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 Substance Abuse

Substance abuse costs individuals substantially, and it costs the nation as a whole.
Substance abuse is a pandemic in the United States. From the abuse of seemingly innocent substances such as marijuana and alcohol to the abuse of street drugs like cocaine and heroin, substance abuse costs individuals substantially, and it costs the nation as a whole. According to the U.S. Department of Health and Human Services:
Illicit drug use costs the United States approximately $181 billion annually.
Excessive alcohol use costs the country approximately $235 billion annually.
It’s not surprising that substance abuse comes with such a high price tag when you consider all the health, legal, criminal, and personal issues that often come in its wake.
In 2012, nearly 24 million Americans, age 12 and older, had abused an illicit drug, per the National Institute on Drug Abuse (NIDA). Marijuana is still the most frequently abused drug, with more than 20 million Americans citing use of marijuana within the prior 30 days, according to the National Survey on Drug Use and Health (NSDUH), and more than 8 million people admitting to using marijuana on a near daily basis.

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Prescription Drug Abuse

While various street drugs are known to be dangerous, such as heroin and crystal meth, prescription drugs are often viewed in a more favorable light, due to their status as being doctor-prescribed. Though many believe these drugs are “safer” as a result, they can be as addictive as heroin.
Today, prescription drugs are abused more often than illicit drugs are, illustrating the prevalence of this issue.
In 2010, opiate painkillers, such as morphine, OxyContin, and Vicodin, were tied to almost 60% of drug overdose deaths.

Short- and Long-Term Effects of Substance Abuse

Drugs work by stimulating various parts of the human body, including certain areas of the brain. The many different types and classifications of drugs produce a variety of short-term effects, but the most common ones include increased heart rate, high blood pressure, dizziness, tremors, mood changes and paranoia. In high dosages, the risk for more dangerous effects increases, and the potential for heart attack, stroke, respiratory failure and coma increase.
In the long-term, substance abuse may lead to mental and physical effects that will require treatment to resolve. These effects can include:
Paranoia.
Psychosis.
Immune deficiencies.
Organ damage.
 

Dependence, Abuse and Addiction

While drug use often begins as a way to seek recreation, the addictive properties of drugs quickly turn a perceived outlet for fun into a constant need to remain high. This compulsion is uncontrollable and may interfere with a person’s everyday life.
While substance abuse comes with a great many side effects, ranging from mild physical side effects like nausea and dehydration to work-related consequences such as reduced productivity, one of the greatest risks of substance abuse is dependence.
What might begin as the occasional bump of cocaine or hit on the bong can quickly spiral into dependence and eventually full-blown addiction. Once addiction takes hold, comprehensive treatment is needed.
Even when the effects of drugs are damaging to a person’s body and relationships with friends, family members and coworkers, the constant need for a substance often overcomes any rational thinking.
Per NIDA, addiction is a persisting disease that requires ongoing management. Individuals are never “cured” of addictions; instead, they learn how to manage their disease so they can lead healthy, balanced lives.

Understanding Overdoses

Most people who struggle with drug addiction face the issue of tolerance buildup. After continuous use, the body becomes less and less stimulated by the drug. This may cause a person to begin using higher dosages to obtain the same high. Although the person may not feel as high, the damaging properties of the drug cause the same amount of harm. If the body receives a level of drugs that it cannot tolerate, this leads to an overdose. While some overdoses occur after continuous use, they can also happen after one single use of a drug.
Signs and symptoms of a drug overdose include:
Losing consciousness.
Fever or sweating.
Breathing problems.
Abnormal pulse.
Change in skin color.
If any of these signs are present, or if you believe a person might be having an overdose, seek life-saving medical attention immediately.

Getting Clean and Sober

The decision to seek out a clean and sober lifestyle is one of the most important steps in the recovery process. Since addiction is such a widespread condition, anyone seeking help will find numerous options for treatment.
These treatment options are designed to help walk a person through the steps to sobriety, which can make the transition easier. By calling 1-877-293-1485Who Answers? or filling out the quick contact form, we can help guide you toward the right option for your situation.

How an Intervention Works

Deciding to stop using drugs may be a difficult decision for a person to make. Even if drugs are causing a disruption in a person’s life, the compulsion to abuse substances habitually often overcomes any desire to quit. In some cases, the family and friends of an addict may consider holding an intervention.
During an intervention, each person needs to plead with the person to consider rehabilitation. While it is important to confront the person with the harsh realities of his or her drug use—including the negative effects the drugs have on the person’s relationships with loved ones—this confrontation should be one tackled with compassion and an understanding of the struggle of drug addiction.

