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May

How to Feel Better by Ending Rumination

You probably know the feeling: you’re a bit bored at work or home, or maybe you’ve just gotten into bed, when some thought pops into your head and you can’t let it go. Maybe it’s something embarrassing you did when you were a child or something you’re worried might happen at some undefined point in the future.

Maybe you start replaying a conversation, thinking about all the things you should have said. The next thing you know, you’ve been rehashing these thoughts for 20 or 30 minutes, perhaps even longer. You haven’t gotten anything done, you haven’t slept, and now you feel more depressed and anxious than you did before.

This is rumination and it’s strongly associated with mental health issues such as depression, anxiety, and PTSD. When you’re recovering from a substance use disorder, ruminating definitely doesn’t help, but it’s also a hard habit to break. The following tips can help you quit ruminating and feel better.

Learn to recognize rumination.

Like other bad habits, you can start ruminating without even being aware of it. You quickly get swept up in your thoughts and are not aware of what your mind is even doing.

If you want to stop ruminating, then you have to learn to notice when you’re doing it. This is a skill called metacognitive awareness — being aware of what you’re thinking about. The first step is to label rumination whenever you catch yourself doing it.

It’s important that you do not scold yourself when you realize you’ve been ruminating. Instead, congratulate yourself for noticing: “Ah, there’s rumination again, good catch!”

Notice your rumination triggers.

Noticing rumination is only the first step. Your real goal is to better understand what’s causing it.

Rumination typically has triggers, just like any bad habit. That is, it doesn’t come out of the blue but rather is caused by something you hear or see — or even a particular train of thought.

When you catch yourself ruminating, notice what you’re ruminating about and notice what triggered it. For example, maybe you were reading an article that mentioned a topic you recently argued with someone about or that reminded you of a bad decision you made, perhaps years ago.

You will probably notice there are only a few topics you get stuck ruminating about and your triggers are likely things closely related to these topics. Once you are aware of your triggers, you can be more vigilant about falling into the rumination trap in the first place.

Distract yourself.

Our minds are very associative and once you fall into the rumination trap, it’s hard to get out just by trying to force yourself to think of something else. If you’re sitting or lying in the same position, in the same room, trying to do the same task, you’ll probably keep getting drawn back into the rumination.

Although rumination has negative outcomes, it is also more interesting to your mind than whatever you’re supposed to be doing because your mind thinks it’s solving a problem. If someone were running toward you and yelling, you would definitely pay attention to them even if you’d rather not have to deal with that situation.

Rumination is similar, except the threat you’re preoccupied with might be far in the past or a hazy possibility in the future.

To get out of that rut, you may have to change more than your focus. You might have to get up and walk around for a while, switch to a different task, go to a different room, or do something that demands more attention than whatever you’re ruminating about.

Maybe get some exercise or play a video game. The more you ruminate on a particular topic, the deeper that groove gets in your brain.

That means you fall into that rut more easily and have a harder time escaping. Distracting yourself will limit rumination and help keep that groove from getting much deeper.

Write down your thoughts.

Writing down your thoughts helps with rumination in several ways. First, it helps you recognize when you’re ruminating, identify your triggers, and distract yourself, as discussed above.

When you write about rumination, you’re automatically enlisting some of your metacognitive awareness. Second, when your mind ruminates, it believes it’s solving a problem, except that it never gets very far.

It just keeps rehearsing the initial steps. Typically, it’s gotten hold of some insight it doesn’t want to forget, so it gets stuck in a loop.

Writing down your thoughts commits them safely to paper so your brain can stop rehearsing it. Writing it down also helps you actually make progress thinking through the problem instead of repeating the first few thoughts.

This helps you process whatever it is you’re ruminating about. If it’s something you’re worried about happening in the future, it can even lead you to some concrete steps that might help you solve the problem and worry less about it.

Practice mindfulness meditation.

Mindfulness meditation is one of the best ways to expand metacognitive awareness, since it’s essentially a practice of spending 20 or 30 minutes a day just watching thoughts and emotions rise and fall in your mind.

With practice, you learn to avoid getting swept up in your thoughts. Mindfulness meditation also helps moderate activity in the brain’s default mode network, which is active during rumination.

Remember that it takes practice.

Finally, keep in mind that getting rumination under control will take practice and persistent effort. Rumination is a habit, probably one that you’ve been doing for years.

Breaking it for good will probably take months. The good news is that every time you catch yourself ruminating and take some definite action to stop it, you’re also sparing yourself a lot of pointless anxiety and self-criticism. After a while, you will notice rumination gradually diminish.

When you’re recovering from addiction, it’s crucial to look after your mental health. Anxiety, depression, PTSD, and other mental health issues are common among people recovering from substance use disorders and they are all conditions highly associated with rumination. Awareness is key, followed by action.

At The Foundry, we know that recovery begins in the mind. That’s why we use cognitive behavioral therapy, dialectical behavioral therapy, mindfulness meditation, and other treatment modalities to help our clients become emotionally resilient. To learn more about our treatment options, call us today at 1-844-955-1066 or explore our website.

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May

When Do You Need More Than the 12 Steps to Beat Addiction?

AA and the many mutual-aid programs they’ve inspired have been helping people get sober since 1935. Working the 12 steps is a time-tested method for quitting alcohol and drugs, and millions of people are now staying sober one day at a time. The social support of mutual aid meetings like AA is especially important, which is why most people go to meetings even after completing professional treatment programs. However, it’s important to remember that 12-Step meetings are just one approach to recovery. Everyone has different needs when trying to overcome addiction. For many people, AA or NA will be all they need. Others may require more help. The following are some reasons you might need something more than your neighborhood 12-Step meeting.

When You’re Facing a Tough Detox

You don’t have to be sober to attend a 12-Step meeting; you only need to want to be sober. Unfortunately, beyond possibly offering some helpful advice, your 12-Step group won’t be able to help you detox. Sometimes, you will be able to tough it out at home, but other times that might be too difficult or too dangerous to attempt. For example, people trying to quit opioids often have a hard time making it all the way through detox because the withdrawal symptoms get too intense. It can be hard to take care of yourself when you’re experiencing what many have said feels like the worst flu you’ve ever had.

If you’re detoxing from a serious drinking problem or a benzodiazepine addiction, your life may even be at risk. Severe alcohol detox, DTs, can come on without warning and lead to death in a small percentage of cases.

It’s hard to know when you might need a medical detox and when you can do it at home. It’s always a good idea to consult with your doctor before deciding. If you have any medical conditions, especially cardiovascular issues or pregnancy, a medical detox is typically a good idea. If you’ve had a difficult time detoxing in the past, it’s likely the next time will be tough too. In general, the longer and more heavily you’ve been drinking and using drugs, the harder detox is likely to be.

When You Have Comorbid Health Issues

As noted above, if you have any medical conditions, it’s best to detox under medical supervision. However, medical issues can continue to be a challenge even after acute withdrawal symptoms have subsided. Many people starting in recovery have problems related to malnutrition, weak immune systems, and other issues related to substance use. Spending some time in a residential treatment program can help you avoid complications and restore your health more quickly. You get healthy meals, plenty of sleep, a bit of exercise, and easy access to medical care, should something go wrong.

When You Have a Co-occurring Mental Health Challenge

Perhaps the most common problem that mutual-aid groups aren’t well suited to deal with is mental health issues. According to the National Institute on Drug Abuse, at least half of people with substance use disorders have co-occurring mental health issues, such as major depression, anxiety disorders, PTSD, ADHD, personality disorders, schizophrenia, and others. Many of these conditions require specialized care and medication. That’s far beyond the support that a mutual-aid meeting can provide.

Trying to get sober without diagnosing and treating co-occurring mental health issues is extremely hard and probably won’t succeed for long. For most people with co-occurring disorders, the mental health issues are the main driver of their substance use. Mental health issues and substance use each tend to make the other worse, so only treating the addiction is not likely to solve the problem for long.

When You Have Trouble Sticking with a Program

Mutual-aid programs can be very effective in helping you to stay sober if you keep going. The problem is that most people don’t keep going. They may go to a few meetings but that’s all. One study¹ found that only about 10 percent of people who go to AA meetings keep going for three months. Some of the features that make AA attractive, such as free attendance, anonymity, and open doors, also make it easy to quietly disappear.

When you invest in a professional treatment program, you are far more likely to stick with it. For one thing, you may actually be in residence, perhaps far from home, so you’re less likely to just stop showing up. You can leave, of course, but your level of commitment is much higher, especially if you’re paying to be there. What’s more, the staff and other clients are more invested in your success. People will definitely notice if you don't show up for group therapy or other activities. You also form connections to others more quickly in treatment and that social bond creates an incentive to stay engaged.

When You Don’t Fit In

There are many effective approaches to addiction recovery, but unfortunately, some people who have succeeded through 12-Step meetings don’t always see it that way. Some groups are fairly rigid and dogmatic, which can put people off. Since 12-Step groups aren’t centrally organized, there is a lot of variation among meetings. However, if you’re in a place without many options, you might have trouble engaging with a group where you don’t feel welcome or comfortable. You may have to explore other options.

