxiety and its treatment options.

WhenPetersen smoked marijuana in college, she experienced a psychotic episode and had a panic attack. She didn't try to self-medicate with cannabis again. Sheavoided alcohol, too, realizing that her abstention was not typical. "Many people with anxiety disorder drink to relax, a way of self-medicating."

In OnEdge, Petersen also recalled the example of her friend Mike, who turned toalcohol and drugs to try to ease his anxiety and depression. "For Mike,marijuana and narcotics like Vicodin were a revelation," she wrote."They took away the worrying. They calmed his twitchy body." Itdidn't last, of course. "After a while, the marijuana turned on Mike. Itstarted making him more anxious. His drinking and use of narcotics slid intoaddiction. He went to rehab. He relapsed. He kicked the drugs and alcoholagain."

Manyusers want to believe that cannabis can make them less anxious, and themarijuana industry is more than happy to accommodate that belief. "Yetlittle independent scientific evidence shows that cannabis is an effectivetreatment for anxiety problems, and some studies have found it can worsensymptoms," wrote Petersen and Wernau. "Researchers say this isparticularly true for products high in THC, the substance responsible formarijuana's intoxicating effects."

"Ihave patients who use it every day. They say it really helps," BethSalcedo, a psychiatrist and medical director of the Ross Center in Washington,DC, who specializes in treating anxiety disorders, told the Wall StreetJournal. "My message is that if it were really working for you, youwouldn't be here with me."

WhenDr. Salcedo talks with patients about what their anxiety was like before cannabis, she said they usually report that their anxiety is unchanged. Any transient relief they feel may be due in part to marijuana's high, she said.

Cannabis is big business. Anxiety is one of the most common symptoms that customers of cannabis dispensaries are looking to address. Several states have made anxiety a qualifying condition to receive a "medical" marijuana card despite there being any supporting evidence to support this.

"Two recent studies show the potential problems with treating anxiety with cannabis," explained Petersen and Wernau. "Cannabis use was significantly associated with increased odds of developing anxiety conditions, according to a review of research published in 2020 in the Canadian Journal ofPsychiatry. Recent cannabis use was associated with more severe symptoms in people with anxiety and mood disorders, according to another review published in 2018 in the Journal of Clinical Psychiatry."

Unsurprisingly, the marijuana industry has funded its own studies. In some surveys, cannabis users have reported that they have felt relief from anxiety symptoms after consuming cannabis. "There is some evidence that cannabidiol, or CBD, which is a nonintoxicating substance derived from cannabis, may relieve anxiety symptoms," reported Petersen and Wernau. However, the science is limited and does not support the use of THC to relieve symptoms.

While the benefits are questionable, the risks are clear. "Using cannabis regularly comes with a significant risk of addiction," wrote the WallStreet Journal reporters. "Marijuana use can become a disorder when people need to use an increasing amount to get the same effect and when the use interferes with work and relationships, among other symptoms."

Marijuana users also run a higher risk of psychosis. "Research has shown that cannabis use is associated with an increased risk for an earlier onset of psychotic disorders (such as schizophrenia) in people with other risk factors, such as family history," according to the National Institute on Drug Abuse(NIDA). "Cannabis intoxication can also induce a temporary psychotic episode in some individuals, especially at high doses. Experiencing such an episode may be linked with a risk of later developing a psychotic disorder."

Cannabis use disorder is a potentially serious condition frequently requiring treatment. "At Foundry Treatment Center Steamboat, we treat patients whose CUD was dismissed as 'only weed' because much of our society does not recognize cannabis as an addictive substance," says Cort. "One of the most pernicious effects of the cannabis industry's strategy of positioning the drug as medicine is that people generally believe that it is safe or poses no significant health risks. This extends to perpetuating the long-held belief that cannabis can provide a form of mental and physical relaxation. While this may be the case for some users, others have the opposite experience, and it can lead to very real and serious medical and mental health problems. The problem with allowing those profiting from the sale to define its uses is that they will always only tell one side of the story unless compelled to tell the entire story. Without considering negative, potentially negative, and unknown effects, it's like telling the story of Jack and The Beanstalk without the giant,"says Cort.

