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Alcohol and Drugs

According to the American Psychiatric Association, addiction is a serious illness. It can negatively affect one's physical health, financial security, interpersonal relationships and career. Alcohol and drug abuse are the foremost causes of preventable illnesses and premature death. Fortunately, many effective treatments are readily available; however, since this is a disease of denial, admission is often slow in coming, and the abuser is often the last to realize that the problem has become serious.

Tolerance, Dependence and Abuse

Tolerance

Anyone can develop a tolerance to a substance. Tolerance means that you must take more of the substance to feel the same effects you used to have with smaller amounts.

Dependence

Dependence means you get withdrawal symptoms if you suddenly stop using the substance.

Abuse

Abuse means that drug seeking behavior takes up a lot of your thoughts emotions and activities. You spend a lot of time thinking about it, looking for it, using it and getting over the effects of using it. You find it difficult to stop using or control how much you use.

Consequences of Use

Alcohol
Many people drink alcohol on social occasions. It can reduce anxiety and nervousness and loosen inhibitions. Regrettably, it is a central nervous system depressant and the recklessness, which often results from excessive drinking, causes serious accidents, permanent injuries and deaths. Alcohol causes birth defects, including fetal alcohol syndrome. Excessive drinking can lead to alcoholism, an illness which runs in families and is often associated with depression. Alcohol's serious effects on health include serious diseases of the liver, greater risk of heart disease, cancer, impotence and premature aging.

Marijuana

Marijuana, known as pot or grass, is associated with the following consequences: 
· Short-term memory loss 
· Accelerated heartbeat 
· Increased blood pressure 
· Difficulty concentrating and processing information 
· Lapses in judgment 
· Problems with perception and motor skills 

Many years of marijuana use can lead to an amotivational syndrome characterized by loss of ambition and an inability to carry out long-term plans or to function effectively.


Stimulants

Cocaine is a stimulant drug. This means it speeds up the brain and nervous system. Stimulants such as cocaine, crack, or amphetamines give a temporary illusion of enhanced power and energy. As the initial elevation of mood fades, a depression emerges. Stimulant abuse can lead to serious medical problems: 

· Heart attacks, even in young people with healthy hearts 
· Seizures, convulsions 
· Strokes 
· Psychosis 
· Violent, aggressive, anxious, or paranoid behavior 
· Bleeding blood vessels in the brain 
· Death

Overdose is common and can happen to anyone from even small amounts. Cocaine use during pregnancy may result in miscarriages, stillbirths, or low-birth-weight babies who may be physically dependent on the drug and later may develop behavioral or learning difficulties. Excessive crack use can lead to a permanent vegetative state. Long-term abuse can result in psychotic effects, such as paranoid delusions and hallucinations.


Heroin

Heroin can be smoked, eaten, sniffed, or injected. It produces an intense momentary feeling of pleasure. Serious withdrawal symptoms begin after 4 to 6 hours. These include: 

· Chills 
· Sweating 
· Runny nose and eyes 
· Abdominal cramps 
· Muscle pains 
· Insomnia 
· Nausea 
· Diarrhea 

Overdose is common and can happen to anyone from even small amounts. Heroin use during pregnancy may result in miscarriages, stillbirths, or premature delivery. Injection of heroin introduces unsterile substances into the bloodstream, which can result in severe damage to the heart, lungs, and brain. Sharing needles spreads diseases such as HIV and hepatitis B.


Hallucinogens

Hallucinogens are a group of drugs which can change perception and cause people to see or hear things that do not exist (hallucinations) and to have feelings of euphoria. They can produce changes in thought, sense of time and mood. Hallucinogens are drugs such as LSD ("acid") or the new "designer" drugs (such as "ecstasy") that are taken orally. Potential consequences of LSD include stressful "flashbacks"---re-experiencing the hallucinations despite not having taken the drug again, sometimes even years later. If ecstasy is used in excess and in combination with strenuous physical activity, serious results can follow including death from dehydration or an exceptionally high fever. The use of some of the hallucinogenic substances can be linked to neuronal damage in animals, and can be neurotoxic to humans. The most common consequence of hallucinogen use is impaired judgment that often leads to rash decisions and accidents.