Twelve-Step meetings like AA and NA can be a great option for many people who want to get sober, but sometimes meetings alone are not enough. If you might face a hard detox, have co-occurring mental health issues, have had trouble sticking with the program, or you just don’t feel comfortable with the available groups, you might need something more. At The Foundry, we use the time-tested 12-Step principles combined with evidence-based modalities for treating co-occurring issues. To learn more, call us today at 1-844-955-1066 or explore our website.

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Sep

Why Cannabis Use Disorder Should Be Taken Seriously

“Marijuana (cannabis) use directly affects the brain — specifically the parts of the brain responsible for memory, learning, attention, decision making, coordination, emotions, and reaction time,” warns the Centers for Disease Control and Prevention (CDC) on its fact sheet. “Long-term or frequent marijuana use has been linked to increased risk of psychosis or schizophrenia in some users.”

Despite these known health risks, 18 states have legalized recreational marijuana. In 2012, Colorado and Washington became the first states to legalize the recreational use of cannabis following the passage of Amendment 64 and Initiative 502. Additionally, 36 states and the District of Columbia currently allow cannabis for “medical” use although the federal Food and Drug Administration (FDA) continues to list cannabis as an illegal schedule I substance “due to its high potential for abuse, which is attributable in large part to the psychoactive effects of THC, and the absence of a currently accepted medical use of the plant in the United States.”

As a result of the continuing normalization of cannabis use, a majority of Americans—including teenagers—perceive little or no risk in using it. Thirty-eight percent of high school students report having used marijuana at least once (although it is only legal for people 21 and older).

The health risks connected with cannabis use are real, however, notwithstanding years of promoting it as a medicinal remedy. “Researchers know that prolonged and heavy cannabis use can alter brain circuitry. However, the specific pathophysiological mechanisms are yet unclear. In terms of addiction, tetrahydrocannabinol (THC) is the primary molecule responsible for the reinforcing properties of marijuana,” report Jason Patel and Raman Marwaha in Cannabis Use Disorder.

THC, acting through cannabinoid receptors, activates the brain’s reward system, which includes regions that govern the response to healthy pleasurable behaviors such as sex and eating. Like most other drugs that people misuse, THC stimulates neurons in the reward system to release the signaling chemical dopamine at levels higher than typically observed in response to naturally rewarding stimuli. The surge of dopamine teaches the user to repeat the rewarding behavior, helping account for marijuana’s addictive properties.

According to a research report of the National Institute on Drug Abuse (NIDA), “THC is able to alter the functioning of the hippocampus and orbitofrontal cortex, brain areas that enable a person to form new memories and shift his or her attentional focus. As a result, using marijuana causes impaired thinking and interferes with a person’s ability to learn and perform complicated tasks. THC also disrupts the functioning of the cerebellum and basal ganglia, brain areas that regulate balance, posture, coordination, and reaction time. This is the reason people who have used marijuana may not be able to drive safely.”

Cannabis use can induce significant behavioral or psychological changes such as impaired motor coordination, euphoria, anxiety, hallucinations, a sensation of slowed time, impaired judgment, increased appetite, dry mouth, and even tachycardia.

In his 2015 book Marijuana, psychiatrist and addiction specialist Kevin Hill listed three popular myths: that cannabis is not harmful, that it cannot lead to addiction, and that stopping the use of marijuana cannot cause withdrawal symptoms.

Cannabis or marijuana use disorder is common in the United States, is often associated with other substance use disorders, behavioral problems, and disability, and goes largely untreated, according to a 2016 study conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health.

Approximately a third of cannabis users develop a clinically diagnosable cannabis use disorder (CUD) at some point in their lives. A major study published in Oct 2020 updated the number of users developing an addiction from 10 to 30 percent, a change that is most likely driven by higher potency use. People who begin using marijuana before the age of 18 are four to seven times more likely to develop a cannabis use disorder than adults.

“Often, patients who use cannabis heavily will report that it helps them with anxiety or insomnia irrespective of whether they have a common comorbid diagnosis such as general anxiety disorder, social anxiety disorder, posttraumatic stress disorder, or attention-deficit hyperactivity disorder,” reported Kevin Hill and Arthur Williams in 2019. “Although the short-term benefits of using cannabis may help with anxiolysis or treating early insomnia, in general cannabis, especially via rebound withdrawal symptoms, can worsen these underlying conditions over time (much like how patients with heavy alcohol use often develop worsening anxiety and irritability).”

We need to emphasize that today’s marijuana is much more harmful than it used to be. Cannabis products are now vastly more potent than the “reefers” of the 20th century.

In the seventies, joints averaged a THC concentration of about one percent, close to the natural levels of the cannabis plant. In the early nineties, the typical THC concentration had increased to three percent. Now it often exceeds 30 percent. In addition to that, cannabis is used in an extremely concentrated form called hash oil or wax. So-called “dabbing” refers to the inhalation of concentrated THC products created through butane extraction. Butane hash oil (BHO) can reach incredible concentrations of over 50 percent—that is 50 joints of the seventies rolled into one!

The legalization of the recreational use of cannabis products in recent years has also led to the commercial production and sale of incredibly potent drugs that bear almost no resemblance to 1970s vintage joints. “To say that we have legalized weed is misleading,” Foundry Steamboat CEO Ben Cort explained in a 2018 TED talk. “We’ve commercialized THC.”

The relentless commercialization has had consequences. Advertising and location of cannabis retailers influence adolescents' intentions to use marijuana, according to a 2020 study in the Journal of Health Communication by Washington State University researchers who conducted a survey of 13- to 17-year-olds in Washington State to find out how marijuana advertising and the location of marijuana retailers influence adolescents' intentions to use the drug. Their research shows regular exposure to marijuana advertising on storefronts, billboards, retailer websites, and other locations increased the likelihood of adolescents using marijuana.

Watch "Surprising truths about legalizing cannabis," a TedTalk delivered by Foundry Steamboat CEO Ben Cort. https://www.youtube.com/watch?v=SmqtPaMMVuY

And the billboards are advertising ever more powerful products. “Concentrates are everywhere and are not just being used by the fringe; they are mainstream and they are what many people picture when they talk about marijuana,” Cort wrote in his 2017 book Weed, Inc. “You are going to think some of this must be talking about hardcore users on the edge, but it’s not; concentrates are everywhere and have become synonymous with weed for this generation of users.”

The higher the concentration of THC and the more frequent the use of such products, the higher the risk of addiction. The current edition of the Diagnostic and Statistical Manual of Mental Disorders or DSM-5 used by psychiatrists in the United States lists—analog to other substance use disorders—eleven criteria for cannabis use disorder:

Cannabis is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control cannabis use.
A great deal of time is spent in activities necessary to obtain cannabis, use cannabis, or recover from its effects.
Craving, or a strong desire or urge to use cannabis.
Recurrent cannabis use results in failure to fulfill role obligations at work, school, or home.
Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis.
Important social, occupational, or recreational activities are given up or reduced because of cannabis use.
Recurrent cannabis use in situations in which it is physically hazardous.
Cannabis use continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
Tolerance, as defined by either: (1) a need for markedly increased cannabis to achieve intoxication or desired effect or (2) a markedly diminished effect with continued use of the same amount of the substance.
Withdrawal, as manifested by either (1) the characteristic withdrawal syndrome for cannabis or (2) cannabis is taken to relieve or avoid withdrawal symptoms.

The DSM-5 specifies three levels of severity for substance use disorders such as CUD. Two or three criteria indicate a mild cannabis use disorder, four or five indicate a moderate CUD, and six or more criteria indicate a severe cannabis use disorder.

According to Patel and Marwaha, cannabis misuse can also lead to a number of marijuana-related issues such as cannabis-induced sleep disorder, cannabis-induced anxiety disorder, or cannabis-induced psychotic disorder.

Sadly, people presenting with CUD do not enjoy the same support from society as people with other substance use disorders, says Cort. “If you go to your doctor saying ‘I need to get off the bottle’ or ‘I need to stop shooting dope’ you can expect encouraging words and specialist referrals. If you say ‘I’m smoking too much weed’ you often only get a ‘so what’ kind of shrug.” Many doctors think that cannabis use is fairly harmless, if not beneficial.

“We even encounter people in treatment whose CUD had been dismissed as ‘only weed’ because our society does not recognize cannabis as an addictive substance,” says Cort. In treatment, Foundry Steamboat has to prepare clients for a trigger-rich environment with ubiquitous “pot shops” and billboards advertising cannabis products—especially in Colorado.

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Apr

Why is Group Therapy So Commonly Used to Treat Addiction?

