Author: Annie Winner

Anger Management as a Tool to Maintain Sobriety

man with anger management during treatment

Anger Management as a Tool to Maintain Sobriety

Anger is a normal and healthy emotion experienced by basically everyone. However, for many people, it can lead to stress, poor responses to input, and out of control emotional flare-ups that lead to drinking in order to control those emotions. Most of us are familiar with the urge to have a drink to cool down from anger – and that feeling can be an extremely difficult trigger when you’re in recovery.

Learning how to manage anger, usually through therapy and anger management classes, is therefore a very common part of addiction treatment. In fact, more and more treatment centers now offer tools like anger management, stress management, mindfulness-based stress reduction, and emotional regulation as normal elements of addiction recovery. Here’s how and why anger management plays a role in maintaining your sobriety.

Uncontrolled Anger can Trigger Relapse

Anger is a very normal emotion. However, if you’re not in control, it can be overwhelming and destructive. For many of us, anger results in poor emotional regulation, extreme stress response, and learned behavior patterns. Each of these can result in triggering an episode of drinking. For example:

Out-of-control anger is often learned from parents or results from not being taught emotional regulation. This means that people with anger management problems often have poor emotional regulation, so any emotion can be overwhelming. Without mechanisms to regulate emotions like anger, it’s easy to resort to substance abuse to manage your anger and other feelings.
Anger can be a symptom of post-traumatic stress disorder and complex PTSD, both of which require additional treatment. Both also greatly increase your risk of substance abuse as you look for means of coping with things that are out of your control.
Anger greatly elevates your stress response which increases cravings for substances that release dopamine and serotonin in the brain. As a result, high stress can result in a relapse and is, in fact, one of the number one causes of relapse. If you can’t resolve your anger, you will experience stress and it will increase your risk of relapse.
Behavior patterns, often known as habits, can be extremely powerful predictors of behavior. You’ll know this if you’ve ever driven the same way to work for years and then tried to take a different route – or found yourself autopiloting past the liquor store on your way home. If you have a habit, you’re more likely to do something automatically, and that means turning to unhealthy coping mechanisms like alcohol. If you’re used to responding to anger by drinking, you’re more likely to continue to do so, even if you have already had substance abuse treatment.

Essentially, there are a lot of ways that anger can contribute to relapse.

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How Does Anger Management Help?

You know how anger is detrimental to sobriety, but how does anger management help? Unfortunately, there’s no quick fix to anger problems or behaviors related to drinking around anger. Instead, you’ll have to work towards slow improvements that help you in the long-term. Let’s take a look:

Identifying triggers for anger – You’ll want to know what causes anger and why. In some cases, anger is a justified response to being treated unfairly. In other cases, anger is a response to stress, like traffic. For many people, you’ll want to spend time writing down when you get angry and what caused it for a few weeks before you can honestly say what triggers anger. Taking time to write that out will almost always be a part of anger management treatment as well.
Identifying what anger triggers – Once you know what triggers your anger, you’ll work to identify what anger triggers in you. For example, how do you behave? Do you lose control? Do you use drugs or alcohol to come down from anger? Do you come out of anger only to experience stress and anxiety? Identifying this will allow you to identify what you’re trying to improve on so it’s also a normal part of anger management.
Developing coping strategies – You’ll work with a counselor or therapist to specifically work on coping strategies that help you with your triggers and behaviors. For example, you can learn to take time-outs, to practice relaxation techniques, to respond in different ways, or to do other things first before responding to anger. For example, if you experience problems with anger while driving, you might be asked to take 30 seconds to concentrate on breathing, to sing a song, or to play a song and listen to it before you’re allowed to redirect attention back to anger. The idea is usually “acknowledge” “Okay I am angry”, “redirect” “Let me do something else for a few minutes” and “check in” “How do I feel now”?
Developing behaviors – It’s sometimes going to be important to develop a list of behaviors you are okay with and those you are not okay with. It’s important to be able to say to yourself “I am not comfortable responding in this way, so I am going to try to do something else”. Setting boundaries for yourself means you’ll have tools to help yourself realize when you’re going out of control, and that will help you to work towards being in control.
Setting goals – Finally, you’re always going to want to set specific and measurable goals for anger management. That can look like “I will practice breathing exercises every day”, “I will do a calming sport every day”, “I will take 30 seconds before I respond to anger”, “I will learn to stop responding to anger by shouting”, etc. If you can establish steps, you can work towards them, measure your progress, and see how it contributes to your goals.

