“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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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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It was supposed to be the panacea for the opioid epidemic. If you decriminalize drug possession and get people with substance use disorder (SUD) into treatment, the crisis will go away. Except, it didn’t.

“When Oregon embarked on a landmark plan three years ago to decriminalize hard drugs, it wagered that a focus on treatment over punishment would create a new model for drug policy around the country,” Mike Baker reported for The New York Times earlier this month. “But after a deluge of overdose deaths and frequent chaos in the streets of Portland, Gov. Tina Kotek signed into law […] a measure to restore criminal penalties for drug possession.”

The new law rolls back a 2020 voter-approved measure by making so-called personal use possession a misdemeanor punishable by up to six months in jail. It also establishes ways for treatment to be offered as an alternative to criminal penalties by encouraging law enforcement agencies to create deflection programs that would divert people to treatment services instead of the criminal justice system.

Measure 110, approved by voters with 58 percent support in 2020, made the personal use possession of illicit drugs such as heroin, cocaine, and methamphetamine only punishable by a ticket and a maximum fine of $100. Supporters said treatment is more effective than jail in helping people overcome addiction and that the decades-long approach of arresting people for possessing and using drugs hasn’t worked.

Farther north, British Columbia became the first province in Canada last year to decriminalize the use of hard drugs as part of its efforts to tackle its deadly opioid crisis. But there, too, the policy is now facing pushback, leaving its future uncertain.

Portugal was the trailblazer for this approach, but the European country has also had second thoughts lately. “Portugal decriminalized all drug use, including marijuana, cocaine, and heroin, in an experiment that inspired similar efforts elsewhere, but now police are blaming a spike in the number of people who use drugs for a rise in crime,” reported Anthony Faiola and Catarina Fernandes Martins in The Washington Post last year.

“Portugal became a model for progressive jurisdictions around the world embracing drug decriminalization, such as the state of Oregon, but [...] some Portuguese voices are now calling for a rethink of a policy that was long a proud point of national consensus. Urban visibility of the drug problem, police say, is at its worst point in decades and the state-funded nongovernmental organizations that have largely taken over responding to the people with addiction seem less concerned with treatment than affirming that lifetime drug use should be seen as a human right.”

Clearly, decriminalization has not ended Portugal’s drug problem. Overdose rates hit 12-year highs and almost doubled in Lisbon from 2019 to 2023. Sewage samples in Lisbon show cocaine and ketamine detection is now among the highest in Europe.

It seems that in all three places—Portugal, British Columbia, and Oregon—decriminalization primarily brought drug use out in the open without actually curbing it. So, why didn’t it work?

“Measure 110 did not reduce Oregon’s drug problems,” wrote Keith Humphreys and Rob Bovett in a recent analysis piece in The Atlantic. “The drug overdose death rate increased by 43 percent in 2021, its first year of implementation—and then kept rising. The latest CDC data show that in the 12 months ending in September 2023, deaths by overdose grew by 41.6 percent, versus 2.1 percent nationwide. No other state saw a higher rise in deaths. Only one state, Vermont, ranks higher in its rate of illicit drug use.”

It appears the notion that decriminalization will induce a flood of help-seeking from people with addiction was hopelessly naive. “The replacement for criminal penalties, a $100 ticket for drug possession with the fine waived if the individual called a toll-free number for a health assessment, with the aim of encouraging treatment, failed completely,” wrote Humphreys and Bovett. “More than 95 percent of people ignored the ticket, for which—in keeping with the spirit of Measure 110—there was no consequence.”

Humphreys and Bovett have spent the better part of their careers studying and working on drug policy and were not surprised that “trivial pressure” to seek treatment proved ineffective. “Fentanyl and meth addiction are not like depression, chronic pain, or cancer, conditions for which people are typically motivated to seek treatment. Even as it destroys a person’s life, addictive drug use by definition feels good in the short term, and most addicted people resist or are ambivalent about giving that up. Withdrawal, meanwhile, is wrenchingly difficult. As a result, most addicted people who come to treatment do so not spontaneously but through pressure from family, friends, employers, health professionals, and, yes, the law.”

The reporters contend that Oregon didn’t even need Measure 110 as “a rebuke to the War on Drugs” because Oregon “had never fought such a war.” The state had the country’s “lowest rate of imprisonment for nonviolent crimes. Short local jail sentences for drug possession were permitted, but diversion programs, including drug courts and community supervision with drug testing, were widely used. However, after Measure 110 was passed and the threat of jail time eliminated, the flow of people into these programs slowed.”

Humphreys and Bovett do not advocate a return to severe crackdowns by the justice system. “Many states are far more punitive toward drug users than Oregon was before Measure 110 passed. They overemphasize incarceration of people who use drugs, they do not provide adequate, publicly funded health treatment and health insurance, and they do not use criminal justice productively to discourage drug use (for instance, by using arrests and probations as leverage to get people into drug courts and treatment).”

If these states could be persuaded to dial down their overly harsh criminal-justice approach to approximate what Oregon had before Measure 110, “except with adequately funded, evidence-based prevention and treatment, substantial gains in public health and safety would likely follow,” they feel. “The future of successful drug-policy reform is not greater laxity in states that are already quite progressive in their approach to drug use; it is using criminal justice and public health together in a balanced, pragmatic fashion, as Oregon is now poised to do.”

While the decriminalization of heroin, cocaine, and meth was based on naive assumptions about addiction, at least proponents have not attempted to declare these substances to be harmless or even good for your health. In the case of the legalization and commercialization of cannabis, that is exactly what happened.

In Colorado, cannabis has been legal for “medical” use since 2000 and for recreational use since late 2012. On November 7, 2000, 54 percent of Colorado voters approved Amendment 20, which amended the state constitution to allow the use of marijuana in the state for approved “patients” with written “medical consent.” Twelve years later, that medical figleaf was dropped with Amendment 64, which led to full recreational legalization in December 2012 and state-licensed retail sales in January 2014.  

The impact has been widespread and negative. Few people are aware that marijuana legalization is largely driven by well-organized multi-state operators selling unregulated and unsafe commercial products. Foundry Treatment Center Steamboat Managing Partner Ben Cort has been raising awareness of these issues for years. In a webinar last year, 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 extreme THC (delta9-tetrahydrocannabinol) content of today's cannabis products.

The average THC content of cannabis products seized by the Drug Enforcement Administration was 15 percent in 2021, up from just four percent in 1995. However, many commercial cannabis products now advertise THC concentrations of up to 99 percent. The potency of the plant is irrelevant because the plant is being converted into products not used on its own. According to Cort, "Rarely, if ever, do we treat an individual who is only using cannabis in anything like its natural form; they use highly concentrated THC produced by extracting THC from the plant."

"There are now users who consume several grams of this unnaturally potent THC daily," says Ben Cort. "I know that because we treat such patients here at our program." The result of the widespread use of these powerful concentrates: "Addiction rates are considerably higher, the higher the potency goes as are negative psychiatric complication."

According to healthcare analytics company Truveta, rates of diagnoses for cannabis-induced disorders were more than 50 percent higher at the end of November 2023 than in 2019. It has been estimated that approximately three in ten people who use marijuana have a cannabis use disorder.

Despite the addiction risk, Colorado is still expanding the availability of cannabis. Since January, retail marijuana stores have been allowed to accept payment for products ordered online. Online ordering became legal in Colorado late last year, but customers still had to pay for their orders in person.

American Heart Association warned last year that marijuana use is linked with an increased risk of heart attack and heart failure. “As more people across the US use marijuana, [...] two new studies suggest its regular intake may damage heart and brain health. In one study, daily use of marijuana raised the risk of developing heart failure by about one-third, even after considering other factors, compared to people who reported never using marijuana. In a second study, older people with any combination of Type 2 diabetes, high blood pressure, and high cholesterol who used marijuana, significantly increased their risk for a major acute heart or brain event while hospitalized, compared to those who reported not using marijuana.”

Legalizing dangerous substances like cannabis because people bought into claims of unproven medical benefits or tolerating the illegal use of heroin and cocaine in the hope that people addicted to these drugs will simply come forward asking for treatment without any encouragement is a path fraught with dangers as it turned out. Addiction is a complex bio-psycho-social disease characterized by the continued use of psychoactive substances or the continuation of addictive behaviors despite negative consequences.

Addiction is frequently driven by underlying trauma and depression, and simply decriminalizing maladaptive attempts to self-medicate such underlying conditions does nothing to address them. Treating a severe substance use disorder often requires the concerted efforts of the affected individuals, their families, and a team of treatment professionals addressing the root causes of the SUD.

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Many Americans are not aware of the grave dangers cannabis use can entail. Ever since the nationwide—if not international—movement to promote marijuana as a healthy substance or even as a medication succeeded beyond its wildest expectations, the risk awareness connected to the use of THC (delta9-tetrahydrocannabinol), the main psychoactive ingredient in cannabis, has been steadily eroded.

Twenty-four states (plus Guam, the Northern Mariana Islands, the US Virgin Islands, and the District of Columbia) now allow the recreational use of cannabis, and around a dozen states, plus Puerto Rico, allow the "medical" use of cannabis products. However, the federal government continues to categorize marijuana as a Schedule I drug, a category for substances like heroin and cocaine that have no medical use and a high potential for misuse and addiction. As of this writing, the recommendation of federal scientists and associated reporting indicate that cannabis may be rescheduled to a lower schedule, a move that could further relax cannabis prohibitions.

Addiction—a severe cannabis use disorder—is not the only risk. Marijuana use can also result in acute psychosis and violent behavior with devastating consequences.

In January, Los Angeles television station KTLA reported on a manslaughter case in which a man was stabbed to death by a Ventura County woman after both used cannabis together.
In May 2018, 32-year-old Bryn Spejcher killed 26-year-old Chad O'Melia after taking several hits from a bong filled with marijuana. Spejcher reportedly experienced an adverse reaction resulting in a cannabis-induced psychotic episode. During that psychotic break, she stabbed O'Melia multiple times, eventually killing him. She also stabbed herself repeatedly, officials said.
According to KTLA, police officers arrived the next morning at O'Melia's apartment to find him "in a pool of blood and Spejcher screaming hysterically while still holding a knife in her hands. As officers tried to disarm her, Spejcher plunged the knife into her neck, authorities said."
Officers had to use "a taser and several baton blows before they were able to finally disarm Spejcher," police said. "A long-serrated bread knife was taken from her hands." Spejcher, who had been dating the victim for a few weeks, was found to have stabbed O'Melia 108 times with three different knives.  

On January 23, a judge sentenced Spejcher to two years of felony probation and no prison time. She had been out on bail since the 2018 slaying. She had faced up to four years in prison along with sentence enhancements. However, the judge cited evidence and expert testimony, saying the defendant did not know marijuana would have this type of effect on her when she smoked with the victim that night.

Family members of Chad O'Melia expressed outrage at the leniency of the sentence and said they were worried about the broader impact of this ruling.  

NOT YOUR PARENTS’ WEED
The core of the problem is that most people don't know that today's cannabis products are largely unregulated and extremely potent. They don't believe that marijuana use can result in psychosis or violent behavior, and they have uncritically absorbed the claims promoted by the cannabis industry of unproven medical benefits of marijuana use for various ailments. Hence, the excuse that a defendant cannot know marijuana would have a murderous effect.  
The effect is well known, however. "Cannabis is involved in approximately 50 percent of psychosis, schizophrenia, and schizophreniform psychosis cases," wrote Shrivastava, Johnston, et al. in a 2014 study on the neurobiology of cannabis and psychosis.

A recent article in the Wall Street Journal pointed out that "more frequent use of marijuana that is many times as potent as strains common three decades ago is leading to more psychotic episodes, according to doctors and recent research."  

Foundry Treatment Center Steamboat CEO Ben Cort has been warning for years that the legalization of cannabis has been largely driven by well-organized multi-state operators selling unregulated and unsafe commercial products. "The average cannabis product sold in Colorado in 2016 had a THC content of 63 percent," he explained in a webinar last year. In the 1970s, "weed" contained roughly 1–3 percent THC.

"There are now users who consume several grams of this weaponized THC daily," Cort says. "I know that because we treat such patients here in our program." The result of the widespread use of these powerful concentrates: "Addiction rates are considerably higher, the higher the potency goes."

CANNABIS AND VIOLENT BEHAVIOR
"According to research studies, marijuana use causes aggressive behavior, causes or exacerbates psychosis, and produces paranoia," wrote Miller, Ipeku, and Oberbarnscheidt in a 2020 study on marijuana use and violence. They, too, noted that marijuana products are far more potent in THC concentrations than they used to be. "Accordingly, and demonstrated in direct studies, more potent marijuana results in a greater risk for paranoid thinking and psychosis. In turn, paranoid behavior increases the risk for paranoid behaviors and predictably associated with aggressive and violent behaviors."

In their study, Miller et al. presented many case examples, one of which pertained to Nikolas Cruz, who killed 17 students and staff at the Marjory Stoneman Douglas High School in Parkland, Florida, in 2018. "Cruz was diagnosed as developmentally delayed at age three and had numerous disciplinary issues dating to middle school. From a young age, he started consuming marijuana heavily." He would "frequently 'hear demon voices' and would consume large amounts of marijuana to try and silence those voices. He also attempted suicide. During an interview after his mass shooting, he stated that he used a lot of marijuana as well as [the] prescription tranquilizer Xanax."

In May 2017, Richard Rojas purposely drove a car along three blocks of pavement in New York's Times Square, killing a teenager and injuring 22 other people. "Evidence indicates that Rojas was a heavy marijuana user. He admitted to the consumption of spiced-up marijuana right before committing the attack," reported Miller et al. in their study.

The year before, Arcan Cetin carried out a mass shooting that killed five people and injured many others at the Cascade Mall in Washington, DC. "Evidence indicates that Cetin was a heavy marijuana consumer. Further, he had a past of violent behavior, with some incidents including the consumption of marijuana."

Twenty-one-year-old white supremacist Dylan Roof murdered nine black people who were attending a prayer service in Charleston, South Carolina, in 2015. His declared intention was to start a race war. His acts were preceded by years of substance misuse. Reports revealed that Roof's drug use started at the age of twelve when he would smoke marijuana three times a day.
Dzhokhar Tsarnaev and his brother Tamerlan, who killed three people and injured more than 250 in the 2013 Boston Marathon bombing, were heavy marijuana users since they were young teenagers.

In the cases presented by the authors, "one of the recurring conditions that most likely led perpetrators to commit violence was paranoia… It is very likely that marijuana played an active role in these people's paranoia, considering that the chemical composition of the drug has compounds that alter a person's perception of reality."

The authors note that "marijuana intoxication results in panic reactions and paranoid feelings whose symptoms lead to violence. The sense of fear, loss of control, and panic are associated with violence. Also, marijuana use increases heart rate, which may be associated with violent behavior."

When people stop using marijuana, they may experience a variety of withdrawal symptoms, including sleep disturbance, irritability or restlessness, loss of appetite, anxiety, and sweating. "Experiencing any of these symptoms can make a person angry, ranging from mild irritation to violent rage," explained Miller, Ipeku, and Oberbarnscheidt. "Marijuana withdrawal can lead to intimidating violent or bullying behavior, endangering the perpetrator or other people and property."

In the case of Bryn Spejcher and Chad O'Melia, the use of high-potency THC sadly also resulted in a psychotic break and the death of a human being. "We now have concentrated THC products such as oil, shatter, dab, and edibles that have been able to get the THC concentration upwards of 95 percent. There is absolutely no research that indicates this level of THC is beneficial for any medical condition. The purpose of these products is to produce a high, and the increased potency makes them potentially more dangerous and more likely to result in addiction," wrote Elizabeth Stuyt, MD, in "The Problem with the Current High Potency THC Marijuana from the Perspective of an Addiction Psychiatrist."

Foundry Treatment Center Steamboat treats adults experiencing cannabis use disorders and other substance use and co-occurring mental health disorders. While cannabis has long been one of the substances used by people suffering from substance use disorders, Foundry Steamboat clinicians have seen significant increases in the acuity of symptoms arising from problematic cannabis use. High-potency THC products, like other psychoactive substances, pose unique health risks, including the potential to cause or exacerbate paranoia, psychosis, hyperemesis, anxiety disorder, and more. While violence and severe adverse mental health impacts resulting from cannabis use affect a small percentage of cannabis users, it seems that these potential harms should be better known. It is also worth noting that treating cannabis use disorder and its co-occurring mental health disorders can be especially challenging. Patients experiencing psychosis, paranoia, or heightened anxiety related to cannabis use may require more treatment than people not experiencing these conditions.

Despite growing evidence that today's high-potency THC products pose specific health risks, reporting indicates increasing rates of adolescent and teen consumption, and states and the federal government seem likely to reduce further cannabis restrictions to expand commercial access.

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Some federal scientists have reportedly concluded that "marijuana is neither as risky nor as prone to abuse as other tightly controlled substances and has potential medical benefits, and therefore should be removed from the nation's most restrictive category of drugs."

This astounding recommendation is contained in a 250-page scientific review "provided to Matthew Zorn, a Texas lawyer who sued Health and Human Services officials for its release and published it online," Christina Jewett and Noah Weiland reported for The New York Times in January. An HHS official reportedly confirmed the authenticity of the document.

It looks like federal health officials could soon follow the example of many states and legalize cannabis products for "medical" and recreational use. This momentous volte-face has been expected for quite some time now.

Since the 1970s, marijuana has been considered a Schedule I drug, a category for substances like heroin and cocaine that have no medical use and a high potential for misuse and addiction. Despite this prohibition, proponents of legalized cannabis use have been pushing unproven medical benefits of marijuana use for various ailments.

"Empirical and clinical studies clearly demonstrate significant adverse effects of cannabis smoking on physical and mental health as well as its interference with social and occupational functioning," wrote Svrakic, Lustman, et al. in "Legalization, Decriminalization & Medicinal Use of Cannabis" in 2012. "These negative data far outweigh a few documented benefits for a limited set of medical indications, for which safe and effective alternative treatments are readily available. If there is any medical role for cannabinoid drugs, it lies with chemically defined compounds, not with [the] unprocessed cannabis plant. Legalization or medical use of smoked cannabis is likely to impose significant public health risks, including an increased risk of schizophrenia, psychosis, and other forms of substance use disorders."

According to The New York Times article, the new federal "documents show that scientists at the Food and Drug Administration and the National Institute on Drug Abuse have recommended that the Drug Enforcement Administration make marijuana a Schedule III drug, alongside the likes of ketamine and testosterone, which are available by prescription."

At the same time, the review noted that marijuana misuse does lead to "physical dependence" and "some people develop a psychological dependence." Nevertheless, the review concluded, "the likelihood of serious outcomes is low."