One aspect of addiction treatment most people are familiar with is group therapy. Every film or TV show about addiction and recovery will have a scene where a character either goes to a 12-Step meeting and shares or participates in a group therapy session in rehab. For many people considering treatment, this might seem a bit intimidating. It’s a bit too much like public speaking and on top of that, the subject of conversation may include your worst thoughts, memories, and emotions. It’s no wonder that people are often hesitant to participate. However, group therapy is a staple of addiction treatment for good reasons. What’s more, once people get started, they usually find group therapy helpful, rewarding, and even enjoyable. Here are some reasons why group therapy is so common in addiction treatment programs.

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You’ll See You’re Not Alone

Shame, stigma, alienation, and isolation are among the biggest barriers to recovery for people with substance use disorders. Trauma is perhaps the single element that people with substance use issues have most in common. This could be in the form of childhood abuse or neglect, domestic abuse, sexual assault, or some traumatic event. By some estimates, half of people with substance use disorders also have symptoms of post-traumatic stress disorder, or PTSD.

Addiction is commonly the result of trying to cope with shame. Most people’s instinctive reaction to shame is to try to hide it, bury it, or push it away, but that only makes shame more powerful. The best way to deal with shame is to open up about it in a safe environment, such as individual or group therapy. What makes group therapy especially good for healing shame is that group members quickly learn that they are not alone. Whatever they experienced in childhood, whatever they did during active addiction, there are almost certainly other members of the group who have had similar experiences. Being able to open up about these experiences and know you’re not alone is liberating.

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Group Dynamics Give the Therapist Insight into Your Behavior

One of the limitations of individual therapy is that, for the most part, you control what information your therapist has. Even if you aren’t deliberately distorting events that you relate in therapy, you necessarily see things through your own perspective. That limits the information your therapist has to work with. However, in group therapy, the therapist can see how you interact with others. Maybe you have a tendency to be defensive or critical without realizing it. Maybe you are friendly to women but not to men. Maybe you believe you’re hopelessly awkward but in fact are charming. These are things that are far more obvious in real interactions than in the privacy of an individual session.

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You Enjoy Social Support

Feeling socially connected is one of the most important parts of a strong addiction recovery. For many people, drugs and alcohol are a way to try to fill a void, which is often caused by a lack of belonging or purpose. There are many different reasons people feel this way and you are likely to find in the group some people who understand.

There are also more concrete reasons social support matters. For one, it creates a greater sense of accountability. People are more likely to show up to sessions, and show up on time, and be engaged if they know other group members are depending on them. In other words, it matters that group therapy is about helping as well as receiving help. Having a connection with the group also makes people a little more reluctant to slip up because they know they will have to tell the group.

Social support has benefits outside of the group as well. One challenge a lot of people face early in recovery, especially as they transition back to regular life, is that they have to distance themselves from friends who drink or use drugs. Sometimes there is stress within the family and they have to work on maintaining boundaries. These kinds of behaviors are easier when you feel like you have people supporting you, even if they aren’t physically with you at the moment.

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You Get Many Different Perspectives

Another particular advantage of group therapy over individual therapy is that group therapy gives you many different perspectives. As an expert, your therapist’s perspective may be well informed but your therapist is still just one person. The group will have had many different experiences and will have many different ways of thinking about things. These will sometimes be surprising and illuminating. Problems that seem intractable to you might seem easy to someone else and being open to other perspectives can expand your repertoire of solutions.

You can also get different perspectives on your own behavior. Part of the challenge of resolving interpersonal conflicts is that it can be hard to tell whether we are acting reasonably. Getting feedback from the group is one way to orient yourself and better understand if your attitude is fair. It can also help you understand someone else’s perspective. For example, if you’ve been arguing with your spouse, it’s possible that your spouse can’t explain themselves well and perhaps someone in the group could be a better advocate with less emotional investment.

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You Can Practice Vital New Skills

Recovering from addiction is, at its core, about learning a lot of new skills for managing emotions, thinking, and behavior. It’s one thing to know, rationally, how to do these things and another thing entirely to be able to use these skills when they matter. For example, if you tend to explode when you are criticized, that will lead to a lot of unnecessary stress and conflict but it’s also hard to practice responding better in real time. The group is the perfect time to practice these kinds of skills in a safe, moderated environment. If someone gives you feedback you don’t like, for example, it’s a perfect time to practice, perhaps with the help of the therapist, using your strategies for responding more constructively. This is why modalities like dialectical behavioral therapy, or DBT, specifically include group therapy rather than relying solely on individual therapy.

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Group therapy can be intimidating at first but most people end up finding it helpful and they even enjoy it. The sense of connection you can find in group therapy is one reason so many people say they’ve met their best friends during addiction treatment. Group therapy heals shame and isolation, it gives your therapist extra insight, it provides social support, and gives you a valuable opportunity to practice new skills. At The Foundry, we use a variety of evidence-based methods, including group therapy and DBT, to provide clients with individualized, holistic treatment. To learn more about our programs, call today at 1-844-955-1066.

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Mar

COVID-19: From Our CEO

As coronavirus (COVID-19) continues to gain momentum and impact others across the globe, proactively communicating the safety precautions that we have taken to ensure the safety of our participants and staff is necessary. The evolution of this pandemic has been, and will be, something that we closely monitor and thoroughly heed the instructions given by Centers for Disease Control and Prevention (CDC).

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Due to the highly contagious nature of this virus, we felt that our two-tier detox continuum needs to be Highlighted. Two years ago, we partnered with Steamboat Emergency Room (SBER) which has become our first line of defense for situations just like the one our country is currently experiencing. Every participant’s journey with Foundry STARTS here, where they are promptly taken to a private room and immediately seen by medical professionals. During this first phase of our detox and assessment process, they are given a comprehensive physical and thoroughly screened for symptoms of COVID-19 following the strict protocol enforced by the CDC. Once cleared for residential treatment, they are transported to our facility (15 minutes outside of town on a secluded 48-acre Ranch) for the second phase of our detox process, and continued monitoring from members of our medical team for at least 24 hours. Once in our care, the following steps are being strictly enforced by every member of our team at Foundry Treatment Center Steamboat.

1) The clients will have limited "off campus" activities. This means they will not be attending 12 step meetings off campus. They will either take part in an in-house or online meeting, structured by our lead residential managers. Wellness activities will either be on campus or involve limited exposure to those in the community.

2) All staff are expected to immediately wash their hands upon arrival on the Foundry campus with soap and water for at least 20; or use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.

3) Throughout their shift, staff are required to frequently maintain CDC standards of hand washing hygiene.

4) Did we mention we are encouraging staff and clients to WASH THEIR HANDS with soap and water?

5) Staff will wipe down the facility at shift exchange with soap and water or wipes. This means the office will be wiped down a minimum 3x per day.

6) During morning opener, clients will be asked if they are experiencing a fever, lower respiratory symptoms, coughing, shortness of breath. If a client endorses any of these symptoms they are to be removed from the milieu and stationed in their room until medical can meet with them to determine next steps. When staff enters a room in which a client may be ill, they will wear a mask and gloves, disposing of the mask and gloves and immediately washing hands once removed.

7) Staff will contact their superior immediately and stay home if they feel ill (fever, respiratory difficulty, cough or just not feeling well) to protect co-workers, clients and the program as a whole.

8) Staff and clients are asked to cover their cough or sneeze with a tissue, throw the tissue in the trash, and wash their hands immediately after.

The SAFETY of our Participants has been and will always be our #1 Priority and will continue to follow the instructions given by the professionals on the front lines of this pandemic.

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Latest Posts

Sep

NRT Celebrates the 2025 Recovery Month Theme

The 2025 Recovery Month theme is “Recovery isREAL (Restoring Every Aspect of Life).”

Recovery Month is a federal government initiative launched in 1989 and currently organized by the Substance Abuse and Mental Health Administration (SAMHSA).Recovery Month, observed in September, recognizes the recovery community, reduces stigma, promotes recovery, and supports treatment providers.

This year’s theme is “Restoring Every Aspect of Life,” which, according to SAMHSA, refers to health, home, community, and purpose. These themes closely align with the so-called Social Determinants of Health, which are critical factors contributing to addiction and recovery.

Researchers, recovery advocates, and treatment providers have long acknowledged the strong connection between the so-calledSocial Determinants of Health (SDOH) and the development and perpetuation of substance use and mental health disorders. The connection between social determinants and addictive disorders was initially recognized in the 1960s. The linkage was eventually solidified and codified when it was written into the2010 Patient Protection and Affordable Care Act. According to the US Department of Health and Human Services, the SocialDeterminants of Health include economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social community context.

Essentially, the social determinants are the factors that significantly influence health and well-being. Access to financial security, education, a safe place to live, quality healthcare, and being connected to others contribute to better health and wellness. When any of these pillars are lacking, however, people can experience severe stress, illness, mental health disorders, and trauma, all of which increase the potential for substance use disorders and addiction.