Eventually, anger management means understanding yourself, what causes reactions, and what your reactions are. From there, you can more easily get therapy and counseling to help you modulate those behaviors. Having those emotional regulation tools will help you to stay in control, will reduce the stress you feel about anger, and may even help you to experience anger less. For example, if you experience anger about small things like someone cutting you off while driving, redirection and doing something else for a bit might save you anger for the rest of the day. That will pay off in improving your mood and decreasing your need to relax – because you’ll be less worked up. Of course, what you need to work on will depend on your situation, how you’re managing anger currently, and what’s causing problems. In some cases, you need better anger management skills and in others you need to step out of situations that are causing problems with anger. Your counselor will help you with that.

Anger management can help you maintain sobriety, especially if you have a habit of drinking after episodes of anger. The more stressed you feel after getting angry, the more that’s likely to be true. The good news is that anger and emotional management is more and more often a standard part of substance abuse treatment, so you’ll have more options to get anger management worked into your normal treatment and aftercare. Of course, you can also go to a program that’s completely separate from substance abuse, just keep in mind that it will touch less on specific overlaps with addiction and relapse. Good luck getting help.

Do Women React Differently Than Men to Meth?

Methamphetamine is one of the most popular drugs in the United States. In 2022, an estimated 176,000 Americans started using the drug. A further 1.8 million Americans, or 0.6% of the U.S. population qualified for a methamphetamine disorder. Today, that mostly means adults aged 26 or older, and almost half of these count as a severe substance use disorder. That data isn’t split by gender, but today we know that while men are more likely to abuse meth, women are just as likely to be addicted as men and are often more susceptible to cravings and addiction. That’s in part because of hormones and in part because of different societal pressures to use.

Women respond to, react to, and use methamphetamine differently than men. Yet, for many women, substance abuse treatment is the same as that designed for and delivered primarily to men. Understanding the differences and how women’s bodies and women’s lived social experiences mean different reactions to addictive substances like methamphetamine can help you to better understand treatment and what you need from it to recover.

Do Women Respond Differently to Meth than Men?

The short answer is, yes. Women respond differently to meth than men. However, the long answer is that there are a lot of factors that come into play including social upbringing, environmental factors, and hormones.

This means that treating substance use disorder has to tackle different problems.

Women are more vulnerable to addiction than men
Women are more vulnerable to relapse than men
Women progress to “addiction” faster than men
Women respond to treatment better than men
Women show fewer symptoms of cardiovascular and brain damage following meth usage
Women have different motivators to use and therefore require different treatment than men

While both men and women are negatively impacted by methamphetamine, the effects are different. Acknowledging and responding to those differences means creating treatment programs tailored around biology and lived experiences rather than handing everyone the same treatment programs.

Hormones and Greater Vulnerability to Addiction

Women show increased susceptibility to the effects of stimulants including cocaine and methamphetamine than men. Women are more likely to show a strong tendency towards cravings and addiction, with more vulnerability to the reward effects of stimulants.

That’s thought to be linked to estrogen, with multiple studies showing increased effects of methamphetamine and other stimulants during the estrogen producing period of the menstrual cycle. Women on progesterone-based birth control are also at increased risk, as progesterone may increase the reward or stimulating effects of methamphetamine, increasing cravings, and increasing the effect of the drug.

As a result, women are more vulnerable to addiction to begin with. Women move from the cycle of initiating methamphetamine usage to addiction faster than men. Women are also more likely to experience relapse even after getting treatment.

This also means that trans women are potentially especially vulnerable to methamphetamine reward and addiction. Anyone taking estrogen supplementation or hormonal supplementation is likely to see increased effects of methamphetamine and therefore to be more at risk of rapidly becoming addicted to the drug. That vulnerability is further exacerbated by low mental health and a strong tendency to use stimulants in the LGTBQ++ community.

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More Resilience to Long-Term Damage

Women using stimulants such as cocaine and methamphetamine are less likely to show abnormalities of blood flow, heart, and brain blood flow than men. They are also likely to show similar negative impacts to concentration, learning, and achievement – even when using methamphetamine for longer than men. The mechanism behind this resilience is poorly understood but may have something to do with hormonal changes.

