Extended-Release Opioids: Dangers, Differences, Precautions

Extended-release or sustained-release opioids tend to contain higher doses. They’re formulated to gradually release into the patient’s body over an extended time, typically either a 12-hour or 24-hour period.

However, this time-release mechanism can be bypassed depending on the technology used. Crushing, snorting, and injecting extended-release tablets greatly increases the risk of life-threatening overdose.

The Current Opioid Overdose Crisis

As of 2015, an estimated 1 6 million people worldwide have been affected by opioid use disorders. A majority of heroin users begin taking opioids as legally prescribed pain-relieving tablets. In 2016, the United States recorded over 42,000 deaths due to opioid overdose.

This number grows every year. Many of the deaths are attributed to recreational use. The illegal manufacturing of the potent synthetic opioids like fentanyl are largely to blame. Fentanyl is 80 to 100 times more potent than morphine. It is commonly mixed in illegally pressed pills and sold as Xanax or various other street drugs.

However, many of the deaths are due to recreational users who take legally manufactured synthetic opioids in ways that are not recommended by physicians.

A Safer Extended-Release Oxycodone

Efforts are being made through the coordinated efforts of pharmaceutical companies and the FDA to reformulate extended-release tablets to reduce the likelihood of overdose. Collegium Pharmaceutical’s Xtampza ER is a sustained-release version of oxycodone. Xtampza ER is used to treat moderate to severe chronic pain in opioid-tolerant patients. It’s made in sustained-release capsules of 9 mg, 13.5 mg, 18 mg, 27 mg, and 36 mg. The pills are designed to release a percentage of the drug immediately upon ingestion, with the majority of the drug being released gradually over a 12-hour period.

The patient takes two pills a day for around-the-clock pain relief. Taking more than 36 mg in a single dose or exceeding 72 mg in a 24-hour period dramatically increases the risk of overdose.

According to a recent study presented at PAINWeek 2017 in Las Vegas, Nevada, Xtampza ER’s new formulation has a lower abuse potential than immediate-release oxycodone. Typically, extended-release opioids have a higher abuse potential due to their higher drug content. When crushed, the total drug content is released into the system all at once, increasing the risk of overdose.

The opposite proved to be the case with Xtampza ER. Researchers evaluated the pharmacokinetics of crushed and intact extended-release oxycodone compared to crushed immediate-release oxycodone.

Participants were asked to rank the euphoria of the high along with its pain-relieving effects. Researchers used various metrics, including pupil constriction to determine the strength of the drug’s effects. In general, the smaller the patient’s pupils, the higher the intensity of the effects. When all the numbers were crunched, immediate-release oxycodone had an overall higher risk of drug abuse and overdose.

This is a great accomplishment, considering that sustained-release opioids tend to have a significantly higher abuse potential, especially when crushed.

A Safer Version of Opana ER

In similar fashion, Endo Pharmaceuticals came out with a reformulation of their extended-release oxymorphone hydrochloride tablets in 2012. Opana is derived from morphine but is significantly more potent. Opana ER was first approved in 2006. Just like Xtampza ER, it’s intended for the management of moderate to severe chronic pain that requires 24-hour pain relief.

In 2012, Endo Pharmaceuticals changed the formulation of Opana ER to make it more difficult to manipulate for snorting or injecting. The new formulation met the FDA’s regulatory standards for approval. Following the drug’s release, the FDA determined that the new formulation did not meaningfully reduce Opana ER’s abuse potential.

Endo suggested adding additional warnings to the Opana ER’s label to highlight the potential of drug abuse. However, since the drug’s 2012 release, more evidence has surfaced indicating additional risk factors.

FDA Requests Removal of Opana ER

The 2012 reformulation of Opana ER is significantly more difficult to take via injection. However, taking it through this route is still possible, and severely opioid-dependent users continue to crush, dissolve, and inject the substance.

Common side effects of Opana ER include nausea, vomiting, heart palpitations, sedation, drowsiness, and respiratory depression. When Opana ER is taken intravenously, these adverse effects can become intensified.

Clinically significant respiratory depression is more likely to occur when Opana ER is injected. This can lead to carbon dioxide toxicity, oxygen-deprivation, coma, critical organ failure, irreversible paralysis, brain damage, and death.

In 2015, state officials in Indiana to emergency action following an epidemic of HIV in Austin, Indiana. The epidemic was spread primarily by drug users who were injecting oxymorphone intravenously. This event was one of the final strikes against extended-release oxymorphone tablets like Opana ER. Following this event, the FDA formally recommended the removal of Opana ER from the market.

In 2017, Endo Pharmaceuticals voluntarily removed Opana ER from the market due to the high rates of overdose and risk factors associated with recreational drug use.

How to Take Opioids Safely

All opioids carry with them a high potential for misuse, addiction, and overdose. Substances like oxycodone, oxymorphone, morphine, codeine, and fentanyl are classified as Schedule II controlled substances by the FDA. The manufacturing and distribution of these drugs are tightly regulated. Most have limits as to how much can be produced each year.

The North American opioid overdose epidemic began in the late-1990s and has been growing exponentially ever since. In response, hospitals and physicians have taken the initiative to reduce the rate at which opioids are prescribed.

Patients should only be prescribed opioids when milder, non-opioid pain-relievers are ineffective. The minimum effective dose of opioids should always be prescribed. Doses can be gradually increased every few days until the minimum effective dose is achieved. In general, only opioid-tolerant individuals should be prescribed extended-release versions of opioids.

When it’s time to stop taking opioids, doses should be reduced gradually to minimize symptoms of opioid withdrawal. Discontinuation of opioid use should always be conducted under medical supervision for the best possible outcome.


If you or someone you love is struggling with opioid dependency, Stonewall Institute Treatment Center is more than happy to answer any questions you may have. Call us today at 602-535 6468 or email us at info@stonewallinstitute.com.

The Dangers of Synthetic Marijuana

Synthetic marijuana is a dangerous substance that can be addictive and toxic to the brain. John W. Huffman, Ph.D., is the chemist who created the most recent component of synthetic cannabis. He had this to say about people who use synthetic marijuana in an interview with ABC News:

“They’re playing Russian roulette. I mean, it’s just like taking a pistol with one bullet in it and spinning the chamber and holding it to your head and pulling the trigger.”

Synthetic marijuana is incredibly toxic to the brain. Despite its illegal status in the U.S., variations of the drug continue to be sold over-the-counter. When a given formula of the drug becomes illegal, chemists alter the recipe and continue distributing it.

Here’s what you need to know about the dangers of synthetic marijuana.

What Is Synthetic Marijuana?

Synthetic marijuana has been sold under various names, including “K2,” “Scooby Snax,” “Black Mamba,” and “Spice.” Each brand contains a unique combination of compounds. Since users never know exactly what they’re going to get, the effects can be unpredictable.

Synthetic marijuana activates the same receptors in the brain as regular marijuana. The difference is that synthetic marijuana overloads the brain. Not only is synthetic marijuana stronger, but it’s also a full opioid agonist instead of a partial opioid agonist like cannabis. In other words, the dose is too high and too intense for the brain to handle.

Jeff Lapoint, MD, an emergency room doctor and medical toxicologist, says that “synthetic cannabinoids are tailor-made to hit cannabinoid receptors – and hit it hard. This is NOT marijuana. Its action in the brain may be similar, but the physical effect is so different.”

A Brief History of Synthetic Marijuana

The various chemicals used in synthetic marijuana have been developed over the course of decades by a collection of companies and chemist.

The chemical CP 47,497 was developed by Pfizer Pharmaceuticals in the 1980s. HU-210 was first developed in 1988 at the Hebrew University in Jerusalem. HU-210 is 100 to 800 times more potent than the THC in regular marijuana. JWH-018 was created in 1995 at Clemson University in South Carolina.

Products containing these chemicals started showing up on shelves in Europe in 2004 under the brand name “Spice.” They started being sold in the U.S. in 2008. The U.S. Drug Administration took emergency actions to restrict the distribution of synthetic marijuana in 2010 due to a spike in emergency room cases. In 2012, a law was passed banning all known formulations of synthetic marijuana.

Synthetic marijuana products continue to be the cause of ER visits. Chemists simply change the formula to avoid legal repercussions. The government continues to ban new substances as they continue to be found, but it’s difficult to keep up with all the new products as they come out.