The social determinants are also closely related to recovery capital, another important measure. Recovery capital is a measure of the intrinsic and external resources that help people sustain recovery from substance use disorders, mental health conditions, and other health problems. Taken together, the social determinants of health are contributing factors that may put people at risk of developing behavioral health disorders, and recovery capital is a factor that helps people maintain health and wellness after recovering from these conditions.

“RestoringEvery Aspect of Life” Resonates at NRT Behavioral Health Treatment Programs

NRTBehavioral Health addiction treatment programs, including Foundry Steamboat, Foundry Front Range, and Foundry Outpatient, pay careful attention to each patient’s social determinants and recovery capital.Effective addiction treatment programs focus on more than addressing the side effects of addictive disorders and teaching skills to reduce reliance on substance use. It also helps people improve their lifestyles and support systems so that they can stay in recovery after completing treatment.

In keeping with the Recovery Month theme,“Restoring Every Aspect of Life,” NRT programs acknowledge that many of their clients struggle with financial stress or joblessness, insecure housing, problematic home lives, social networks that normalize substance misuse, and more. Significant numbers of NRT Behavioral Health program clients face social determinants of health deficits that are shared by many Coloradans, especially those in rural communities. Our programs attempt to help clients access available resources and make connections to increase recovery capital after completing programming. NRT programs also use a specialized Recovery CapitalIndex measure to determine the overall recovery resources of its client base to improve care, identify appropriate resources and partners, and give clients more ways to sustain recovery.

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Sep

Quitting Tobacco Associated With Recovery From Other Addictions

Adults who smoke cigarettes and are addicted to alcohol or other drugs were more likely to achieve sustained remission of their substance use disorder (SUD) symptoms if they also quit tobacco, according to scientists at the National Institutes of Health (NIH).

Based on their analysis of data from a large US study of smoking and health, the researchers believe the results clearly show the benefit of pairing smoking cessation with addiction recovery efforts.

“We now have strong evidence from a national sample that quitting cigarette smoking predicts improved recovery from other substance use disorders,” explained Nora Volkow, MD, director of NIH’s NationalInstitute on Drug Abuse (NIDA), which partly funds the study, known as the Population Assessment of Tobacco and Health (PATH) study. “It underscores the importance of addressing different addictions together, rather than in isolation.”

Scientists analyzed data from 2,652 people 18 and older who had a history of substance use disorder and who experienced a change in their recovery status over the next four years.

Participants in the PATH Study are asked annually about their smoking status and other substance use. In this analysis, a change in smoking status from “current” to “former” use of cigarettes was associated with 42 percent greater odds of the individual being in recovery from their non-tobacco substance use disorder.

People with addiction to alcohol or other substances have a higher likelihood of being addicted to nicotine as well. Previous research has suggested an association between smoking cessation and improved outcomes from other substance use disorders. However, the authors note that most prior studies used data from treatment centers focusing on addiction to a single substance or from smoking cessation trials, and those that used nationally representative samples could not adequately test for an association with recovery. Researchers believe the new finding is generalizable to the millions of adults with substance use disorder and accounts for numerous confounding factors, thus increasing confidence in the results.

“Although the health benefits of quitting smoking are well-known, smoking cessation has not been seen as a high priority in drug addiction treatment programs,” said Wilson Compton, MD, deputy director of NIDA and senior author of the study. “This finding bolsters support for including smoking cessation as part of addiction treatment.”

Although this was a longitudinal analysis that was strongly suggestive that quitting smoking plays a role in improved recovery outcomes from other substance use disorders, further research will be needed to establish a causal connection definitively. Also needed is more research on the best ways to support smoking cessation among people in treatment or recovery for substance use disorders.

The PATH study is an ongoing, nationally representative longitudinal cohort study of youth and adults who may or may not use tobacco products, funded by the NIH and the federal Food and DrugAdministration (FDA).

FOUNDRY STEAMBOAT HELPS CLIENTS QUIT TOBACCO

Foundry Steamboat is a tobacco-free treatment provider that encourages and helps clients stop using tobacco products while receiving treatment for other substance use disorders. As an evidence-based treatment provider with experienced clinicians, Foundry Steamboat knows that smoking cessation is an important opportunity for people receiving treatment for substance use and co-occurring mental health disorders. Foundry Steamboat provides education, support, and can occasionally prescribe medications that reduce craving associated with tobacco cessation.

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Aug

17 Percent of Americans Have Substance Use Disorder

Every year, the National Survey on Drug Use and Health (NSDUH) provides the most recently available information on tobacco, alcohol, and other substance use, mental health, and other health-related issues in the United States.

The NSDUH began in 1971 and is conducted annually in all 50 states and the District of Columbia. Approximately 70,000 people were interviewed for this important study.

Information from the NSDUH is used to support prevention and treatment programs, monitor substance use trends, estimate the need for treatment, and inform public health policy.

17 PERCENT HAVE SUBSTANCE USE DISORDER

In 2024, nearly 50 million Americans, 16.8 percent of people 12 years or older, met the diagnostic criteria for a substance use disorder (SUD) in the past year. Of these individuals, 27.9 million had an alcohol use disorder, and 28.2 million had an SUD involving drugs.

About one in six people with a past year substance use disorder (16.0 percent or 7.7 million people) had both an alcohol use disorder and a “drug use disorder” in the past year. Cannabis (marijuana) use disorder (CUD) was the most common drug use disorder (20.6 million), followed by opioid use disorder (4.8 million), and a central nervous system stimulant use disorder (4.3 million).

“With the ready availability of illicitly made fentanyl and other potent synthetic opioids such as nitazenes, the emergence of substances like xylazine, medetomidine, and illicit benzodiazepines, and increasing polysubstance use, Americans face an illicit drug supply that is more toxic, unpredictable, and dangerous than ever,” wrote Art Kleinschmidt, Ph., MBA, Principal Deputy Assistant Secretary, Substance Abuse and Mental Health Services Administration in a press release. “In addition, the proliferation of social media and other technology that is inundating America’s young people, coupled with other social stressors in homes and communities across the Nation, has contributed to declining mental health and well-being and rising rates of suicide in the past two decades.”

MAJOR TRENDS

The 2024 NSDUH identifies “areas of progress” and “trends heading in the wrong direction.”

“Americans are binge drinking and smoking tobacco less but consuming marijuana significantly more,” summarized Lev Facher in the findings of the new federal survey on STAT News.

“On the progress front, we see from the NSDUH that the percentage of people 12 years or older reporting use of most substances either decreased or remained stable between 2021 and 2024, with decreases in past month use of tobacco, cigarettes, binge and heavy drinking as well as decreases in past year use of cocaine, misuse of prescription opioids, and past year alcohol use disorder,” reported Dr. Kleinschmidt.

Heading in the wrong direction, however, are trends that include past year illicit drug use, marijuana use, and hallucinogen use, and past year drug use disorder and cannabis use disorder. “Among adults, we also saw that the percentage of people 18 or older [who] reported making a suicide plan increased between 2021 and 2024.”

Dr. Kleinschmidt points out that “the increases in past-year illicit drug use and past-year drug use disorders are largely driven by increases in marijuana use and [cannabis] use disorder among adults 26 years or older. Although marijuana use and [CUD] trends remained stable among adolescents and young adults between 2021 and 2024, the increase in adult use is important to inform prevention and treatment activities given changing attitudes around marijuana use and the shifting state policy landscape which has increased risk for marijuana use and use disorder among young people, and enabled the ready availability of high-potency marijuana products linked to negative health impacts in communities across the country.”

MENTAL HEALTH AND SUBSTANCE MISUSE

The NSDUH highlights the “substantial overlap” between substance use and mental health. “Although mental health and substance use funding and treatment systems have historically often been separate, the NSDUH clearly demonstrates that in reality, people with substance use disorders and those with mental health challenges often have co-occurring conditions.”

For the first time in 2024, the NSDUH included the Generalized Anxiety Disorder (GAD-7) scale, a validated self-report measure to screen for and assess symptoms of GAD in the past two weeks.

Among adults 18 years or older in the US, 7.4 percent had moderate or severe symptoms of anxiety and 14.3 percent had mild symptoms. Moderate to severe symptoms were more common among 18 to 25-year-olds (14.5 percent) compared to 26 to 49-year-olds (9.0 percent) and adults 50 years or older (3.9 percent).

TREATMENT NEEDS NOT MET

According to the NSDUH, “approximately one in five people (19.3 percent) who needed substance use treatment actually received treatment in the past year. Treatment receipt was highest among adolescents aged 12 to 17 years (30.2 percent of those needing treatment reported receiving treatment in the past year), followed by those 26 years or older (20.5 percent) and those 18 to 25 years old (11.3 percent).”

Modern, evidence-based addiction treatment needs to be trauma-informed and dual diagnosis capable, addressing the needs of the patient as a whole person, including their life experiences, and going far beyond simply suppressing powerful cravings to use drugs and alcohol.