However, that doesn’t mean women don’t experience damage from methamphetamine abuse. Women see significant reductions in gray matter volume when using meth. This reduces blood and oxygen levels in the brain and can reduce cognition, attention, memory, and emotional processing. Like with men, this damage is expected to heal after about 2 years of abstinence.

Different Motivators to Use

Women often report using methamphetamine and other substances for very different reasons than men. For example:

Women report significant rates of co-occurring depression when using methamphetamine. For some women, methamphetamine initiation is a tactic to manage depression while maintaining energy levels to continue household responsibilities. Methamphetamine is a stimulant and may be used to reduce side-effects and symptoms of low-mood and sleeplessness – or for self-medication. This means that treatment must involve treating the co-occurring disorder to prevent a relapse and a return to self-medication following treatment.
Women very often have roles related to caregiving and social support which they cannot easily step out of. As a result, women cite using methamphetamines to keep up with work, home care, childcare, and family responsibilities. With methamphetamine taking on an enabling role, treating methamphetamine use in women may not involve changing behaviors of avoidance but rather changing behaviors of taking on too much – which means a completely different treatment trajectory is needed.
Women face higher societal pressure to be thin and many women cite methamphetamine use as part of a weight loss strategy. This means that methamphetamine may reflect underlying eating disorders which must be treated as part of relapse prevention.
Women are significantly more likely to be dependent on a significant other because of children or lack of independence. This can mean that exposure to methamphetamine originates in a partner or spouse and that substance abuse is likely to be a shared activity in the relationship as well as a means of escaping from domestic trouble or violence. These motivators means that significant effort must be put in to provide domestic shelters, housing assistance, and childcare assistance as part of recovery efforts to ensure that women with childcare obligations are not forced to remain in situations that trigger and result in further methamphetamine abuse.

Women use drugs like methamphetamines for significantly different reasons than men. Often, that’s exacerbated by social issues, childcare, lack of independence, and roles in which they are the primary caregiver. Women need structural support including childcare, structural treatment for mental health disorders, and help finding and treating underlying problems and disorders.

Men often need this as well, but for different motivators and problems. Therefore, the approach has to be different if both are to receive a high quality of care.

Getting Help

If you or a loved one is struggling with methamphetamine, it’s important to actively look for help. That means talking to your doctor and reaching out to a rehab center for longer-term treatment and assistance. Here, choosing a treatment center with programs for women can offer significant advantages for recovery including better interventions tailored to the motivations and underlying problems faced by women. Programs made for women also take biology into account and the increased vulnerability to cravings and addiction as well as the role hormones play in both into account – meaning you’ll receive better and more targeted treatment.

At the same time, you may want to look for treatment centers offering childcare, family therapy, aftercare with housing assistance such as sober living, and outpatient care options to enable ongoing childcare. Meeting the needs of women in recovery should mean meeting lifestyle needs as well, so that you can feel safe in taking time to go to treatment because family and responsibilities are taken care of.

Can You Force Someone to Go to Rehab?

If your loved one is struggling with drugs or alcohol, watching them do so can be the hardest thing. Not only are you aware of what they are doing to themselves, you’re aware of treatment and options to help. Rehab clinics or substance use disorder treatment centers are designed to help people overcome physical addiction and then build the life skills they need to build a life where they don’t need drugs or alcohol. But, getting them there can be extremely difficult. That’s especially true considering many people are in denial of their substance abuse problems, think they can quit whenever they want, and may not be ready to get help.

The bad news is that no, you can’t force someone to go to rehab unless they are under the age of 18. If your loved one is a minor, you can make them get treatment providing you’re their parent or guardian. However, in every other case, your loved one will have to choose help for themselves. That’s hard, but it also means they are going to be ready for treatment when they go to look for it.

In this article, we’ll expand on that and some of the steps you can take to make sure your loved one gets into treatment. In addition, we’ll go over the legalities of forcing an adult into treatment by taking them to court.

What is Involuntary Commitment?

Today, an estimated 48.6 million Americans struggle with a substance use disorder. This means that almost one in five Americans has a substance use disorder and needs some form of rehab or treatment. In extreme cases, where the individual in question is deemed to be a danger to themselves or others, you can get the law to step in and force that person into care. In addition, that will be easiest if your loved one breaks the law. For example, if your loved one has a history of driving under the influence, especially if they’ve been arrested in the past.