FoundryTreatment Center Steamboat developed a specific treatment track for people affected by cannabis use disorder (CUD) because the condition poses specific challenges. In 2000, Ben co-authored the first published best practices on treating CUD alongside Dr. LaTisha Bader in a medical text and reference book entitled Cannabis In Medicine and Evidence-Based Approach. He has spent the years since working to educate clinicians and medical professionals in our field on these practices. Many people experiencing cannabis use disorder suffer from extended periods of cannabis-induced psychosis and must be safely housed and medically supervised until their symptoms subside enough for them to start treatment programming.

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Nov

America’s Out-of-Control Drug Overdose Crisis

“More Americans than ever are dying fromfentanyl overdoses as the fourth wave of the opioid epidemic crashes throughevery community, in every corner of the country,” reported Nadine Yousif on BBC News in September.

A recent study by researchers at theUniversity of California, Los Angeles, outlined the four waves: “The UnitedStates overdose crisis has escalated in an exponential fashion for over fourdecades, yet with a shifting profile of drugs implicated in each successive ‘wave’of the crisis. The first wave of the overdose crisis is typically argued tohave begun in the late 1990s or early 2000s with the rise of deaths involvingprescription opioids, the second wave beginning in 2010 driven by a shift toheroin, and the third wave beginning in 2013 driven by illicit fentanylanalogs. Recently, scholars have argued that the ‘fourth wave’ of the USoverdose crisis has begun, in recognition of rapidly rising polysubstanceoverdose deaths involving illicitly manufactured fentanyl, with stimulantsplaying a key role.”

In 2018, in a rare moment of bipartisanship,Republicans, Democrats, and former President Trump came together aroundlegislation that dedicated $20 billion to the treatment and prevention of andrecovery from drug addiction. Five years later, the SUPPORT Act has lapseddespite the fact that the number of Americans dying from drug overdoses hasincreased by more than 60 percent in those five years—largely driven by thepowerful synthetic opioid fentanyl.

“We are in the middle of a crisis ofproportions we couldn’t have imagined even five years ago when the originalSUPPORT Act was passed,” Libby Jones, program director of the OverdosePrevention Initiative at the Global Health Advocacy Incubator, told Politico. “If they can’t pass this, it’sreally sad.”

“Community-based organizations are on thefrontlines of the overdose crisis, and the SUPPORT Act delivers crucial fundingand resources, allowing them to continue providing hands-on overdose preventioncare,” Libby Jones, the program director of the Overdose Prevention Initiativeat the Global Health Advocacy Incubator explained on a Johns Hopkins webpage. “Some of the originalprovisions in the 2018 SUPPORT Act saw modest increases, while others sawsizeable expansion of funding.”

Highlights of the SUPPORT Act include:

● Funding for communities ofrecovery was raised by $11 million each year (from $5 million to $16 millionfor each of the fiscal years 2024 through 2028).

● Residential treatment programs forpregnant and postpartum people saw an increase in funding of $9 million yearly(from $29,931,000 to $38,931,000 for each of the fiscal years 2024 through2028).

A few days ago, the 2018 SUPPORT Act expired,and it doesn’t look like Congress is coming to the rescue any time soon. TheHouse just restarted legislating after emerging from 22 days without a speaker.“Despite its dysfunction, the House is further along legislatively than theDemocratic-controlled Senate,” wrote Carmen Paun on Politico. “The House Energy andCommerce Committee unanimously approved a new SUPPORT Act in July. But thatmeasure’s limited ambition suggests a reason for the lack of urgency to passit.”