Every patient with addiction deserves the best medical care. When it comes to behavioral healthcare, the ability of your treatment provider to understand your needs, provide effective therapies, and identify the specific resources that will help you maintain health and recovery after treatment is vital to your success.

FOUNDRY FRONT RANGE TREATS CANNABIS USE DISORDER

NRT Behavioral Health Managing Partner Ben Cort has written two books on the problems associated with today’s high-potency cannabis products and their effects. Growing evidence demonstrates that consuming highly concentrated cannabis poses significant health risks, from anxiety and depression to cardiac problems and suicidal ideation.

A minority of cannabis users will develop cannabis use disorder and its serious effects. However, those who are impacted, and their family members and loved ones, face significant challenges and the same risks associated with other forms of substance use disorder.

NRT Behavioral Health programs, including Foundry Steamboat, Foundry Front Range, and its intensive outpatient program, have specialized expertise in treating cannabis use disorder. With some of the most experienced clinicians, modern and well-equipped clinical facilities, and leading experts in addiction medicine, Foundry Steamboat and Foundry Front Range represent an appropriate treatment option for people experiencing cannabis use disorder.

If you or a loved one needs help or to learn more about our comprehensive addiction treatment program, visit www.foundryfrontrange.com or call (720) 807-7867.

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Aug

The Damaging Impact of Polysubstance Use on the Heart

New research has revealed problematic cardiac changes in patients with both cocaine and alcohol use disorders. This raises concerns about the effects of cocaine and alcohol use on the heart, even after treatment and abstinence.

“Cocaine use is a well-established cardiovascular risk factor, further enhanced by concurrent alcohol use. However, cardiovascular risk is poorly managed in individuals with cocaine use disorder,” wrote Porras-Perales, Segovia-Reyes, et al. in their cross-sectional case-control study on cardiac troponin alterations in patients with cocaine and alcohol use disorders.

People with substance use disorder (SUD) frequently misuse more than one addictive drug, which is known as polysubstance use. This includes taking two or more together or within a short period, either intentionally or unintentionally.

“Whether intentional or not, mixing drugs is never safe because the effects from combining drugs may be stronger and more unpredictable than one drug alone, and even deadly,” explains a CDC webpage.

“While research indicates combined use of cocaine and alcohol poses [a] greater threat than either substance alone, there may be different mechanisms of injury,” explained Mark Gold, MD, in Psychology Today.

Researchers studied 84 participants with substance use. “Highly sensitive cardiac troponin T (cTnT) blood levels were measured. Cardiac troponin levels are markers for heart attack and other heart abnormalities. CTnT is a substance released into the bloodstream with damage to heart muscle. It includes troponin I (cTnI), a protein in heart muscle cells that regulates muscle contraction. The research showed distinct cardiac troponin blood alterations in cocaine addicts.”

When heart muscle is damaged during a myocardial infarction (heart attack), cTnI releases into the bloodstream. The major research finding was that cocaine use disorder patients showed significantly elevated cTnT levels relative to controls. In addition, patients with alcohol use disorder exhibited elevated cTnI levels relative to controls.

“This suggests possible subclinical myocardial injury caused by cocaine distinct from alcohol’s effects,” wrote Dr. Gold. “Sadly, even with abstinence and without overt cardiovascular disease, substance use disorders (especially cocaine) are associated with detectable and important heart and injury signals.”

The new study is a reminder that among drug combinations, cocaine (and methamphetamine) is a well-established cardiovascular risk factor. “The combined use of methamphetamine/cocaine plus alcohol may cause cardiovascular disease (CVD) problems so often that when addiction treatment begins in early abstinence, physicians should consider a cardiovascular risk assessment,” explained Dr. Gold.

“Chronic heavy alcohol use has a direct negative effect on the heart, referred to as myocardial toxicity. This causes cardiomyopathy, arrhythmias, and hypertension. In the Porras‑Perales et al. study described at the beginning of this post, researchers found that alcohol use was associated with elevated cTnI, suggesting subclinical injury.”

Chronic alcohol use contributes to dilated cardiomyopathy, atrial fibrillation, left ventricular dysfunction, and increased heart failure risk.

NRT Behavioral Health programs take a comprehensive approach to treating Substance Use Disorder.

Our programs provide modern, evidence-based addiction treatment and integrated addiction medicine to address the needs of the patient as a whole person. Many individuals suffering from prolonged substance use disorder and who use multiple substances have increased risks for complex medical problems, such as heart conditions.

Our experienced medical team members are experienced at identifying comorbid health conditions accompanying long-term substance misuse and can refer clients to appropriate specialized treatment. Treating comorbidities is crucial for maintaining lasting health and promoting recovery. Unless chronic conditions are treated, people may experience a range of debilitating symptoms that prevent them from feeling well and sustaining their recovery.

NRT Behavioral Health residential treatment programs, Foundry Front Range, and Foundry Steamboat provide the level of comprehensive assessment and treatment needed to successfully diagnose and create treatment plans to find and treat heart problems and other healthcare problems associated with substance use disorders.

If you or a loved one needs help, please get in touch with our informed admissions team at (720) 807-7867.

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Jul

Cannabis Use Increases Depression and Suicidal Ideation

This article mentions suicide. If you or someone you know is in crisis, please call, text, or chat with the Suicide and Crisis Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.

“The frequent use of cannabis is associated with a plethora of negative health and social consequences,” wrote Langlois, Potvin, Khullar, and Tourjman in their 2021 study regarding depression and cannabis.

“There is a growing body of evidence pointing to the co-occurrence of cannabis use and depression,” confirmed Feingold and Weinstein in the same year. “There is also some evidence that the use of cannabis may lead to the onset of depression; however, strong evidence points to the inverse association, i.e., that depression may lead to the onset or increase in cannabis use frequency.”

New research has now raised more concerns about cannabis use, especially for young users.

“Cannabis use has become increasingly normalized in the United States, and at least half the states have 'medical marijuana' laws,” wrote Mark Gold, MD, in Psychology Today in July. “This reversed criminalization, but rather than following FDA-like testing and approval, cannabis was suddenly ‘a medicine.’ Access to cannabis or its intoxicant THC has never been greater. Adolescents may not legally purchase cannabis; however, their access has increased.”

Alarmingly, there appears to be a strong relationship between cannabis use and suicidal thinking that can only partly be explained by depression.

“Cannabis is largely unstudied or has failed rigorous medication trials, so its impact on mental health is mostly unknown,” warned Dr. Gold. “However, new findings indicate distressing results, causing experts to call for a reassessment of the risks and benefits of cannabis, as nearly 30 percent of users develop cannabis use disorder (CUD). For adolescent users, risks for addiction are twice that of adults, and after four years, one in five adolescents develop problematic use. Disturbingly, new studies suggest elevated cannabis risks for depression and suicidal thoughts and behaviors, especially in adolescents and young adults.”

Gold pointed to a new review and meta-analysis by Maviel, Somma, et al. that found “a clear relationship between cannabis use and suicidal behaviors.” After adjusting for depression, adolescent cannabis use was significantly associated with increased risks for thinking about suicide and more than double the risk for suicide attempts. Among adolescents, cannabis use was linked to a 1.85 times higher likelihood of attempting suicide.

“Depression may contribute to the relationship between cannabis use and suicidality, but doesn’t fully explain it, suggesting cannabis use poses independent risks for suicidal thoughts and behaviors,” explained Dr. Gold. “Cannabis may act as a catalyst, accelerating depressive processes.’

Recent high-quality studies have reinforced findings that cannabis use during adolescence can predict increases in depressive symptoms and suicidal ideation. Gobbi, Atkin, et  al. reported in JAMA Psychiatr y that “adolescent cannabis consumption was associated with increased risk of developing depression and suicidal behavior later in life, even in the absence of a premorbid condition.” Cannabis use in adolescence was associated with an increased risk for major depression and suicidal ideation (about 1.5 times greater), and adolescent cannabis use was associated with suicide attempts in young adulthood (3.4 times greater).

A major study in Proceedings of the National Academy of Sciences compared a large sample of hospitalized adolescents with cannabis use disorder (CUD) vs. those without CUD and controlled for depression. Adolescents with CUD had substantially increased odds of suicide attempts and self-harm; the presence of comorbid depression more than doubled risks.

The authors concluded that their study “provides evidence for the association between CUD and suicide risk among hospitalized adolescents and underscores the importance of recognizing and addressing co-occurring mental and substance use disorders along with CUD to mitigate suicide risk.”

A study in Frontiers in Public Health found cannabis use associated with higher risks of major depressive disorder, as well as suicidality. “Another study demonstrated that adolescents with cannabis use disorder (CUD) symptoms were more severely ill than adults, suggesting a developmental vulnerability,” Gold wrote. “Experts concluded youth cannabis use likely fuels depression and suicide in young people.”