Civil Commitment or involuntary commitment is not available in every state. Otherwise, you can take your loved one to court with proof of their addiction, proof that they are posing a danger to themselves or others (neglect of themselves, driving under the influence, suicidal ideation, violent ideation) and then hand the decision over to a court. This will involve:

A mental assessment where a medical professional will determine if your loved one is able to make informed decisions about their mental health
The family or family doctor (depending on state) has to make a petition to the court requesting involuntary/civil commitment
The court will evaluate the decision
A hearing will be held where the court will decide if it is valid to force the individual to go to rehab or not.

This type of involuntary commitment is legal in about 30% of states. In many, you’ll need a petition filed by at least two people and the family doctor. Here, Colorado is the easiest place to file for involuntary rehab, as the state makes allowances for up to 180 days of involuntary commitment into rehab.

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What Happens if Involuntary Commitment Works?

If you successfully take your loved one to court and have them involuntarily committed to rehab, what next? In most cases, your loved one will be mandated to 30-180 days of mandatory inpatient or outpatient treatment. Here, most forced rehab is “inpatient” meaning that your loved one stays at a facility chosen by the court for that period. In other cases, your loved one may be asked to attend an outpatient program with a probation officer to ensure they keep going. If they don’t, they could end up in jail.

Motivation is a Crucial Part of Treatment

It’s important that people go to treatment when they are ready. For millions of Americans, getting treatment means acknowledging that they have a problem, that they can’t stop on their own, and that they are out of control. That can require a significant mental shift and is a step that can be extremely painful for many people. We’re all used to people who deny that they have a problem. “I don’t drink that much”, “at least I’m not as bad as X”, “I’m not THAT bad”, “I can quit tomorrow if I want,”. All of these phrases come from people who aren’t yet ready to face that they need help. And, that means they won’t benefit from help without significant motivational therapy upfront.

This is known as “resistance to treatment” and results in non-compliance, non-engagement, and high rates of relapse after treatment ends.

Once you understand that, you can take the approach of building motivation to get help. Helping people realize that their substance use disorder is crippling them, getting in the way of their ability to live and enjoy life, and their ability to reach goals. Many people will painfully feel those impacts, especially if they are still at a point where they are living a normal life, working a job, and taking care of family.

Alternatives to Forcing Treatment

“If only I could just make them get help”, is a tempting thought. At the same time, it can be extremely harmful to your loved one and may not have the results you want. Most states will not allow forced rehab unless the situation is truly dire. For example, if your loved one has lost their house, are homeless, and are not taking care of themselves. If your loved one is still functioning normally, you’re generally better off taking other steps first. For example:

Offering Support – Offering support over the long-term, reinforcing that you’re worried about your loved one, and trying to get your loved one into treatment may have an effect over time. However, progress will be slow.
Interventions – Interventions can be a powerful way to force someone to acknowledge that they are struggling and that they need help. If you’re not sure how to hold an intervention, there are generally professional counselors who can help you plan and hold the intervention to maximum effect.
Harm Reduction – Harm reduction strategies work to reduce the harm of substance abuse without forcing your loved one into treatment. That can mean working to ensure clean needles and safe drugs, ensuring naloxone or other anti-overdose medication is available, and ensuring that your loved one drinks or uses under supervision such as a medication-assisted treatment site. The idea is that they are using anyway, you want them to do so in as safe of a manner as possible before they come to the conclusion that they need help.
Going to Therapy – If you can’t get your loved one into rehab, you might still be able to get them into counseling or therapy. That will, in turn, push them into rehab. Here, you generally want to push getting help with things that they are struggling with like mental health, feeling good, side-effects of substance abuse, work, etc., because you are worried about them.

People who aren’t ready to go to rehab are often facing significant stigma and shame. Therefore, one of the most important things you can do for your loved one is to offer support, to destigmatize addiction, and to treat their problem just like you would depression or a broken leg. It’s a problem that needs treatment and then you can recover and be healthy again.

Getting your loved one into treatment can be extremely difficult. If they’re not ready to go, many states don’t even offer a legal alternative. Instead, you’ll be forced into working to motivate your loved one to get help, staging an intervention, and working to reduce harm until they get into treatment. Good luck getting your loved one into rehab.

What Is Cocaine Cut With?