Side Effects of Synthetic Marijuana

Synthetic marijuana can produce a wide range of adverse side effects. Mild side effects include relaxation, elevated mood, and an altered the perception of sounds and objects. Moderate to severe side effects include confusion, rapid heart rate, extreme anxiety, vomiting, paranoia, hallucinations, psychosis, suicidal thoughts, and violent behavior.

Several case reports have documented gastrointestinal problems, hyperthermia, acute cerebral ischemia, heart attack, rhabdomyolysis, and respiratory depression.

How Synthetic Marijuana Behaves in the Brain

Synthetic marijuana binds to CB-1 (cannabis-1) receptors in the brain. This is the same receptor than regular marijuana binds to. Synthetic marijuana, however, does so in a way that overwhelms the brain.

A chemical’s toxicity is always dependent on dose. A little water keeps you hydrated and healthy while drinking too much water can cause seizures. The same goes for activating the CB-1 receptor. According to Paul Prather, Ph.D., professor of pharmacology and toxicology at the University of Arkansas for Medical Sciences, “[synthetic marijuana’s] potency can be up to one hundred or more times greater than THC.”

The brain is packed with CB-1 receptors, so if a drug like synthetic marijuana is present, there’s a lot of places for it to latch on to. To top it all off, the body doesn’t know how to deactivate synthetic marijuana. Once the potent drug binds to CB-1 receptors, the brain struggles to neutralize the drug’s effects.

Synthetic Marijuana Withdrawals

Abruptly stopping regular synthetic marijuana use is known to produce withdrawal symptoms. Severe withdrawals from synthetic marijuana may include recurring seizures, chest pain, heart palpitations, rapid heart rate, and shortness of breath. More common withdrawal symptoms include drug cravings, anxiety, nausea, vomiting, insomnia, excessive sweating, and loss of appetite.

In severe cases of long-term use, withdrawals can occur shortly after smoking the product. One case has been reported where the patient would wake up every 45 minutes throughout the night to smoke in response to intense withdrawals.

In general, the more synthetic marijuana you use daily, the worse the withdrawal symptoms will be. There’s a growing body of reports where patients site severe withdrawals as the main reason why they continue using.

Treating Synthetic Marijuana Withdrawals

There’s still a lot of work to be done when it comes to effectively treating synthetic marijuana withdrawals. Patients are usually given IV fluids to address electrolyte and mineral imbalances. Some doctors have found that treatment with benzodiazepines and the atypical psychotic quetiapine helps reduce withdrawals. Most patients can manage withdrawal symptoms with an intensive outpatient program (IOP) care. Severe cases require inpatient care and constant monitoring.

Recovering From Synthetic Marijuana Use

The more you use synthetic marijuana, the more likely you are to need extensive drug treatment. In a recent New Zealand study, patients who needed outpatient care reported having smoked an average of 4.6 grams of synthetic marijuana a day. Patients who required medically supervised detox reported having smoked an average of 5.3 grams per day. 53% of the 47 patients in the study were recommended for inpatient care, while the remaining 47% received outpatient care.

Final Thoughts on Synthetic Marijuana

Using synthetic marijuana is like playing Russian roulette with your brain. Even the chemist that created one of the chemicals used in synthetic marijuana thinks that you’d have to be crazy to smoke it. Synthetic marijuana is incredibly toxic and has severe side effects including psychosis, seizures, and heart attack.

If you or someone you know is struggling with synthetic marijuana use, Stonewall Institute Treatment Center is available to answer any questions you may have. Call us today at 602-535 6468 or email us at info@stonewallinstitute.com.

Symptoms of Opioid Withdrawal

Symptoms of Opioid Withdrawal

 

If you or anyone you love has made the strong decision to enter drug rehabilitation, it’s key to be mentally prepared of the experience. Everyone who enters drug treatment must start with a professionally supervised drug detox. This is to ensure that the body is safely cleaned out in preparation for mental changes that will follow.

 

When it comes to opioids, it’s important to remember that we are talking about some of the most overwhelming drugs one can take. In essence, their introduction to the medical world was precisely for extreme pain. Pain so devastating, only a substance of power can truly take it away.

 

And though opioids have done some wonders in the medical world, they’ve only done harm to the streets. For people who end up experimenting with these substances almost always end up hooked being the power of the high.

 

It’s important to be aware of this due to the fact that the withdrawal symptoms are just as overwhelming. Your body is going to experience a change so impactful, it’s not going to understand how to properly handle the metamorphosis immediately. It’s going to take lots of time and effort in order for the body to return to its normal, functioning state.

 

This is what you or your loved one should be mentally prepared for. If you are unaware of the types of substances that are considered opioids, refer to the following list:

 

  • Oxycontin (Oxycodone)
  • Dilaudid (hydromorphone)
  • Vicodin (hydrocodone or acetaminophen)
  • Fentanyl
  • Morphine
  • Heroin

 

The Causes of Opioid Withdrawals

 

Just as with any other substance, over a period of time, your body becomes more and more immune to its effects. Therefore, you’ll need more of the substance in order to feel a high. This increases your risk at death and is one of the prime reasons for overdose. To put this into picture, the National Institute on Drug Abuse claims that 90 Americans die daily from an opioid overdose.

 

As your tolerance constantly builds, your brain and body come to need opioids. This is due to the fact that the chemicals become apart of your regular functioning. Your body expects to intake the drug on a regular basis and if it doesn’t, your mind comes to only desire the next intake. During withdrawals, it should be expected that your conduct will be an experience out of this normal.

 

Withdrawal symptoms have been comparable to an extreme flu. With this, there are many users out there who don’t even realize they’ve become dependent. In fact, even after the first couple uses of opioids, the body has already begun to miscomprehend the drugs as something normal. When this happens, the dependence slowly builds upon itself – to an extent where the user truly isn’t aware of the dependence they’re creating.

 

This is especially true for those who’re prescribed certain opiates. Often, individuals are overprescribed a particular substance and, inevitably, start taking more than necessary. People who find themselves in this position will build tolerances that cause dependence. According to the National Institute on Drug Abuse, around 24% of people who’re prescribed opioids for chronic pain will end up misusing them.

 

The withdrawal symptoms that will be experienced vary from one individual to the next. Tolerances are built at different rates. Therefore, not everyone has the same dependence. With that, it can be expected that the withdrawal symptoms will, likewise, vary.

 

However, there’s one condition that’s pretty common amongst opioid addicted individuals. This is called acute opiate withdrawal. It is a condition that occurs when the body starts losing that normality it had felt from the opioid drugs. It’s also when the brain experiences a major deficiency of dopamine – a happy hormone opioids trigger.

 

This should be something you need to mentally prepare for. The journey that follows after will be that of replacing the void opioids always filled. And in order to that, your body and mind must be completely taken off the chemical.

 

The Five Most Common Withdrawal Symptoms

 

Typically, when it comes to opioid addiction, individual’s experience five common symptoms. It should be noted that there are many factors which go into these symptoms, but the following are something to be expected;

 

  • Insomnia
  • Agitation and anxiety
  • Excessive sweating
  • Symptoms similar to the flu
  • Depressive/dysphoric state

 

Let’s look into these symptoms a little deeper in order to properly understand them for the benefit of your expectations.

 

Insomnia

 

Being that your body is going through an overwhelming amount of pain during withdrawals, it’s going to be difficult to sleep at night. The withdrawal caused by opioids is traumatizing for the body to experience. Insomnia only worsens these symptoms because it leaves the body continuously feeling worse as the mind lays in bed wide awake.

 

Agitation and Anxiety

 

Being that your brain experiences a lack of dopamine, there’s this constant urge to find an instant kick of the chemical to balance out the mind. Previously, opioids were what brought the brain to this balance. Yet, as you go through withdrawal, you’re going to realize that dopamine won’t come so easily anymore.

 

The agitation and anxiety that follow will be out of a loss of focus as to how to receive dopamine without a substance. What you’ll learn in drug treatment is that there are many ways to find this dopamine within your average day-to-day life. It’s important you focus on these ways.

 

The amount of agitation and anxiety one feels all depends on how big of a dependence you have to opioids. It’s said by professionals that the more one intakes, the harder and longer they will fall during withdrawals.

 

Excessive Sweating

 

Due to the large amount of chemical changes the body will be going through, it’s going to react in a natural sense to the stress it bears. One of these ways is through excessive sweating. Just as with agitation and anxiety, the amount of sweat one experiences has lots to do with the level of their opioid dependence.