FOUNDRY FRONT RANGE TREATS CANNABIS USE DISORDER

NRT Behavioral Health Managing Partner Ben Cort has written two books on the problems associated with today’s high-potency THC products and their effects. Growing evidence demonstrates that consuming today’s highly concentrated cannabis poses significant health risks, from anxiety and depression to cardiac problems to suicidal ideation. A minority of cannabis users will develop cannabis use disorder and its serious effects. However, those who are impacted, and their family members and loved ones, face significant challenges and the same risks associated with other forms of substance use disorder.

NRT Behavioral Health programs, including Foundry Steamboat, Foundry Front Range, and its Intensive Outpatient Program, have specialized expertise in treating cannabis use disorder. Cannabis, which is stored in fat cells, can remain in the body and cause psychoactive effects long after a person stops consuming it. This can lead to residual effects of cannabis that must be stabilized before clients are ready to engage in treatment programming. Specialized medical attention may also be required to help people experiencing severe side effects of cannabis use disorder, like cannabis-induced hyperemesis or psychosis, feel stable and comfortable before entering treatment.

With some of the most experienced clinicians, modern and well-equipped clinical facilities, and leading experts in addiction medicine, Foundry Steamboat represents a good treatment option for people experiencing Cannabis Use Disorder (CUD). To learn more, call us at (844) 955-1066.

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Jul

Colorado Fentanyl Deaths Down, But Economic Toll Remains

Fentanyl deaths in Colorado dropped last year, but still inflicted a severe economic toll, says a new report by the Common Sense Institute (CSI), a free-enterprise think tank.

Fentanyl-related deaths in Colorado “dropped from 1,184 in December 2023 to 801 in November 2024, a 32.4 percent reduction, but that’s still well above death rates before 2020,” reported Derek Draplin in the Kiowa County Press.

CSI estimates that “the total cost of fentanyl-related overdose deaths in Colorado is on par with 2022 at $13.1 billion in 2024 – approximately $2,220 per Coloradan.”

Though last year’s overdose rates and their associated economic impacts are trending downward, “they are still highly elevated compared to any point before 2020. This mirrors the development of Colorado’s crime rate generally, which has recently improved from 2022 but remains far above the norm set in the previous decade.”

OTHER KEY FINDINGS

Fentanyl-related overdose deaths have declined since the passage of HB22-1326, the Fentanyl Accountability and Prevention Act. The legislation was a response to rising fentanyl overdose deaths in the state.

Colorado’s Drug Overdose Competitive Index is still higher (30th) than it has been since 2015. This is due to increased drug overdose per capita in Colorado and improvements in other states.

CSI recommends that policymakers consider reverting to the effective drug laws that imposed stronger criminal penalties for the possession of any amount of drugs like methamphetamine, cocaine, and heroin. “While the state made some strides in strengthening fentanyl possession laws with the passage of HB22-1326, the law fails to address other hard drugs that often contribute to overdoses,” the report says. The authorities should be “proactive in anticipating whatever drug will eventually replace fentanyl,” and “adopt a robust public health strategy with rigorous tracking criteria aimed at reducing fentanyl-related overdoses.”

Fentanyl is a powerful synthetic opioid that is up to fifty times stronger than heroin and one hundred times stronger than morphine. Its misuse is a major contributor to fatal and nonfatal overdoses in the United States. As the CSI report explains, “fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths. Even in small doses, it can be deadly. Over 150 people die every day [nationally] from overdoses related to synthetic opioids like fentanyl.”

According to the latest data from the Colorado Department of Public Health and Environment, there were 222 fentanyl-related deaths in 2019, 540 in 2020, 912 in 2021, 920 in 2022, and 1,097 in 2023. The total number of drug overdose deaths decreased 15.7 percent from 1,935 in November 2023 to 1,631 in November 2024.

OPIOID USE DISORDER

Opioids such as fentanyl and heroin can produce feelings of euphoria that make it more likely that people will continue to misuse opioids, despite severe negative consequences such as addiction and death. Opioid use disorder (OUD) is a serious condition requiring treatment.

NRT Behavioral Health treatment programs, including Foundry Front Range and Foundry Steamboat, strive to make addiction treatment as accessible as possible. Every person with addiction deserves effective medical care. When it comes to behavioral healthcare, the ability of your treatment provider to understand your needs, provide effective therapies, and identify the specific resources that will help you maintain health and recovery after treatment is vital to your success.

If you or a loved one needs help, please contact us at (720) 807-7867.

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Jun

A Quarter of US Children Have a Parent With Substance Use Disorder, Study Finds

Nearly 19 million children in the United States have at least one parent with a substance use disorder (SUD), according to a new study published in JAMA Pediatrics on May 12. A significant number of those children have a parent whose SUD is moderate or severe as opposed to mild, the study finds.

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Witnessing a parent misusing drugs and alcohol as a child is considered an "adverse childhood experience" (ACE) that can have long-term negative impacts on health and well-being. ACEs are common. About 64 percent of adults in the United States reported they had experienced at least one type of ACE before age 18. Nearly one in six adults reported they had experienced four or more types of ACEs.

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"Children exposed to parental SUD are more likely to develop adverse health outcomes than their peers without parental SUD exposure, including early substance use initiation, substance-related problems, and mental health disorders," wrote study authors Sean Esteban McCabe, Vita McCabe, and Ty Schepis. "We aimed to estimate the number of US children living in the same household as at least one parent or primary caregiver with a DSM-5-defined SUD."

As Rhitu Chatterjee reported on NPR, "the new study used data from the 2023 National Survey on Drug Use and Health, a federal survey that estimated the prevalence of substance use and mental health disorders based on the most updated criteria in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). The national survey is managed by the Substance Abuse and Mental Health Services Administration, but the team in charge of the survey was let go as part of the recent reduction in force. It is unclear how the cuts will affect the future of the survey."

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"If one-quarter of kids in the US have a parent with a substance use disorder, that tells us that every day in our clinics we are encountering many, if not dozens of families that are affected by substance use disorders," Dr. Scott Hadland, chief of adolescent medicine at Massachusetts General Hospital told NPR. "We need to be poised and ready to help support those families."

"The study's main finding is significantly higher than previous estimates (7 million in a study originally published in 2022), which had relied on diagnostic criteria from the DSM-IV," reported Chatterjee. "The new study also estimated how many children have a parent with a moderate or severe addiction as opposed to mild."

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McCabe and his team found that 7.6 million US children have a parent with a moderate or severe SUD, and 3.4 million live with a parent dealing with multiple substance use disorders. The authors also found that more than 6 million children have a parent dealing with both a substance use disorder and a co-occurring mental health condition.

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"These estimates are incredibly important to understand the scope of parental substance use disorder in the United States," Davida Schiff, a pediatrician and addiction physician at Massachusetts General Hospital, told NPR. Dr. Schiff pointed out that a majority of the parents (12 million) had alcohol use disorder. "While alcohol is more socially acceptable in our society, the study points to a need to pay greater attention to a rising number of children exposed to parental alcohol use disorder."

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Adverse childhood experiences and other lifetime traumas are regularly encountered by addiction professionals. The strong correlation between addiction and trauma, especially childhood trauma, is well known.

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Addiction is truly a family problem.

NRT Behavioral Health Chief Clinical Advisor Dr. Michael Barnes is a foremost expert in family system disorders and trauma. The Trauma-Integrated Care Model, developed by Dr. Barnes and used at NRT Behavioral Health treatment programs, emphasizes the importance of identifying trauma and substance use in family systems. Because parental substance use disorder exposes children to physical and psychological danger and increases their risk of developing SUD in later life, addressing the effects of these problems on all family members is key to stopping generational cycles of behavioral health disorders. Family programming is a central part of treatment at NRT Behavioral Health programs. It focuses on educating clients and family members and helps families create recovery-supportive lifestyles and home environments.

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Recognizing how families experience, normalize, and perpetuate substance use is vital to reducing high rates of SUD in America's rural communities. Close-knit families that spend more time together and are more isolated from other community members can inadvertently create an internal culture that makes using substances to self-medicate mental health disorders more acceptable. Ensuring that rural community members can access high-quality treatment is one way to address this problem. Helping individuals address anxiety, depression, loneliness, and other psychological problems through therapy and psychiatric medications can reduce their perceived reliance on alcohol and substances to reduce their symptoms. Sometimes, when one family member gets help, other members become more willing to accept help and to change their relationship with substances.

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If you or a loved one is experiencing problematic drinking or drug use, we may be able to help. Please call us for a free and confidential conversation at (720) 807-7867.

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Jun

Marijuana is Bad for Your Heart

Marijuana causes heart problems — A new study led by UC San Francisco researchers has found that chronic cannabis use, whether smoked or consumed in edible form, is associated with significant cardiovascular risks.

The report, published in JAMA Cardiology, found that people who regularly used marijuana in either form had reduced blood vessel function comparable to tobacco smokers. Vascular function in those who used cannabis by either means was reduced roughly by half compared to those who did not use it.

Decreased vascular function is associated with a greater risk of heart attack, hypertension, and other cardiovascular conditions.