Cocaine is a euphoria-inducing drug often used recreationally in the United States. For many people, cocaine is a casual use drug, which never escalates into a problem or problematic use. In fact, in 2022, over half a million people used cocaine for the first time. For many of those people, cocaine is seen as a relatively safe and low-impact drug that wears off quickly and has few side-effects other than a hangover and maybe a nosebleed or two. At the same time, 1.4 million Americans aged 12 or older (0.5% of the population) also have a substance use disorder or problematic usage of cocaine.

In addition, while millions of Americans will use cocaine and then only use it occasionally, it remains dangerous. Cocaine is a powerful stimulant that causes stress on the cardiovascular system and can result in heart attack or heart problems. In addition, it interacts badly with many other drugs. And, increasingly, cocaine is cut not with potentially illness-inducing white powders but with other, stronger drugs that look similar but cost less to acquire.

As a result, every single time you use cocaine, you could end up in the hospital. Using a drug like cocaine is always a risk. That’s because it’s unregulated, you have no idea what you’re taking, and you could experience negative cardiovascular side-effects that could be fatal.

Why is Cocaine Cut?

Cocaine can be cut for a number of reasons. However, the most common is that the dealer is trying to save money or the person they bought it from is. Here, cocaine is often mixed with white powders that look similar to cocaine, or so much so that you couldn’t tell the difference.

Cocaine can also be cut if what you’re taking is not actually cocaine. For example, it’s increasingly common to see products that are essentially fentanyl powder cut with baby powder or talk sold as cocaine. There’s no actual cocaine in the product, but the dealers often don’t even know that. Instead, they get “cheap” cocaine, which they can then sell for a higher profit margin or pass on cheaply.

In each case, the primary goal is more money for someone in the chain of manufacturer to dealer. And, in some cases, that can result in significant danger to the user, because the person selling the cocaine doesn’t necessarily know what they are selling or what safe usage looks like.

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What is Cocaine Cut With?

Cocaine is cut with a large number of substances. The only thing they have in common is that all of them are white powders. Adulterants and cutting agents can include:

Flour
Baking soda/powder
Baby powder (unscented)
Talcum
Boric acid
Gypsum powder/chalk

These “fillers” increase the quantity of “cocaine” the dealer has to sell. Often, they are used to increase the volume of the cocaine to increase profit margin. In this case, it’s common to see ratios of 10-60% of what are essentially household ingredients used as cutting agents.

However, there are other cutting agents often used. These are typically added in the case that the cocaine has been cut too much and someone could tell that their cocaine isn’t doing anything or that it tastes different. They can also be added in the case that there isn’t any actual cocaine in the product you’re being sold, and the dealer wants to ensure that the drug “does something”.

Levamisole (veterinary strength dewormer with a similar taste and melting point to cocaine)
Fentanyl (high strength opioid drug which is available cheaply and is commonly used to create faux cocaine)
Amphetamines (Used to create a euphoric high similar to cocaine, but more cheaply)
Caffeine (used to create a high similar to cocaine, but with higher risk of cardiovascular complications)
Hydroxyzine (antihistamine medication)

If there’s a filler in your cocaine, it’s very likely to be one of these. However, you might also end up with a filler like a local analgesic or painkiller, powdered paracetamol, or a similar filler. These are less common but may still be used to cut cocaine.

Are Fillers Dangerous?

In the best-case scenario, fillers in cocaine can be relatively harmless and merely reduce the strength of whatever you’re taking. For example, it’s not exactly healthy to snort flour up your nose or inject it into your veins, but you’ll probably survive it (although injecting it can cause you to go into shock).

However, many substances that are used to cut cocaine are not safe for taking in any kind of volume. Most are also not intended for use via the membrane layer in the nose or mouth or for injection. This means you can easily reach toxicity with substances that might be safe to take via a pill.

What else? Cutting agents like fentanyl can be extremely strong. If you don’t know what you’re taking, you run the risk of an opioid overdose, without having an overdose reversal agent like Naloxone on hand. Finally, agents like amphetamines can be extremely habit inducing and can result in psychosis, behavioral dependency, cardiovascular problems. Cocaine also penetrates the membrane layer between the brain and the cardiovascular system. It can saturate that layer, drawing other substances with it, and can cause toxicity on its own. In this case, the result is often sudden death.

What Can You Do About Cut Cocaine?