 

Excessive sweating can, likewise, cause much of the insomnia experienced at night. Just remember that it’s nothing more than the body trying to find a way to feel normal again. And it will ease off just as the other withdrawal symptoms with time.

 

Symptoms Similar to the Flu

 

Just like excessive sweating, the flu-like symptoms are simply out of the body trying to rebalance to its natural chemicals. The symptoms that can be expected are diarrhea, runny nose, body aches, and puking. This is a primary reaction of the immune system, for most it’s the part of the body that’s most affected by withdrawal.

 

Depressive/Dysphoric State

 

Just as with agitation and suicide, the depressive state of withdrawal is due to a lack of dopamine. Your mood is going to be greatly weighted once the body no longer feels a normal amount of the chemical. Depending on the individual, each will experiences different senses and levels of depression. However, extreme sadness and dissatisfaction should be expected.

 

On top of everything mentioned above, you may also experience the following;

 

  • Pupil dilation
  • Restlessness
  • Goosebumps
  • Increased heart rate/blood pressure

 

Treating Opioid Addiction

 

As mentioned above, the body’s detox of chemicals comes before any kind of therapy. Depending on the individual and their circumstance, the timeframe for withdrawal symptoms vary. Generally speaking, the symptoms mentioned in the section above hold possibility for around twelve to thirty hours after the last intake of the drug.

 

However, in order to truly clean the body out of the chemical, these symptoms should be expected to last for anywhere between 4 to 10 days. There are instances known as “extended release opioid” in which recovering individuals will experience the symptoms for up to 21 days.

 

To further the withdrawal period, there’s also the situation known as post-acute withdrawal symptoms (PAWS). This takes place after the acute symptoms are no longer apparent and can be defined as similar symptoms to those mentioned above, but at minor levels of pain. Depending on the individual and their mentality throughout treatment, these symptoms can last up to months. They mostly include; depression, anxiety, insomnia, fatigue, and mood swings.

 

Being the overall state of the opioid epidemic happening in America, there are numerous treatments being offered to the public. One example is known as medication-assisted withdrawal. This is when a person eases off opioids by taking smaller and smaller doses over a period of time.

 

There are also a few behavioral therapies to look into that focus on treating the mentality of opioid addiction rather than the body.

 

The first is cognitive-behavior therapy. A treatment that centers its focus on the effects opioids have had over the individual. You can expect to explore your thoughts, beliefs, and experiences on the drug and what you desire out of a life without it.  This also includes Intensive Outpatient therapy.  Stonewall Institute Treatment Center provides services for drug and alcohol dependency and co-occurring issues. Our program allows for clients to sustain life responsibilities while providing an intensive treatment environment 3 evenings per week for 10 weeks. Clients in our Drug and Alcohol Treatment program will learn about underlying issues that contribute to substance dependence and obtain the vital skills necessary to sustain long-term sobriety and recovery.

 

The second is contingency management. This is a reward based treatment in which individuals who remain drug-free will receive prizes for their productive behavior.

 

The third is motivational interviewing. Just as the title intends, this is when individuals are interviewed for the sake of discovering what motivations will help them through their recovery. And to discover their true desires in such a major life change.

 

Lastly, there’s family therapy. Depending on your family and friend’s situation in terms of your drug use, you may want to consider this option. It’s meant to inform any loved ones of what the experience of substance abuse is truly like. It’s also meant to build relationships through recovery.

 

If you or anyone you love is interested in an opioid treatment or looking for more information on the topic, Stonewall Institute Treatment Center is glad to help. Please, give us a call today at (602) 535 6468 or email us at info@stonewallinstitute.com.

Supplements to Reduce Anxiety in Recovery

Supplements to Reduce Anxiety in Recovery

Being clean and sober from alcohol and drugs doesn’t mean you can’t take natural, homeopathic supplements to improve your mood and reduce anxiety. A wide variety of natural anti-anxiety remedies are out there to try. They’re non-addictive and non-habit forming. Some impact the brain in ways similar to alcohol, but without the addictive effects. You won’t feel intoxicated, but you may feel relaxed and ready to take on the day.

Stonewall Institute supports holistic and natural recovery, but understands that every patient is different. Proper medication, supplements, and intensive therapy are important for a successful recovery.  Please consult with your doctor before taking any of the supplements mentioned below.

Theanine

Theanine is an amino acid that has anxiolytic (anti-anxiety) effects. ​It’s found in​ high quantities in green tea leaves. When you’re recovering from addiction to drugs or alcohol, the brain may need a little encouragement to return to normal neurotransmitter production. Theanine is an amino acid analog of two critical neurotransmitters: L-glutamate and gamma-Aminobutyric acid (GABA).

When glutamate activity in the brain is high, and GABA activity is low, anxiety can become worse. Taking theanine as an oral supplement can promote the expression of GABA in the brain by suppressing the expression of glutamate.

Theanine also increases levels of nerve growth factor (NGF) and brain-derived neurotrophic factor in the brain (BDNF). BDNF is critical for rebuilding damaged neurons, something that’s often desperately needed in the brain of someone seeking substance use recovery.

Theanine increases alpha waves in the brain. Alpha waves are one of several ranges of frequency that characterize the brain depending on whether you’re sleeping, feeling energized, or in a state of calm. Alpha waves are present during meditation and REM sleep.

5-HTP

Before there was serotonin, there was 5-hydroxytryptophan (5-HTP). 5-HTP is an amino acid that serves as a primary building block for the production of the neurotransmitter serotonin. Rave culture is familiar with 5-HTP as an ecstasy (MDMA) hangover cure. MDMA (3,4-Methylenedioxymethamphetamine) induces feel-good effects by triggering the brain to produce serotonin in large quantities.

Serotonin has many functions throughout the body and ​is closely involved in digestion​. The majority of the serotonin produced in the body is made by bacteria deep in the intestinal tract. In the brain, serotonin is responsible for producing a feeling of peace and general well-being.

Supplementing with 5-HTP can help you sleep better. Recovery from addiction can make it hard to sleep at times. Poor sleep can further throw off neurotransmitter and hormone levels as you try to recover. While you’re awake, the brain converts 5-HTP into serotonin. While you sleep, it converts it into melatonin. Without adequate melatonin, the brain doesn’t know to shut off and get some rest.

By promoting restful sleep and increasing serotonin expression during the day, 5-HTP can be an excellent addition to your recovery toolkit.

GABA

GABA, full name gamma-Aminobutyric acid, is a non-essential amino acid that functions as a neurotransmitter in the brain. GABA’s job is to calm overactive brain activity and ​reduce anxiety​. When you drink alcohol, you can thank increased GABA production for the relaxation component of the alcohol buzz.

GABA is an inhibitory neurotransmitter of the excitatory neurotransmitter glutamate. Gaba reduces anxiety by decreasing glutamate activity.

GABA supplements don’t work for a large percentage of the population. For some, it can be very useful at inducing feelings of calm without being sedative. Individuals with anxiety tend to be low on GABA.

B-Complex Vitamin

If you’re deficient in GABA, it can be helpful to stock your body up on B-vitamins. The vitamin-B family includes all the essential water-soluble vitamins besides vitamin C. You have to get them through diet because the body can’t make them on its own. B-vitamins include thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, biotin, folic acid, and the cobalamins. Pyridoxine, also known as B6, and the cobalamins, also known as B12, are especially helpful for treating anxiety and depression.

B6 and B12 are cofactors in many of the body’s metabolic processes. Being deficient in these essential nutrients can cause a host of cognitive problems, ​including anxiety and brain fog​. It’s important that your body’s vitamin B profile is balanced. Taking a B-complex multivitamin is a safe way to restore optimal brain activity following addiction. B-vitamins help balance hormone production, increase energy, support the adrenal gland, and maintain the health of nerve cells.

Valerian Root

Valerian root is one of several herbs that achieve their anxiolytic effects by increasing GABA production. This is another good one to take if you’ve been having a hard time sleeping at night. Valerian is a common ingredient in many herbal sleep tinctures along with kava, lemon balm, passionflower, and chamomile. Many of these share valerian’s GABA-promoting effects.

Xanax reduces anxiety by dramatically increasing the expression of GABA. If you’re recovering from addiction to Xanax, supplements like valerian that boost GABA may be especially helpful. Because valerian can be so sedative, it’s best to avoid taking it during the day.

Studies indicate that ​valerian root may slow the reuptake of GABA​ in the brain, thereby increasing its effects. This is the same way the selective serotonin reuptake inhibitors (SSRI’s) treat depression by slowing the reuptake of serotonin.