A bipartisan group of representatives focusedon mental health and substance use has proposed more than 70 bills to fight theoverdose crisis. Still, there hasn’t been the sense of urgency lawmakersdisplayed five years ago.

While some have hailed the SUPPORT Act as asignificant accomplishment, it has barely made a dent in the drug overdoseepidemic. “Over 100,000 deaths is not a success in this country. It’s not apolicy success,” Regina LaBelle, a former White House Office of National DrugControl Policy acting director, told Politico.

Addiction is an extremely complex diseasedriven by complicated bio-psycho-social aspects. Allocating funds to a fewgroups and organizations can only be a small part of the solution.

“When addiction epidemics strike, we want toknow why,” wrote psychiatry professor Carl Erik Fisher in his sweeping 2022analysis of the addiction crisis, The Urge. But a complex situation with amultitude of factors is too often reduced to a simplistic scenario. “What isnecessarily a complex web of intersecting forces is too often reduced to onesimplistic story: trauma, brain disease, an evil and unstoppable drug, a badpill-mill doctor, a hereditary taint, or a weak will, or poor morals.”

While certain pharmaceutical, alcohol,cannabis, and tobacco industries cannot exactly be viewed as blameless—Fisherregards many such companies as “addiction supply industries”—they are only partof the problem. “Epidemics are never caused solely by an inherent power of thedrugs themselves or the efforts of the addiction supply industries; there isoften if not always, social wounding underneath, driving the substance use.”

The combination of social disconnection,anxiety, depression, and substance misuse can expose individuals to seriousphysical and mental health risks. People with substance use disorder needcomprehensive treatment to address all relevant concerns.

Foundry Treatment Center Steamboat ChiefOperating Officer Tom Walker is well-versed in the effects of governmentpolicies and funding on population health. “Our legislators need to prioritizethe continuation of the SUPPORT Act or legislation like it to ensure thatresources exist to fight the nation’s leading cause of preventable death. Ourelected officials and government departments responsible for allocating fundsshould look carefully at the social determinants of health that lead to theastonishingly high and deeply troubling rates of mental and behavioral healthdisorders we are facing. Funding treatment is important, but understanding andstemming the underlying factors contributing to intensifying and rampantanxiety, depression, trauma, hopelessness, homelessness, and family systemdysfunction is also critical,” says Walker.

Foundry Treatment Center Steamboat operates aspecialized treatment program for men experiencing substance use andco-occurring mental health disorders. Its parent company, NRT Behavioral Health^TM,also operates intensive outpatient and telehealth services for adults inColorado and Wyoming. These programs focus on helping individuals and familiesidentify the root causes that lead to the development of substance use andco-occurring mental health disorders, learn ways to manage these issues, andreduce the stressors that perpetuate a perceived need to use substances to feelnormal or escape overwhelming distress and pain.

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Aug

Suicides in the US Reach All-time High

This article includes the topic of suicide. If you or someone you know is in crisis, please call, text, or chat with the Suicide and Crisis Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.

Suicides in the US reached an all-time high in 2022, according to new data provided by the Centers for Disease Control and Prevention (CDC). According to provisional findings from death certificates, about 49,449 people took their own lives last year, an estimated 3 percent increase compared to 2021.

KFF, an independent source for health policy research, notes that “Increases in the number of suicide deaths follow high levels of mental health symptoms during COVID, rising financial stressors, and longstanding difficulty accessing needed mental health care—particularly for some populations. Total suicide numbers may be undercounted, as some research suggests that suicides may be misclassified as drug overdose deaths since it can be difficult to determine whether drug overdoses are intentional.”

“The largest increases were seen in older adults,” reported NBC. Deaths rose nearly seven percent in people ages 45 to 64 and more than eight percent in people 65 and older. White men, in particular, have very high rates, the CDC reported. The suicide rate among males in 2021 was approximately four times higher than the rate among females. Males make up about half of the US population but nearly 80 percent of suicides.