Methods for Drug Withdrawal and Detoxing from Drugs

Before an addict can begin a rehabilitation program, full withdrawal or detoxification may be necessary. During this process, the body adjusts to its drug-free state and rids itself of the remainder of the drug. Some detox programs use controlled amounts of medicinal drugs to help a person through this process.

Rehab and Addiction Treatment Options

A doctor or addiction specialist or counselorcan help each individual find the right rehabilitation or treatment option. The setting is determined by individual needs, so some people may benefit from an inpatient rehab, while others may thrive by using an outpatient program.
At the core, the goal is to help a former addict assimilate into a drug-free life as easily as possible. The most commonly used treatment options for addiction include:
Psychotherapy, which helps patients learn how to resist and redirect compulsions.
Support groups
Individual counseling
If you want to know where to look for help for someone with a drug problem, call 1-877-293-1485Who Answers? or fill out the easy contact form to learn about your options.

Aftercare and Relapse Prevention

Relapse is best prevented by structured cognitive-behavioral therapy. By learning about drug abuse prevention and avoid situations that may cause compulsions or cravings, a person is more likely to retain control and make the decision to not seek out or use drugs. Utilizing therapy or support groups as aftercare options can reduce the potential for relapse.

Support Groups and Recovery Tools

The guidance of an experienced peer can be invaluably helpful to someone going through the initial steps of sobriety.
At times, an addiction can seem like a personal struggle that no one around you understands. For this reason, drug addiction support groups can help recovering addicts find comfort in their peers.
Depending on the person’s location, there may be a single support group for anyone recovering from an addiction, or there may be groups tailored to those recovering from a specific drug. In addition to providing support as a group, these organizations often pair up new members with existing members who have maintained sobriety for an extended amount of time. The guidance of an experienced peer can be invaluably helpful to someone going through the initial steps of sobriety

Shaming the Sick: Addiction and Stigma

AUTHORED BY Lauren Villa, MPH
  1. Table of Contents
The concept of stigma describes the powerful, negative perceptions commonly associated with substance abuse and addiction. Stigma has the potential to negatively affect a person’s self-esteem, damage relationships with loved ones, and prevent those suffering from addiction from accessing treatment.
Stigma is a public health issue — it contributes to high rates of death, incarceration, and mental health concerns among dependent populations.

Defining Stigma

Stigma is defined as a set of negative beliefs that a group or society holds about a topic or group of people. According to the World Health Organization (WHO), stigma is a major cause of discrimination and exclusion and it contributes to the abuse of human rights. When a person experiences stigma they are seen as less than because of their real or perceived health status. Stigma is rarely based on facts but rather on assumptions, preconceptions, and generalizations; therefore, its negative impact can be prevented or lessened through education. Stigma results in prejudice, avoidance, rejection, and discrimination against people who have a socially undesirable trait or engage in culturally marginalized behaviors, such as drug use (Link, 2001).
Family, friends and the general public can carry negative feelings about drug use or behavior. They may even use derogatory terms such as “junkie,” “alcoholic,” or “crackhead.” These thoughts, feelings, and labels can create and perpetuate stigma.

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How Prevalent is Addiction Stigma?

We live in a society where millions of Americans are dependent on drugs or alcohol and only a small percentage receive treatment at a facility. In fact, the 2014 National Survey on Drug Use and Health found that 21.5 Americans age 12 and older had a substance use disorder in the previous year; however, sadly only 2.5 million received the specialized treatment they needed.
Stigma affects all of us – and nearly everyone has felt stigmatized or has stigmatized others at some point in their lives. In a study done by Johns Hopkins Bloomberg School of Public Health, the general public was more likely to have negative attitudes towards those dealing with drug addiction than those who were dealing with mental illness. Additionally, researchers found that people don’t generally support insurance, housing, and employment policies that benefited people who were dependent on drugs (JHU, 2014).

A Picture of Stigma

Becoming dependent on drugs can happen to anyone. It’s important to keep in mind that we can all do a better job of decreasing stigma around drug use.
Recovery Brands conducted a survey of people who use drugs, and respondents provided written reflections about what they wished people or society at large understood about addiction. Their responses help illustrate the importance of remaining kind, compassionate, and human. The image below includes quotes from some of the respondents.


How Stigma Hurts

Stigma can negatively impact a number of areas, including:
Willingness to attend treatment and access to healthcare.
Harm reduction.
Self-esteem and mental health.

