Substance Use Therapy

I frequently meet people in the mental health field who have no idea what methadone is, or they believe that it is not a real treatment. The cost of this lack of knowledge or refusal to accept it as a valid treatment choice is lives. People who are struggling with opioid dependence need to know their options and should be given the freedom to make their own choice about treatment.

We all know we must protect our money. We know we are not supposed to flash it around in public or leave it unattended. We lock it up, we put it in banks, we carefully consider who we share it with. Yet, if time really is money why don’t we safeguard it in the same way?

Often, substance use is viewed from a binary perspective. You either use or you do not. Therefore, many treatment approaches treat “users” with the goal of “not using.” However, any time we attempt to view only the ends of a continuum, we are subsequently ignoring the complexities and experiences that are happening in the middle.

Of all the types of boundaries, emotional boundaries are without a doubt the hardest to navigate. Trying to identify them can feel elusive, like trying to hold water. We can think of emotional boundaries that are too rigid as impermeable—no water gets through. Too loose and we drown . When our emotional boundaries are not working for us, we are not taking care of ourselves or those we care about. When our emotional boundaries are intact, we can be both compassi

Many people feel that the best way to use cocaine is to use it with alcohol. People like the perceived counterbalance they feel occur when the two are taken together. Coke gotten you too jittery? Well, then have a drink. Alcohol making you too tired? Well, then do a line. Studies estimate approximately 75% of cocaine users regularly consume alcohol while using. It is a not-so-secret secret that usually the easiest places to score coke are the places where the alcohol f

Long before the required social distancing of the COVID-19 era, Seinfeld was well attuned to the discomfort that occurs when people get in our space. The close talker episode is one of the most famous and for good reason—most of us can relate to being in a similar situation. Jerry Seinfeld’s monologue at the end of that episode discusses respectable space needed at ATM’s and urinals, stating, “…I guess whenever someone's taking something valuable out of their pants you want t

When I think of boundaries, I think of the way they build skyscrapers. Modern day skyscrapers are designed to sway in the wind. Too rigid and they would snap under windy conditions and too much movement and you no longer have a building to bother with. How much they need to sway is of course dependent on geographic wind conditions, building height and a multitude of other factors beyond the reach of my therapist brain. Ideally our boundaries function in the same way.

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.

Problems managing anger. Poor self-esteem. Communication issues in relationships. Feeling the effects of burnout at work. Believe it or not, lack of assertiveness is often at the root of these seemingly different issues. Assertiveness is often misunderstood. Many people think assertiveness is a fixed trait or think being assertive is about being intimidating. Both are untrue.

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.

There is a lot about addiction that seems paradoxical. However, it turns out one can be perfectly rational and have a substance use disorder. It forms some basis of internal shame too. When one can objectively see the problems, the harm done, the pain caused and choose to do it anyway—surely, they must be fundamentally flawed. Or weak. Or immoral. Of course, none of those are true.

Never has there been a time that most of us can recall that loss has been so pervasive. Loss in 2020 has seeped into every crack and crevice of our social supports, our health, our traditions, our financial security, our safety, and our communities. Before 2020, we could perhaps seek refuge in times of grief with our families, or throw ourselves into work, or even engage in activities like haircuts or going to the grocery store without looking like an old-timey bandit.

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.)

Shrooms generally refer to Psilocybin mushrooms. They belong to a class of drugs known as hallucinogens. Hallucinogens change our thought processes, mood, and perceptions. There are three broad categories of hallucinogens (also referred to as psychedelics). Psilocybin is in the serotonin-related class along with LSD and DMT.

Whatever our reasons may be, none of us are better off by not getting enough sleep. It is consistently reported that a little over one-third of Americans do not get enough sleep. Lack of sleep can impact our mental health and cause or worsen issues with drugs and alcohol.

Cocaine is a short-acting central nervous system stimulant. A powerful one too. Its ability to increase our focus, alertness and minimize fatigue is largely the reason for its popularity. Cocaine has amassed a reputation as a party drug, due to the euphoria it produces as well as its influence on sexual appetite and performance. However, many people use it to bolster their school or work output.

Our society has some deeply held beliefs about what kinds of people use drugs and alcohol. This is largely due to the criminalization of addiction, alcohol not withstanding. Usually when people with substance use disorders are portrayed in movies and television, they are shown as devious and dangerous. They are portrayed as volatile and somehow morally compromised.