Cocaine is never safe to use on its own. Every time you use it, you take on risks to your health. However, additives and fillers add new layers of risk, because you simply don’t know what you’re taking. For that reason, there are many drug testing organizations in the United States, some of which will test your drugs for free. The best solution is always to not use illicit drugs. However, if you’re going to use them anyway, organizations like DanceSafe provide avenues to ensure that you’re using in as safe of a way as possible. Often, that means ordering drug testing kits or taking a sample of your drugs in to be tested. This won’t get you into trouble. However, you will get a report back on what’s actually in your cocaine, so you can make a decision about whether it’s safe enough for you to use. For example, most people might be surprised to learn that about 5% of all cocaine collected by the DEA includes fentanyl or heroin. Understanding the risks and that you are taking an opioid can allow you to practice much better drug safety.

And, of course, most of us aren’t to pleased with the prospect of using household cleaning products or baby powder as a drug either.

Getting Help

If you or a loved one is using cocaine, it’s important to understand that it is a risk. For example, in 2022, roughly 10,000 people died of stimulant-related overdose without contaminants like fentanyl and a further 47,000 died of overdose-deaths after taking a stimulant mixed with fentanyl or heroin.

Many people see cocaine as a safe drug that they can use and have vanish in a few hours. While that’s often the case, the drug comes with its own significant risks and it’s never safe to use, even if you’ve safely used it before. That may mean it’s important to get help, to look into talking to your doctor about drug use, and to get treatment or therapy to explore the reasons behind using, so you can improve those direct causes and not need it.

What is the Connection Between Addiction and Impulsive Behaviors?

For many people, impulsivity or impulsive behavior and risk-taking behavior go hand-in-hand with substance use disorder or “addiction”. This means that, even when completely sober, people with substance abuse problems are more likely to engage in impulsive decision-making, risk-taking behaviors, and otherwise very quickly jump to things. However, impulsive behaviors have a complex relationship with addiction and substance abuse.

For example, impulsive behaviors are one of the leading risk factors behind substance abuse. People who are impulsive are less able to say no, more likely to make risky decisions like substance use, and more likely to take actions that could put them in danger. At the same time, substance abuse can increase impulsivity and sensation-seeking by changing how the brain works, which means that impulsivity will get worse as you continue to use.

That’s further complicated by the fact that people who are very impulsive often have complications from trauma, stress, and adverse childhood experiences. This means that the same factors which increase the likelihood of addiction are also likely to increase impulsive behaviors.

Impulsivity and Pleasure-Seeking

The thing that most people think of when they think of impulsive behavior is pleasure-seeking. Here, impulsive people may have a hard time saying no to things that make them feel good. They may quickly and with little thought do high-risk activities that result in adrenaline and a rush of feeling good. Think impromptu car races, binge drinking, binge eating, skipping school or work, etc.

These kinds of behaviors are often driven by a desire to feel good, usually as a result of learning poor coping mechanisms, trauma as a child, or brain development.

In some cases, pleasure seeking can look fairly normal. In other cases, it can look like seeking out extreme experiences, akin to going after roller coaster rides and bungee jumping. More often, it means someone who drinks or uses drugs, goes out too much, and indulges in fast food, sugary drinks, and other chemical ways to feel good.

Eventually, that puts you at risk of substance use disorder, because it means you’re exposed to substances, sometimes very regularly.

Sensation Seeking after Exposure to Drugs and Alcohol

The more you use drugs and alcohol, the worse sensation seeking is likely to get. For many people, this means that substance abuse results in the brain reducing its production of serotonin, dopamine, and oxytocin. That means you feel less in response to whatever you’re doing. Therefore, you need more of the drug, the alcohol, or an even more gratifying experience to feel the same amount of pleasure from it. That quickly deteriorates into a pattern of escalation that can become dangerous.

As a result, using substances for sensation seeking very often results in a chronic condition with patterns of building tolerance, increasing usage, and dependence.

Stress Response

Impulsive people often use sensation seeking to manage stress and to feel good around negativity. As they use drugs and alcohol to do so, they reduce their ability to feel good in other ways, while increasing stress from mental and physical health problems, job stress, interpersonal relationship turbulence, and hangovers. That means an increase in stress and an increased need for sensation-seeking behavior.

As a result, people who are in this position often need to feel good more and more just to cope with daily life. The stress response refers to how the brain changes to adapt to drug use, which results in a vicious cycle where you feel bad and want to do something that feels good, but nothing feels as good as it used to, so you keep using more.