Many addiction experts disagree. "They note that any long-running study of marijuana that the federal authorities have reviewed may not account for the escalating strength and increasingly frequent use of marijuana, which has been tied to psychiatric problems and chronic vomiting among users in recent years," wrote Jewett and Weiland.

For years, there was the promise—ultimately unmet—that marijuana could be used to combat opioid abuse or treat mental health problems, Keith Humphreys, a Stanford health policy professor and a former federal drug policy official, told The Times. "As the science has gotten better in the intervening decades, most of the therapeutic claims about cannabis have been debunked," he said.

A recent article by Julie Wernau in the Wall Street Journal made the same point. "More frequent use of marijuana that is many times as potent as strains common three decades ago is leading to more psychotic episodes, according to doctors and recent research," she wrote.  

Few people know that the legalization is largely driven by well-organized multi-state operators selling unregulated and unsafe commercial products. Foundry Treatment Center Steamboat CEO Ben Cort has been raising awareness of these issues for years. In a recent webinar, 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 extreme THC (delta9-tetrahydrocannabinol) content of today's cannabis products.

The Cannabis sativa plant has over 480 constituents, with THC being the main psychoactive ingredient. "The average cannabis product sold in Colorado in 2016 had a THC content of 63 percent," Cort said. He doesn't like to talk about the plant anymore because the people treated at Foundry Treatment Center Steamboat for cannabis use disorder (CUD) have not been smoking the pot passed around in the 1970s; they are using high-potency commercially produced cannabis-based products.

The average THC content of cannabis products seized by the Drug Enforcement Administration was 15 percent in 2021, up from just four percent in 1995. However, many commercial cannabis products now advertise THC concentrations of up to 99 percent. The potency of the plant is irrelevant because the plant is being converted into products not used on its own. According to Cort, "Rarely, if ever, do we treat an individual who is only using cannabis in anything like its natural form; they use highly concentrated THC produced by extracting THC from the plant."

"There are now users who consume several grams of this unnaturally potent THC daily," says Ben Cort. "I know that because we treat such patients here at our program." The result of the widespread use of these powerful concentrates: "Addiction rates are considerably higher, the higher the potency goes as are negative psychiatric complication."

According to healthcare analytics company Truveta, rates of diagnoses for cannabis-induced disorders were more than 50 percent higher at the end of November than in 2019, "The trend is contributing to the broader burden of caring for people who developed mental health and addiction problems during the pandemic," Wernau reported.

Symptoms of serious mental disorders, including schizophrenia, often emerge in adolescence. While cannabis cannot be definitively isolated yet as the only culprit in any particular case, a growing body of evidence seems to support this conclusion. Large studies show a clear link between frequent and more potent cannabis use and higher rates of psychosis, particularly in young users, Yale University psychiatrist Deepak D'Souza told the Wall Street Journal.

Even one psychotic episode following cannabis use was associated with a 47 percent chance of developing schizophrenia or bipolar disorder, a 2017 study published in the American Journal of Psychiatry showed. The risk was highest for people 16 to 25 years old and higher than for substances such as amphetamines, hallucinogens, opioids, and alcohol.

The Wall Street Journal cited the example of Dr. Karen Randall, who moved to Pueblo, Colorado, for a job in an emergency room more than a decade ago after working in Detroit for 18 years. She thought it would be like retiring early. She bought a ranch where she could ride horses in an area locals now call the Napa Valley of Cannabis. "I see more psychotic people here than I did in Detroit," she told the Wall Street Journal. "We're just making this huge population of people who we can no longer fix." Dr. Randall is right, we can 'no longer fix' these issues in an acute setting like an emergency department. Individuals affected by the type of THC-induced psychosis she sees need long-term care.

Cannabis use disorder (CUD) is a potentially serious condition frequently requiring treatment. Sadly, people presenting with CUD do not enjoy the same support from society as people with other substance use disorders, explained Cort. "If you ask your doctor for help because you drink too much alcohol or because you can't stop using opioids, you can typically expect encouraging words, immediate action, and specialist referrals. If you ask your doctor for help because you are concerned that you are using too much THC, you may only get a shrug or a simple recommendation to cut down." Many doctors, especially those who have not graduated recently from medical school or received new training in cannabis use disorder, think that cannabis use is relatively harmless or poses few risks. Some doctors believe that cannabis may be less harmful than using alcohol or medications to cope with stress symptoms and anxiety.

"At Foundry Steamboat, we treat patients whose cannabis use disorder had been dismissed as 'only weed' because our society does not recognize cannabis as an addictive substance even though it is objectively demonstratable as such," Cort said. In treatment, Foundry Steamboat has to prepare clients for a trigger-rich environment with ubiquitous "pot shops," billboards advertising cannabis products, and family systems and friend groups in which cannabis use is considered normal.

Foundry Treatment Center Steamboat offers men's residential treatment and telehealth for adults of all genders experiencing substance use and mental health disorders and offers specialized treatment for cannabis use disorder. Treating cannabis addiction can be complex and prolonged compared to the treatment for other types of substance use disorders. Some people presenting with a cannabis addiction experience lengthy periods of psychosis and hyperemesis syndrome, which may require lengthy periods of supervised stabilization before clients are mentally and physically able to safely engage in treatment.

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The USFood and Drug Administration (FDA) has not approved the use of cannabis as a treatment for any medical condition. However, after a long legalization campaign, most states now allow "medical" use of marijuana to treat pain, nausea, and other conditions. Twenty-three states, theDistrict of Columbia, and Guam have fully legalized the drug for recreational use as public support for legalization rose rapidly—despite marijuana being illegal at the federal level.

Cannabis sativa (the marijuana plant) contains many active compounds. The best known aredelta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the primary ingredient in marijuana that makes people "high."

Today, many Americans believe in the unproven health benefits of cannabis, but few people know about the danger of addiction and other health impacts of marijuana use. The FDA continues to classify cannabis as a Schedule I controlled substance "with no currently accepted medical use and a high potential for abuse." Recent research estimates that approximately three in ten people who use marijuana have cannabis use disorder (CUD). For people who begin using cannabis products before the age of 18, the risk of developing a marijuana addiction is even greater.

Among the many risks and possible side effects of "medical" marijuana, the Mayo Clinic lists  

increased risk of heart attack and stroke, potential for addiction, hallucinations or mental illness, and withdrawal symptoms.

FoundryTreatment Center Steamboat CEO Ben Cort has raised awareness of these health risks for years. In a recent webinar forHarmony Foundation, Cort pointed out that the THC levels in cannabis products have dramatically increased in the last few decades from less than one percentTHC in the seventies to well beyond 40 percent in recent years. And that's just the plants—concentrates and other products can reach 99 percent THC. 

Cort doesn't really want to talk about the plant anymore because the people who are treated at Foundry Treatment Center Steamboat for CUD have not been smoking the pot passed around in the 1970s. "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 2017book 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." Cort will publish a new book in 2024 that focuses, in part, on the wide-ranging effects of expanded cannabis commercialization since the release of his first publication.

One group of individuals regularly self-medicating with cannabis is people with anxiety. "Lots of people with anxiety are counting on cannabis's ability to treat their symptoms," wrote Andrea Petersen and Julie Wernau in the Wall Street Journal in October. But "there's a problem: The science shows that it probably doesn't help, and it may make those symptoms worse."

The cannabis industry is promoting its products as helpful for anxiety because it's a very lucrative market. "Anxious consumers have turned to weed and edibles for relief as treatments for their ailments have become harder to find," wrote Petersen and Wernau. "The number of available and affordable therapists badly lags demand, and traditional medications don't work for everyone."

Petersen has personal experience with anxiety issues and cannabis use. In her 2017book On Edge – A Journey Through Anxiety, she used that experience and her expertise as a health reporter to explore the nature of anxiety and its treatment options. 

WhenPetersen smoked marijuana in college, she experienced a psychotic episode and had a panic attack. She didn't try to self-medicate with cannabis again. Sheavoided alcohol, too, realizing that her abstention was not typical. "Many people with anxiety disorder drink to relax, a way of self-medicating."

In OnEdge, Petersen also recalled the example of her friend Mike, who turned toalcohol and drugs to try to ease his anxiety and depression. "For Mike,marijuana and narcotics like Vicodin were a revelation," she wrote."They took away the worrying. They calmed his twitchy body." Itdidn't last, of course. "After a while, the marijuana turned on Mike. Itstarted making him more anxious. His drinking and use of narcotics slid intoaddiction. He went to rehab. He relapsed. He kicked the drugs and alcoholagain." 

Manyusers want to believe that cannabis can make them less anxious, and themarijuana industry is more than happy to accommodate that belief. "Yetlittle independent scientific evidence shows that cannabis is an effectivetreatment for anxiety problems, and some studies have found it can worsensymptoms," wrote Petersen and Wernau. "Researchers say this isparticularly true for products high in THC, the substance responsible formarijuana's intoxicating effects."

"Ihave patients who use it every day. They say it really helps," BethSalcedo, a psychiatrist and medical director of the Ross Center in Washington,DC, who specializes in treating anxiety disorders, told the Wall StreetJournal. "My message is that if it were really working for you, youwouldn't be here with me."

WhenDr. Salcedo talks with patients about what their anxiety was like before cannabis, she said they usually report that their anxiety is unchanged. Any transient relief they feel may be due in part to marijuana's high, she said.

Cannabis is big business. Anxiety is one of the most common symptoms that customers of cannabis dispensaries are looking to address. Several states have made anxiety a qualifying condition to receive a "medical" marijuana card despite there being any supporting evidence to support this. 

"Two recent studies show the potential problems with treating anxiety with cannabis," explained Petersen and Wernau. "Cannabis use was significantly associated with increased odds of developing anxiety conditions, according to a review of research published in 2020 in the Canadian Journal ofPsychiatry. Recent cannabis use was associated with more severe symptoms in people with anxiety and mood disorders, according to another review published in 2018 in the Journal of Clinical Psychiatry."

Unsurprisingly, the marijuana industry has funded its own studies. In some surveys, cannabis users have reported that they have felt relief from anxiety symptoms after consuming cannabis. "There is some evidence that cannabidiol, or CBD, which is a nonintoxicating substance derived from cannabis, may relieve anxiety symptoms," reported Petersen and Wernau. However, the science is limited and does not support the use of THC to relieve symptoms. 

While the benefits are questionable, the risks are clear. "Using cannabis regularly comes with a significant risk of addiction," wrote the WallStreet Journal reporters. "Marijuana use can become a disorder when people need to use an increasing amount to get the same effect and when the use interferes with work and relationships, among other symptoms."

Marijuana users also run a higher risk of psychosis. "Research has shown that cannabis use is associated with an increased risk for an earlier onset of psychotic disorders (such as schizophrenia) in people with other risk factors, such as family history," according to the National Institute on Drug Abuse(NIDA). "Cannabis intoxication can also induce a temporary psychotic episode in some individuals, especially at high doses. Experiencing such an episode may be linked with a risk of later developing a psychotic disorder."

Cannabis use disorder is a potentially serious condition frequently requiring treatment. "At Foundry Treatment Center Steamboat, we treat patients whose CUD was dismissed as 'only weed' because much of our society does not recognize cannabis as an addictive substance," says Cort. "One of the most pernicious effects of the cannabis industry's strategy of positioning the drug as medicine is that people generally believe that it is safe or poses no significant health risks. This extends to perpetuating the long-held belief that cannabis can provide a form of mental and physical relaxation. While this may be the case for some users, others have the opposite experience, and it can lead to very real and serious medical and mental health problems. The problem with allowing those profiting from the sale to define its uses is that they will always only tell one side of the story unless compelled to tell the entire story. Without considering negative, potentially negative, and unknown effects, it's like telling the story of Jack and The Beanstalk without the giant,"says Cort.

FoundryTreatment Center Steamboat developed a specific treatment track for people affected by cannabis use disorder (CUD) because the condition poses specific challenges. In 2000, Ben 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 start treatment programming.

“More Americans than ever are dying fromfentanyl overdoses as the fourth wave of the opioid epidemic crashes throughevery community, in every corner of the country,” reported Nadine Yousif on BBC News in September.

A recent study by researchers at theUniversity of California, Los Angeles, outlined the four waves: “The UnitedStates overdose crisis has escalated in an exponential fashion for over fourdecades, yet with a shifting profile of drugs implicated in each successive ‘wave’of the crisis. The first wave of the overdose crisis is typically argued tohave begun in the late 1990s or early 2000s with the rise of deaths involvingprescription opioids, the second wave beginning in 2010 driven by a shift toheroin, and the third wave beginning in 2013 driven by illicit fentanylanalogs. Recently, scholars have argued that the ‘fourth wave’ of the USoverdose crisis has begun, in recognition of rapidly rising polysubstanceoverdose deaths involving illicitly manufactured fentanyl, with stimulantsplaying a key role.”

In 2018, in a rare moment of bipartisanship,Republicans, Democrats, and former President Trump came together aroundlegislation that dedicated $20 billion to the treatment and prevention of andrecovery from drug addiction. Five years later, the SUPPORT Act has lapseddespite the fact that the number of Americans dying from drug overdoses hasincreased by more than 60 percent in those five years—largely driven by thepowerful synthetic opioid fentanyl.

“We are in the middle of a crisis ofproportions we couldn’t have imagined even five years ago when the originalSUPPORT Act was passed,” Libby Jones, program director of the OverdosePrevention Initiative at the Global Health Advocacy Incubator, told Politico. “If they can’t pass this, it’sreally sad.”

“Community-based organizations are on thefrontlines of the overdose crisis, and the SUPPORT Act delivers crucial fundingand resources, allowing them to continue providing hands-on overdose preventioncare,” Libby Jones, the program director of the Overdose Prevention Initiativeat the Global Health Advocacy Incubator explained on a Johns Hopkins webpage. “Some of the originalprovisions in the 2018 SUPPORT Act saw modest increases, while others sawsizeable expansion of funding.”

Highlights of the SUPPORT Act include:

●     Funding for communities ofrecovery was raised by $11 million each year (from $5 million to $16 millionfor each of the fiscal years 2024 through 2028).

●     Residential treatment programs forpregnant and postpartum people saw an increase in funding of $9 million yearly(from $29,931,000 to $38,931,000 for each of the fiscal years 2024 through2028).

A few days ago, the 2018 SUPPORT Act expired,and it doesn’t look like Congress is coming to the rescue any time soon. TheHouse just restarted legislating after emerging from 22 days without a speaker.“Despite its dysfunction, the House is further along legislatively than theDemocratic-controlled Senate,” wrote Carmen Paun on Politico. “The House Energy andCommerce Committee unanimously approved a new SUPPORT Act in July. But thatmeasure’s limited ambition suggests a reason for the lack of urgency to passit.”

A bipartisan group of representatives focusedon mental health and substance use has proposed more than 70 bills to fight theoverdose crisis. Still, there hasn’t been the sense of urgency lawmakersdisplayed five years ago.

While some have hailed the SUPPORT Act as asignificant accomplishment, it has barely made a dent in the drug overdoseepidemic. “Over 100,000 deaths is not a success in this country. It’s not apolicy success,” Regina LaBelle, a former White House Office of National DrugControl Policy acting director, told Politico.

Addiction is an extremely complex diseasedriven by complicated bio-psycho-social aspects. Allocating funds to a fewgroups and organizations can only be a small part of the solution.

“When addiction epidemics strike, we want toknow why,” wrote psychiatry professor Carl Erik Fisher in his sweeping 2022analysis of the addiction crisis, The Urge. But a complex situation with amultitude of factors is too often reduced to a simplistic scenario. “What isnecessarily a complex web of intersecting forces is too often reduced to onesimplistic story: trauma, brain disease, an evil and unstoppable drug, a badpill-mill doctor, a hereditary taint, or a weak will, or poor morals.”

While certain pharmaceutical, alcohol,cannabis, and tobacco industries cannot exactly be viewed as blameless—Fisherregards many such companies as “addiction supply industries”—they are only partof the problem. “Epidemics are never caused solely by an inherent power of thedrugs themselves or the efforts of the addiction supply industries; there isoften if not always, social wounding underneath, driving the substance use.”

The combination of social disconnection,anxiety, depression, and substance misuse can expose individuals to seriousphysical and mental health risks. People with substance use disorder needcomprehensive treatment to address all relevant concerns.

Foundry Treatment Center Steamboat ChiefOperating Officer Tom Walker is well-versed in the effects of governmentpolicies and funding on population health. “Our legislators need to prioritizethe continuation of the SUPPORT Act or legislation like it to ensure thatresources exist to fight the nation’s leading cause of preventable death. Ourelected officials and government departments responsible for allocating fundsshould look carefully at the social determinants of health that lead to theastonishingly high and deeply troubling rates of mental and behavioral healthdisorders we are facing. Funding treatment is important, but understanding andstemming the underlying factors contributing to intensifying and rampantanxiety, depression, trauma, hopelessness, homelessness, and family systemdysfunction is also critical,” says Walker.

Foundry Treatment Center Steamboat operates aspecialized treatment program for men experiencing substance use andco-occurring mental health disorders. Its parent company, NRT Behavioral Health^TM,also operates intensive outpatient and telehealth services for adults inColorado and Wyoming. These programs focus on helping individuals and familiesidentify the root causes that lead to the development of substance use andco-occurring mental health disorders, learn ways to manage these issues, andreduce the stressors that perpetuate a perceived need to use substances to feelnormal or escape overwhelming distress and pain.

Unions and the leadership responsible for protecting the health and wellness of their members can play essential roles in addressing America’s addiction epidemic and changing public perception about the disease. Since its inception, organized labor has empowered workers to negotiate better wages, insurance benefits, paid leave, and safety standards. In recent years, unions have also begun to tackle one of America’s most formidable health problems — addiction.

The National Labor Relations Act of 1935 legalized unions in the United States. Union density, the percentage of union employees, peaked at 35 percent in 1954, and more than 20 million Americans belonged to a union in 1979. Today, union workers account for just 10.1 percent of workers, representing roughly a twenty percent decline since the early 1980s.

While total union membership has waned, more people are joining, and the desire to unionize is significantly growing. According to the Economic Policy Institute, union petitions increased by 53 percent between 2021 and 2022, and more than 60 million people wanted to join unions but could not do so. It is no secret that some of America’s largest private employers oppose unionization. A May New York Times article detailed efforts by Apple, Trader Joe’s, Starbucks, and REI to stop unionization and their potential use of retaliatory practices and firings to suppress unionization support.

The Writers Guild of America strike (in its third month at the time of this writing) is using its member’s notoriety to draw attention to the stark pay inequity between the front-line workers who produce entertainment and the corporations who reap the lion’s share of the profits. What seems clear is that more people see the benefits of union membership to offset growing income inequality, slow wage growth, reduced paid leave, more costly or limited health benefits, and other workplace challenges.