Magnesium

Several recent research studies have linked magnesium deficiency to increased rates of anxiety. In animal studies, ​test subjects display reduced anxious behavior​ when administered magnesium. Researchers believe that magnesium achieves its effects by modulating the HPA-axis, the body’s stress response system.

Being deficient in magnesium can have widespread negative effects on overall health. It’s involved in over 600 different processes in the body and brain. In addition to increasing anxiety, magnesium deficiency can contribute to low energy, brain fog, and depression.

Magnesium is used by the mitochondria in your cells to turn food into energy. It also helps repair damaged strands of DNA and RNA.


Although supplements can be helpful in your recovery, seeking proper treatment for substance use is also essential.  Stonewall Institute’s 10-week Intensive Outpatient Program allows for holistic recovery in a comfortable and flexible environment.

As a recovering addict, your brain has most likely been through a lot of stress. As you progress in recovery, your brain chemistry will stabilize and mood will improve. Along the way, the supplements covered in this article can help manage symptoms of anxiety. If you or someone you know is struggling with drug or alcohol abuse, Stonewall Institute Treatment Center is more than happy to answer any questions you may have. Call us today at 602-535 6468 or email us at info@stonewallinstitute.com.

Handling Anxiety and a Drug Addiction

 

We’ve talked much about mental disorders and their relation to drug addiction through this blog. However, just like any of these disorders, anxiety is an illness that can be looked into at great length for its effects on treatment are just as strong as the addictions it may cause.

Many anxious people require substances of some sort that allow them to feel at ease.  Medications that cause their central nervous system to slow down and relieve them of constricting thoughts are most common, however alcohol is also very common due to its wide availability.

Benzodiazepines are a class of drugs typically prescribed to alleviate symptoms of anxiety within a patient.  Commonly prescribed benzodiazepines include Xanax, Ativan, Klonopin, and Valium.

These medications, while highly effective, are also highly addictive and are cause for concern when taken regularly.  The most commonly abused benzodiazepine is Xanax due to it’s effectiveness and sedating effects.  The risk for dependence is high, even with a legitimate prescription from a doctor.

When considered, one of the biggest problems with addiction is the cycle of constantly looking for a quick fix.  Seeking out something to alter our moods in order to ease those unwanted emotions.  This is why dual diagnosis has been taken much more seriously in the last couple decades rather than before.  For those unaware, a dual diagnosis is when an addiction is diagnosed alongside a mental disorder.  It’s becoming apparent to many professionals that without treating the two together, further complications will inevitably follow after treatment.

For in the end, the goal of addiction is beyond getting one into a sober life.  Rather, it’s about changing one’s perspective on what life can be.  Changing their perspective into a drug-free and productively optimistic future.

 

Understanding Anxiety and its Effects on the Mind

The American Psychological Association distinguishes anxiety as an emotion of pure tension.  A rigidity of worried thoughts that even come with some physical changes – such as increased blood pressure.  Everyone has anxiety to some regard, as it’s a natural way of reacting to stress.

However, what will be discussed throughout this blog is that of an anxiety disorder – a condition where anxiety is prominent to a person’s overall emotional stability and controls them on a day-to-day basis.  With that, those with this condition generally seek out some kind of coping method, whether it be prescription medication from a doctor, cognitive behavioral therapy, or different self-medication methods such as alcohol or drug use.

To a person with anxiety, using substances is a means of self-medicating. It’s a way these individuals go about coping with their symptoms. In comparison to the general population, substance abuse is much more common in people with anxiety. In fact, the National Institute of Drug Abuse estimates that people with the disorder are twice as likely to seek out something that will sufficiently alter their mood.

This is important in regards to treatment because it also gives anxious individuals more problems within rehab. For one, it’s been scientifically proven that people of the disorder experience more severe addiction withdrawal symptoms. To top it off, they all have more of a chance at relapse. The situation after addiction rehabilitation where someone goes back to abusing a substance.

If only anxious individuals were aware that drugs do anything but medicate their emotions. Rather, they actually make anxiety worse. It’s a ruthless cycle when really considered. People of the disorder seek out something to calm their tension.

Though the tension might be calmed for a moment of time, it always returns as the drug wears off. This leads them to feeling the necessity for more. And as a tolerance is built to certain chemicals, there will be the need to intake more in order to feel the calming effects. With the need for a drug constantly growing and building, so one’s anxiety.

For us to continue on the subject, it’s vital we differentiate the difference between anxiety and an anxiety disorder. As mentioned above, everyone experiences anxiety from one time to another. An anxiety disorder is when these tense feelings become so prominent, it leaves a large impact on one’s life.

 

What to Look Out For

There are some things to look out for if you’re skeptical that a loved one has an anxiety disorder. People who suffer generally tend to avoid certain day-to-day activities that the general population finds no problem with. They do this as a means of avoiding anxiety.

Sometimes, people of the disorder also experience uncomfortable physical sensations. This inevitably could lead to physical health problems.

The following are symptoms of an anxiety disorder. If you’re skepticality matches some of these conditions, you might want to think about talking to your loved one. Anxiety disorders are treatable and should be done so through a professional manner. For without that, one may end up seeking self-medication.

  • Dizziness/fainting
  • Nervousness/restlessness/and a consistent feeling of tension
  • Rapid heart rate
  • Increased of heavy sweating
  • Weakness or lethargy
  • Loss of concentration or focus
  • Fear of large amounts of people
  • Insomnia and/or poor rest
  • Chest pain
  • Nausea/vomiting
  • Feelings of constant danger/dread/or panic
  • Rapid breathing/hyperventilation
  • Muscle trembles/twitching
  • An overwhelming sensation of fear/panic/uneasiness/nervousness/worry
  • Inability to relax or get comfortable
  • Excessive sweating
  • Muscle tension/soreness

There are three different anxiety disorders to be aware of. Each are of their own context, but there are instances where individuals will experience more than one of these at once.

Generalized Anxiety Disorder (GAD)

To sum it up, GAD is when a person feels – what seems to be – unexplainable anxiety on a day-to-day basis.

Studies have found that a little more than 3% of the U.S. population suffers from GAD. Less than half of those people are receiving treatment.

Panic Disorder

If an individual feels a consistent stream of panic attacks, they could be suffering from a panic disorder. Often, these co-occur with depression.

Social Anxiety Disorder

To put it simple, individuals with SAD generally only feel anxious in social situations. Which is much more frequently than some understand. Whether it’s work, school, a family/friendly event, we find ourselves in social situations on a day-to-day basis.

People with SAD find it hard to handle these day-to-day situations. It makes them feel tense. And their comfortable preference is in alone corders.

 

Seeking Treatment

As mentioned above, anxiety disorder is something that can be treated. Parallel to this, drug addiction can, likewise, be treated. With a dual diagnosis, you’re given the ability to not only enter sobriety, but to take away the problems that have led to substance abuse.

When seeking alcohol and/or drug treatment, an important aspect to remember is that you find a facility that can properly handle treating an anxiety disorder. If you’re preparing yourself to undergo such a huge life change, you’re going to want to receive only the most professional help available.

This is due to the fact that a dual diagnosis is much more difficult to treat in comparison to just drug addiction. When considered, the professionals at hand are in charge of guiding you out of two illnesses.

Typically, individuals who receive a dual diagnosis enter an inpatient program or an intensive outpatient program. Since a dual diagnosis is such a big (and often complicated) problem in an individual’s life, there’s lots to be done in terms of treatment. So much so that it’s vital the individual takes the time and effort to completely focus on these problems and finding a solution. An inpatient or outpatient program offers just this along with the safety of being under professional guidance.

When talking about anxiety, it’s fairly common for people going through substance abuse detox to experience attacks – usually due to the lack of “self-medication”. When the body undergoes a drainage of chemicals that have always made it feel good, the mind has the tendency to not know how to handle the situation. Therefore, it doesn’t come to much of a surprise that anxiety attacks can occur.

If an individual were to do this on their own terms, it may be all too difficult to handle. To top it off, there’s also more of a risk they’ll seek out means of self-medication. However, within an inpatient program or an intensive outpatient program, individuals are assured their under proper professional guidance. Inevitably, making the possible anxiety attacks more of an ease to experience.

It must be considered that under this professional help, you will have the ability to let yourself open up emotionally. And when undergoing such a life changing process, this is very important to the better of yourself as an individual.