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Self-Medication

Self-medication is a very closely related phenomenon to both the stress response and sensation seeking. However, here, the individual is specifically drinking to feel “not bad” rather than to “feel good”. That makes this a different response. However, it is one that impulsive people are extremely vulnerable to. Here, people are very likely to:

Drink alcohol to destress
Take extra pills or more than their prescription in case of pain
Use medication outside of a prescription
Preemptively take painkillers or drink to prevent stress and pain
Feel like they need a substance to cope with a problem

People who use substances to self-medicate typically start out doing so on an impulsive basis. “I feel bad and I know this will make me feel better”. However, like with sensation-seeking, it can very easily get out of control. That’s especially true when people self-medicate for stress, chronic illness, or other frequently recurring issues. And, with stress, drinking or using to cope with it actively makes the situation worse, because drinking and using do eventually create more stress in terms of financial stress, relationship friction, fatigue, reduced capability at work, etc.

It also means that the people who are most likely to be vulnerable to impulsivity are also the people most likely to be vulnerable to substance use disorders. That means people with recurring, existing, or chronic mental health problems from stress, depression, anxiety, or a mental health disorder.

Adverse Childhood Experiences and Impulsivity

The Adverse Childhood Experience (ACE) study was conducted during the 90s, with over 17,000 participants at the Kaiser Permanente and the Centers for Disease Control and Prevention. The study tracked how trauma at an early age impacted brain development as well as vulnerability to physical and mental health disorders. It found that more exposure to traumatic experiences resulted in an increase in impulsive and risk taking behavior. It also found that traumatic experiences before the age of 14 were significantly likely to impact physical and mental health problems, greatly increasing vulnerability to substance use disorders, mental health disorders, and even physical illnesses.

Therefore, the same factors that result in impulsive behaviors also result in substance use disorders.

In Short:

Impulsive behaviors increase risk of substance use disorder by increasing exposure to substances. They also make it harder to say no to further exposure because of sensation seeking and self-medicating patterns. People who are impulsive look for fast and easy fixes to stress, strong and negative emotions, and problems in their life. They also want to feel good, to experience highs, and to escape when they want to. That means impulsive people are very vulnerable to substance abuse. In addition, impulsivity gets worse as you use drugs and alcohol, which exacerbates the original issue further.

Getting Help

If you or a loved one is struggling with addiction, it’s important to reach out and get help. Today, your treatment options include behavioral therapy like CBT, which will help you to assess the underlying reasons behind addiction, to cope with stress in a healthy way, and to build healthy responses and behaviors that can help you to get in control of impulsivity, cravings, and difficulty managing substances in a healthy way. Addiction is a complicated disorder that’s impacted by hundreds of factors ranging from stress and environment to genetics and upbringing. At the same time, you can learn to manage it and you can get in control of your symptoms and your life. That may take months or even years of therapy, but having risk factors and having personality that contributes to a vulnerability to addiction does not mean you’re stuck with it. There is help and it will allow you to get your life back.

How to Stay Clean and Sober Over the Summer

sober friends on road trip during summer

How to Stay Clean and Sober Over the Summer

If you’re in early recovery, you know that recovery is a journey, you have to keep working for it. That can seem intimidating around things and events where you’d normally party or drink and use drugs or alcohol. For many of us, summer is about vacations, time off from school and work, and getting to party. For some of us, that can be intensely triggering. In other cases, it can mean facing the prospect of a “boring” summer, without the usual outlets of getting to let go and party.

The good news is that there are plenty of things you can do to have a great summer without drugs and alcohol. However, you might have to put in time to plan that summer. You might have to figure out what you can do, explore fun things to do, and look into ways you can feel social, get excitement, and enjoy being around others without drugs and alcohol. The closer you are to having been in recovery, the harder that might be. However, you can take steps that will ensure you stay clean and sober over the summer and hopefully enjoy yourself as well.

Mindset is Everything

It’s interesting how much of relapse is about mindset. For many of us, relapse is forwarded by finding ourselves reminiscing about the “good times” and getting to let loose, to party, to feel good. The minute you find yourself thinking in that way, it’s time to stop and reevaluate your mindset.

After all, it may be easier to let go of your inhibitions and go dancing or sing karaoke after a few drinks, but how much of it do you remember? How much of what is said is genuinely you? Do you get to make genuine connections with others? And what about the morning after when you wake up tired, dehydrated, and feeling bad? What about that? Most of us conveniently forget that drug and alcohol binges come with at least twice that amount of time of feeling bad. Correcting yourself by thinking about those bad times, thinking about throwing up, needing friends to get you home, passing out in places, being uncomfortable, having a headache – that’s all important too.