"There is a popular belief that marijuana smoke is harmless," wrote Mohammadi, Navabzadeh, Jiménez-Téllez, et al. in their study. "However, marijuana smoke contains many of the thousands of chemicals contained in tobacco smoke, along with fine particles that contribute to cardiovascular morbidity and mortality. As cannabis legalization increases, it is crucial to understand the public health and clinical implications of marijuana use."

The researchers recruited 55 people between October 2021 and August 2024 who were outwardly healthy and either regularly smoked marijuana or consumed edibles containing tetrahydrocannabinol (THC), the primary psychoactive compound found in cannabis.

Along with decreased vascular function, marijuana smokers had changes in their blood serum that were harmful to endothelial cells, which form the inner lining of all blood and lymphatic vessels. Those who took edibles containing THC, however, did not display these changes in blood serum. It's unclear how THC damages blood vessels.

"This study enhances the understanding of the potential risks to vascular health linked to cannabis use and provides more evidence that cannabis use is not benign," the researchers concluded.

THE RISE OF HIGH-POTENCY THC

Cardiovascular issues are not the only risks associated with cannabis use, of course. Many well-meaning Americans have internalized the propaganda of the well-organized cannabis industry, suggesting that cannabis products can cause no harm and may even mitigate specific health problems such as glaucoma or anxiety disorders, despite a distinct lack of scientific evidence for such claims. In an astonishing turnaround, cannabis went from a dangerous gateway drug to a wellness product in a matter of decades.

Foundry Front Range Managing Partner Ben Cort has been raising awareness of the commercialization of cannabis products for years. In his 2017 book Weed, Inc., he explained how the potent products the marijuana industry is selling in the 21st century are a far cry from the weed people smoked in the 1970s. "The average cannabis product sold in Colorado in 2020 had a THC content of 69 percent," says Cort. "Concentrates are everywhere and are not just being used by the fringe; they are mainstream, and they are what many people picture when they talk about marijuana," he wrote in Weed, Inc. In other words, cannabis products have been weaponized. Cort's 2024 follow-up book, "Weed Inked," contains further evidence that high-potency THC products are harmful to personal and public health.

Chronic cannabis use is associated with an increased risk of developing a substance use disorder (SUD) and can induce psychosis.

Cannabis Use Disorder (CUD) is a growing problem nationwide. Studies indicate increasing rates of cannabis use disorder following the legalization and commercialization of cannabis in recent years. Cannabis use disorder poses specific health challenges, including hyperemesis, psychosis, paranoia, and—as the UCSF study confirms—heart health risks.

FOUNDRY FRONT RANGE TREATS CANNABIS USE DISORDER

Foundry Front Range has specialized expertise in treating cannabis use disorder. Cannabis, which is stored in fat cells, can remain in the body and cause psychoactive effects long after a person stops consuming it. This can lead to residual effects of cannabis that must be stabilized before clients are ready to engage in treatment programming. Specialized medical attention may also be required to help people experiencing severe CUD side effects, like nausea or psychosis, feel stable and comfortable.

Because 58-plus percent of people with SUD have more than one substance use disorder, treating the effects of cannabis use disorder can be even more complex. Patients with cannabis use and at least one other substance use disorder are more likely to need more clinical attention and medical resources. They may also have home environments or relationships that make substance use seem permissible or supported, requiring family programming and education about how to build recovery-supportive environments.

Continuing care planning, which ensures that individuals have a specific ongoing care plan after completing treatment, is crucial for allowing them to navigate the fragile period of early recovery safely. As this article suggests, cannabis use disorder and other substance use disorders increase the potential for chronic health problems. With growing evidence that cannabis can affect the heart and blood flow, cardiological assessment may be advisable during and after substance use disorder treatment.

With some of the most experienced clinicians, a modern and well-equipped clinical facility, and leading experts in addiction medicine, Foundry Front Range represents a good treatment option for people experiencing Cannabis Use Disorder. To learn more, visit www.foundryfrontrange.com or call (720) 807-7867.

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Sep

The Weaponization of Cannabis Products

“A strange thing has happened on the path to marijuana legalization. Users across all ages and experience levels are noticing that a drug they once turned to for fun and relaxation now triggers existential dread and paranoia,” wrote Malcolm Ferguson, an assistant editor at The Atlantic, in August. Like other journalists, Ferguson is beginning to realize what many addiction professionals have known for many years. Cannabis products in the United States have been weaponized on an industrial scale.

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“In 2022, the federal government reported that, in samples seized by the Drug Enforcement Administration, average levels of tetrahydrocannabinol, or THC—the psychoactive compound in weed that makes you feel high—had more than tripled compared with 25 years earlier, from 5 to 16 percent. That may understate how strong weed has gotten. Walk into any dispensary in the country, legal or not, and you’ll be hard-pressed to find a single product advertising such a low THC level. Most strains claim to be at least 20 to 30 percent THC by weight; concentrated weed products designed for vaping can be labeled as up to 90 percent.”

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NRT Behavioral Health™ managing partner Ben Cort has been raising awareness of the commercialization of cannabis products for years. In his 2017 book Weed, Inc., he explained how the potent products the marijuana industry is selling in the 21st century are a far cry from the weed people smoked in the 1970s. "The average cannabis product sold in Colorado in 2020 had a THC content of 69 percent," says Cort. "Concentrates are everywhere and are not just being used by the fringe; they are mainstream, and they are what many people picture when they talk about marijuana," he wrote in Weed, Inc. "You are going to think some of this must be talking about hardcore users on the edge, but it's not; concentrates are everywhere and have become synonymous with weed for this generation of users." “Weed Inked,” Cort’s recently published “Weed, Inc.” follow-up, discusses how many of the predictions about the harmful effects of high-potency THC product commercialization and industrialization have come to pass.

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The consequences of making this largely unregulated psychoactive product available through legalization and commercialization have been devastating.

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“In the past few years, reports have swelled of people, especially teens, experiencing short- and long-term ‘marijuana-induced psychosis,’ with consequences including hospitalizations for chronic vomiting and auditory hallucinations of talking birds,” reported Ferguson. “Multiple studies have drawn a link between heavy use of high-potency marijuana, in particular, and the development of psychological disorders, including schizophrenia, although a causal connection hasn’t been proved.”

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The wider public remains largely unaware of these significant risks. In May, the number of Americans who use cannabis daily was reported to have surpassed the number who drink alcohol that frequently for the first time in the history of the United States. As the Associated Press reported, it is “a shift some 40 years in the making as recreational cannabis use became more mainstream and legal in nearly half of US states.”

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In 2022, an estimated 17.7 million people reported using marijuana daily or near-daily compared to 14.7 million daily or near-daily drinkers, according to an analysis of national survey data. In 1992, when daily cannabis use hit a low point, fewer than one million people said they used marijuana nearly every day.

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“Cannabis is in and alcohol is out”—a preference change likely driven by Gen Z, Nikki Battiste reported for CBS News in May. The cannabis industry has mostly succeeded in convincing large numbers of Americans—particularly young people—that their potent products are harmless if not beneficial for their well-being. As a consequence, millennials and Gen Z tend to think of alcohol as harmful and marijuana as healthy.

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After years of promoting cannabis as "medication" (although the evidence for its efficacy is mostly anecdotal) and downplaying the risks of marijuana use, the cannabis industry is close to achieving another goal. In May, the federal Justice Department proposed reclassifying the drug, saying the change would recognize marijuana’s “medical” uses and suggesting it had less potential for abuse than other illicit drugs.

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For now, however, the federal government continues to classify cannabis as a Schedule I controlled substance with “no currently accepted medical use and a high potential for abuse.” Any reclassification is not expected before the November election.

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Meanwhile, the National Institute on Drug Abuse (NIDA)—one of 27 institutes and centers comprising the National Institutes of Health, which is part of the US Department of Health and Human Services—informs the public on its website that “marijuana use can lead to the development of a substance use disorder, a medical illness in which the person is unable to stop using even though it's causing health and social problems in their life.” A severe cannabis use disorder (CUD) is considered an addiction. “Research suggests that between 9 and 30 percent of those who use marijuana may develop some degree of marijuana use disorder. People who begin using marijuana before age 18 are four to seven times more likely than adults to develop a marijuana use disorder.”

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Cannabis products—especially those with dangerously high THC concentrations—also affect brain development. When people begin using these weaponized THC products as teenagers, the drug may impair thinking, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions.

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A 2022 review study found that higher THC concentrations are now causing more people to become addicted to cannabis. “One of the highest quality studies included in our publication found that use of high potency cannabis, compared to low potency cannabis, was linked to a four-fold increased risk of addiction,” study coauthor Tom Freeman told CNN.