Organized labor represents more than collective bargaining power. Unions offer a form of community, identity, and safety net. At a time when mental health disorders, substance use disorders, and deaths of despair are at record levels, belonging to an organization that provides a degree of fellowship, protection, and resources may seem more meaningful than ever.

Chris Carlough, a national labor leader, educator, and mental health advocate, comes from a long line of union members. To Carlough, the appeal of unions is fundamentally unchanged — greater negotiating power leads to better contracts, better wages, and a more level playing field. What is new, however, is the ability of unions to make a vital resource available to millions of Americans in need — mental and behavioral healthcare.

“Growing up, I remember my grandfather telling us, ‘Never trust a man who doesn’t drink,’ and that was a message that stuck with me during my formative years,” says Carlough. “The idea that using alcohol or other substances to cope with physical or psychological pain is deeply ingrained in some workplace cultures.” Carlough points to high rates of substance use disorder among some industries with high union representation. The Substance Abuse and Mental Health Administration reports that 17.5 percent of miners and 16.5 percent of construction workers have heavy alcohol consumption or alcohol use disorder. “There is a culture of acceptance, and it is a means of coping with the physical pain that comes with the job and emotional pain that comes from childhood or other trauma picked up along the way. These are careers in which injury is fairly common. Someone may fall from a ladder, for example, and the unspoken response from co-workers is ‘this is a no-pain zone’ or ‘rub some dirt on it’ and get back to work,” says Carlough. “This is exactly the kind of thinking and behavior that leads to substance abuse. People have been injured but feel like they would be considered weak if they saw a doctor. So, they drink, misuse prescription medicines, or take illicit drugs to cope with the pain. But they have not treated with the underlying injury, and the pain persists, and so does the substance use.”

Injury is one of many factors that can lead to substance use and mental health disorders. Many workers are exposed to various stressors, including job insecurity, fear of being replaced by technology or automation, the need to be retrained for new jobs, an inability to save adequately for retirement or to fund daily life and childcare, and more. People are even reporting more anxiety about existential issues like climate change and societal ones like political unrest. Many factors are converging to exacerbate stress and anxiety, leading more people to seek relief through substances or unhealthy behaviors.

Today, Carlough and his colleagues are working to change how union members think about mental health and substance use disorders and improve access to high-quality care. Carlough is the coordinator of the SMOHIT SMART MAP program, a mental health awareness, and peer-led action program that highlights the issues associated with all mental health issues with a particular focus on substance use disorder and suicide prevention and trains union members to help fellow members and their families in need to access those resources. Carlough travels the country, providing education and training and spending time with union leaders and members to dispel old thinking, reduce stigma, and normalize treatment. Another focus is overcoming some remnants of toxic masculinity that can still be found throughout the workforce, which can make it harder for people to admit that they are struggling and seek help. “It helps when I tell people, ‘Me too,’ as in I have struggled with mental health issues, and I share some of that vulnerability relating to my own alcoholism and addiction and how I got the help I needed, so maybe they can too.”

The SMART MAP Peer training takes trusted, respected, and empathetic union workers, from apprentices to long-standing journey-level tradespeople who want to help and enlist them into this service. “Your union brother and sister can make the difference. Part of what we do is train our members to simply ask people how they’re doing and not take someone’s first answer at face value. We want them to dig a little deeper to elicit an authentic response. If someone can feel safe and comfortable telling you that they are feeling down, are in pain, or are having other problems, that is the first step toward getting them help — help that might save their lives and the lives of their family members. We also work to ensure that everyone from peer support to company owners and union representatives are aware of all available resources and how to access them to get people into treatment. Not only can this help people feel that reaching out for help is normal, but that they are supported compassionately throughout the entire process.”

Carlough also connects unions with high-quality treatment providers and employee assistance programs (EAPs) to ensure union members receive the quality and range of services needed. “Not all treatment providers are the same, and people may need access to multiple levels and types of care. Unions control significant health plan funding, and this can be used to create beneficial relationships with the best medical providers. We want to ensure that when members feel comfortable getting help, they get the excellent, evidence-based treatment from experienced caregivers all workers deserve. We need effective treatment that addresses root causes and helps people access the continuum of services and resources they need to get the mental healthcare they need or to enter and stay in recovery.”

When Carlough wanted to increase education efforts for union members, he tapped long-time friend and Foundry Steamboat CEO Ben Cort. Cort and Carlough have collaborated to develop education and find appropriate treatment partnerships for organized labor unions nationwide. Now, Cort is interested in ensuring that Foundry Steamboat’s trauma-integrated care is available to union members who could benefit from it. “Unions are a vital part of this country’s labor force and are lifelines for millions of American families. Union members, including first responders, are at risk for witnessing or experiencing physical and psychological trauma and need appropriate treatment to be easily accessible. I want to ensure that in addition to educating unions about how to connect members to excellent treatment resources, we are doing all we can to make our unique trauma-integrated care model available and accessible to as many union members as possible.”

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This article includes the topic of 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.

Suicides in the US reached an all-time high in 2022, according to new data provided by the Centers for Disease Control and Prevention (CDC). According to provisional findings from death certificates, about 49,449 people took their own lives last year, an estimated 3 percent increase compared to 2021.

KFF, an independent source for health policy research, notes that “Increases in the number of suicide deaths follow high levels of mental health symptoms during COVID, rising financial stressors, and longstanding difficulty accessing needed mental health care—particularly for some populations. Total suicide numbers may be undercounted, as some research suggests that suicides may be misclassified as drug overdose deaths since it can be difficult to determine whether drug overdoses are intentional.”

“The largest increases were seen in older adults,” reported NBC. Deaths rose nearly seven percent in people ages 45 to 64 and more than eight percent in people 65 and older. White men, in particular, have very high rates, the CDC reported. The suicide rate among males in 2021 was approximately four times higher than the rate among females. Males make up about half of the US population but nearly 80 percent of suicides.

As we reported on this blog, men are also much more prone to drug overdose deaths than women, and the fatalities are not always accidental. Another important factor is the wide availability of firearms. According to an analysis by the Johns Hopkins Bloomberg School of Public Health, “Gun suicides continued to reach all-time highs, increasing 1.6 percent from a previous record in 2021; 26,993 people died by gun suicide in 2022.”

“While the increase in gun homicides has gained public awareness, less attention has been paid to the growing epidemic of gun suicides—which historically make up the majority of gun deaths. The gun suicide rate has steadily increased, nearly uninterrupted, since 2006. In 2021 it reached the highest level since the CDC began recording such data in 1968; and this past year, in 2022, it surpassed that record,” the JHU researchers wrote.

The current epidemic of suicides by white, middle-aged men is correlated with an epidemic of loneliness. Approximately one in five American men say they do not have a close friend, according to the Survey Center on American Life's May 2021 American Perspectives Survey. “Only 30 percent of men reported having a private conversation with a close friend when they divulged personal emotions in the past week,” wrote psychiatry professor Charles Hebert in Newsweek in 2022.

Earlier this year, US Surgeon General Vivek Murthy issued an advisory on the “healing effects of social connection,” in which he warned that “about one-in-two adults in America reported experiencing loneliness” in recent years. “Loneliness is far more than just a bad feeling—it harms both individual and societal health,” Dr. Murthy wrote. “It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death. The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day and even greater than that associated with obesity and physical inactivity.”

Loneliness, social disconnection, anxiety, depression, and other stressors can lead to substance misuse and, ultimately, suicide. “There is considerable evidence from population-based and clinical studies supporting a positive association between psychosocial adversity, negative affect, and chronic distress, and addiction vulnerability,” stated Rajita Sinha in a 2009 study entitled “Chronic Stress, Drug Use, and Vulnerability to Addiction.”

Addressing social isolation and chronic distress usually requires people to seek help — an act that some men see as a weakness. “Men are socialized to not ask for help or be vulnerable—and they can be penalized when they challenge this notion,” wrote David Mayer in Harvard Business Review in 2018. “An informative set of studies from 2015 finds that when male (but not female) leaders ask for help, they are viewed as less competent, capable, and confident. And when men make themselves vulnerable by disclosing a weakness at work, they are perceived to have lower status. This is problematic, as not seeking help when you need it or admitting areas for improvement inevitably leads to mistakes and less development.”

The combination of social disconnection, anxiety, depression, and substance misuse can expose individuals identifying as male to serious physical and mental health risks. Men with substance use disorder need comprehensive treatment to address all relevant concerns.

Foundry Treatment Center Steamboat operates a specialized men’s treatment program for adult males experiencing substance use and co-occurring mental health disorders. The program regularly treats men struggling with feelings of isolation, loss, trauma, and hopelessness. As previously reported by Foundry Steamboat, many of the men the program serves perceive a lack of purpose and meaning, which can contribute to relationship problems and depression.

“Living with active substance use disorder — even before someone knows that they have a problem — can cause extreme isolation and loneliness. Addiction destroys relationships and separates people from the very people best positioned to help them. Men with addiction are at especially high risk of suicidal ideation and suicide attempts for numerous reasons. We regularly use symptom rating scales to assess client depression and suicidality to ensure that they are getting the clinical and psychiatric help they need to feel better while they pursue recovery. We also build strong therapeutic relationships with clients and get to know them and their situations,” says Foundry Steamboat Chief Clinical Officer Michael Barnes, Ph.D.

“The need to assure that men feel a sense of belonging and know that they have peers with whom they can have a conversation about how they are feeling is a central reason for our alumni program and why we encourage clients to find a community-based support group that suits them. Suicide is very often preventable if people feel authentically connected and are able to self-regulate their emotions, and it is a problem directly related to addiction that requires vigilance and study.”

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While the rates of deaths and devastation wrought by ongoing addiction and mental health crises are unprecedented, these problems have always been with us.

Despite estimated one-trillion-dollar productivity losses from depression and anxiety and $215 billion productivity losses from addiction annually, treatment resources are vastly outweighed by the need. A major problem is too few people are becoming behavioral health professionals. According to the Commonwealth Fund, “In 2021, fewer than half of people with a mental illness were able to access timely care; those with substance use disorders were even less likely.” Workforce shortages are cited as the primary cause of treatment inaccessibility. The Association of American Medical Colleges reported in 2022 that the country will soon”...be short between 14,280 and 31,109 psychiatrists, psychologists, social workers, and others…”

Behavioral healthcare careers can be very challenging. Frontline workers, like psychologists, psychotherapists, and psychiatrists, experience high rates of burnout. In 2022, 46 percent of psychologists felt unable to meet the demand for care, and 45 percent felt burned out, according to the American Psychological Association. Compassion fatigue, heavy administrative paperwork requirements, compliance-related issues, insurance claim management, and even hard-to-use electronic health record systems make a tough job even harder. Almost 60 percent of therapists stay in the same job for less than two years.

High-quality treatment provider organizations, and even smaller private practices, recognize the need to support clinicians and other team members to create workplaces and teams that reduce fatigue and increase longevity. Treatment providers committed to maintaining long-term employees and building expertise are committed to developing healthy and supportive cultures and fostering safety, openness, and personal wellness. Treatment organizations also do well to remember that many healthcare workers feel a calling to this work that helps them endure its inherent challenges. Designing practices and procedures that honor and protect this sense of calling can reduce stress and create client-centered environments in which practitioners feel supported and able to do high-quality work.

Direct caregivers are one behavioral healthcare role among many. Many treatment provider organizations, but especially those operating extended care residential and intensive outpatient levels of care, require numerous positions, including managers and directors, case managers, compliance and insurance utilization specialists, outreach and admissions professionals, wellness experts, nutritionists and chefs, recovery coaches and recovery peer support specialists, and more. Every member of these teams is vital to supporting the program’s treatment mission and creating a therapeutically-centered environment conducive to client success and clinical excellence.

Foundry Treatment Center Steamboat is led by experienced professionals who have gained experience at some of the nation’s leading behavioral healthcare institutions. When acquiring the program and planning its expansion, this team knew that creating a clinically-focused and supportive environment was crucial to clinician longevity and client outcomes.

“The trauma-integrated care model developed by Dr. Barnes requires an operation completed organized around the goals of reducing retraumatization and supporting perceived safety. We must put this theory into practice for clinicians as well as clients. To be effective at treatment, we also must treat one another well,” says Chief Operating Officer Tom Walker.

“We offer very competitive pay and benefits, pay for continuing education and personal development, provide ample vacation and paid leave time, offer free access to wellness services, and generally create an open environment where our team members feel open about sharing and feeling supported,” says Human Resource Manager Amanda Lacey.

Other Foundry Steamboat team members recognize the benefits of working with colleagues who support their aspirations. Outreach & Special Projects Manager Amber King felt supported to spearhead a novel initiative rooted in a personal passion. “When Amanda and I proposed organizing treatment providers in rural communities, the team was immediately receptive and supportive. Our personal passions drive this project to bring resources to communities like the ones we grew up in, and that lack adequate care. Not many employers would be so open to allocating the time and resources, and fewer would realize that supporting this project is actually supporting and rewarding us by doing something we love.”

Access to leading experts and training is another advantage of working at Foundry Steamboat and other high-caliber providers. Foundry Steamboat provides internship opportunities for rising healthcare professionals. It is a place where leading thinkers and practitioners with decades of experience share their insights and help others learn and grow.

Behavioral healthcare is a demanding job but a deeply helpful profession. Some of the most rewarding aspects of this work are seeing individual lives saved and families salvaged, clients celebrating recovery anniversaries, and the future prospects of generations changed.

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Denver Mayor Mike Johnston declared a homelessness state of emergency on July 18 — his first act as the city’s new mayor. According to the U.S. Department of Housing and Urban Development, Denver ranks tenth in the nation for homelessness and third for sheltered homelessness — rates higher than Las Vegas and almost as high as San Francisco. This week, the Denver city council voted to extend the state of emergency to August 21 in light of new data indicating higher rates of homelessness than previously known. As of this writing, an estimated 9,065 people are homeless or sheltered homeless in the Denver metro area. “The homeless population has grown 31% over the year before. The number of those experiencing homelessness for the first time rose by 51%. The greatest percentage increases were among families, increasing 64%,” according to CBS News.

Homelessness and behavioral health disorders are strongly related. Addictive disorders and mental health conditions can lead people to become homeless or housing insecure, and these conditions can be the result of becoming homeless. However, evidence suggests that social determinants of health, including housing affordability and employment status, are the primary drivers of homelessness. This week's Dow Jones MarketWatch report indicates that rising rents are the leading causes of homelessness nationwide. The article cites Steve Berg, chief policy adviser at the National Alliance to End Homelessness, who says the "number of people who lose their housing and become homeless is [going] up faster than the number of people who are homeless and move back into housing." Berg goes on to say, “rent is the No. 1 issue…for 75 years, the long-term trend has been that the cost of modest rental housing has been going up faster than modest income."

The U.S. Department of Health and Human Services identifies “five domains” of social determinants of health, including economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Deficits in any of these domains can mean significant adverse life events for entire family systems, including medical problems, limited opportunities and upward mobility, mental and behavioral health disorders, housing insecurity, homelessness, trauma, suicidality, and more. As has been widely reported, social determinants of health, especially those linked to purposeful employment and a sense of community belonging, maybe a significant driver of the epidemic rates of suicidal ideation and deaths by affecting the nation in recent years — so-called “deaths of despair.”

As behavioral healthcare providers, we often treat clients who experience housing insecurity and homelessness, and subsequent trauma. Many experienced mental health professionals and policymakers know that traumatization resulting from financial setbacks and insecure housing can make drastically reduce the odds of rebounding.

Foundry Chief Clinical Officer Michael Barnes, Ph.D., suggests that mental health conditions and trauma can be precursors and results of homelessness, and acknowledging the role of trauma is vital to helping homeless individuals and families become safely rehoused. “As a medical community and public, we are just beginning to fully understand the profound role trauma plays in a multitude of health problems. People can become traumatized far more readily than we realize, our culture perpetuates and normalizes countless traumatic stimuli, and there is a general lack of treatment resources up to the task of treating traumatized people. When it comes to the issue of homelessness, we must understand that becoming homeless immediately reprioritizes our hierarchy of human needs and changes our patterns of behaviors and beliefs at a deep subconscious level. Homelessness is absolutely traumatizing, and trauma must be addressed, processed, and resolved before people are once again able to respond normally and restore emotional well-being.”

“Homelessness and addiction are inextricably linked. Regardless of the root cause of becoming homeless, there is almost always a mental health or substance use component involved. People who are otherwise healthy are less likely to become homeless because they oftentimes have the agency and cogency to seek available resources, though this is not always the case, and not enough resources are available. For many people, unfortunately, the experience of becoming homeless is a sea change so devastating that they feel the need to use substances to self-treat the symptoms of severe anxiety and depression. Many homeless people also use stimulants to stay awake for very long periods for fear of being victimized while asleep,” says Barnes.

Dr. Barnes believes that addressing the homelessness problem in Denver and elsewhere will benefit from trauma-oriented approaches. “We still do not have enough truly trauma-informed treatment providers for the housed patients seeking mental and behavioral healthcare. My hope is that policymakers anticipate the need for trauma-informed approaches to helping homeless people because without adequately treating their underlying trauma, other interventions are less likely to succeed, and they are more likely to end up back on the streets.”

Foundry Steamboat and other high-quality providers are beginning to assess client recovery capital to evaluate their prospects of successfully maintaining recovery and developing recovery-supportive lifestyles. The program instituted the Recovery Capital Index measure in 2022, which measures individualized social determinants of health and other extra-therapeutic factors to indicate advantages or potential areas that need to be addressed using available resources.

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Men were significantly more vulnerable than women to overdose deaths involving opioid and stimulant drugs in 2020–2021, according to a new study analyzing data from across the United States.

The study, published in Neuropsychopharmacology, found that men had a two to three times greater rate of overdose mortality from opioids (like fentanyl and heroin) and psychostimulants (like methamphetamine and cocaine). The study was led by researchers from the Icahn School of Medicine at Mount Sinai in New York City and the National Institute on Drug Abuse (NIDA).

While we know that men use drugs at higher rates than women, the researchers found that this alone could not explain the gap in overdose deaths, noting that biological, behavioral, and social factors likely combined to increase the mortality risk for men. From 2020 to 2021, men had a rate of overdose mortality from opioids and psychostimulants that was two to three times greater than the overdose mortality rate for women, according to a recent study.

“Though men and women are being exposed to the modern, fentanyl-contaminated drug supply, something is leading men to die at significantly higher rates,” NIDA Director Nora Volkow, MD, said in a news release. “It may be that men use drugs more frequently or in greater doses, which could increase their risk of death, or there may be protective factors among women that reduce their risk of death compared to men. Understanding the biological, behavioral, and social factors that impact drug use and our bodies’ responses is critical to develop tailored tools to protect people from fatal overdose and other harms of drug use.”  