Impact on Treatment

Unfortunately, people who experience stigma regarding their drug use are less likely to seek treatment, and this results in economic, social, and medical costs. In the United States, costs associated with untreated addiction (including those related to healthcare, criminal justice, and lost productivity) amounted to a whopping $510 billion (Harwood, 2000).
Perceived stigma in hospitals or doctors’ offices can discourage people from accessing needed healthcare services. Having a trusted primary care doctor is associated with maintaining well-being and a good quality of life. However, studies have found that some healthcare providers feel uncomfortable when working with people who are dependent on drugs. In a study of nurses’ attitudes towards patients, the majority of nurses held negative views about people who used drugs (Howard & Chung, 2000). In another study of nurses in the UK, most of the nurses had a stigma against injection drug users (Monks, Topping, & Newell, 2013). When health providers carry a stigma towards people with drug dependencies, it can affect their willingness to assess or treat the patient for substance abuse, how they approach him or her, and it may prevent addicted individuals from seeking healthcare altogether.

In order to better support people with substance use disorders, the Affordable Care Act (ACA) includes benefits for addiction treatment. People who have Medicaid or purchase plans through the health exchanges are eligible for treatment services, including psychotherapy and counseling. Plans vary, and some have limits on the number of days or visits covered, how much of the deductible and copayment will be covered, and whether or not you need authorization for treatment. Despite these limits, more Americans have access to care than they did before. Due to social factors such as stigma, however, whether or not they gain access to treatment still remains a major public health issue.
The problem of access to treatment even extends into the criminal justice system. A study conducted by The National Center on Addiction and Substance Abuse (CASA) found that of the 2.3 million people incarcerated in the United States, more than 65% of them met the criteria for a substance abuse disorder, yet only 11% of those people received treatment (CASA, 2010).

Impact on Harm Reduction

Unfortunately, stigma can affect the public’s perception of evidence-based harm reduction strategies. Harm reduction refers to public health interventions like:
Needle exchanges.
Substitution therapies.
Safe drug consumption rooms that are designed to decrease the risk associated with drug use (e.g., infected needles).
Due to widespread stigma about those who use drugs and who suffer from addiction, however, these interventions are not usually supported by the public and believed by some to facilitate and encourage drug use – despite evidence demonstrating that they actually decrease drug use (Logan & Marlatt, 2010).

Social and Mental Impact

Perceived stigma can cause major harm to people in their social lives. The chronic stress of discrimination may affect the mental and social health of individuals who use drugs. People who use drugs can feel pushed to the outskirts of society and may lose touch with their community and family and experience profound loneliness and isolation.
When a person does not have social ties or a person to talk to, they are less likely to reach out for healthcare or treatment. They are also more likely to be depressed and may hide their drug use from health care providers to avoid stigma and drug shaming. The mental health consequences of isolation can fuel even more drug use, leading to further isolation, and ultimately a vicious cycle that is hard to be break out of.
Perceived stigma can also be internalized. People who use drugs can view themselves as deviants; this can severely impact their self-esteem and self-worth. Historically, a dependence on drugs has been viewed as immoral or the result of a lack of self-control. These views contribute to stigma and present barriers to people accessing necessary treatment.

Fighting Back Against Stigma

People report perceived stigma from healthcare providers, loved ones, and the general public. No matter the situation, no one likes to feel judged or devalued. In order to encourage people to reach out for help and get on the path to recovery, it is important to reduce the stigma surrounding their situation. Educational programs and modeling of nonstigmatizing behavior can help people provide nonjudgmental, empathic support.
Effective ways for individuals to help reduce stigma include:
Offering compassionate support.
Displaying kindness to people in vulnerable situations.
Listening while withholding judgment.
Seeing a person for who they are, not what drugs they use.
Doing your research; learning about drug dependency and how it works.
Treating people with drug dependency with dignity and respect.
Avoiding hurtful labels.
Replacing negative attitudes with evidence-based facts.
Speaking up when you see someone mistreated because of their drug use.

Fighting Stigma Through Next-Generation PSAs

In mid-2016, Recovery Brands launched the LIVES Challenge to help fight the stigma of addiction by asking the public to create next-gen public service announcements (PSAs) that moved passed the stigmatizing announcements of years ago (think: "this is your brain on drugs"). The contest looked to find a new inspiring message for those suffering with the disease to feel supported, encouraged and motivated to step on the path to seek treatment for their addiction. The Judge's Choice winner is shown below:

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