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Foundry Treatment Center Steamboat, part of NRT Behavioral Health, developed a specific treatment track for people affected by cannabis use disorder because the condition poses particular challenges. In 2000, Cort co-authored the first published best practices on treating CUD alongside Dr. LaTisha Bader in a medical text and reference book entitled Cannabis In Medicine and Evidence-Based Approach. He has spent the years since working to educate clinicians and medical professionals in our field on these practices. Many people experiencing cannabis use disorder suffer from extended periods of cannabis-induced psychosis and must be safely housed and medically supervised until their symptoms subside enough for them to engage in treatment programming successfully. Cannabis use disorder treatment is also an area of specialty offered by Foundry Front Range, a comprehensive residential addiction treatment program opened by NRT in August.

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May

US Government Expected to Reclassify Cannabis as Lower-risk Drug

It is a move that has been expected for a long time. After years of promoting cannabis as "medication" and downplaying the risks of marijuana use, the cannabis industry is about to score another victory.

On April 30, US Attorney General Merrick Garland recommended loosening the restrictions on marijuana, a historic shift in federal drug policy that could broaden access to the drug for "medicinal" and recreational use even further and boost the cannabis industries in states where it is already legal.

"Today, the Attorney General circulated a proposal to reclassify marijuana from Schedule I to Schedule III," the Justice Department said in a statement. "Once published by the Federal Register, it will initiate a formal rule-making process as prescribed by Congress in the Controlled Substances Act." On May 13, the Drug Enforcement Administration added its support for reclassification.

The proposal, which the White House has one to three months to review, would recognize the unproven "medical" uses of cannabis and acknowledge it has less potential for abuse than some of the nation's most dangerous drugs. However, it would not legalize marijuana outright for recreational use on a federal level.

The proposed change could nevertheless increase the profits of the cannabis industry dramatically. Unsurprisingly, industry leaders believe that declassifying cannabis altogether, as opposed to reclassifying it, would be even better.

The FDA has approved just one drug, the epileptic seizure treatment Epidiolex, that contains CBD derived from cannabis plants. It has also approved three drugs containing synthetic THC compounds to treat nausea associated with cancer treatment and reduce wasting associated with HIV/AIDS. Like all prescription drugs, these FDA-approved medications are prescribed by doctors to treat very specific medical conditions.

By contrast, “medical” cannabis can only be recommended by doctors to address a range of ailments. Research on other claimed medical and health benefits of marijuana is scant to non-existent, while the negative effects of mass consumption are becoming more and more evident in states that have legalized cannabis. One of those states is Colorado, where Chuck Smith, who leads an alliance of cannabis business executives, described rescheduling as progress.

"The HHS rescheduling recommendation marks a historic step toward federal cannabis policy reform," Smith said. "For over a decade, Colorado has been demonstrating states' ability to effectively regulate cannabis for medical and broader adult use, and it's time for federal law to reflect that reality. State-legal cannabis businesses that create jobs, pay taxes, and provide adults and medical patients with safe and legal access to cannabis deserve to be treated fairly, and this would be a big step in that direction."

Legalization in states across the nation has fueled rapid growth of the marijuana industry, with an estimated worth of nearly $30 billion. Rescheduling cannabis could reduce the tax burden by allowing deductions unavailable for a Schedule I substance. There are fears that rescheduling cannabis could now open the door for large pharmaceutical companies and other major corporations to take over the industry.

NRT Behavioral Health™ President Ben Cort has been raising awareness of the commercialization of cannabis products for years. In his book Weed, Inc., Cort explained how the potent products the marijuana industry is selling in the 21st century are a far cry from the weed people smoked in the 1970s. The reason is the dangerously high THC content of today's cannabis products.

THC (delta9-tetrahydrocannabinol) is the main psychoactive ingredient in marijuana, and THC levels in cannabis products have dramatically increased in the last few decades from less than one percent THC in the seventies to well beyond 15 percent in recent years. And that's just the plants—concentrates can reach much higher levels of THC.

"The average cannabis product sold in Colorado in 2020 had a THC content of 69 percent," says Cort. "Concentrates are everywhere and are not just being used by the fringe; they are mainstream, and they are what many people picture when they talk about marijuana," Cort wrote in Weed, Inc. "You are going to think some of this must be talking about hardcore users on the edge, but it's not; concentrates are everywhere and have become synonymous with weed for this generation of users."

The National Academies of Science pointed out that despite a growing acceptance of marijuana in many states, "evidence regarding the short- and long-term health effects of cannabis use remains elusive" and that "no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively."

A 2020 letter from the director of the National Institute on Drug Abuse said, "Marijuana impairs short-term memory and judgment and distorts perception" and, as a result, "can impair performance in school or at work and make it dangerous to drive."

Although it is illegal for Coloradans under 21 to buy, have, or use retail marijuana, and it is a felony for anyone to give, sell, or share marijuana with anyone under 21, teenage consumption and addiction are on the rise.

A 2021 systematic review found that past-year cannabis vaping nearly doubled from 2017 to 2020 in adolescents - jumping from 7.2 percent to 13.2 percent," warned Ty Schepis, a professor of psychology at Texas State University, in a recent article for The Conversation. "A more recent study in five northeastern US states found that 12.8 percent of adolescents vaped cannabis in the past 30 days, a more narrow time frame that suggests potential increases in use. In addition, a 2020 study found that one-third of adolescents who vape do so with cannabis concentrates."

The notion that Colorado is effectively regulating the medical adult use of cannabis seems to provide a partial view of cannabis use within the state by not also acknowledging widely accepted concerns about the negative effects of use and increased underage use. However, the state may only be providing minimal resources when it comes to regulating adult cannabis use, according to Ben Cort’s forthcoming sequel to “Weed, Inc.” The book also talks about how the state’s Marijuana Enforcement Division (MED), which is tasked with regulating commercial cannabis, seems primarily to be a recruiting apparatus to help grow Colorado’s commercial THC industry.

Cannabis misuse by adolescents is dangerous because it can alter the way their brains develop, explained Schepis. "Research shows that the brains of adolescents who use cannabis are less primed to change in response to new experiences, which is a key part of adolescent development. Adolescents who use cannabis are also more likely to experience symptoms of schizophrenia, struggle more in school, and engage in other risky behaviors."

Smart Approaches to Marijuana (SAM) President Kevin Sabet, a former White House drug policy advisor to Presidents Obama, Bush, and Clinton, issued the following statement:

"Politics and industry influence have loomed over this decision from the very beginning. [...] Now, against the recommendations of prior Attorneys General, the medical community, and law enforcement, the Administration unilaterally reversed decades of precedent despite volumes of data confirming marijuana's harmfulness. Moreover, a drug can be taken off Schedule I only if it has accepted medical use—raw, crude marijuana has never passed safety and efficacy protocols. A drug isn't medicine because it's popular."

"Medical and scientific studies, as well as government data, have conclusively linked THC drugs with addiction, psychosis, schizophrenia, depression, anxiety, suicidality, and IQ loss, among other impacts," Dr. Sabet wrote. "The Administration's effort to push through this action in an election year could be perceived as a thinly veiled attempt to reverse polling trends with the principal targets of the pot industry, namely young people."

Ben Cort also believes that the decision is “a reflection of politics rather than medical science. I’ve had several conversations with the nation’s thought leaders and researchers since this recommendation was leaked. They all agreed that there is no science to support the decision, while there are a lot of scientific indicators encouraging a much more careful and deliberate approach.”

“This is a tight election year and somebody did the math on how many swing votes this might pull for the current administration,” says Cort. “We still haven’t learned our lesson as a nation that thoughtless engagement with psychoactive intoxicants doesn’t end well. We still haven’t understood that bad things happen when corporations sell things that have addictive potential.” While groups promoting the purchase and use of THC products continue to get their way, across-the-board decriminalization of drug possession and use has seen some pushback lately.

Marijuana use can lead to the development of cannabis use disorder (CUD), which takes the form of addiction in severe cases. Recent data suggest that 30 percent of those who use THC products may have some degree of marijuana use disorder. People who begin using marijuana before the age of 18 are four to seven times more likely to develop a marijuana use disorder than adults.

At a time when growing evidence suggests that cannabis legalization and commercialization are making potentially dangerous products more available, increasing accidental THC poisonings and other adverse health events, and are not resulting in the promised financial boons to cannabis business owners or states where cannabis is legal, rescheduling could exacerbate these problems.

Regardless of whether rescheduling cannabis changes the way it is sold, the move is likely to reduce further the perceived dangers associated with cannabis use. Research suggests that young adults are more likely to use cannabis after it is legalized because they perceive it as less dangerous.

Rescheduling cannabis could send an even more significant signal to people that cannabis is not harmful, which may further increase its use. The same study suggests that increased use by adolescents and young adults could stimulate cannabis use disorder while making it less likely that they seek treatment.

The behavioral healthcare field is seeing more patients presenting with cannabis use disorder and complex cases linked to high-potency THC use that are difficult to treat. Rescheduling could result in more people than ever before believing that cannabis use is without risks while THC products are more potent than ever, a situation that may lead to more problematic cannabis use with implications for individuals, families, and communities nationwide.

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