After controlling for sex-specific rates of drug misuse, researchers found that overdose death rates by sex for the following drugs were:

Synthetic opioids, such as fentanyl: 29.0 deaths per 100,000 people for men, 11.1 for women;

Heroin: 5.5 deaths per 100,000 people for men, 2.0 for women;

Psychostimulants, such as methamphetamine: 13.0 deaths per 100,000 people for men, 5.6 for women; and

Cocaine: 10.6 deaths per 100,000 people for men, 4.2 for women.

Higher overdose death rates for men were consistent across states, even when accounting for other demographic factors. The difference in overdose mortality between men and women was significantly more significant than in reported drug misuse between men and women. For example, men had a 2.8 greater rate of cocaine overdose mortality than women while having just a 1.9 greater rate of cocaine misuse.

“These data emphasize the importance of looking at the differences between men and women in a multi-layered way,” Eduardo R. Butelman, Ph.D., assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai and a lead author on the study, said in a news release. “Moving forward, it will be important for researchers to continue to investigate how biology, social factors, and behaviors intersect with sex and gender factors, and how all of these can impact addictive drug misuse and overdose deaths.”

The authors hypothesize that it is a combination of biological factors (e.g., men may have a greater vulnerability to the toxicity of drugs than women), behavioral factors (e.g., men may use these drugs in a riskier way than women), as well as other social- and gender-related factors.

The Loneliness Crisis

One possible factor is the lack of mitigating social connections. A 2019 study found that “females find same-sex social interactions to be more rewarding than males, and females are more sensitive to the rewarding actions of oxytocin than males.” As we reported on this blog, approximately one in five American men say they do not have a close friend. “Only 30 percent of men reported having a private conversation with a close friend when they divulged personal emotions in the past week,” wrote psychiatry professor Charles Hebert in a 2022 Newsweek article.

This comes at a cost. “Loneliness increases the risk of mental illness among men,” warned Hebert. “Persistent loneliness independently predicts risk of Alzheimer's disease. Additionally, psychiatric illnesses such as major depressive disorder often go unrecognized in men due to reluctance to discuss one's symptoms.”

Persistent social isolation, depression, anxiety, and trauma are major drivers of substance misuse and addiction. “Addiction is an illness of escape. Its goal is to obliterate, medicate, or ignore reality. It is an alternative to letting oneself feel hurt, betrayal, worry, and—most painful of all—loneliness,” Patrick Carnes wrote in Facing the Shadow. “Escaping reality for even the briefest time brings some relief. When escaping becomes habitual, we have a mental illness known as addiction.”

In a famous 2016 TED Talk, Johann Hari provocatively stated that the opposite of addiction is not sobriety but human connection. Surgeon General Vivek Murthy warned in May that “widespread loneliness in the US poses health risks as deadly as smoking up to 15 cigarettes daily. About half of US adults say they’ve experienced loneliness, Dr. Murthy said in an 81-page report.

Foundry Treatment Center Steamboat operates a specialized men’s treatment program for adult males experiencing substance use and co-occurring mental health disorders. This report resonates with Clinical Compliance Director Jasmine Aranda, LPC, LAC, LAT, TTS, ADS. Aranda, who has years f experience focusing on male clients and the issues they relate that have led to the development of dual-diagnosis conditions, sees evidence that loneliness and purposelessness may play fundamental roles in this crisis.

“Cultural and socioeconomic shifts affecting all people started well before the pandemic, but the pandemic seems to have worsened and accelerated the effects of these issues. We regularly hear clients who feel financially insecure, uncertain how long they can remain gainfully employed or hold on to housing. They fear mostly for the future of loved ones. Many men we treat feel less cohesion with family, friends, and neighbors. It can be very difficult for people, especially those in rural parts of the country, to make a living as they used to or to carry on family-owned businesses. Women, men, and adolescents are affected mentally, emotionally, and physically by these problems,” says Aranda.

“Among our male residential clients, who tend to have families and careers, today’s culture is challenging their long-standing narratives. Societal sentiment and economic realities are making it harder for men to be sole breadwinners and fulfill the role of protector. Purposelessness is a major problem for many men. Fathers can feel like they don’t understand how to navigate a rapidly changing world and lack the knowledge or skills to help their children navigate it. They may feel displaced and devalued because of increased economic disparity and the inability to earn a living that affords them a good quality of life despite working hard. Even the values of ruggedness or toughness and stoicism that were prized by previous generations are seemingly being questioned as our society becomes more open to discussing hardship and mental health disorders — which is a very good thing.”

Aranda suggests that increased rates of death by overdose correlate to increased rates of despair and perceived uncertainty.

“This program focuses heavily on the resolution of trauma and the ability of people to naturally self-regulate their autonomic nervous response to stress. Many of our clients live with a constant, debilitating rate of anxiety, hypervigilance, and panic that may, in part, be the response to increased uncertainty. We can help men by making it safe and comfortable for them to seek help, increasing awareness about the rise in uncertainty and anxiety, and helping them connect and feel valued. Doing these things could go a long way in reducing the perceived severity of the issues that drive them to misuse substances to feel normal or relieved.”

Pharmaceutical innovations continue improving the quality and longevity of life, even when beneficial side effects of these medicines are discovered unexpectedly. Numerous medications created to treat specific illnesses have found new applications because they were found to be effective at addressing completely different problems. One example is Prazosin, a medication originally developed to treat hypertension. After its FDA approval for use in 1988, the drug was found to reduce nightmares associated with Post-Traumatic Stress Disorder (PTSD), and is now sometimes prescribed for this purpose.

Ozempic (semaglutide) a diabetes drug introduced in 2017, was later FDA-approved to help people with diabetes and obesity lose weight. Recent reporting suggests that the drug could help people lose more than the desire to overeat. It may also reduce people’s desire to overuse substances, making it a promising target for treating addiction.

Semaglutide is a GLP-1 receptor agonist, mimicking the action of the human incretin glucagon-like peptide-1 (GLP-1), thereby increasing insulin secretion and blood sugar disposal and improving glycemic control. Side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation.

As semaglutide increased in popularity (as a weight-loss medication), patients have been sharing interesting effects beyond appetite suppression. “They have reported losing interest in a range of addictive and compulsive behaviors: drinking, smoking, shopping, biting nails, picking at skin,” wrote Sarah Zhang in The Atlantic. “Not everyone on the drug experiences these positive effects, to be clear, but enough that addiction researchers are paying attention.”

Some physicians report that the effect of reduced alcohol use is the most common thing they hear from people taking Ozempic or similar drugs. Lorenzo Leggio has been studying the phenomenon at the National Institutes of Health. His team recently published a study indicating that semaglutide can reduce alcohol drinking in rodents (this effect has not yet been studied in humans).

“GLP-1 analogs like semaglutide may influence interest in psychoactive substances such as alcohol because they have an effect not just in the gut but in the brain, Leggio told CNN. “We believe that at least one of the mechanisms of how these drugs reduce alcohol drinking is by reducing the rewarding effects of alcohol, such as those related to a neurotransmitter in our brain, which is dopamine” he said. “So these medications are likely to make alcohol less rewarding.”

Asim Shah, a professor in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor University, heard similar things from people he treats. “Patients do say that they feel a benefit on their addiction, whether it’s alcohol or smoking or anything like that. People are even saying they’ve decreased their gambling,” Shah told the Houston Chronicle. “Is it true or not? We don’t have proof.”

Should that proof emerge in future research, it would yield further support for the disease model of addiction. “Discovering how the new weight loss medications alter appetite and the compulsive behavior that can be associated with it could offer new insight into the nature of pleasure and addictions,” addiction expert Maia Szalavitz wrote in The New York Times. “Adjusting brain systems that regulate desire may also affect the stigma that society pins on people with conditions that can lead to loss of control. When drugs can significantly ease weight loss or addiction recovery, it’s hard to argue that the problem is moral rather than medical.”

In her influential book Unbroken Brain, Szalavitz explained that desire comes in two flavors: the “pleasures of the hunt” and the “pleasures of the feast,” also described as “wanting” and “liking.”  Drugs such as cocaine and methamphetamines engage the wanting circuits of the brain, while heroin and alcohol are about sedation and satisfaction.

“The positive side of wanting is feeling empowered and focused on getting what you desire; the negative side, of course, is craving that goes unsatiated,” Szalavitz explained in The New York Times op-ed. “The second kind of pleasure [liking]...  is linked with the satisfaction and comfort of having achieved your goal.”

The wanting circuits tend to rely on the neurotransmitter dopamine, while liking is more associated with the brain’s natural opioids and serotonin. Having these common currencies of emotion allows our brains to modulate what we want, depending on what it perceives as our most pressing needs.

Szalavitz explains how medication-assisted treatment utilizing opioid agonists such as buprenorphine or methadone satiates “opioid craving by providing a consistent level of a drug similar to the one that is wanted, without the chaos that can prevent people with addiction from living well.”

Other medications, like naltrexone, do the opposite and prevent opioid receptor activation. These medicines, however, can reduce the experience of pleasure overall. GLP-1 drugs act differently. They modulate the motivational dopamine systems but apparently without depressing desire overall. So far, the data on using GLP-1 drugs for substance addictions are mixed. Some studies showed positive results in animals and humans, but others found no effect.

Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), is funding research on these medications for drug addictions. Szalavitz quotes Dr. Volkow as saying they might work “by interfering with that urge to have more.” It will be fascinating to determine whether it is possible to alter or even create a set point that signals that “enough” drugs have been taken. People with alcohol use issues seem to lack such an off switch, while those who drink moderately report knowing when to stop.

Szalavitz hopes the research will eventually yield medications that help people “change with ease” after years of struggling. The experience with methadone—first studied as a treatment for opioid addiction in the 1950s and 60s—shows that full recovery from addiction usually takes much more than just taking a single medication.  

While medications that can help stem the desire to use substances or reduce their ellative effects can be highly effective treatment aids, experienced medical and behavioral health providers know that substance use disorders and their co-occurring mental health conditions can result from complex underlying issues that cannot be resolved with medicines alone. Essentially, reducing the effect of a substance does not necessarily address the factors leading that person to seek substance-induced relief. When considering messages promoting the promise of medications, it is important to include the fundamental concept that addictive disorders have biological, psychological, and sociological components that can lead to their development and exacerbation. Stopping people from feeling the effects of substances or being able to stop taking them does not always mean that the underlying issues causing them to misuse the substance are reduced. Creating the perception that a medication alone can comprehensively “cure” addiction should be carefully avoided.

Foundry Treatment Center Steamboat, like other experienced behavioral healthcare providers, avails clients of psychiatric medications to help control cravings and restore mental health while taking a holistic approach that considers the bigger picture affecting clients. As a program that emphasizes the outsized roles that trauma and family system issues play in developing a range of health problems, including addiction and mental illnesses, Foundry Steamboat clinicians suggest taking a judicious approach to the role of medications in personalized treatment plans.

“The problems our clients are facing are often the underlying reasons that they developed substance use disorders in the first place,” says Chief Clinical Officer Michael Barnes, Ph.D. “Medication can certainly help people feel better and help them establish a baseline from which they can deal with underlying problems, but medication is very rarely a complete answer to this very complex disease.”

Medication-assisted treatment (MAT), which has been promoted as the gold standard for addiction treatment and has been used for decades, is a case in point. While medication-assisted treatment tremendously benefits many people, others relapse and overdose, divert their medications, or change the substances they use to achieve a high. This is not because MAT is ineffective or without merit, but because many of the people prescribed medicines to reduce their ability to feel the elative effects of alcohol or opioids still face daunting problems that make them feel deeply stressed, anxious, and depressed. Problems such as family estrangement and divorce, abandonment, housing insecurity, financial instability, legal entanglements, physical health problems, and victimization are some of the many reasons that people have difficulty entering and maintaining recovery, regardless of medications they may be prescribed.

“The potential benefits of semaglutide are certainly welcomed, if studies prove its efficacy to safely reduce cravings. We need as many tools in the toolbox as we can get,” says Foundry Chief Medical Officer Dr. Jim Shuler. “But when treating addictive disorders cohesively and fully, we need to consider social determinants of health, medical and trauma histories, and lifestyle factors and treat for these. Medication, while potentially very helpful, doesn’t treat these issues. These take a different set of therapies, skills, and supports. We do not want to instill the idea that medicine is the answer because, in the vast majority of cases, the answer lies in identifying and addressing a much deeper set of issues than one’s inability to stop using substances despite wanting to. In other words, medication is just one spoke that can help keep the entire wheel of the patient round.”

“In some cases, not even the most well-tuned medication plan is going to help a person dealing with the profound effects of trauma and negative life experiences,” says Dr. Barnes. “Some problems simply cannot be medicated away. Many people simply do not have the ability to regulate their autonomic nervous response to stress naturally, and without that ability, they will either always be dependent upon medications that attempt to control it or will not experience relief. The answer, in these cases, is to teach them how to achieve homeostasis and make important lifestyle changes that moderate stressors.”

Foundry Steamboat takes a holistic approach to treating substance use and co-occurring mental health disorders, including trauma. Psychiatric prescribing, which is provided to clients in the program’s residential and intensive outpatient programs, makes a significant difference to many clients. However, the program employs thoughtful assessment, psychotherapy, fitness and nutrition support, recreation and wellness services, and specialized trauma therapies with the aim of helping clients develop recovery-supportive lifestyles and learn to reduce the potential triggers of substance use disorder.

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An inspirational article written by Foundry Steamboat Wellness and Recovery Coach is published in Steamboat Pilot & Today. This piece celebrates Mental Health Awareness Month, which is the month of May, and provides practical suggestions to support positive mental health.

Read the full article here: https://www.steamboatpilot.com/news/sarah-coleman-i-see-you-i-hear-you/

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Many people in rural America are on their own when it comes to mental healthcare. Nearly half a million, or 14 percent of, Coloradans are affected by mental health challenges, a 2016 report from the Colorado Health Foundation revealed, and many of them lack access to care. A 2020 report by the Colorado Rural Health Center (CRHC) found that of the state’s 64counties, 22 don’t have a psychologist or psychiatrist working there. 

According to the CRHC’s2022 Snapshot, “Nine rural counties in Colorado have no pharmacy, while eleven other rural counties have only one pharmacy.” Thirty-seven of Colorado’s64 counties (all rural or frontier) do not have any ICU beds.

The region around Durango in southwestern Colorado is a good example. Although many residents suffer from substance use disorder, treatment options are sparse. “The region has no recovery homes, no medical detox, and no inpatient substance use treatment facilities,” reported the Durango Herald in May. “While treatment resources do exist, those demanding inpatient care must usually travel to the Front Range.”

Many residents of rural America feel generally isolated and left behind by the modern world. In 2015, two Princeton economists argued that middle-aged white Americans without a college degree were now facing “deaths of despair”—suicide, overdoses from drugs and alcohol, and alcohol-related liver disease. They suggested that distress caused by globalization and rapid technological change probably drove those deadly outcomes. Middle-aged whites are now more likely than their predecessors to report pain and mental health problems and are experiencing symptoms of alcoholism at a younger age.

Middle-aged white males in rural areas are often also affected by so-called “man rules.” The rugged and self-reliant frontiersman is supposed to be able to “hold his liquor” and not “go on” about his feelings. Men, in general, face different expectations than women, which can impact their mental health and substance misuse. In the 2022 CRHC Snapshot, 21 percent of adult rural Coloradans reported drinking excessively.

Foundry Steamboat Rural Community Connection Effort

The Foundry Steamboat men's residential program treats adult men experiencing substance misuse, co-occurring mental health conditions, and trauma. The program offers comprehensive, coordinated treatment, including medical care, psychiatry, psychotherapy, fitness, and wellness coupled with gender-responsive and trauma-informed approaches. Its focus, milieu, and expertise make this program especially appropriate to men for whom previous treatment episodes have been successful. Foundry Steamboat also offers a virtual intensive outpatient program for men and women in Colorado and Wyoming and operates Chrysalis Continuing Care, an in-person IOP in Denver’s RiNo neighborhood. 

Foundry Steamboat team members are experienced with the challenges facing rural Coloradans, including steep rises in suicide and untreated mental health disorders. In 2022, Foundry Steamboat outreach representatives Amber King and Amanda Buckner, who hail from rural Colorado hometowns, established monthly virtual meetings to make connections between therapists and other behavioral health stakeholders in these rural communities. 

This rural community outreach and networking effort is beginning to yield results. Therapists, case managers, and peers are identifying new resources, and more people are being referred to treatment. The group’s recent discussions indicate that therapists are seeing positive changes that could make it easier for people in some communities to seek care. 

In Vail, for example, therapists have noticed that young people are becoming more vocal about experiencing mental health conditions, such as anxiety, depression, and suicidal ideation. Vail community members are also building a peer recovery system, which can help people seeking treatment and support those living in recovery.

Vail offers an important example of how problems facing rural Americans affect communities across the socioeconomic spectrum. Although Vail is a small community of 5,000 full-time residents, the town receives more than1.3million visitors per year who ski its slopes in winter and hike its mountains in summer. Tourism makes Vail a relatively affluent community and supports a range of businesses and healthcare facilities.

Despite its resources and infrastructure, Vail struggles from a lack of mental and behavioral healthcare and experiences stigmas affecting many rural communities, some of which are stubborn remnants of longstanding rural culture. And like many so-called mountain towns that attract a high population of visiting tourists, residents can struggle with forming lasting relationships or feel isolated despite being surrounded by people.

“While life in mountain towns and agricultural communities can differ greatly, rural communities can sometimes perpetuate unhealthy cultural cues by normalizing substance use as part of daily life. It can be easy for families to inadvertently keep cycles of substance misuse going by enabling or even encouraging substance use to overcome boredom, pain, or as a social lubricant. When communities are isolated from major population centers by hundreds of miles, it’s easier for ideas and behaviors — both good and bad — to remain unchanged while these thoughts and behaviors may be changing in the broader population,” says Foundry SteamboatCommunity Relations Manager Amanda Buckner.

"As a voice in rural recovery work, collaborating with community leaders throughout the state has transformed inspiration into action and helped build the recovery community organization in our mountain town,”says Rob Shearon, Founder of Reconnected, an app that helps people recovering from mental health and addiction to connect with others. Before foundingReconnected, Shearon was a program manager for the University of ColoradoCollegiate Recovery Center.

"At Reconnected, we're not just providing peer recovery coaches through our partnership with the local hospital, we're building a supportive community through a variety of social events, from non-alcoholic happy hours to mountain bike rides with the local rec district.We're creating a network of like-minded individuals who are there for each other every step of the way in their recovery journey," says Shearon.