If you or anyone you love has anxiety and/or a substance addiction or you’re looking for more information on the subject, Stonewall Institute Treatment Center is more than happy to help. Please, give us a call at (602) 535 6468 or email us at info@stonewallinstitute.com.

Is It Safe To Take SSRIs For Depression While In Recovery?

Selective Serotonin Reuptake Inhibitors (SSRIs) are one of the most frequently prescribed drugs for Major Depressive Disorder (MDD). Depression is more common among addicts and alcoholics than other groups. During recovery, symptoms can worsen. If you’ve been diagnosed with depression, SSRIs can potentially improve brain chemistry and ease recovery.

SSRIs are in a class of drugs that don’t have the same addictive qualities as opioids and benzodiazepines (Xanax). Their onset is gradual, and the effects can take weeks to take effect. In the rest of this article, we’re going to discuss how SSRIs behave in the brain and how to determine if they’re appropriate for you or your loved one while in recovery.

Many seeking recovery from alcohol and drug use are diagnosed with a co-occuring disorder.  Many times, these co-occuring disorders include anxiety and depression.  Treatment for co-occuring disorders is very common within the realm of addiction recovery.

 

How SSRIs Work

Serotonin is known as the “happy,” “feel-good” neurotransmitter because it increases feelings of general well-being. SSRIs treat depression by temporarily preventing serotonin from being reabsorbed into the bloodstream. When serotonin is absorbed into the bloodstream it gets returned to the inside of your brain’s neurons. To be actively influencing how you feel, serotonin needs to be outside of your brain’s neurons and in the synaptic gap between them. Once here it can get to work at making you feel happy. SSRIs work by allowing serotonin molecules to stay suspended in the synaptic gap for an extended period before reabsorption.

Serotonin has multiple functions in the body and brain, but its main job is to keep you upbeat and content. Folks that have too little serotonin in the synaptic gaps between neurons are more prone to feelings of depression and nervousness.

 

How Depression Influences Addiction

Someone who’s chronically depressed early in life is more likely to self-medicate with drugs and alcohol. This gets the ball rolling, and genetic tendencies for addiction pick up the momentum from there.

Not all people with depression have low serotonin, and not everyone with low serotonin is depressed. Depression can also be caused by imbalances of dopamine and norepinephrine. For people who are both depressed and low in serotonin, SSRIs can be helpful at managing symptoms during alcohol and drug recovery.

 

How Recovery From Addiction Impacts Brain Chemistry

Recovery throws your brain chemistry into chaos. In a state of addiction, the brain relies on substances as an external source of the happy neurotransmitters it would otherwise produce on its own. In the depths of addiction, your brain balances on shaky legs. When you stop taking drugs and alcohol, those legs get kicked out from under you. Recovery is the process of re-establishing healthy brain chemistry that isn’t dependent on substances.

This transitional period can last over a year before your brain returns to its pre-addiction baseline. It’s during this time that untreated depression can create the most risks for recovering addicts.

 

Depression Increases The Risk Of Suicide In Recovering Addicts

One study suggests that the suicides of alcoholics contribute to 25% of the total suicides nationwide. John H. Krystal, M.D. is the chair of the Department of Psychiatry at Yale University School of Medicine. In his opinion, although therapy alone can be helpful, persistent depression is best treated with a combination of therapy and antidepressants.

 

Antidepressants Can Increase The Risk Of Suicide

For some recovering addicts, taking SSRIs can increase the risk of suicide. For others, taking antidepressants can significantly decrease the risk. This makes it critical to work closely with a psychiatrist who’s experienced in dealing with both depression and addiction. The first few weeks of taking SSRIs, and anytime that doses are changed, are high risk periods for suicide. During this time, depression can get worse before it stabilizes. Patients ages 25 and under report the highest occurrences of such episodes.

 

SSRI Side Effects

The biggest risks associated with SSRIs are suicide and decreased sex drive. Aside from these, SSRIs can cause the following side effects: weight gain, nausea, nervousness, dry mouth, fatigue, rash, diarrhea, increased perspiration, trouble sleeping, and headaches.

 

The goal of recovery is to live a long and happy life. For people with depression, taking SSRIs can be lifesaving in its ability to decrease suicidal thoughts. While abstaining from antidepressants may be appropriate for people with mild or intermittent depression, chronically depressed individuals should rely on the opinion of their psychiatrist to help them make the final call. If you or someone you know lives in the Phoenix, AZ area and is in need of treatment for addiction, our 10-week Intensive Outpatient Program is here to help support you through this challenging time.

 

Prescribing SSRIs (How Psychiatrists Evaluate The Need)

Only a psychiatrist can weigh in on the question of whether or not SSRIs are right for your recovery. More likely than not, if you were already taking SSRIs, your doctor will recommend you continue taking them throughout recovery. Discontinuing use will only create further chaos in a brain that’s scrambling to rewire itself post-addiction.

When deciding whether or not to start an SSRI, your doctor will look at your mental health history. If you weren’t consistently depressed leading up to getting clean, your psychiatrist will likely discourage the use of SSRIs.

If you do have a history of chronic depression, your psychiatrist may diagnose you with Major Depressive Disorder. This would warrant getting you started on an SSRI.

Finding Which Antidepressant Works For You

Most antidepressants take several weeks to build up in your system and become effective. This is a long time to be in limbo for someone struggling with depression, thoughts of suicide, and recovery from addiction. It isn’t unusual for a patient to spend an entire year rotating through different medications before finding one the works. The following are antidepressants that your psychiatrist may suggest for you.

Selective Serotonin Reuptake Inhibitors (SSRIs)

These are usually the first types of antidepressants that your psychiatrist will start you on. They tend to have the least side effects and highest success rates. SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil, Pexeva), escitalopram (Lexapro), and citalopram (Celexa).

 

Serotonin And Norepinephrine Reuptake Inhibitors (SNRIs)

This class of antidepressants targets the neurotransmitter norepinephrine as well as serotonin. These include venlafaxine (Effexor XR), duloxetine (Cymbalta), levomilnacipran (Fetzima), and desvenlafaxine (Khedezla, Pristiq).

 

Tricyclic Antidepressants

Your psychiatrist will likely try other antidepressants before suggesting tricyclics due to their higher rates of complications. Examples of tricyclics include nortriptyline (Pamelor), imipramine (Tofranil), and desipramine (Norpramin).

 

Atypical Antidepressants

These are antidepressants that don’t fit nicely in any category. They include vilazodone (Viibryd), trazodone, mirtazapine (Remeron), bupropion (Wellbutrin, Aplenzin, Forfivo XL), and vortioxetine (Trintellix).

 

Monoamine Oxidase Inhibitors (MAOIs)

This is another class of antidepressants that your psychiatrist may wait to try. They can have serious side effects and require a strict diet when taking them. MAOIs don’t combine well with SSRIs.

 

SSRIs Don’t Get You “High”

SSRIs are notoriously slow at making an impact on brain chemistry. The best case scenario is that after several weeks the drug will begin positively impacting on how you feel. You never “get high” in the same way that you do with opioids or benzodiazepines. In fact, after being on SSRIs for a while, you probably won’t notice any change until you stop taking them.

 

SSRIs Don’t Cause Withdrawal Symptoms, But You Do Notice When They’re Gone

SSRIs aren’t considered addictive. You will start to feel different, however, if you miss a few doses or if you stop taking them altogether. Stopping SSRIs causes what the doctors call “discontinuation syndrome.” Discontinuation syndrome can result in nausea, dizziness, and flu-like symptoms in addition to feelings of uneasiness. Let your psychiatrist know if you want to stop taking SSRIs. He or she will put together a plan for gradually decreasing your dose in a way that minimizes undesirable symptoms.

 


 

Only you and your psychiatrist can decide whether or not taking SSRIs is right for you. For certain individuals, SSRIs can reduce depression and be a critical component of a safe and successful recovery. SSRIs’ lack of addictive properties makes them safe for recovering addicts to take, so long as they meet the right requirements and are closely monitored by health professionals. If you or anyone you love is currently dealing with drug or alcohol addiction, it’s vital to keep an eye out for developing dependence. Stonewall Institute Treatment Center is more than happy to answer any questions you may have. Call us today at 602-535 6468 or email us at info@stonewallinstitute.com.