Inhalants

Inhalants are breathable chemical vapors that cause psychoactive, mind-altering effects. Many people do not think that products, such as spray paints, glues, and cleaning fluids, are drugs because they were never meant to be used to achieve an intoxicating effect. Teenagers often abuse inhalants because they are easy to obtain and because they produce mind-altering effects when "sniffed" or "huffed." These chemicals reach the lungs and bloodstream very quickly and can be deadly. The result of high concentrations of inhalant fumes can cause heart failure or suffocation. There can be permanent damage to the nervous system with long-term abuse of inhalants.

Sedatives

Most individuals who take prescription medications use them responsibly. However, the non-medical use of prescription drugs is a serious public health concern. Physicians usually prescribe sedatives because they are highly effective in relieving anxiety and promoting sleep. Much harm can occur when they are taken in excess of the prescribed dose or without physician or nurse practitioner supervision, such as when they are obtained illegally. The combination of sedatives with alcohol or other drugs greatly increases the likelihood of death by overdose. The use of sedatives during pregnancy may cause birth defects (such as, cleft palate) in those who may also be physically dependent on the drugs.

Nicotine

Tobacco kills more than 430,000 U.S. citizens each year. This is more than alcohol, cocaine, heroin, homicide, suicide, car accidents, fire and AIDS combined. Cigarette smoke contains more than 4,000 chemicals, including toxins like ammonia. The main reason why cigarette smoking is such a serious concern is that nicotine is a powerful and addictive drug that has the potential to kill someone. Nicotine in tobacco products has addictive properties similar in severity to those of heroin. Stopping is difficult because of the unpleasantness of withdrawal, which includes feelings of anxiety, anger, frustration, irritability, insomnia, and depression. However, continued smoking may lead to far more dire consequences, such as cancer, high blood pressure, lung cancer, heart attacks, emphysema, and ulcers.

Treatment

The treatment process for drug and alcohol will help patients recognize their problem. This process is often complicated by a lack of understanding about substance abuse and addiction or, worse, denial. In these cases, interventions by concerned friends and family assist treatment. 

Multiple forms of treatment are often needed because substance abuse affects many aspects of an individual’s life, as well as often significantly affecting the lives of family members and significant others. Many people find that a combination of medication and individual or group therapy is most effective. Medications can help control the drug cravings and relieve the severe symptoms of withdrawal. Through psychotherapy and counseling, addicted individuals learn to understand their behavior and motivations, develop higher self-esteem, and cope with stress. Other treatment methods may also be used to assist the rehabilitative process, such as drug rehabilitation centers, therapeutic communities, and outpatient programs. 

In addition to treatment, self-help groups for substance-abusing individuals (Alcoholics Anonymous, Narcotics Anonymous) as well as their family members (Al-Anon or Nar-Anon Family Groups) are useful in providing support and reinforcing messages learned in treatment.

Codependence

Codependency is often developed by those people who live with a substance abuser. A codependent person lets another person's behavior or feelings affect them in a way that interferes with their work, creativity, other relationships and/or personal growth. The word codependency also refers to people who are preoccupied with controlling other people's behaviors and feelings. Contrary to what many people think, codependency does not only refer to dependent relationships that involve substance abuse, although it often does. Codependents tend to be overly concerned with other people's problems while ignoring or neglecting their own needs and wants, resulting in an inability to feel balanced, whole, and empowered. Codependency is one of our most destructive psychological habits, and, unfortunately, one of the most prevalent. Distorted and damaged self-esteem often lies at the roots of codependency. Those who feel healthy and whole understand that they cannot control other people's feelings, ideas, or behaviors. They make decisions that are best for themselves, and others are afforded the same right and responsibility.

Patterns and Characteristics of Codependence

Denial Patterns:

· Having difficulty identifying what one is feeling. 
· Minimizing, altering or denying ones true feelings. 
· Perceiving oneself as completely unselfish and dedicated to the well- being of others. 

Low Self Esteem Patterns:

· Having difficulty making decisions. 
· Judging everything you think, say or do harshly - as never "good enough." 
· Being embarrassed to receive recognition, praise or gifts. 
· Not asking others to meet your needs or desires. 
· Valuing others' approval of your thinking, feelings and behavior over your own. 
· Not perceiving you as a lovable or worthwhile person.