“The fact that Vail is starting a peer recovery support network and getting community involvement happening represents major progress,”says Buckner. “When we started these Zoom meetings, we weren’t sure how responsive people would be or if it could help to make a change. It is still very early. But when we hear colleagues like Rob telling us about these successes, or that young people are feeling more comfortable talking about their problems, that’s a big deal. It shows that change is possible and that this effort can help to make change.”

Join the Connecting Rural Community monthly calls, which take place on the second Monday of each month by emailing amanda.buckner@foundrysteamboat.com.

The animal tranquilizer xylazine has become the latest scourge in the American addiction crisis. The substance often pushed under the names “Tranq” or “Tranq dope” is a non-opiate sedative, analgesic, and muscle relaxant only authorized in the United States for veterinary use, according to the federal Food and Drug Administration.

Xylazine—currently not a controlled substance—“was first noted as an adulterant in Puerto Rico in the early 2000s,” reported the Drug Enforcement Administration (DEA) in October. “Xylazine, reported as an adulterant in an increasing number of illicit drug mixtures, has also been detected in a growing number of overdose deaths. It is commonly encountered in combination with fentanyl but has also been detected in mixtures containing cocaine, heroin, and a variety of other drugs.”

“The drug causes dangerously low blood pressure, slow heart rates, blackouts, and skin wounds so severe they can lead to amputations,” reported Axios Denver on March 15. “The sedative, which makes the effects of fentanyl even deadlier, is also unresponsive to common overdose-reversal treatments, like naloxone.” The reason: naloxone (Narcan) only counteracts the effects of opioids and not of other psychoactive substances.

Tranq started to appear in Philadelphia about three years ago. The more powerful synthetic opioid fentanyl has edged out heroin in the Pennsylvania city, but the fentanyl high fades more quickly than heroin, so xylazine is being added to make the effects of fentanyl last longer. Exposure to xylazine is common among people addicted to heroin, fentanyl, and cocaine, as the tranquilizer is often added without the knowledge of the addicted user.

Misusing xylazine can have serious consequences. CNN recently reported that “the drug has side effects like ‘tranq walk,’ where people seem unaware of their surroundings, along with sores and wounds.” The sores frequently turn into horrific ulcers on the extremities and are associated with copious purulent drainage and foul smell. Necrosis of subcutaneous tissues and abscesses are common.  

Local police told Axios Denver that xylazine has now arrived in Denver. Authorities detected 18 cases in 2022 through a fentanyl-monitoring project that tests drugs. Authorities say that figure is likely higher, even though Denver has nowhere near the levels seen in the Northeast, where the drug is prevalent.

“The emergence of xylazine across the United States appears to be following the same path as fentanyl, beginning with white powder heroin markets in the Northeast before spreading to the South, and then working its way into drug markets westward,” reported the DEA. “This pattern indicates that use of xylazine as an adulterant will likely increase and be commonly encountered in the illicit fentanyl supply.”

Fentanyl and xylazine are just the latest chemical weapons in America’s seemingly endless battle with addiction. Over 110,000 people died of drug overdoses last year, according to the CDC—a new terrible record. Once again, we are largely blaming a substance (fentanyl) and its merchants (foreign cartels) while ignoring the deeper reasons why so many Americans are willing to ingest and inject dangerous, addictive substances. Once again, cities and states are pushing for much harsher sentences for people caught with the deadly substance-de-jour.

Critics are already calling “the new crackdown a ‘War on Drugs’ 2.0,” reported NPR’s Jasmine Garsd in March, but many experts warn that further criminalization is not going to fix the problem.

"There's no doubt in my mind that law enforcement should be involved. There's no doubt in my mind that the court system should be involved," Adam Scott Wandt, assistant professor of public policy at John Jay College of Criminal Justice, told NPR. "But we cannot law-enforcement our way out of this fentanyl epidemic. It's a public health epidemic. We need to concentrate and focus on public health solutions in order to help people break their habits, break their addictions."

People with addiction need compassion and treatment. They are already continuing with their self-destructive behavior despite severe punishing consequences. More punishment will achieve very little. Addiction is a complex disease, often driven by desperate attempts to self-medicate trauma, anxiety, depression, and other mental health conditions. If the resulting emotional pain is left unaddressed, criminal interdiction is unlikely to achieve much.  

Amber King, a Foundry Steamboat team member who grew up in rural Colorado, is familiar with the relationship between social determinants of health and mental health and addictive disorders. King and colleague Amanda Buckner recently started a free networking event for therapists and other mental healthcare stakeholders in rural Colorado communities. “Addiction has long been viewed as a moral failure or the result of making bad life choices. Despite public education efforts in recent years and the fact that most people today know a friend or family member affected by addiction, this is still a widely held belief. The reality is that addiction is very often the result of terrible life events and cycles of addiction and violence that affect family systems for generations. The roots of this problem, for many people, stem from feeling mitigated, isolated, oppressed, hopeless, and lacking resources to help them address these feelings and experiences. Substances come and go and change. More people are still dying from alcohol misuse every year than from all other substances. We need to acknowledge that addressing the problem of xylazine, or fentanyl, or opioids, or any substance takes more than stopping the supply — it comes from helping reduce the perceived need for people to self-medicate with substances to feel normal,” says King.

Foundry Steamboat offers a men’s residential treatment program in Steamboat Springs and virtual IOP services to adults in Colorado and Wyoming. The program’s clinicians are experienced with people who face financial, legal, and relational challenges and who feel marginalized. The program’s Trauma-Integrated Care model helps clients understand why they develop addictive disorders and how to develop recovery-supportive lifestyles and provides skills to naturally self-regulate the autonomous nervous system to reduce the need for substances.

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Since it was introduced in November, the artificial intelligence model known as ChatGPT has garnered substantial interest from the media and the general public.

ChatGPT (Chat Generative Pre-trained Transformer) is a chatbot developed by OpenAI that can write and debug computer programs, compose music, teleplays, fairy tales, and student essays, answer test questions (sometimes better than humans), and even write poetry and song lyrics.

Now, it’s also venturing forth into the realm of medical diagnosis. “ChatGPT is not the first innovation in this space,” reported Ruth Hailu, Andrew Beam, and Ateev Mehrotra on Statnews in February. “Over the last decade, various symptom checkers have emerged on websites and in smartphone apps to aid people searching for health information. Symptom checkers serve two main functions: they facilitate self-diagnosis and assist with self-triage. They typically provide the user with a list of potential diagnoses and a recommendation of how quickly they should seek care, like see a doctor right now vs. you can treat this at home.”

A StatNews team tested the capabilities of previous symptom checkers and came away decidedly unimpressed: “Our team once tested the performance of 23 symptom checkers using 45 clinical vignettes across a range of clinical severity. The results raised substantial concerns. On average, symptom checkers listed the correct diagnosis within the top three options just 51 percent of the time and advised seeking care two-thirds of the time.”

But ChatGPT seems to outperform its forerunners. “We gave ChatGPT the same 45 vignettes previously tested with symptom checkers and physicians,” reported the StatNews researchers. “It listed the correct diagnosis within the top three options in 39 of the 45 vignettes (87 percent, beating symptom checkers’ 51 percent) and provided appropriate triage recommendations for 30 vignettes (67 percent). Its performance in diagnosis already appears to be improving with updates. When we tested the same vignettes with an older version of ChatGPT, its accuracy was 82 percent.”

So far, so good. However, one of ChatGPT’s significant issues is its potential to generate inaccurate or false information. Occasionally, the chatbot seems to be making things up. “When we asked the application to give a differential diagnosis for postpartum hemorrhage, it appeared to do an expert job and even offered supporting scientific evidence. But when we looked into the sources, none of them actually existed,” reported Rushabh Doshi and Simar Bajaj on Statnews. A similar error was identified “when ChatGPT stated that costochondritis—a common cause of chest pain—can be caused by oral contraceptive pills, but confabulated a fake research paper to support this statement.”

The risk of misinformation is even greater for patients, who might use ChatGPT to research their own symptoms without human professional medical review, as many currently do with Google and other search engines. Indeed, ChatGPT managed to generate an alarmingly convincing explanation of how “crushed porcelain added to breast milk can support the infant digestive system.”

OpenAI has acknowledged that ChatGPT "sometimes writes plausible-sounding but incorrect or nonsensical answers." This behavior is common to large language models. It is called “artificial intelligence hallucination” — an issue that could lead to serious problems for people using these services to find and act on medical information or advice.

The use of large language models and generative AI is in its infancy. However, future iterations of ChatGPT could vastly expand its knowledge base and increase its accuracy across domains, including medicine. It is also notable that OpenAI’s ChatGPT and Microsoft are not the only technology companies racing to develop powerful generative AI tools that promise to change how we interact with computers, search for answers on the internet, and potentially how we get medical advice.

Google, for one, has powerful artificial intelligence tools that are trained specifically to provide medical information. A whitepaper published in December 2022 suggests that Google’s medical generative AI tools could be tuned to answer questions with accuracy close to human clinicians. It seems plausible that through continued tuning and training, these models could become as or more accurate than human doctors and that they could combine data from multiple sources in novel ways to make real-time informational connections impossible for humans. While all of this is currently conjecture, the future may hold tremendous promise for making high-quality medical information more accessible.

AI is Already Being Used to Assist in the Delivery of Mental Healthcare

While large language models like ChatGPT are all the rage and hold tremendous promise, artificial intelligence has been used in medical applications for years. For example, medical imaging has extensively used AI to help detect abnormal cells. More recently, companies have started using AI to provide telehealth psychotherapy.

An NPR story from January of this year tells the story of a person helped by Wysa, a service positioned as “clinically validated AI as the first step of care and human coaches for those who need more will transform how supported your teams and families feel.” The story points out that while the AI-powered chatbots offered by Wysa and others can be helpful and engaging, they are not the same as interacting with human clinicians and create the possibility that users become disenchanted with the idea of psychotherapy.

It seems possible, if not probable that medical AI will become increasingly advanced and capable. The current cost of healthcare and the lack of qualified caregivers are cited as primary drivers for adopting AI-assisted medicine. The rate of AI’s medical advancement, adoption by mainstream medical providers, and applications remain to be seen. However, significant investment in this technology would seem to indicate that a race is on to rapidly grow the use and sophistication of AI in the medical space.

Behavioral Healthcare Remains a Human-Centered Domain

The desire to make psychotherapy more accessible and to reduce the workloads of fatigued and stretched clinicians through the use of technology is, perhaps, understandable. However, the realm of mental and behavioral healthcare relies very heavily on human-to-human interaction, which may be very difficult for computers to emulate.

The very concept of using technology to deliver therapy flies in the face of a bedrock principle of modern psychology and psychiatry because, ultimately, it attempts to replace the essential relationship between therapist and client with a computer algorithm.

“There is consistent evidence that the quality of the therapeutic alliance is linked to the success of psychotherapeutic treatment across a broad spectrum of types of patients, treatment modalities used, presenting problems, contexts, and measurements,” wrote Dorothy Stubbe, M.D. in 2018 on Psychiatry Online. “Although scholars may differ in how the alliance is conceptualized, most theoretical definitions of the alliance have three themes in common: the collaborative nature of the relationship, the affective bond between patient and therapist, and the patient’s and therapist’s ability to agree on treatment goals and tasks.”

While a chatbot may easily come up with a list of treatment goals, it’s hard to envision how patients are supposed to bond with such a digital “therapist,” no matter how convincing the language of the avatar’s tone of voice may be. Addiction, in particular, is a complex, systemic problem, and only a careful individual assessment can determine the best treatment option. Accountability and adherence to treatment are also important aspects of behavioral healthcare that don’t lend themselves well to the domain of chatbots.

Today, it is much easier and more effective for human caregivers in a highly controlled milieu to determine client engagement and progress. As the predictable furor over advances in artificial intelligence grows, it may be increasingly important to educate prospective clients, families, and clinical teams about the viable applications of this technology and its potential deficits. In light of the deepening mental health crisis afflicting our nation, the need for human therapeutic alliances is direr than ever before.

“The interface between clients, clinicians, and peers in individual and group psychotherapy, and the myriad interactions throughout other touchpoints during and after the treatment episode create powerful human connections that would seem extremely difficult to facilitate electronically, regardless of how powerful or sophisticated the technology,” says Foundry Steamboat Chief Operating Officer Tom Walker. “Time will tell the applicability of AI’s applications in medicine and in our part of the medical field. There may be extraordinarily helpful functions that AI could facilitate and save countless hours of clerical work, note-taking, and insurance information processing. It may also usher in a new era of information transfer, where very recent peer-reviewed treatment innovations are made immediately available through interconnected systems. There are very smart people thinking of ingenious ways for this technology to make the provision of treatments of all kinds more efficient and effective,” says Walker. “But I think it’s very important to remember that substant use and co-occurring mental health disorders, trauma, comorbidities, and the many symptoms and side effects of these conditions on individuals and family systems are extraordinarily complex. Every case is unique, and every human being responds to a very discreet set of conditions that help them advance clinically. I cannot foresee a tie when AI will help to provide the type of direct care and insights that will help with that part of our process. While it may seem very tempting to want to rely upon these technologies to answer the critical need for treatment, I think we need to be very careful about how we educate the public about the need for in-person behavioral healthcare, regardless of how advanced AI may become in the future.”

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Focaccia 

Prep time: 20 minutes

Bake time: 20 minutes

Idle time: 2-14 hours

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If you have done any kind of “artisan” bread baking before then this recipe is essentially very similar. There are a few key things to try to remember while you are making an “artisan” loaf of bread; keep the dough a little sticky, develop gluten, and be patient.

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Ingredients

• 1000 grams of flour; bread flour and whole wheat (about 4 ½ cups, but weighing the ingredients is best)
• 700 grams of water
• 150 grams of sourdough starter (optional)
• 1 - 3 grams of yeast (½ - 1 teaspoon) (using less yeast slows down the rise and will make the bread have more flavor)
• 15 grams of salt (about 3 teaspoons) 
• 20 grams of olive oil (about 3 tablespoons)

**Traditional focaccia bread will use some version of a “starter” If you are interested in making your own sourdough starter, see my recipe about how to put together a starter. For this recipe a sourdough starter is not actually needed. If you do not have a starter use a higher amount of yeast and the rise times will be faster. If you want to use starter and have the time, this recipe can take as long as all to create a more interesting flavor. If you use starter and a small amount of yeast, be prepared to wait longer on your rise times. 

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Directions 

• In a large mixing bowl on top of a zeroed kitchen scale, weigh out 700 grams of warm water. *Note that zeroing your scale in between measurements makes things easier to keep track of.
• In the same bowl add in 1-3 grams of yeast (and 150 grams of sourdough starter if using) and stir to combine.
• Add 400 grams of whole wheat flour into the mixing bowl and stir to combine. (at this point you can let your mixture sit with plastic wrap or a tight fitting lid for up to 8 hours at room temperature or 12-14 hours in the refrigerator)
• Add in 20 grams of olive oil, 15 grams of salt and 600 grams of bread flour and stir until combined.
• Once all of the ingredients are combined, turn the dough out onto a floured countertop and knead by pressing the palm of your hand into the dough and stretching it then pulling it back towards you. Kneading by hand will take about 5-7 minutes or until the dough is smooth and elastic. If you have a kitchenaid mixer you can also use the dough hook, and let the machine knead it on speed 3-4 for 5 minutes. 
• Put the dough into a greased bowl and cover with plastic wrap or a tight fitting lid to let rise for 1-2 hours or until the dough has noticeably expanded (if you used yeast and starter mix it will be around 2 hours or more).
• Once the dough has expanded, take the dough out of the bowl and use the “stretch and fold” method to build gluten in the dough (take one end of dough and stretch it as far as you can without tearing it then fold it back on itself, repeat this on all 4 “sides” of dough). Now place your dough back into the greased bowl and cover again to let rise for another 1-2 hours.
• After this rise time, proceed in doing the “stretch and fold” method one more time. Let dough rise for around another 30-45 minutes (rising should speed up a little throughout the day). After this stretch and fold session, start preheating your oven to 400 degrees fahrenheit. 
• After this rise it is time to shape the dough. Turn your dough out of the bowl onto a countertop that has been coated in olive oil. Work your dough with your hands into a flattened oven shape. This is a bit like working with a large pizza dough, where it is important to get it fairly flat but do not tear it (refer to video for shaping). Transfer the flattened dough to a baking sheet lined with parchment and cover with plastic wrap or a wet towel to let rise one last time for around 30-45 minutes. 
• After the rise, coat the loaf with olive oil and poke little “pockets” into the dough where the olive oil will settle. Sprinkle salt and pepper over the top of the loaf and place in the oven for about 20 minutes or until slightly golden on top.
• Let your loaf cool on a cooling rack until completely cool before cutting, or enjoy warm.
• Focaccia will keep in the refrigerator for about 2 weeks or around 5 days on the counter if kept out of direct sunlight. 

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Notes

• Depending on the weather in your area rise times might differ, and they could be longer or they could be shorter. Be patient and do not panic. If you have the time to let it sit longer let it sit.

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People struggling with a substance use disorder (SUD) or behavioral addiction often report feeling lost or devoid of purpose. This is very similar to the way some people describe how they feel when they have lost connection with their spirituality. This kind of spirituality is not about a catalog of commandments but a sense of interconnectedness with all living beings and a personal quest for meaning.

 Spirituality can be defined as an individual's search for ultimate or sacred meaning and purpose in life. Furthermore, it can mean to seek out or search for personal growth, religious experience, belief in a supernatural realm or afterlife, or to make sense of one's own "inner dimension.”

 Spirituality can be a powerful tool in the healing process. “Patients who are spiritual may utilize their beliefs in coping with illness, pain, and life stresses. Some studies indicate that those who are spiritual tend to have a more positive outlook and a better quality of life,” wrote Christina Puchalski, MD, in her study on the role of spirituality in healthcare. According to Puchalski, specific spiritual practices have been shown to improve health outcomes. “Spiritual commitment tends to enhance recovery from illness and surgery.”

Dr. Puchalski is the founder and executive director of the Institute for Spirituality & Health (GWish) atGeorge Washington University. GWish was established in 2001 and quickly took on a leadership role in the nascent field of spirituality and health. Conducting research, educating practitioners, and impacting healthcare policy worldwide, GWish frequently collaborates with religious, spiritual, and health organizations to create more compassionate healthcare systems around the globe.

A spiritual outlook also tends to enhance recovery from addiction. The American Psychological Association reported in 2000 on a study that found that higher levels of religious faith and spirituality among people recovering from substance use disorder were associated with several positive mental health outcomes, including more optimism about life and higher resilience to stress, which may help fortify the recovery process.

Despite such results, the aspect of spirituality is often still excluded from a modern medical environment. However, recovery support groups such as Alcoholics Anonymous (AA)have long described addiction as a disease of the spirit.