As we reported on this blog, men are also much more prone to drug overdose deaths than women, and the fatalities are not always accidental. Another important factor is the wide availability of firearms. According to an analysis by the Johns Hopkins Bloomberg School of Public Health, “Gun suicides continued to reach all-time highs, increasing 1.6 percent from a previous record in 2021; 26,993 people died by gun suicide in 2022.”

“While the increase in gun homicides has gained public awareness, less attention has been paid to the growing epidemic of gun suicides—which historically make up the majority of gun deaths. The gun suicide rate has steadily increased, nearly uninterrupted, since 2006. In 2021 it reached the highest level since the CDC began recording such data in 1968; and this past year, in 2022, it surpassed that record,” the JHU researchers wrote.

The current epidemic of suicides by white, middle-aged men is correlated with an epidemic of loneliness. Approximately one in five American men say they do not have a close friend, according to the Survey Center on American Life's May 2021 American Perspectives Survey. “Only 30 percent of men reported having a private conversation with a close friend when they divulged personal emotions in the past week,” wrote psychiatry professor Charles Hebert in Newsweek in 2022.

Earlier this year, US Surgeon General Vivek Murthy issued an advisory on the “healing effects of social connection,” in which he warned that “about one-in-two adults in America reported experiencing loneliness” in recent years. “Loneliness is far more than just a bad feeling—it harms both individual and societal health,” Dr. Murthy wrote. “It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death. The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day and even greater than that associated with obesity and physical inactivity.”

Loneliness, social disconnection, anxiety, depression, and other stressors can lead to substance misuse and, ultimately, suicide. “There is considerable evidence from population-based and clinical studies supporting a positive association between psychosocial adversity, negative affect, and chronic distress, and addiction vulnerability,” stated Rajita Sinha in a 2009 study entitled “Chronic Stress, Drug Use, and Vulnerability to Addiction.”

Addressing social isolation and chronic distress usually requires people to seek help — an act that some men see as a weakness. “Men are socialized to not ask for help or be vulnerable—and they can be penalized when they challenge this notion,” wrote David Mayer in Harvard Business Review in 2018. “An informative set of studies from 2015 finds that when male (but not female) leaders ask for help, they are viewed as less competent, capable, and confident. And when men make themselves vulnerable by disclosing a weakness at work, they are perceived to have lower status. This is problematic, as not seeking help when you need it or admitting areas for improvement inevitably leads to mistakes and less development.”

The combination of social disconnection, anxiety, depression, and substance misuse can expose individuals identifying as male to serious physical and mental health risks. Men with substance use disorder need comprehensive treatment to address all relevant concerns.

Foundry Treatment Center Steamboat operates a specialized men’s treatment program for adult males experiencing substance use and co-occurring mental health disorders. The program regularly treats men struggling with feelings of isolation, loss, trauma, and hopelessness. As previously reported by Foundry Steamboat, many of the men the program serves perceive a lack of purpose and meaning, which can contribute to relationship problems and depression.

“Living with active substance use disorder — even before someone knows that they have a problem — can cause extreme isolation and loneliness. Addiction destroys relationships and separates people from the very people best positioned to help them. Men with addiction are at especially high risk of suicidal ideation and suicide attempts for numerous reasons. We regularly use symptom rating scales to assess client depression and suicidality to ensure that they are getting the clinical and psychiatric help they need to feel better while they pursue recovery. We also build strong therapeutic relationships with clients and get to know them and their situations,” says Foundry Steamboat Chief Clinical Officer Michael Barnes, Ph.D.

“The need to assure that men feel a sense of belonging and know that they have peers with whom they can have a conversation about how they are feeling is a central reason for our alumni program and why we encourage clients to find a community-based support group that suits them. Suicide is very often preventable if people feel authentically connected and are able to self-regulate their emotions, and it is a problem directly related to addiction that requires vigilance and study.”

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Contact Foundry

Call today to get started on your journey or if you have any questions.

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