Glamorizing drugs and alcohol as part of your lifestyle is not going to get you a fun summer. However, you can actively confront your mindset when you do and make sure you remember the bad times as well.

And, having a summer without those bad times probably sounds pretty good right?

Make Sure You Understand Yourself

It’s important to know what triggers you. Chances are, if you’ve been going to therapy or addiction treatment, you’re already working on that. Understanding what is likely to trigger you means you can better plan having support networks around you when those triggers occur. You can also think about avoiding those triggers.

For most people, triggers look like:

Being around drugs or alcohol
Seeing people you used with
Being put in situations of stress
Being in situations that would previously have resulted in drinking or using
Being at parties or around others using
Being in certain environments like a beach, a bar, etc., that you might associate with getting drunk or using

For example, if you used to go to a resort in Mexico to get drunk and high over the summer, you probably don’t want to go to a beach in Mexico this summer. That will probably trigger you a great deal, and it will be difficult to avoid being surrounded by people who are heavily drinking.

Understanding your triggers means you can take steps to plan your vacation around those triggers and to have support when you can’t avoid those things. E.g., you’re going on a city trip and you know you can’t avoid bars, so you bring a sober friend you can talk to so you know you’ll get support even if you’re feeling cravings.

Here, it’s also a good idea to plan in how to react to cravings. That means figuring out how to take 15 minutes to do something with your hands, talk to a friend, solve a Rubik’s cube,

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Plan Sober Fun

Knowing what to avoid is only half the battle. You also have to know what you think is fun, what you can do for fun, and where you’ll find enjoyment. You still want your summer to be enjoyable, relaxing, and entertaining. You still want to feel like you’ve had a good time. That often means planning in sober fun. What is “sober fun”? That depends on you and what you like. For most people, “fun” works out to:

Social time where you get to engage with others, including people you know and strangers
Challenge
Games
Feeling like you’re contributing or making a difference
Adrenaline

Not everyone will like all of these things. However, most people like at least some of them. You can work that out to:

Sober parties and social outings, like dance classes, where you get to engage with others without alcohol. Don’t be afraid to throw your own parties. But, keep in mind there are sober events in most areas.
Physical activities, especially group activities. Think dancing, skating, bouldering, and other similar activities. Swimming might be less fun because it’s less social on average unless you’re playing water polo. Hiking is a great choice whether you’re traveling or staying home.
Challenging activities, like bouldering, escape rooms, chess, or board games, are a great option.
You’ll still want to feel excitement, so do things that are exciting. That can mean taking spontaneous trips, going on rollercoasters or water slides, going skydiving, or asking people to dance. The point is that you want to feel excitement because that’s an important part of having fun.
Volunteering, helping out with friends, and contributing to your self-help group or family are also an important part of having fun. Especially as you move further into recovery, you’ll find that fun and enjoyment is more about building moments that are enjoyable and creating a life that is worth living, and that means giving back. You’ll find that volunteering is extremely rewarding, if not “fun” in the most classic sense.

If you’re traveling, it’s also important to make time to experience food, culture, and sights. That means hiking, eating, local music, and city trips as part of your planned fun.

Don’t Give Up Self Care Routines

Most of us learn significant self-care routines as part of rehab. That means you’ll have a routine of wake up at a specific time, eat something healthy, work out, clean a bit, do your therapy or maintenance homework, go about your day, come home, eat something healthy, clean up, have a bedtime routine, go to bed at about the same time every night. The order of that can differ a lot but all of those elements should be in it.

Here, it’s important that you stick to that routine as you go about your summer. It doesn’t matter that you might not be going to college or to work, you might be in a different location, etc., but you should still maintain the self-care routines. That normally means that you should exercise about 80% of days, you should eat healthy meals about 80% of the time, and you should go to bed at the same time about 80% of the time. It’s okay to give that up for 2-3 days of short vacation, but other than that, you should stick to your routines so you can maintain your self-care and your mental health.

If you think you’re struggling or you’re not sure about getting through the summer clean and sober, it’s always a good idea to ask for extra help. That can mean signing up for a self-help group at your destination, it can mean signing up for telehealth therapy, it can mean going into treatment over the summer. It’s important that you ask for the help you need so you have the support you need to get through your summer clean and sober.