“Diseases of the flesh(e.g., cardiovascular disease, diabetes, cancer) are physical in nature and are treated using the traditional medical model: a history is taken, a physical exam and laboratory or other tests are conducted, and treatment is discussed with the patient.” wrote Paul King, MD, in 2012 on psychiatrist.com.“Diseases of the Spirit, on the other hand, may result from the misuse of short-term anxiety-relieving techniques and may not be adequately addressed by the medical model. For example, drinking to relieve stress may lead to alcoholism, opiates and benzodiazepines can lead to abuse problems and chemical dependency, sexual promiscuity may become sex addiction, excessive gambling and shopping may lead to financial ruin, and pornography can lead to sex offender behavior.”

“The Spirit or soul requires sustenance and care, and neglect of the Spirit can lead to disorders,”wrote Dr. King, “just as neglect of the body leads to disease.”

In his new book The Myth of Normal, addiction expert Gabor Maté takes a similar approach: “Addiction is a complex psychological, emotional, physiological, neurobiological, social, and spiritual process.”

Maté criticizes modern medicine for separating the mind from the body, although “living people cannot be dissected into separate organs and systems.” For Maté “health and illness are not random states in a particular body or body part” but “an expression of an entire life lived.” That would also include a spiritual aspect or lack thereof.

In the 1930s, famousSwiss psychiatrist and psychoanalyst Carl Jung also weighed the impact of spirituality when he corresponded with the founder of Alcoholics Anonymous,Bill Wilson, in an attempt to discover a cure for the disease of alcoholism.Dr. Jung concluded that the misuse of alcoholic “spirits” was primarily an attempt to fill the thirst for “the spirit of God.” He asserted that the remedy was spiritual because a spiritual problem cannot be resolved with a material solution.

“You see, ‘alcohol’ inLatin is ‘spiritus,’ and you use the same word for the highest religious experience as well as for the most depraving poison,” Jung wrote to Wilson.“The helpful formula, therefore, is: spiritus contra spiritum.”

Today, many addiction professionals see the disease of addiction well beyond psychosomatic body-mind interactions. They recognize a deeper malaise at the core of addiction: the disconnection from a higher power—whatever that might be exactly, a missing sense of purpose, a failure at authentic self-actualization, the highest level in the pyramid of human needs proposed by American psychologist Abraham Maslow in 1943.

NYU psychiatry professor Marc Galanter regards spirituality as an important form of recovery capital: “Achieving an enhanced spiritual orientation can provide increased recovery capital, the enhanced ability to sustain recovery from substance use disorders(SUDs). This can be valuable in adding to the resources, such as pharmaceutical or institutional, on which such a person can draw.”

Spiritual recovery capital may also help prevent a relapse. “An approach to enhancing personally experienced spirituality, as embodied in the availability of culturally syntonic approaches, and thereby improving one’s recovery capital, may serve to yield relief from the pressure to turn to substance misuse and addictive behaviors,” wrote Galanter, Hansen, and Potenza in July.

Foundry Steamboat takes the mind, body, and spirit approach to recovery. Its curriculum and psychoeducation directly address the benefits of exploring, developing, or reconnecting with one’s spiritual aspect. Wellness programming, including fitness, recreational activities, mindfulness work, nutritional education, horticulture, and bonding experiences, have the intention of helping clients feel a connection with themselves and others. The concept of meaning plays an important role in Foundry Steamboat’s clinical approach. The Trauma-Integrated Care model developed by Chief Clinical Officer Michael Barnes helps people learn to self-regulate naturally. A major part of being able to feel centered and less stressed about one’s life is seeing oneself in a larger interconnected context. Spirituality can help clients learn to appreciate their roles within the broader frameworks of relationships, families, and communities and to find a sense of deep personal meaning that can make a crucial difference when modulating stressful situations, dealing with adversities, and working through relationship issues.

The growing Foundry Steamboat alumni community and its alumni programming also strive to help people experience a deeper sense of fellowship and spiritual connection. The Foundry Treatment Center Steamboat alumni program offers in-person gatherings for clients and family members, and regular virtual meetings that keep people in close touch with care team members and peers. Alumni events remind clients of the goals of recovery and lessons learned during treatment and foster the growth of supportive friendships.

Learn more about Foundry Treatment Center Steamboat. The program offers a residential trauma-integrated men’s program in Steamboat Springs, Colorado, and a virtual Intensive Outpatient Program for men throughout Colorado. Speak confidentially with an informed team member at (720)477-6757.

Possibly the most underrated season of all time in a mountain town is Fall. Fall is often called “shoulder season”. Of course Steamboat Springs is home to some of the best aspen groves that anyone could ask for and their leaves are truly stunning! The brisk cooler air of the fall reminds all of us the ski season is right around the corner and it’s hard not to be excited about the future powder days, but other than stunning leaves and hopes of great future powder days, what is actually going on in the season of Fall itself? Sometimes I think of Fall as the season of food. You can’t talk about Fall without talking about Thanksgiving, and let’s not forget about a good halloween chili! 

Chili is a hot topic around the Foundry right now. The annual “chili cook off” is back! Foundry’s chili cook off is a chance for staff to come together and be actively engaged with each other in a setting that isn’t just “another day at the office”. People naturally will gather around food. Just think about any event or gathering that you have been to (birthdays, weddings, sporting events, etc…), there was probably some sort of food being served. People gathering around food is probably the most human thing that we can do. Every single person needs food to survive, meaning that food is possibly the most basic thing that all humans have in common. 

Not only is food a necessity, it is often a way of life. So many people around the world spend large portions of their day dedicated to cooking and prepping food. I’m not talking about just restaurant workers, I’m talking about everyday people. In some cultures around the world it is common for people to just make their own bread or make their own tortillas, but here in America it is much more common for people to just go buy bread and tortillas at the store. Why we have gotten away from making foods probably comes down to time. Most people will say there isn’t enough time to make bread or tortillas or for some people even just any food at all. Make time!!

I say Fall is the season of food, and I mean it! Fall is a time where a lot of us find ourselves spending more time indoors due to the weather. Some of us miss the abundant outside time we can spend during the summer months. Instead of feeling down about being inside more, get excited about all that you can do inside! Cook something, bake something, prep food for the week, or spend hours trying to come up with the perfect chili! Cooking and baking is my favorite indoor activity and one day I hope it becomes your 

Garden Update!

Yes, Fall is here, so our garden season is wrapping up quickly. The green house is still chugging along as always, but we have more exciting news that is similarly related to the garden! We’ve gotten ourselves a Pig! His name is Tatter Tot and he is just adorable! We love him unconditionally.

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Recipe!

Fall is the season of pumpkin and also the season of baking! So why not put two and two together to make yourself some great pumpkin banana bread!

‍Pumpkin Banana Bread

‍Yield: 1 9x5 loaf pan

Prep time: 30 minutes

Bake time: 45-50 minutes

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Ingredients

• 1 cup whole wheat flour
• ¾ cup all purpose flour
• 1 whole egg and 1 egg yolk (room temperature) 
• ½ stick of butter (melted)
• 3 T of honey
• 4 bananas (very ripe or overripe)
• 1 teaspoon of cinnamon
• ½ teaspoon of nutmeg
• 2 teaspoon of baking powder
• ½ teaspoon baking soda
• 8 ounces of pumpkin purée 

For the honey cinnamon butter

• 1 teaspoon of cinnamon 
• 2 tablespoons of honey 
• ½ stick of unsalted butter (softened enough for mixing)
• 1 teaspoon of kosher salt

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Instructions

• Preheat the oven to 350 degrees
• In a large mixing bowl or stand mixer combine egg, egg yolk, pumpkin purée, honey, bananas and melted butter.
• Mash the bananas with a masher or fork until the egg banana mixture has turned into a paste
• Now add all of your dry ingredients; whole wheat and all purpose flour first, then baking powder, cinnamon, nutmeg, and salt.
• Once all of your dry ingredients have been added, mix until combined.
• Grease a 9x5 loaf pan with butter or a spray oil.
• Pour your batter into the pan and then place in the oven for 30-40 minutes or until a toothpick inserted into the center of the loaf comes out clean. 
• While the loaf is baking, make your honey cinnamon butter. 
• Put your softened butter, cinnamon, kosher salt, and honey into a small mixing bowl and beat together with a fork until combined. 
• Serve your pumpkin banana bread warm with the honey cinnamon butter over the top!

As always, have a safe and clean season! - Chef Henry Olson 

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**Photo credit: Andrew Olson (@_andrew__olson_)

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Could Clinical Trial Reporting Spur Illicit Substance Use?

Might the widespread publicization of oversimplified clinical study findings contribute to increased substance use? The precipitous rise of cannabis legalization, industrialization, and use may prove a powerful case in point. Some studies suggesting the efficacy of cannabis to treat various medical problems were used by cannabis proponents to support the drug’s legalization and commercialization.

In recent years, stories citing small-scale clinical trial data published in traditional and social media channels suggest that cannabis could effectively treat pain and some mental health disorders, and even replace the use of some opioids to help address the opioid epidemic.

More recent information about the effects of legal medical and recreational cannabis calls into question many of the claims made by these earlier studies and highlights the adverse knock-on effects of cannabis legalization, including sharp rises in cannabis use disorder, cannabis induce psychosis, emergency department visits, and traffic accidents.

Importantly, America’s longest-running study on substance attitudes indicates that fewer people than ever feel that cannabis poses health risks, and cannabis use among all age groups, including teens and adolescents, is up.

If it holds true that people’s beliefs about substances and consumption behaviors can be swayed by exposure to clinical trial data (no matter how preliminary and cursory), this may be one reason for recent increases in hallucinogen use.

Data from the Centers for Disease Control and Prevention (CDC) indicate that just this year, clinical trials conducted by highly trusted institutions including Johns Hopkins, Columbia University Irving Medical Center, the University of California at San Francisco, and others, show that hallucinogens like psilocybin and ketamine may reduce the symptoms of treatment-resistant depression, a major public health problem.

The findings of these studies have been circulated by esteemed publications including the New York Times, The Guardian, the BBC, National Public Radio, Stat News, and others. In fact, a Google search for “psilocybin treats depression” returns more than 5.5 million results. While research into the potential mental health benefits of hallucinogens has peaked in recent years, the study of these substances as commercial medications has been underway for decades.

A peer-reviewed study released in August by the Columbia University Mailman School of Public Health and Columbia University Irving Medical Center indicates hallucinogen use grew from 1.7 percent in the U.S. in 2002 to 2.2 percent in 2019.

Just as promising clinical trial data may have spurred increased cannabis use, so too the publication of studies indicating potential health benefits of hallucinogens may reduce perceived health risks and make people feel more comfortable about using these substances.

Part of the problem posed by news reporting about clinical trials is that people may not read beyond the headlines or think critically about the study’s findings. Many of the articles reporting on the trials of psilocybin and ketamine make it clear that trial sample sizes may be small, that additional phases of research are needed to determine if compounds found in these substances can be turned into safe and efficacious medications, and that people should not attempt to achieve the same effects by using these substances on their own.

The Nature article “Psychedelic drugs take on depression — Mind-altering drugs might provide relief for those who don’t respond to conventional therapies — but does the hype outweigh the hope?” questions the significance of some claims made by recent studies suggesting the health benefits of hallucinogens and cites an important fact — that the promising effects of hallucinogens like esketamine show modest differences when compared to placebo. Additionally, many of the clinical trials being conducted are performed under close medical supervision and often include trained psychotherapists who counsel test participants during their study experience.

Despite the fact that most clinical trial reporting contains cautionary language and suggests that further study is needed to substantiate initial findings, it is possible that many readers may simply conclude that the substances are safe or beneficial because they either skim news headlines without reading full articles or choose to make their own interpretations.

As summarized in a 2014 Washington Post article, “Americans read headlines. And not much else.” “So, roughly six in 10 people acknowledge that they have done nothing more than read news headlines in the past week. And, in truth, that number is almost certainly higher than that, since plenty of people won't want to admit to just being headline-gazers but, in fact, are.” It is possible that even fewer people read in-depth news coverage or follow-up on news stories today — seven years after this article was written.

Before internet-based news and the ubiquitous use of mobile devices, most people got their news through a relatively small number of television and radio channels, newspapers, and periodicals. The relatively high cost of producing and distributing news, and the pressure by advertisers to control the quality of editorial content, meant that most major news outlets spent significant time fact-checking stories, and fewer news stories made it into mass circulation.

Scholarly articles like clinical trial information were most likely to be found in esoteric trade publications read by members of the medical profession rather than in mainstream media. Today, we are exposed to millions of times more sources of information, many sources do not fact-check information, and still, other information channels shape news to suit political or commercial outcomes. Another major change is the algorithmic distribution of information, largely driven by social networks, that attempts to deliver news that evokes an emotional response among consumers (as has been claimed about the inner workings of Facebook).

Confirmation bias is another issue that can impact information consumers and make them more likely to draw their own conclusions when presented with facts. Confirmation bias is the tendency to use information to confirm existing beliefs. If an individual is predisposed to believing that hallucinogens, like psilocybin, are natural substances that are harmless or efficacious, reading headlines that seem to support this point of view can solidify their belief in this supposition despite the fact that this assertion may not be accurate.

Digesting news uncritically and confirmation bias has led people in some quarters to expect a “psychedelic revolution” in the treatment of substance use disorders and other mental health conditions.

“In light of popular media reports of a forthcoming ‘psychedelic revolution’ with commercialization and marketing that may further reduce the public perception of any risk, researchers, clinicians, and policymakers should increase their attention to the rising rates of unsupervised hallucinogen use among the general public,” observed Columbia University study author Deborah Hasin. “Our results highlight such use as a growing public health concern and suggest that the increasing risk of potentially unsupervised hallucinogen use warrants preventive strategies.“

LSD, psilocybin, phencyclidine (PCP), MDMA, and other dangerous hallucinogens are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) used by psychiatrists in the United States to diagnose substance use disorders. Symptoms of LSD use can include panic attacks, psychosis, seizures, and delusions. Another condition listed in the DSM-5 is cannabis use disorder (CUD), a potentially serious condition frequently requiring treatment.

Treatment providers see the impacts of misleading or misinterpreted substance information

Clinicians at Foundry Treatment Center Steamboat, and colleagues across the country, often witness the collision between incorrect perceptions about psychoactive substances and the negative effects of their problematic use. It is common, for example, for Foundry Steamboat clinicians to find clients experiencing cannabis use disorder surprised to learn that cannabis addiction is possible. The prevailing narrative that cannabis is not habit forming is untrue, and rates of cannabis use disorder and problematic use have increased since the substance became medically and recreationally legal.

Cannabis legalization, commercialization, and use disorder may be a bellwether for the future of hallucinogens and other substances highlighted in clinical studies. The specter of changing public risk perceptions that may increase the likelihood of substance trial and use is worrisome to behavioral healthcare providers.

“When Colorado legalized recreational cannabis, many of us were worried about the results, especially for younger people. Unfortunately, these worries were justified,” says Amber King, Foundry Steamboat Outreach and Special Projects. “We are not only seeing more people finding themselves addicted to high-potency THC products, but we are also seeing other negative impacts in the community. Some of these problems, like increased traffic accidents and children accidentally accessing these products, mirror some of the problems caused by alcohol, which kills more people every year than any other substance.”

“Now we are afraid that the trend toward relaxing concerns about other substances will result in similar problems,” says King. “Widespread headlines that suggest that hallucinogens may help treat mental health conditions could lead some people to attempt to self-medicate with these substances — a choice that without proper clinical supervision and dosages could exacerbate preexisting mental health disorder symptoms instead of alleviating them. Other people may simply believe that using these substances is unlikely to be harmful. Still other people may use this information to push for legalization and commercialization, a move that has had catastrophic effects for many people negatively affected by cannabis legalization.”

The Foundry Treatment Center Steamboat Men’s Program provides comprehensive, Trauma-Integrated Care to men experiencing substance use and co-occurring mental health disorders. The program’s virtual Intensive Outpatient Program treats adults throughout Colorado. For more information call (844) 955-1066.

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This article discusses suicide. If you or someone you know is at risk of suicide, please call the Suicide and Crisis Lifeline at 988. The previous National Suicide Prevention Lifeline at 1-800-273-8255 is also still available. 

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Colorado’s Rural Communities Offer Stark Evidence of Factors Reducing the Nation’s Life Expectancy

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US life expectancy dropped for the second consecutive year in 2021, falling by nearly a year from 2020, according to government data released in August.

In 2019, someone born in America had a life expectancy of almost 79 years. In 2020, the first year of the COVID-19 pandemic, that dropped to 77 years. Last year, the life span dropped again—to 76.1 years. 

Life expectancy estimates the average number of years a baby born in a given year might expect to live, given death rates at that time. It is “the most fundamental indicator of population health in this country,” Robert Hummer, a University of North Carolina researcher focused on population health patterns, told the Associated Press. 

Officials of the Centers for Disease Control and Prevention (CDC) blamed COVID for about half the decline in 2021, a year when vaccinations became widely available, but new coronavirus variants caused waves of hospitalizations and deaths. Other longstanding problems were major contributors as well, though: drug overdoses, heart disease, suicide, and chronic liver disease. 

According to the CDC release, the decline “between 2020 and 2021 was primarily due to increases in mortality due to COVID-19 (50.0 percent of the negative contribution), unintentional injuries (15.9 percent), heart disease (4.1 percent), chronic liver disease and cirrhosis (3.0 percent), and suicide (2.1).” 

“This is the biggest two-year decline—2.7 years in total—in almost 100 years,” reported Kate Sheridan on Stat News. “The COVID-19 pandemic is the primary cause of the decline. However, increases in the number of people dying from overdoses and accidents are also a significant factor.”

A large percentage of the cases of chronic liver disease is caused by alcohol misuse and alcohol use disorder, and a lot of the unintentional injuries are really drug overdose deaths; the increase in suicides is driven by trauma, depression, anxiety, and substance misuse. 

Provisional data from CDC’s National Center for Health Statistics indicate there were an estimated 107,622 drug overdose deaths in the United States in 2021, an increase of nearly 15 percent from the 93,655 deaths estimated for 2020 which in turn amounted to a 29 percent increase over 2019. As recently as 2014, the number of overdose deaths in the US was 47,055. 

COVID-19 may have exacerbated the decline in US life expectancy in the past two years, but the downtrend started quite some time before the pandemic. For decades, US life expectancy was on the upswing. But, as the AP reported in July 2021, that trend stalled in 2015, for several years, before hitting 78 years, ten months in 2019. A person born in Canada could expect to live 82 years in 2019. The life expectancy in Japan was 84 years three years ago. 

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Deaths of Despair

Years before the emergence of the COVID pandemic, Princeton economists Anne Case and Angus Deaton suggested in a 2015 paper and a subsequent book that working-age white men and women without four-year college degrees were dying “deaths of despair” by suicide, drug overdoses, and alcohol-related liver disease at unprecedented rates. 

