Substance Use Therapy

Many of us use or come to depend on the effects of drugs without quite understanding how they work. All drugs (well the good ones anyway) affect our brain and are thusly referred to as psychoactive drugs. A psychoactive drug is one that crosses the blood brain barrier and subsequently cause changes in our mood, perception, and brain function. This includes everything from coffee to heroin.

For most of us, alcohol takes up a lot of space in our brain, for one reason or another. But how much do we know about it?

In 2020, Texas saw an increase in overdose deaths of 31.9%. Just two years earlier, GovernorAbbott blocked two bills, Senate Bill 305 and House Bill 2432, despite significant support from the House Select Committee on Opioids and Substance Abuse.

Hangovers may be ubiquitous, but research around on the topic is not. Surprising, right? Apparently, the research is so scant, they have not even produced an agreed upon definition. The National Institute on Alcohol Abuse and Alcoholism defines a hangover as “set of symptoms that occur as a consequence of drinking too much.” They then provide a list of symptoms so long it calls to mind the prescription drug commercials and their possible side effects.

As grim as these numbers may be, the situation is not hopeless. There are steps that people who are actively using can take to keep themselves and others safe. Below are some tips and resources to help reduce harm.

Change is hard, especially changing our habits. Compounding the difficulty is often the expectation from others and ourselves, that change should happen quickly. Our modern society is partially to blame for this. Entire bathroom remodels are shown in 30-minute episodes. The 8 Minute Ab work out video did not make $20 million because we are all amazing at being patient. So, we decide need, want, must make a change and then we become utterly defeated because…change is hard.

Historically, we have been taught to use the tough love approach or begin scheduling a dramatic intervention. This often results in shame and judgment, even if that is not what was intended. Frequently, these approaches backfire or are just simply ineffective. Subsequently, there is often anger and resentment on both sides, which does not help anyone involved.

Even though buprenorphine is an evidence-based treatment for opioid dependence, there are very few substance use facilities that will prescribe it. According to one study in the Journal of the American Medical Association (JAMA), out of 368 treatment programs contacted in the US, only 29% offered buprenorphine as an option. 21% actively discouraged the use of buprenorphine.

This is important, so I am going to repeat myself. You are NOT an addict or an alcoholic. You are a person. You may struggle with drug and alcohol use. You may have a substance use disorder. You may be addicted to something. But first and foremost, you are a person.

It has happened to the best of us. We start drinking, we remember getting to the bar and that annoying song was playing. We remember ordering a drink and seeing that guy from work…and then we wake up the next morning. We do not feel so great, maybe a headache, maybe nausea, definitely thirsty. We wonder, how did I get here? Why am I wearing two different shoes? Where did I get this panda head? What the hell happened last night?

This may come as a surprise to you, but there are no pharmacological differences between crack and cocaine. The two main differences between them are baking soda and sentencing laws. However, those two things are substantial enough to create some big differences and considerations.

Perhaps the holidays are one of your favorite times of the year. Or, maybe you dread them the way other people dread Tax Day. Even under the best of circumstances, it is not uncommon for people to increase their substance use or relapse during the holiday season.

Methadone treatment is widely criticized, but often, those criticisms are based on myths or lack of understanding. Granted, methadone, like any treatment has its drawbacks. It is not the right treatment for everyone. However, it is an incredibly valuable treatment option and it saves lives. It is worth taking the time to understand.

Perhaps this is a crude metaphor, but let’s compare it to gambling. We know the odds are slightly in favor of the house. You might win, but it is a little more likely you will lose (especially if you keep going back to the table instead of taking your win out the door with you). And some people ultimately lose it all. Fentanyl is not like gambling at a casino. Fentanyl is like one of those cheap carnival games that is rigged—almost impossible to win. The odds of losing are e

Ecstasy or MDMA (a grateful shortening of methylenedioxymethamphetamine) is considered an entactogen (meaning touch within), a class of psychoactive drug that produces feelings of emotional openness. Although not strictly a stimulant or hallucinogen, it has properties of both.

Most of us do things every day to mitigate harm to ourselves and each other. We use sunscreen to protect us from harmful UV rays. We try to minimize our sugar intake. We wash our hands and cover our coughs. Harm reduction practices for people who use drugs are just as important as the practices mentioned above. Harm reduction advocates believe that everyone should have access to accurate information so that people can make safer choices.

All opiates are opioids, but not all opioids are opiates. Opioid is a broad term for any drug (natural, semi-synthetic or synthetic) that interacts with opioid receptors on nerve cells in the body and brain. All opioids will produce similar effects such as a euphoric state, reduced pain, slowed breathing, constipation, and pinpoint pupils.

If you have never seen the 1936 film, Reefer Madness, I encourage you to check it out. Bizarre, dramatic, and overly theatrical. They smoke a little marijuana and from there on out, it is manslaughter, suicide, rape attempts and just general lunacy. It is ludicrous and hilarious. But it was also part of a larger movement carefully designed to instill fear into people, not only about marijuana, but also about minorities and immigrants.

Self-compassion is a positive, emotional stance towards oneself. It is also considered an emotional regulation strategy in which we accept our negative feelings with awareness, kindness, understanding and a sense of common humanity. Essentially, self-compassion can help to transform our negative emotions into positive ones, or at the very least, less painful emotions.

Alcohol overdose (or poisoning) occurs when there is so much alcohol in the bloodstream that areas of the brain controlling basic life-support functions shut down. This includes our breathing, heart rate and temperature control. A lethal half dose (LD50) is defined as the dose in which half of the test subjects die. For alcohol, the LD50 is a BAC of 0.45. Inexperienced drinkers are most likely to suffer alcohol poisoning. (I will attest to this.)