Compliance Patterns:

· Compromising your own values and integrity to avoid rejection or others' anger. 
· Being overly sensitive to how others are feeling. 
· Being too loyal - remaining in harmful situations too long. 
· Valuing others' opinions and feelings more than your own and being afraid to express differing opinions and feelings.
· Putting aside your own interests and hobbies in order to do what others want. 
· Accepting sex when you want love. 

Control Patterns:

· Believing most other people is incapable of taking care of themselves. 
· Attempting to convince others of what they "should" think and how they "truly" feel. 
· Becoming resentful when others will not let you help them. 
· Freely offering others advice and directions without being asked. 
· Lavishing gifts and favors on those you care about. 
· Using sex to gain approval and acceptance. 
· Having to be "needed" in order to have a relationship with others.
 
Codependency is a learned pattern of feeling and behaving and, therefore, can be "unlearned" and replaced with healthier patterns of loving oneself and loving and relating to others.

Adult Children of Alcoholics Issue

The phrase “Adult Children of Alcoholics” (ACOAs) refers to those individuals who were negatively affected by familial alcoholism. These individuals are particularly vulnerable to certain emotional, physical, and spiritual problems.

There are identifiable core issues that most ACOAs experience. Control is one such issue and the fear of loss of control is a dominant theme in their lives. Control dominates the interactions of an ACOA with themselves as well as the people in their lives. Fear of loss of control, whether it is over one's emotions, thoughts, feelings, will, actions, or relationships can be pervasive. ACOAs may rely upon defense mechanisms such as denial, suppression in order to control their internal world of thoughts and feelings as well as the outward manifestation of those thoughts, feelings, and behaviors.

A second core issue is trust. This may be directly attributable to being raised in an environment of chaos, unpredictability, and denial. Repeatedly told to ignore the obvious, deny their own feelings, and distrust the accuracy of their own perceptions, ACOAs eventually begin to distrust not only other people but their own feelings and senses as well. For example, father may be passed out on the couch, mom's face may be buried in a bowl of soup, yet nothing is wrong.

A third core issue is avoidance of feelings. In the alcoholic family, the child's expression of feelings is typically met with censure, disapproval, anger, and rejection. Often the child is told explicitly, "Don't you dare say that to me; don't even think it!" or "Don't upset your mother. You have to be more understanding." In other words, children of alcoholics may be taught very early that it is necessary to hide their feelings. Hiding their feelings leads to not even being aware of having any feelings, as they master the art of repressing, denying, or minimizing them.

A fourth core issue is over-responsibility. ACOAs come to believe they are responsible for what is happening in their family. This is because blame is such a big part of an alcoholic family-- "I drink because the kids are out of control." This just feeds a child's already existing self-centeredness. Because of these childhood experiences, COAs (Children of Alcoholics) grow up believing they are responsible for other's emotions and actions. Because children do not know that the alcoholic drinks because the alcoholic has lost their choice to drink, they begin to believe that they are responsible for their drinking because of their "bad" behavior and therefore they are responsible for the alcoholic to stop drinking. Therefore a COA may decide that the way to end the bickering and drinking is to be a model child. Another reason that ACOAs develop a sense of over-responsibility is that children in alcoholic families often times become the family counselor or even a substitute parent for the "absent" alcoholic.

A fifth core issue of an ACOA is that they tend to ignore their own needs. This likely stems from the fact that their emotional needs continually took a back seat to alcoholism, chaos, and emotional and physical violence. All too many ACOAs equate acknowledging their emotional needs with being vulnerable or even weak. Feeling vulnerable also is equated with being out of control, a state of being which an ACOA may find intolerable. Along with feeling vulnerable and out of control, acknowledging their emotional needs may make an ACOA feel dependent, inadequate, or even worse, forever in debt to the person who met their needs.

If you want more information about substance abuse, codependence or ACOA issues, want to discuss your particular needs, or want to schedule an appointment, call our offices today. We can help suggest the therapist that best meets your needs.

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