 

Healing The Gut After Alcohol Abuse

Alcohol abuse is gut abuse. When you seek treatment for alcohol use, you not only must think about the disease itself, but you also must think about the physical consequences your body endured for a long time. Increased and long-term alcohol use bombards your digestive system with sugars, carbs, and inflammatory toxins. This raises the acidity level of your body, throws the ratio of your gut bacteria out of balance, compromises your gut lining, and can lead to chronic, systemic inflammation. Your stomach and intestinal tract are more than just part of the digestive system. They’re your immune system’s first line of defense against the toxins you consume.

When your gut health is compromised, inflammatory agents can quickly cross into the bloodstream. From there, toxins can trigger inflammation anywhere that blood travels, including your brain. In the rest of this article, we’re going to discuss which foods and supplements to take, and which to avoid to heal your gut and brain while recovering from alcohol abuse.

 

Avoiding Sugar

Sugar is something that most everyone has too much of in their diet. Sugar (such as alcohol) feeds the harmful bacteria that colonizes your gut. Scientists and researchers have yet to discover the ideal ratio of the many different strains of bacteria that live in your digestive system. What they do know is that some are obviously beneficial, while excessive amounts of others can compromise gut health.

These harmful bacteria are associated with obesity, autoimmune disease, ADHD, anxiety, depression, hypothyroidism, adrenal fatigue, skins conditions like eczema, and the list goes on.

Bad gut bacteria consumes sugar for energy, while healthy bacteria thrives off of dense, fibrous leafy greens and other low-sugar vegetables. Eating less sugar and more veggies can speed the gut healing process. Keep in mind that as you detox from alcohol, you’ll also be detoxing from sugar. Sugar is highly addictive on its own, so you’ll be fighting two battles at once.

 

Eat Dense, Fibrous Veggies

Eating dense, fibrous veggies will give the good bacteria in your gut a fighting chance to thrive. Veggies like broccoli, cauliflower, kale, and chard are fuel for good bacteria. Artichokes are also an excellent source of fuel. When you eat broccoli, the good bacteria feeds on it in the small intestine. The denser the vegetable, the deeper into the digestive tract it survives without being completely broken down by enzymes. This means more food for good bacteria.

 

Supplement With Prebiotics and Probiotics

When vegetables serve as food for healthy bacteria, they play the role of prebiotics. Prebiotics are exactly this, fuel for healthy bacteria to consume. In the world of supplements, the bacteria themselves are referred to as probiotics. Supplementing with probiotics (good bacteria) and prebiotics (bacteria food) can help to recolonize your gut flora.

Before you take your probiotic supplement, make sure to eat plenty of broccoli, cauliflower, and other fibrous vegetables. You can also take a prebiotic supplement just before taking your probiotics. When you do this, the good bacteria (probiotics) will have something to munch on immediately. Artichoke is one of the most effective natural prebiotics, and several quality prebiotic supplements are derived from the plant.

 

Glutamine: One Of The Most Important Supplements For Repairing A Damaged Gut

Glutamine seals up that leaky gut. In scientific terms, glutamine “decreases intestinal permeability.” The cells of your small intestine use glutamine as a primary fuel source. When glutamine runs out, it becomes hard for the cells of the small intestine to repair themselves. By supplementing with glutamine, you give your cells the fuel they need to stay healthy and protect the body and brain from inflammation. Glutamine helps with nearly all gut issues: Irritable Bowel Syndrome (IBS), ulcers, diarrhea, leaky gut, bowel movements, diverticulosis, and Crohn’s disease. If it’s a gut-related issue, glutamine can reduce symptoms.

 

Glutamine Improves Focus, Concentration, and Working Memory

Glutamine is one of the most abundant amino acids in the body. Your gut can’t survive without it, and neither can your brain. In the brain, glutamine is used to make the neurotransmitters GABA and glutamate. The balance between these two neurotransmitters is critical to overall brain health, cognitive performance, and the prevention of serious brain-related disorders. Epilepsy, anxiety, depression, bipolar disorder, schizophrenia, and addictive behaviors are all affected by a healthy balance of GABA and glutamate. If you or someone you know in the Phoenix, AZ area is struggling with addiction or believes they have a problem with alcohol, Stonewall Institute’s 10-week Intensive Outpatient Program allows patients to work towards recovery without disrupting daily life.

 

Glutamine Strengthens The Immune System

Leaky gut is the starting point for a lot of autoimmune diseases. A compromised gut lining allows too many inflammatory agents into the bloodstream. This can lead to thyroid disease, Hashimoto’s disease, and a greater chance of getting sick in general.

 

Glutamine Reduces Pain Associated With Chronic Inflammation

Inflammation in the gut leads to inflammation all over. Leaky gut can make arthritis worse, exacerbate skin problems (like psoriasis) and wreak havoc on overall health. Strengthening the gut with glutamine can reduce these symptoms.

 

Digestive Enzymes

Digestive enzymes help your gut process the difficult to digest foods like protein. In fact, enzymes are what allow you to digest all food, including complex sugars and starches. When not enough enzymes are present in the gut, intestinal inflammation can occur. As the food sits without being broken down, the lining of your intestine can become inflamed. Supplementing with digestive enzymes before and after eating can reduce intestinal inflammation by speeding up the digestive process.

It’s best to supplement with a broad spectrum of enzymes. A quality product will contain protease, lactase, lipase, and amylase. Protease is a pro at digesting protein, lactase breaks down dairy, lipase breaks down fat, and amylase goes to work on starches.

 

Herbs That Support The Adrenal Gland

Adrenal fatigue is more common in people with compromised gut health. Adaptogenic herbs like licorice root and ashwagandha are proven to aid in recovery from adrenal fatigue.

Licorice root increases hormone availability while alleviating adrenal fatigue by aiding the absorption of cortisol. Not only that, but it also promotes gut health by strengthening the mucosal lining of the stomach and small intestine. If you’d like to try supplementing with licorice root, go for the ‘DGL’ version. This type has had the glycyrrhizin removed, which can cause edema (swelling) and high blood pressure.

Ashwagandha is another adaptogenic herb that is especially effective at recovering from adrenal fatigue and balancing hormone levels post-addiction. It’s also proven to improve mood and cognitive health. Ashwagandha is a stress reliever, but also prevents against brain degeneration.

Ashwagandha’s effectiveness lies in its potent antioxidant content. The antioxidants in ashwagandha neutralize the free radicals in the blood that cause inflammation and cell damage. Ashwagandha is also proven to reduce symptoms of anxiety and depression. Unlike prescription medications used to treat anxiety and depression, ashwagandha has no adverse side effects.

 

Bone Broth And Collagen

Collagen is the ingredient in bone broth that makes it so valuable for gut health. Collagen is also influential in reducing joint inflammation and strengthening soft tissue throughout the body. The amino acids proline and glycine in collagen can repair damaged intestinal lining. Supplementing with collagen also helps increase the gastric juices that strengthen the mucosal lining.

 

 

HCL (Hydrochloric acid)

Hydrochloric acid is the stomach acid that’s most important for breaking down protein before it enters the intestines. Individuals with poor gut health from drinking alcohol excessively or taking prescription meds tend to have too little HCL. This can be problematic because HCL plays a significant role in keeping bad bacteria from growing out of control in the small intestine. Check with your doctor before supplementing with HCL. Your doctor will want to test your stomach acid levels to make sure that you are, in fact, low on HCL. If she advises you to supplement with HCL, make sure it’s the ‘pepsin’ variety. Also be sure to take it with a meal that contains protein.

 

Oil Of Oregano

Oil of oregano extract is an anti-fungal. Supplementing with it can help balance the ratio of bacteria in your gut. Oil of oregano isn’t something to supplement with long-term, but initially, it can speed recovery. An overgrowth of yeast and candida can make gut flora imbalances worse. If you’ve been a beer drinker, you’re an ideal candidate for excessive yeast growth. The anti-fungal properties of oil of oregano can reduce yeast levels, giving your gut a better chance to heal itself and balance bacteria levels. Try building up your gut bacteria for a few weeks using the other techniques described in this article, then supplement with oil of oregano for one to two weeks.

 


Aside from taking supplements and eating healthy, exercise can ignite metabolism and stimulate the brain for a faster recovery from addiction. In the end, a healthy, well-rounded lifestyle is your best weapon against relapse. Having a healthy gut will make it easier to stay motivated and on track. It’s much harder to stay in a negative mindset when your digestion, immune system, and brain are all significantly improving together. Focus on accomplishing the small health goals, and the larger goal of sobriety will follow close behind. If you or someone you love is a habitual drinker, it’s important to keep an eye out for developing dependence. Stonewall Institute Treatment Center is a safe resource for any questions you may have. Call us today at 602-535 6468 or email us at info@stonewallinstitute.com.