In a review of the book, Carlos Lozada noted, “even before the coronavirus struck, America was suffering an eviscerating epidemic. Its cause was not a virus; its spread could not be blamed on foreign travelers or college kids on spring break. No masks or gloves could slow its contagion, no vaccine could prevent new cases.”

Although Case and Deaton completed their book before the onset of the COVID pandemic, Lozada found that their diagnosis was “painfully relevant.” 

“The debate over how quickly to ease social distancing restrictions and get the economy moving again forces a reckoning: How do we balance the risk of increased coronavirus infections if we reopen the economy too soon against the risk of more deaths of despair if we do so too late?”

Some researchers observed as early as July 2020 that the unfolding COVID pandemic and the existing addiction epidemic in the US would converge into a “perfect storm”:

“Given the COVID-19 pandemic, tackling the alcohol and substance use disorder crisis may be even more problematic because, as in a perfect storm, a combination of elements serves to worsen the already complex clinical conditions of patients with these disorders. The consequences of this storm may spread long after the pandemic is resolved and may affect a large proportion of the population, beyond individuals with current alcohol and substance use disorders.”

The CDC data show that men were hit harder by this perfect storm: While the decline in life expectancy for the male population due to unintentional injuries was 19.1 percent, it was 14.8 percent for females; in chronic liver disease and cirrhosis, it was 3.4 percent for males versus 2.4 percent for females.

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Colorado’s Rural Communities Especially Hard-Hit

Colorado has some of the nation’s highest rates of substance use disorders and age-adjusted suicides, according to the Centers for Disease Control and Prevention (CDC). Research from the Colorado Health Institute suggests that untreated mental health conditions, stigma and structural racism, prevalent alcohol and marijuana use, and firearm ownership rates are some of the leading factors contributing to Colorado’s suicide and behavioral health problems. Another recent study points to financial insecurity and economic disparity, lacking infrastructure and federal support resources, and perceived breakdowns in community connectedness and family systems as leading causes of “diseases of despair” in rural and urban communities. 

In rural communities throughout Colorado, the problems represented by statistics and data points in research studies can be seen in the real lives of people suffering their effects. 

During recent visits with community workers and care providers in Cedaredge, Grand Junction, Telluride, Hotchkiss, Paonia, Delta, Ridgway, and Durango, Foundry Steamboat team members Amanda Buckner and Amber King heard harrowing reports of staggeringly high rates of substance use disorder and suicide — two neighboring towns reporting ten suicides in just one week. They were told about how many of the people in these communities feel isolated and distant from one another and have limited access to high-paying jobs and healthcare resources. Native American people in these communities, like Native American people throughout the US, continue to suffer myriad and disproportionate socioeconomic problems that contribute to addiction, mental health disorders, and suicide. 

Problematic ideas about addictive disorders also seem to be a common issue embedded in the cultures of some rural Colorado communities. “I grew up and live in a rural Colorado town, and I hear the same misperceptions perpetuated there today. The belief that using substances, especially alcohol, is fine as long as someone is able to function and has a house to live in,” says Amanda Buckner, Foundry Steamboat Community Outreach Manager. “For many families in these areas, substance use has become normalized, even encouraged, within the family system and passes for acceptable behavior. In too many cases, this leads to people self-medicating underlying mental health issues with substances instead of recognizing that they have a problem and seeking treatment."

Amber King, who also grew up in a rural Colorado town, cites the lack of access to a continuum of care in rural communities. “Most people who need help in these communities are hours away from the levels of care and specialized providers they need. They have few financial resources and lack family and peer support needed for people to feel comfortable and safe seeking help.” Challenges unique to rural communities can also prevent people from acknowledging that they are experiencing mental health problems or seeking care. “These towns can be very tight-knit communities with some families going back generations. Residents may know more about the lives of their neighbors than people who live in larger cities, and this lack of perceived anonymity can make it hard for people to feel safe getting help. This issue especially affects first responders, physicians, and other professionals who live in and serve these towns, who perceive a need to maintain a local reputation. When you believe that the people you interact with every day know what’s happening in your life, it can be hard to admit that you have a problem and ask for help,” says King. 

Foundry Steamboat is establishing close and regular ties with rural communities to facilitate connections between caregivers and make it easier for individuals and families to talk about mental and behavioral health problems. Foundry Steamboat team members are hosting ongoing virtual meetings where mental health professionals, community leaders, school officials, and others responsible for the mental health and wellbeing of rural communities can discuss needs, share resource information, and find camaraderie and understanding. Through these efforts, Foundry Steamboat hopes to play a positive role in helping to dispel the stigma surrounding mental health and substance use disorders, expand resources for rural communities, and break down the barriers that make it harder for people to seek treatment and find recovery.

No parent wants to see their child have problems with drugs and alcohol, whether those problems are short-term like bad decisions or long-term like an addiction. Although many parents worry about their kids using drugs and alcohol, they don’t always know how to talk to their kids about them. The following tips can help you talk to your kids about drugs and alcohol so they are less likely to make bad decisions and less likely to have substance use issues later in life.

Set a Good Example

The most important thing to remember about minimizing the risk that your children will have problems with drugs and alcohol is that whatever you actually say to them is not as important as other factors, including your own behavior. Your kids watch your behavior and assume that whatever you do is how adults normally behave. If you come home from work every day and immediately have a few drinks to relax, your kids will associate drinking with adult behavior. When they start wanting to assert their independence and act more grown-up, drinking will be part of that template. 

If you have a problem with drugs or alcohol, the best thing you can do for your kids, especially when it comes to their own future risk of addiction, is to seek help. Having a parent with a substance use disorder is one of the biggest risk factors for addiction. There are genes related to addiction that you may have passed on, your kids learn your substance use patterns, and addiction makes it harder to provide a stable environment. By getting help for your own substance use issues, you set a responsible example and you show that your family is your top priority.

Create a Healthy Environment

As noted above, one reason a parent’s substance use puts their kids at greater risk for addiction is that addiction makes it harder to provide a safe, stable environment for kids. However, drugs and alcohol are only one factor in the home environment. Many studies have found that adverse childhood experiences, or ACEs, significantly contribute to substance use issues and mental health issues later in life. For example, one study found that people who had five ACEs or more were seven to 10 times more likely to struggle with addiction as adults. ACEs are experiences of either emotional or physical abuse or neglect. Experiences such as not knowing whether you’ll get to eat, being abused, either physically, sexually, or emotionally, witnessing domestic violence, having a parent with a mental health or substance use issue, and other stressful experiences each contribute to later addiction risk as well as other mental and physical health issues.

You can hedge against these risks by creating the safest and most stable environment as possible for your kids. They should feel safe, supported, and loved. That means having regular routine and structure, especially for younger children, shielding them from violence, and giving them emotional support. As discussed, if you struggle with any substance use or mental health issues, seek help, and stick to your treatment plan. 

Start Early

When it comes to talking to your kids about drugs and alcohol, most parents wait too long. They look at their 12-year-old, for example, and think, “They’re still too young to worry about that.” It may be true that most kids haven’t yet started experimenting with drugs and alcohol at that age but they are already approaching the age when they listen to their peers more than their parents. 

That means, if you want to get through to your kids about drugs and alcohol, you have to start much earlier than you think. Even four or five years old is not too young to begin the conversation. Of course, your approach should be age-appropriate. For example, if you give your child cold medicine, make sure to tell them they should only take medicine from a parent or doctor. As they get older and understand more, you can talk more about illicit drugs and alcohol. 

Continue the Conversation

Once you’ve broached the subject of drugs and alcohol, don’t just assume that now that you’ve had the drugs and alcohol talk, everything will be fine. Look for opportunities to keep the topic open. For example, if they ask why their uncle was acting strange at Thanksgiving, use it as an opportunity to talk about how alcohol affects your body and mind. Kids need to hear a consistent message over time so don’t tell them about how drinking too much is bad for you and can make you sick and cause accidents and so on but then talk about how much you’re going to drink on vacation. Consistency and repetition are important, as is behavior that’s consistent with your message, as discussed above. 

Be Honest

As your child gets older, your conversations about drugs and alcohol can get more in depth. It’s important to remember that you always want to be as honest as possible. Sometimes you have to explain things in age-appropriate ways but nothing should be false or misleading. Don’t try to scare your kids off of drugs and alcohol with exaggerations. That will only harm your credibility. You want them to see you as a reliable source of information on drugs and alcohol and they should always feel comfortable coming to you with questions. Keeping the conversation going, as discussed above, is much easier than trying to talk to your child about drugs for the first time as a teenager and getting them to trust you. 

On a similar note, make sure your kids know--at any age--that if they find themselves in a jam, whether they’re with a grown-up who’s drinking or at a party where there are drugs, that you will come to get them with no questions asked. Their safety is always the most important thing and they’ll be less likely to call you if they’re afraid of punishment.

There’s nothing easy about being a parent and teaching your kids about drugs and alcohol is one of the bigger challenges. They get all kinds of conflicting signals on the subject, perhaps even from their parents. Teens are also incredibly vulnerable to peer pressure, making good judgment around drugs and alcohol even more difficult. If you want to protect your kids and minimize the risk they’ll have substance use problems later in life, the most important things are to set a good example and create a safe, healthy, happy environment for them. Then, be sure to talk to them early about drugs and alcohol and keep the conversation going as they get older. Finally, be honest so they know you’re a reliable source. If you’re currently struggling with substance use, getting help as soon as possible may be the single best thing you can do for your kids. 

At Foundry, we know that mental health and good family relationships are both incredibly important for a strong recovery from addiction. Our program takes an evidence-based, holistic approach to mental health and involves families in the recovery process. To learn more about our approach to addiction treatment, call us today at (844) 955-1066.

Happy Holidays everyone! We hope you enjoyed your December as much as we did here at Foundry Treatment Center Steamboat Springs! While ourWellness Activities looked slightly different this year due to COVID restrictions, that didn’t stop us from getting a little CREATIVE here on campus.

Healthy Habits

This month during Healthy Habits group, we put a special emphasis on Self-Care. Do you know what self-care is? Self-Care is defined as deliberately taking care of yourself through restorative activities. Some examples of self-care are writing in a journal, meditating, volunteering for a cause that is meaningful to you, working in the garden, playing a game, reading a book, exercising, being out in nature, getting creative and connecting with friends.What do you like to do for self-care?

The Holiday season can be especially stressful, so we make extra effort to help our participants cultivate their own individual self-care plan as well as develop coping skills through self-care to help them navigate their triggers. For our participants who are about to transition to a sober living or aftercare program, we help them work through their emergency self-care plan, which lists specific activities they will use as daily self-care, while also identifying their top three positive coping strategies. In addition, they will write out their top five emergency self-care practices. This could include the name and number of their sponsor, meditation, being out in nature, box breathing or other coping skills. We also ask them to list 5 practices, people or places toAVOID in times of crisis or stress to use as a helpful reminder to keep them on track. When they have completed this emergency self-care plan, we encourage them to keep it either on their person, or in a place where they can see it every day, to get in the practice of utilizing their tools and skills!

Do you have your own Self-Care plan?

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December Wellness Activities

With the lack of snow here in the Yampa Valley for most ofDecember, in addition to the COVID restrictions in Routt County, we had to get a bit creative for our wellness activities this year, which just made them all the more fun!

We got into the holiday spirit by decorating a Christmas tree and doing our own version of the Great British Bake Off! Participants were split in to two different teams and were given intentionally vague recipes to make either Grandma’s Chocolate Bread or Cinnamon Swirl Cheesecake and were only given 2 hours to complete their desserts. Participants had to use problem solving and team work to figure out how to successfully make their recipe.Let’s just say the results were interesting…. but undeniably delicious! During the Christmas week we had an in-house Gingerbread House building contest! Which one is your favorite?

A new opportunity we were able take advantage of this month was having our own private rock-climbing film festival premier, complete with popcorn machine and concession stand! Our gym is the perfect place to inflate our GIANT inflatable movie screen for special occasions like this! One of the positive things to come out of COVID is how much more accessible things have become virtually. In a ‘normal’ year, a ski film or a rock-climbing premier would be in a theater and is typically not a sober event, but, due to COVID and films moving virtually, we were able to provide a safe and sober space for our residents to enjoy these films!

Fitness and Yoga!

Speaking of virtual, we were able to maintain a normal yoga and fitness schedule for our participants with the help of Zoom! During the restrictions we had a hybrid model where our yoga instructors would Zoom in to teach yoga, and in person fitness instruction was provided. Our goal for fitness and yoga is to educate and lay the foundation of exercise and yoga for participants to carry into their recovery!

Below is one of the workouts we did the week of Christmas.To do this work out, you do it like the carol “The Twelve Days of Christmas.”You start at one, then you do 2, then 1. Then 3, then 2, then 1 and so on until you have done all 12 days of Christmas!

12 days of Christmas Workout:

1 plank for 20 sec

2 Burpees

3 Push ups

4 Bicycle Crunches

5 Squats

6 Tricep Dips

7 Boxing Punches

8 Mountain Climbers

9 Jumping Jacks

10 Alternating Lunges

11 Crunches

12 High knees

That was our Wellness for December in a nutshell! We hope you have a safe and happy holiday, and we can’t wait to share all of the funWellness things we have in store for January 2021!

Cait Mowris, Wellness Director, Foundry Steamboat

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So you are new to recovery from some form of substance abuse. You learned and experienced in treatment that exercise is of great benefit to you. It has aided you in reducing your stress, decreasing your anxiety and  improving your mood. You feel better about yourself and your body as a result. It taught you that you can overcome adverse conditions thus cultivating your self-confidence.  

Some of your friends and family have begun to verbalize concern about your exercising. They have even mentioned that you are becoming addicted to exercise. You find yourself firing back at them when the topic comes up that exercise is good for you and it is better than using heroin.  However, part of you secretly wonders if it is true. Are you replacing one addiction with another?  

Is there such a thing as exercise addiction? According to Psychology Today, it is a “legitimate problem whose prevalence is thought to be highest amongst triathletes, runners, and individuals who suffer from eating disorders.”

A published review from 2012 estimated that about 2.5 to 3.5 percent of the general exercising public may be affected by exercise addiction. The National Center for Biotechnology Information has published a number of studies attempting to understand and define exercise addiction. However, the American Psychiatric Association has not recognized it as a primary disorder.  

Despite the conflicting data as to whether exercise addiction exists, there are some agreed upon symptoms identified by various researchers regarding exercise addiction: tolerance, withdrawal, inability to limit amount of time engaged in exercise, reduction in other activities to engage in exercise, and continuing to engage in the exercise despite the negative effects it is having.  

To put these symptoms into actions that are recognizable, those addicted to exercise may feel driven to work out daily, for long periods of time, and do so even through illness and injury.   The person may miss so much work (due to exercising, recovering from, or preparing to exercise) that they can no longer successfully pay their bills, and /or is spending more than they can afford on equipment. The person may express increased stress levels when not exercising, and may display irritability, frustration and the inability to concentrate when not engaging in exercise.  

Do some of these sound familiar? These are some of the same criteria for substance abuse disorder.   The symptoms of exercise addiction seem to parallel substance abuse, but what about the effects?  Individuals who engage in exercise addiction may find themselves suffering from injuries due to repetitive motion, fractures due to overuse, and muscle damage due to overtraining.  They may also begin to experience irregular heartbeats and enlargement of the heart.  

Exercise addiction may also take a significant toll on a person’s family, work, and social life as more and more time is dedicated to exercising since it has become the main priority. Family and friends may accept the heavy training schedule, because a specific performance is the goal, a marathon or triathlon for example, with the expectation that a more normal lifestyle will resume after the event. However, the event comes and goes and the behavior remains the same. Again, the toll seems to be equivalent to that of substance abuse.

You find yourself asking since exercise addiction is a possibility, and recall you were taught in treatment that once a person has been addicted to one substance they can more easily cross over to another addiction, should you exercise at all?  

Yet, you recognize that exercise has been good for you. It has improved your mood by decreasing your depression and anxiety, as well as improving how you respond to stress. You also know it has been shown to reduce cravings for substances, for those who abuse alcohol, illegal drugs and/or some prescribed drugs, and believe it has assisted you with cravings and filled your time. In addition, you have made some new friends and begun to develop a positive support network as a result of working out through The Phoenix or fitness center.  

So the question remains: should you stop exercising?

The answer lies in whether you can exercise in moderation and have a balanced lifestyle. Do the symptoms above describe you? Has exercise become a compulsion? Look inside and you will know the answer.

Here at The Foundry, we know how important physical fitness can be to recovery, and have created an entire Wellness Program centered on yoga, hiking, cycling, snowshoeing, gym fitness as well as countless other activities related to well-being. In the beautiful state of Colorado, receiving drug and alcohol treatment at a recovery center in a beautiful setting can show you how beneficial exercise and the outdoors can be for the body, mind and spirit. We can help cultivate your interested in fitness and help you understand how to keep this new (or reignited) passion healthy.

Jasmine Aranda, LPC, LAC, is the Chief Quality & Compliance Officer at The Foundry Treatment Center Steamboat, a rehab and substance abuse treatment center in Colorado, providing clinical therapy services for Foundry participants to help envision a life after recovery. The Foundry provides nearly double the therapy time of a traditional treatment program to provide the guidance and support needed for lasting recovery.

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We often think of relaxation as a luxury, something we do every once in a while if we can manage to get a few days off of work or get someone to watch the kids. However, daily relaxation is a necessity. It’s a vital part of good self-care, especially for anyone recovering from a substance use disorder and their families as well. Most people recovering from addiction say that stress is their biggest cause of cravings, and in fact, many addictions begin as a way of coping with stress and other challenging emotions. Chronic stress can also worsen health risks, such as heart disease, obesity, insomnia, digestive problems, and more frequent illnesses. These are all risks that are also increased by heavy drug and alcohol use. 

In short, taking time each day to relax isn’t just a luxury, but a way of protecting your physical and mental health, and a vital element of your recovery plan. However, it’s not always easy to relax, especially early in recovery when you may be feeling unusually tense, anxious, and irritable. The following tips can help you make relaxation part of your everyday life.

Set Aside Time

If you want to make relaxation a habit, you need to actually dedicate some time in your day to it. If you just figure you’ll squeeze it in when you have some free time, you’ll usually end up skipping it. Figure out a time that will work most days. Just before bed works pretty well for most people and relaxing can be a great way to improve your sleep as well. Right after work might be another good time and having a little buffer between your work and home life might improve your relationships. Find a time that works for you and try to stick to it every day.