Cocaine Addiction: Side Effects and Withdrawals

Cocaine is powerfully addictive. It’s a stimulant that, like many drugs, circulated among medical professionals well before it reached the general population. In 1884, William Stewart Halsted became the first physician to use cocaine as an anesthetic in surgery, however, Halsted also liked to use cocaine to enhance his performance in the operating theatre. He soon became the first cocaine-addicted physician on record. Sigmund Freud, the famous psychiatrist, was also a prevalent cocaine abuser. Cocaine is attractive to intellectuals and hard-partying weekend warriors alike because of its cognitive-enhancing and dopamine-boosting effects. This is also why this substance has a high potential for addiction and dependence.

Receiving treatment for cocaine addiction is crucial, and the earlier it’s treated the better.  Stonewall Institute Treatment Center’s 10-Week Intensive Outpatient Program is designed to not only treat cocaine addiction itself, but to also provide the tools, structure, guidance, and support that will help maintain long-term sobriety.

 

What Is Cocaine?

Cocaine is a stimulant narcotic that’s used almost exclusively as a recreational drug. Cocaine is now only occasionally used in surgery as a topical anesthetic or for controlling bleeding during nasal surgery.

Cocaine is made from the leaves of the cocoa plant. Indigenous cultures in South America chew the leaves for their energizing effects. Bolivian and Peruvian cultures continue to chew cocoa leaves in high volumes. In Bolivia, an estimated one-third of the population chews cocoa leaves. In leaf form, the intoxicating effects are milder while the cognitive-enhancing effects, like improved mental clarity, are longer lasting.

Once cocaine is extracted from the leaves, it becomes significantly more potent. Both forms are addictive, but pure extracted cocaine holds a higher risk for addiction and dependence. The cocaine that hits the streets is rarely pure cocaine by the time it reaches consumers. Cocaine is often mixed with cornstarch, sugar, or quinine to increase profits. Because you never know what you’re going to get when you buy cocaine on the street, it adds another layer of health risk. Sharing straws or dollar bills to snort cocaine can increase the risk of catching hepatitis C. Snorting cocaine can cause abrasions in the nasal cavity that allows bloodborne pathogens to spread.

 

How Cocaine Works In The Brain

Cocaine affects the brain through a complex interaction of various neurotransmitters and proteins. The two neurotransmitters that cocaine most strongly influences are serotonin and dopamine. Most of the research on cocaine has been focused on its impact on dopamine transmission, as this is the area of the brain that seems to be most strongly affected. Cocaine blocks the function of the dopamine transporter protein. This transporter protein is responsible for removing dopamine from where it can remain active. As a result, the effects of dopamine increase, and the user feels high.  Because of this, many users will ignore the fact that they have a serious drug problem.

At the same time that cocaine makes you feel good by increasing dopamine activity, it improves cognition through a variety of functions, most notably by boosting levels of the protein BDNF (brain-derived neurotrophic factor). BDNF is a protein that’s critical for memory and learning. There are plenty of safer ways to increase BDNF, including exercise, yoga, meditation, sleep, and a healthy social life.

 

Cocaine Addiction: Risks and Side Effects

After only a short period of use, cocaine has a high rate of addiction. The same reason that scientists like Sigmund Freud and William Stewart Halsted loved cocaine is the same reason that makes it so addictive. The mechanism of action that boosts BDNF is also behind its addictive qualities. Without going into too much detail, cocaine enhances your sensitivity to experiencing the reward that comes from getting a hit of dopamine or serotonin.

The positive effects of cocaine include intense happy feelings of euphoria and increased energy. Along with these effects come a long list of dangerous risks and harmful side effects.

Medical professionals consider cocaine to be the perfect “heart attack drug” because it creates the perfect storm for cardiovascular issues. Large doses of cocaine can result in the stiffening of the walls of the arteries, high blood pressure, irregular and rapid heart rate, and myocardial infarction (heart attack).

Other side effects can include paranoia, psychosis, panic attacks, cognitive impairments, mood swings, and dramatic changes in personality.

Long-term risk factors for cocaine abuse include increased body temperature and the development of a manic-like condition similar to amphetamine-induced schizophrenia. These episodes are characterized by severe paranoia, aggression, confusion, and hallucinating the feeling of bugs crawling under the skin, also known as “coke bugs.”

Cocaine addicts can also exhibit rapid weight loss, decreased appetite, weakened immune system, difficulty managing relationships, and increased thoughts of suicide. Because of this life-threatening disease, it’s vital to seek professional substance abuse treatment as soon as possible.

 

Cocaine Withdrawal

One of the reasons why cocaine is so addictive is because its withdrawal effects come on fast. The crash that cocaine users experience at the end of a night of partying is a harsh reminder of withdrawals that await them if they try to get off the drug.

The immediate effects involved with cocaine withdrawal include pounding headaches, anxiety, and insomnia. The headaches are largely due to the dramatic changes that cocaine has on the cardiovascular system. As the walls of the arteries begin to relax and blood pressure decreases, it can be a challenge for the blood vessels in the head to adjust.

As you commit to staying off the drug, all of the negative side effects of cocaine use can get amplified. Long-term cocaine withdrawal symptoms include paranoia, anxiety, mood swings, depression, irritability, exhaustion, insomnia, fatigue, nausea, vomiting, and intense cravings.

The “coke bugs” can return during withdrawals as well. Some users report symptoms similar to schizophrenia and the feeling that their mind is disconnected from themselves. Severe symptoms like these can last from weeks to months depending on the depth of the addiction. The intensity of cocaine withdrawals forces many users to turn to other substances like alcohol and marijuana to help cope with withdrawals and cravings.

 


Deciding to get clean from cocaine is an encouraging step forward in the path towards healing and recovery. The next step is to complete an alcohol and drug evaluation so it can be determined exactly which course of treatment will best suit your needs.  If you or someone you know needs advice about drug or alcohol addiction, feel free to contact Stonewall Institute Treatment Center at 602-535 6468 or email us at info@stonewallinstitute.com.  We’re here to help.

7 Myths About Marijuana Use

Marijuana use and addiction has been on the rise in the U.S. Several states have legalized marijuana for both medical and recreational use.  Marijuana use is also glorified in pop culture, such as musicians talking highly of the substance in their lyrics.  There is also a deeply ingrained myth within cannabis culture that claims marijuana isn’t ‘physically’ addictive, but rather is only ‘mentally’ addictive or habit forming.  The truth is that marijuana addiction is prevalent among users and can be addictive just like any other drug.

As a parent, the challenge lies in presenting kids with an accurate picture of the risks involved with marijuana addiction.  While talking to your children is important, it’s also very important to seek professional assistance if you or your child are dependent on marijuana.  In our 10-week Intensive Outpatient Program, we not only address and recover from the addiction itself, but we also provide necessary tools to address commonly reported co-occuring disorders, such as anxiety and insomnia.

 

In this article, we will address common myths regarding marijuana use that many young adults use to support their pro-cannabis stances.


Myth #1:  That Marijuana Isn’t Physically Addictive

The reason why so many adults end up seeking treatment for habitual marijuana use is that it has the same propensity for addiction as any other substance. The average adult seeking treatment for marijuana addiction is a near-daily user for an average of 10 years Adults make an average of six serious attempts at quitting before finally trying drug counseling. Individuals addicted to marijuana continue to smoke despite admitting that it causes relationship and family problems, financial stress, dissatisfaction with productivity levels, low life satisfaction, and sleep and memory problems.

 

Myth #2:  Many People Who Smoke Aren’t Addicted

A person’s tendency for addiction is largely determined by genetic factors that are then amplified by environmental factors such as common life stresses and nutrition. People with a predisposition for addiction share certain characteristics regarding brain chemistry. With marijuana, addicted individuals tend to have issues regulating the production of the neurotransmitter dopamine. Dopamine influences focus, drive, and determination. It also induces feelings of well-being when introduced to the brain in high doses as it is with marijuana use.

Explain to your kids that some people can smoke nearly every day without getting addicted because their brain chemistry doesn’t become altered by the drug long term. You never know that you’re addicted until your brain fails to produce enough dopamine on its own. The brain thinks, “Hey, I’m getting plenty of dopamine from an outside source now, so I don’t need to produce it on my own.” When the addicted individual tries to stop, their dopamine-starved brain craves more of the drug.  However, many users still do not realize that they have a problem with drugs.

 

Myth #3:  Marijuana Has Been Legalized In Several States, So It Can’t Be That Bad

The decision to legalize marijuana on the state level is influenced by many factors. One thing is for sure: marijuana doesn’t become legalized because it’s determined to be safer than previously thought. Marijuana still has the same potential for addiction and is carcinogenic when smoked.

For anyone under the age of 21, marijuana is still illegal in all states. It can be helpful to remind your kids that ‘minor in possession’ charges still apply, as they do with alcohol.

If your child is of driving age, remind them that they can absolutely receive a drug DUI for marijuana, just as they could receive a DUI for alcohol consumption. Marijuana lingers in the system of certain individuals longer than it does others. Compared to alcohol, it’s hard to know exactly how long testable levels will remain in your system. Because marijuana is fat-soluble, it takes longer for blood levels to sink below the drivable limit if you have a higher body fat percentage.

 

Myth #4:  Addressing The Prevalence of Marijuana Use In Music and Counterculture Scenes

Musicians and performers often heavily promote drug use in their music. While many artists do live the lives they portray, for most, the glorification of illicit activities is used as propaganda. Many admit in interviews that they over-exaggerate their drug use because they know it will result in better sales. It can be helpful to remind your children about the reality of drug glorification as a marketing strategy.

 

Myth #5:   “I’ve Smoked Plenty of Times and I Don’t Have Cravings or Withdrawals”

Drug dependence can develop gradually, and this is certainly true for marijuana. Early withdrawal symptoms and cravings are less noticeable because the effects of the drug are milder compared to other recreational substances. Users experience very little ‘comedown’ as the marijuana high wears off, and it may be a week or longer before your brain starts to itch for more of the drug.

 

Myth #6:  Marijuana Isn’t Expensive

Marijuana is one of the most affordable drugs to purchase, both legally and illegally.  When marijuana was first legalized in Washington State, there was concern that the high taxes would make marijuana too expensive, but the opposite effect has happened. Marijuana is now significantly more affordable than it used to be. Over time, however, the frequent marijuana consumption adds up and becomes expensive as it’s accessibility increases.  Just as it’s true for legal substances such as alcohol, marijuana can be considered a financial stressor in certain circumstances.

 

Myth #7:   Marijuana Isn’t as Bad For The Lungs as Cigarettes

While several studies have been done to compare the carcinogenic effects of marijuana to those of tobacco, no conclusive evidence exists to say that one is worse than the other. The truth is, the cancer-causing effects depend on the frequency of use. If you frequently smoke large amounts of marijuana, it’s undoubtedly a risk to your lung health. Although the scientific evidence of the carcinogenic effects of cigarettes vs. marijuana is inconclusive, it still should not be used as an argument supporting the use of marijuana.  Rather, it should be argued that ingesting any foreign substance into your body should be considered hazardous to your health.

 


 

Marijuana use is often thought of being significantly less dangerous to experiment with than alcohol or other drugs, however, this is not the case.  Although marijuana is generally thought to be the “basic” type of drug, the possibility for dependence is just the same as it is for other substances. However, the conversation should not be based solely on marijuana use, but based on alcohol and drug use in general.  By explaining to young adults that all illicit drugs, including marijuana, have a great propensity for dependence and addiction, it allows them to understand the extreme risks of alcohol and/or drug use in general.

If you have any further questions regarding drug or alcohol addiction, Stonewall Institute Treatment Center is more than happy to answer any questions you may have. Call us today at 602-535-6468 or email us at info@stonewallinstitute.com.

5 Tips For Boosting Self-Esteem While In Recovery

Getting sober may come with many sudden realizations, such as the amount of time you lost while under the influence. It’s a reality that can be hard for many to grapple with. Low self-esteem is common among recovering individuals and coming to terms with this can be difficult. By pursuing new challenges, you can start to rebuild your sense of self-esteem in recovery. It’s easy to dwell on the past, but the rest of your life is ahead of you. At Stonewall Institute Treatment Center, not only do we offer superior treatment for alcohol and substance use issues, we also focus on getting yourself in the right headspace so that you can get out there and meet your recovery goals.

1. Meet New People

Stagnancy is a big part of addiction. It’s easy for anyone to get lulled into the same daily routines without growing and moving forward in life. When you use, you tend to spend a large amount of time with other people who are doing the same things as you. Meeting new people can introduce you to a new set of healthy habits.  Picking a group of people with healthy practices takes the guesswork out of making good lifestyle choices. A group of friends that are inspired to live life to the fullest. Following their lead is the simplest way to get inspired to live a fulfilling life.

 

2. Learn Something New

Proving that you can still learn new skills will reduce anxiety about the future. Though sometimes hard, it’s possible to quiet that voice of doubt that lives in the back of your head. You just have to prove that you still have what it takes to acquire new skills. Anxiety comes from concern about the future. Nothing is more anxiety inducing than not believing you can start from scratch with something new. If you have faith that you can learn new things, you’ll quickly start to feel better about the road ahead. This is easier said than done. The majority of people go through life with stretches of time spent in stagnancy. Shaking the cobwebs loose and going for it is even harder when you’re coming out of the mental haze of addiction. Push yourself in the early stages of recovery to let go of lost time and get aggressive about tackling fresh challenges. Anything you can do to prove that you still have what it takes to acquire new skills will calm the anxiety you have about the future and build self-confidence.

3. Start An Exercise Routine

Physical challenges are great for building self-esteem. First, physical accomplishments and health goals are straightforward to execute. You put in the work, and the results come. There isn’t a lot of room for judging yourself. This makes exercise habits one of the best ways to prove to yourself early on in recovery that you can stay consistent and get results. The key here is consistency. Any form of physical exercise is beneficial. If you get bored of the same workouts, try a yoga class or go on a long walk with a loved one. Whatever you choose doesn’t have to be strenuous, just as long as you’re moving your body and thus, reducing stress and anxiety.

Making small strides every day refreshes your memory about the benefits of hard work. The emotional satisfaction that comes with that feeling of accomplishment is its own reward. The joy that comes from hard work is easy to forget when you’ve been struggling with the complications of addiction. Exercise reminds you of that feeling of success, and you can use it to translate positive momentum into other, more complicated areas of your life.

 

4. Share Your Story

Addiction can bring with it a lot of feelings of guilt and shame. The harm that some addicted individuals cause directly or indirectly to their loved ones can be a heavy burden to bear. It can leave the lingering question of whether or not you’re worthy of the love and acceptance you once were. By taking the step to share your full story with the world, you can get confirmation that you are still, in fact, deserving of love. Being vulnerable is also the mark of a great leader, and people respond accordingly. When you take the first step to expose your true self, people react by doing the same, and they share with you the best possible version of themselves. This opens the door to making new connections with emotionally available people who resonate with your story. If you live in the Phoenix, AZ area, the Stonewall Institute Treatment Center’s 10-week alcohol and drug treatment program can be a safe place to share your story and get support from knowledgeable experts and like-minded individuals.

 

5. Make Space In Your Day For Quiet Reflection

Spending time alone is part of the journey towards self-acceptance in the face of recovery. Just as being vulnerable with others can make connections and build self-esteem, meditating can help you reconnect with yourself. The modern world is so fast-paced and over-stimulating that it can be hard to get quiet time alone. Much of the benefit that comes from meditation is the result of removing all the background noise. A traditional meditation practice is something you can work up to, but initially, blocking off technology-free time to yourself is a great first step.

When you’re ready to kick your reflection time into the next gear, try going on hikes. There’s quite a bit of research on the mental health benefits of what the Japanese call forest-bathing. According to scientific literature, the smells, sights, and sounds of a babbling creek and wind rushing through the trees reduces anxiety. The sounds of nature are the perfect contradiction to the hyperactive stimulus of heavy traffic, computers, and cell phones.

 

The brain fog of addiction and recovery can make life seem emotionally stifling and overwhelming. Individuals suffering from addiction can have low self-esteem from the regrets that come with wasted time. By putting in the extra effort to reconnect with yourself and the world, you can get in a better headspace for living a productive life. Pushing yourself to master new skills and staying consistent with hard work is the best way to build self-esteem in recovery. If you or someone you love is struggling with substance dependence, don’t hesitate to contact Stonewall Institute Treatment Center today. Call us today at 602-535-6468 or by email at info@stonewallinstitute.com.

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