Progressive Relaxation

As for relaxation itself, this is often harder than you would expect. You might sit down in your comfy chair with some nice music and still feel tense and agitated. One strategy that will probably help is progressive relaxation. Start at the top of your head, notice any tension there, and let it go. If it won’t seem to go away, try tensing the muscles for five seconds or so and then relax. When that area feels warm and relaxed, move on to the next area, perhaps your face or the back of your neck--both places that hold a lot of tension. It may also help to use visualization. For example, you may imagine the tense areas as a block of ice melting.

Meditation‍

The body and mind are connected in complex ways and it’s very hard to relax your body if your mind is tense, agitated, or racing. Relaxing your body should help to calm down your mind, but it can work the other way as well. Meditation can be an excellent way to relax your mind. There are many different methods of meditation and many of these are great for helping you mentally relax. Mindfulness meditation is currently the most popular form of meditation and it specifically emphasizes not getting wrapped up in thoughts. The Relaxation Response is a simple meditation method that combines progressive relaxation and mantra meditation. Research published in Public Library of Science ONE found that this technique--and likely others as well--actually cause genetic changes in the way your body responds to stress, including genes related to inflammation and oxidation, two kinds of stress that can lead to heart disease and cancer, respectively.

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Deep Breathing

Meditation can relax your mind and help you respond better to stress but it does take a little practice. In the meantime, deep breathing is a quick way to activate your parasympathetic nervous system and get your body and mind to relax. Deep breathing, and in particular, a long exhale, has been shown in many studies to activate the vagus nerve, which stimulates your rest-and-digest system. The ideal rate for relaxation appears to be about six breaths per minute. A regular rhythm like a three-second inhale, six-second exhale, and a brief pause before repeating should help you relax both mentally and physically. Furthermore, taking a few slow deep breaths is something you can do pretty much any time throughout your day when you need a short break.

Moderate Exercise

Many studies show that exercise is good for your mental and physical health, and good for addiction recovery. One reason is that regular exercise makes your brain less reactive to stress, which makes it easier to relax. If stress relief is your main goal, it’s best to keep your exercise fairly moderate because intense exercise, whether it’s long endurance-training sessions, or spending hours in the weight room can increase cortisol and require more sleep to recover. To relax, you would do better to engage in more moderate forms of exercise like walking or tai chi. Yoga can be a bit more intense but it also incorporates relaxation, stretching, deep breathing, and meditation, which can make it ideal for relaxing. The only caveat is that exercising within two hours of bedtime can make it harder to sleep.

Hot Bath or Shower

For relaxing your muscles and getting a little space from other people, it’s hard to beat a hot shower or bath. Music can make it more relaxing, and many scents, such as lavender are relaxing as well. Guys typically prefer showers but it’s hard to beat the relaxing power of a hot bath. As with exercise though, a hot bath too close to bedtime can raise your core temperature and impair the quality of your sleep. Therefore, if you’re taking a shower or bath near bedtime, go for warm, not hot.

Be Careful About Media Consumption

Finally, if you’re trying to relax, beware of unnecessary exposure to things that will make you tense. Exciting, suspenseful, or violent movies and TV shows get your adrenaline going and make it harder to relax. News and social media are terrible if you’re trying to wind down because much of that content is specifically calculated to make you angry. If you’re trying to unwind by looking at Facebook, you’re not doing yourself any favors. If you’re going to watch something to unwind, go for something funny or positive. Laughter is great for relaxing.

Relaxation plays an important role in addiction recovery. It helps keep you mentally and physically healthy. It’s crucial to make relaxation a regular part of your day. In fact, the more moments of relaxation you can work into your day the better. If you look at the best pro athletes, for example, they are typically the ones who look the most relaxed the instant they step off the field, off the court, or out of the ring. They know it’s time to let go of whatever mistakes they made and rest before they have to get back in the game. Stress is cumulative, so the more of those kinds of microbreaks you can incorporate into your day, the less burdened you will feel.

 At Foundry, we know that recovery from addiction is really about living a better life. It’s about being more skillful in the way you cope with stress, manage your emotions, and relate to other people. That’s why life skills, emotional regulation skills, self-care, meditation, yoga, and other practices are integral to our holistic addiction treatment program. For more information, call us today at (844) 955-1066.

In recent decades, more people have become aware of the importance of emotional intelligence, and it is especially important for recovering from addiction. While cognitive intelligence can help you get good grades in school and excel in certain jobs, it won’t protect you from developing a substance use disorder. In fact, some studies suggest that IQ correlates with a greater risk of substance use issues.

The problem is that cognitive intelligence has little influence over emotions. And once you develop a substance use issue, you mainly use your intelligence to get more drugs and alcohol. That’s why they often say in AA that “your best thinking is what got you here.” In a way, recovery from addiction is all about strengthening your emotional intelligence. The following are the five standard components of emotional intelligence and how they contribute to sobriety.

Self-Awareness

Self-awareness is the foundation of all emotional intelligence. It means being aware of your own strengths, weaknesses, blind spots, biases, and triggers. It means knowing what your core values are, what you enjoy, and what you don’t. Having relatively good self-awareness is like having a good map of your own mind. It helps you accomplish the things you want to do.

Unfortunately, self-awareness is not easy. As noted above, well all have biases and blind spots and these are usually most extreme regarding ourselves. This is compounded by the illusion that we know ourselves very well. Luckily, you can improve your self-awareness. The best tools for doing that are group and individual therapy.

These provide the rare opportunity to get objective feedback about your personal history, your beliefs, and your thinking habits. Another way to improve self-awareness is just to ask for feedback from people who know you well--friends, family members, coworkers, and so on. However, these people may be reluctant to be too honest, so you have to make it clear that you’re trying to better understand yourself, including your weaknesses.

Self-Regulation

Self-regulation is when you put your self-knowledge to good use. It’s the ability to keep yourself from lashing out in anger or from pouring a drink when you feel stressed. It’s the ability to cope with feeling overwhelmed or comfort yourself when you’re feeling anxious.

When you know yourself, you know what kinds of situations are likely to trigger cravings and which people you have trouble saying no to. Self-regulation is the main area where the rubber meets the road in addiction recovery, where the self-discovery you did in therapy is put to practical use improving your real-life behavior.

Self-regulation, like self-awareness, is a never-ending process and each depends on the other. Again, therapy is the single most powerful way to improve self-regulation. You learn many cognitive and behavioral strategies to help you cope with challenging emotions and make better decisions.

Some therapeutic methods, like dialectical behavioral therapy, or DBT, specifically use group sessions as a safe space to practice new skills before you have to use them in the wild. For example, it’s a good place to practice hearing constructive feedback without becoming angry or defensive. 

Motivation

Motivation is being able to motivate yourself and others to do what needs to be done. In addiction recovery, self-motivation is most important, but it can also be a way to support fellow group members and possibly even mentor others later on. People often start out in recovery feeling motivated because they are desperate for change. However, motivation often wanes as people encounter unexpected challenges or start to feel complacent about recovery. Knowing how to motivate yourself can make the difference between sticking to your recovery plan and gradually sliding toward relapse. 

Motivation is mainly about three factors: remembering why sobriety matters to you, remembering how bad things were when you were actively addicted, and overcoming your doubts about whether you can succeed. There are various ways to address each of these but a good place to start is by connecting sobriety to your highest values. Having a why can keep you going through tough times.

Empathy 

Empathy is the ability to put yourself in someone else’s place, to be able to have some idea of what they’re feeling and thinking. It’s the basis of compassion, which is empathy plus the desire to relieve someone’s suffering. In the context of addiction recovery, empathy is most important for its role in strengthening relationships--both with friends and family and with your sober network. The more connected you feel to others, the easier it is to stay sober. Socially connected people feel less stressed, less lonely, more accepted, and more accountable. 

Increasing your empathy is mainly a matter of making a consistent effort to understand other people’s perspectives. This is especially important for people you don’t especially like or get along with. It helps to start by identifying the things you have in common. For example, you both want to be happy, you don’t want to be in pain, you want to feel like you matter, and so on. Recognizing these universal needs can help you understand what other people are going through.

Social Skills

Social skills are built on empathy and they are important for many of the same reasons as empathy is important. However, just as self-awareness is the foundation of self-regulation, empathy is the foundation of social skills. Much of our stress in life comes from interpersonal conflict, and much of that comes from poor communication. By improving your communication and conflict resolution skills, you can eliminate a lot of stress and irritation. 

Improving your social skills is a huge subject, but it all starts with being a good listener. Give the person you’re talking to your undivided attention--which means put down your phone for a minute. Use reflection to show you’re listening and figure out whether you’ve understood correctly. Reflection usually involves phrases like, “So, what you’re saying is--” Validate what the person is saying and try to understand points of confusion or ambivalence. 

Although some people are born with more emotional intelligence than others, we can all improve our emotional intelligence. What’s more, some people are stronger in some areas than others. You might have loads of empathy but poor self-awareness or vice versa. Correcting your weaknesses can help you have a better, longer recovery and be happier overall.

At The Foundry, we believe that overcoming a substance use disorder is really part of the larger project of living a better life. We use methods like DBT, group therapy, and mindfulness meditation to help our clients live fully realized lives, free from drugs and alcohol. For more information about our treatment options, call us at (844) 955-1066.

One stereotype commonly associated with people recovering from substance use disorders is that they are constantly drinking coffee and smoking cigarettes. At least one study suggests there may be some truth to this particular stereotype. The study of nearly 300 AA members in the Nashville area found that nearly 57 percent smoked cigarettes, compared to only about 14 percent of Americans overall.

By now, we’re all aware of the negative health effects of smoking but many in recovery tend to regard it as the lesser evil--it’s clearly bad, but if it helps keep you sober, maybe it’s worth the health risks down the road. However, it’s not clear that smoking does help you stay sober, and there may also be other reasons to consider giving up smoking at the same time you give up drugs and alcohol.

Smoking and Relapse

As noted above, smoking in recovery is a bit of a gambit: You’re accepting possible risks down the road to hedge against a present threat. The assumption that smoking can help prevent relapse is largely based on the idea that it can help manage negative affect--more on that below--but research suggests there may be more important factors in play. 

One study of more than 34,000 adults found that smoking was correlated with a much higher risk of relapse. Researchers from Columbia University examined three years’ worth of data from the National Epidemiologic Survey on Alcohol and Related Conditions, or NESARC, and found that among people who had struggled with substance use issues in the past, those who smoked were nearly twice as likely to relapse as those who didn’t--about 11 percent and 6.5 percent, respectively. Those who started recovery as smokers but later quit had a relapse rate somewhere in the middle, about 8 percent.

With so much data and such a large disparity between smokers and non-smokers, this is one of the more compelling studies related to addiction. However, it does leave some questions unanswered. Although the study controlled for a number of factors, including demographics, mood, anxiety, alcohol use disorders, and nicotine dependence, it may be that smoking correlates with more serious substance use issues. And this was a population study, not an intervention. Despite these limitations, there may still be reasons to think smoking increases relapse risk, including those below.

Smoking Can Trigger Cravings

Perhaps the biggest reason to think smoking may increase risk of relapse is that it is often a powerful trigger. For example, people quite often drink and smoke at the same time. Smoking is a perfect trigger because it has a distinctive taste, smell, and motor pattern associated with it.

So, for example, if you had been in the habit of coming home from work, lighting a cigarette and pouring your first drink of the evening, you may find yourself craving a drink after you light a cigarette. Identifying and avoiding triggers is especially important early in recovery and smoking may be a potent one.

Smoking Kills More People

Since the rationale for smoking involves a risk calculation, it’s a good idea to look at the actual numbers. In 2018, more than 67,000 people died of a drug overdose, and each year, about 88,000 people die from alcohol-related causes. That’s about 155,000 deaths a year combined. By comparison, more than 480,000 people die from smoking-related causes each year. These include lung cancer, heart disease, stroke, diabetes, respiratory infections, and COPD. 

For many people, a serious health scare--perhaps an overdose, a heart problem, or a diagnosis of liver disease--is what finally convinces them to get sober. It makes little sense to trade one serious medical issue for another.

Even if the trade buys you an extra 10 or 15 years, diminished quality of life is almost certain. Other people decide to get sober because of the way their substance use affects their families. Similarly, it’s worth considering how a protracted struggle with cancer, heart disease, or emphysema would affect your family.

Smoking and Unresolved Issues

In the study of Nashville-area AA members, smokers typically reported that the reason they smoked was to reduce negative effects, such as depression, anxiety, and irritability. While these are all common problems early in recovery, they may also be symptoms of untreated mental health issues, such as major depression or an anxiety disorder.

‍Mental health issues affect at least half of people with substance use disorders and they must be treated simultaneously for recovery to succeed long term. One shortcoming of mutual aid groups such as AA is that they can’t offer mental health treatment. So, if you are smoking more specifically to ward off depression or anxiety, it’s possible that you need to talk to a doctor or therapist about getting to the underlying cause.

Quitting and Willpower

Finally, quitting smoking might give you a slight boost in willpower. While it’s not a good idea to rely on willpower alone to recover from a substance use issue, it does play a supporting role and it can be handy in a pinch. One line of psychological research suggests that willpower is a faculty that can be strengthened with use.

A study on--of all things--smoking cessation found that participants who were asked to avoid sweets or squeeze a hand gripper for two weeks were more successful at quitting smoking than participants who were given a task that required no willpower. It’s possible you get a similar boost in willpower from quitting smoking, which can transfer to greater adherence to your recovery plan and longer abstinence from drugs and alcohol. 

Quitting smoking isn’t easy, but then, neither is overcoming any addiction. People with multiple addictions are expected to quit them all at the same time--with the exception of cigarettes. Although most addiction treatment programs don’t currently offer help quitting smoking, you can always decide to do it yourself. Given the other challenges of recovering from addiction, early recovery may be the least difficult time to quit smoking and it may improve your chances of a long recovery. 

At The Foundry, we know that recovery from addiction isn’t only about abstaining from drugs and alcohol, but rather about making changes that help you live a healthier, more fulfilling life. We provide a supportive recovery environment and use a variety of evidence-based methods to help our clients succeed long term. To learn more, call us at (844) 955-1066.

Enjoyment of a casual drink is no big deal for some people. They can go out with family and friends, have a few drinks, and enjoy time with loved ones. Some people go out every weekend, go to the club, or go see a band. We pop Champagne or buy rounds of drinks to celebrate. Alcohol is socially acceptable and available everywhere, making it hard for people who suffer from substance use disorders.

The casual social drinker will not give it a second thought, but to the person struggling, every store, restaurant, bar, alcohol commercial or TV show with a bar in it can be a trigger. When someone cannot control how much they drink or doesn’t know how or when to stop, it can be a sign of alcoholism. One of the most significant differences between those who casually drink what they want and those who cannot stop is control. When drinking becomes excessive, frequent, and out of control, it often leads to traumatic consequences, including death.

Signs of Alcoholism

People who go out with their friends and loved ones to enjoy a drink are not usually addicted to alcohol. Casual drinking behavior is having a few drinks with friends one or two nights a week socially but returning home to normal activities, as planned. Problem drinking behavior means not being able to stop drinking, feeling an urge to drink, and more. The lack of good judgment that accompanies drinking in excess can have many undesirable consequences. There are warning signs to pay attention to, including:

-Giving up hobbies, friends, and special interests just to drink.

-Developing a high tolerance to alcohol that requires a person to drink more to feel the effects.

-Experiencing withdrawal symptoms like nausea, vomiting, tremors, and other issues when a person tries to stop drinking.

-Drinking before work or doing normal daily activities.

Self-Guided Assessment

People can often gauge for themselves how much they are drinking or if they are experiencing problems with alcohol. Problem drinkers don’t need to go to rehab to stop drinking, but many do because they cannot stop on their own. If some of the following statements are true, there may be a problem with drinking:

• Drinking alone is a habit.
• Drinking too much happens more often than not.
• Every day there is a drink or the thought of drinking.
• Turning to alcohol to cure boredom.
• Using alcohol to anesthetize pain, trauma, or other issues.
• Requiring a drink to deal with regular everyday occurrences.
• Keeping a hidden supply of alcohol.

People who have issues with alcohol may be able to stop on their own, but they may not want to stop drinking. Some people may require some form of therapy or support to learn how to control drinking and stay away from its dangerous effects.

Alcoholism

When someone cannot control their drinking, that is usually a sign of alcoholism. They may appear to be high-functioning or normal functioning, but they are experiencing problems with drinking. Their behavior may get them in legal trouble, jeopardize their professional license, or have other dangerous effects. If others think drinking is a problem, school or work suffers, and if there have been failed attempts to quit, then it may be time to consider outside support services.

Finding Help for a Substance Use Disorder

It is difficult to quit drinking by oneself without the support of loved ones. Still, the decision belongs to the person experiencing substance use disorder symptoms. When a loved one struggles with alcoholism, recovery can take a long time, and they need to feel they will have that support. It means physical, mental, and spiritual work to free themselves from the confines of substance use behavior.

Whether a person needs structured inpatient treatment or monitoring from professional staff, there is a program that will support people’s individual needs in recovery. It is not useful or necessary to suffer alone. To create a personalized plan means seeking out all the help that is needed. Most methods include mental health support, physical health support, detox, long-term treatment, aftercare, and much more.

Seeking Support

For people who struggle with alcoholism, finding the right support and acting with intention are positive first steps to a successful recovery. The right program may come along, but outside supportive services are necessary to help a person healthily navigate their healing. Recovery is difficult, but a person who feels free and can heal will usually do so much better with loved ones standing alongside them.

Alcoholism can often push people away because it puts them in bad situations. The loved ones may be frustrated and tired of dealing with their behavior, so they are not able to deal with the issues. Putting effort into navigating the journey with those who will stand alongside the person as they go to treatment might mean asking friends, rather than family, for support. Regardless of individual needs, the resources and information are available to those seeking assistance.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their own values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at (844) 955-1066.

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At the moment, Americans and people around the world are currently advised to stay home to help prevent the spread of Covid-19, or the coronavirus. While this is a sensible precaution to protect public health, it may seriously test many people’s mental health, especially anyone with a history of anxiety or depression. No one knows how long the quarantine might last but the current estimate is at least eight weeks. On top of that, people aren’t sure how this virus might affect their jobs or the economy overall.

Then, of course, there is the possibility that you or someone you care about might get sick. Compounding all this uncertainty, we are denied major sources of comfort such as spending time with family and friends, religious and spiritual gatherings, and 12-Step meetings. If the quarantine has got you on edge, here are some suggestions for managing your mental health.

Don’t Obsess Over the News

It’s tempting to spend your day refreshing Twitter or watching cable news, trying to keep up on new developments with the virus. That’s especially true since this is--we hope--a once-in-a-lifetime event. We want to know if we should be doing anything, if there have been new cases or cures, how many cases there are in our area, what the government is doing, and when this whole thing might be over.

However, obsessing over the news, now more than ever, is only going to make you feel worse. While a lot of the media coverage has been uncharacteristically measured, it can still give you the feeling that we’re all living in a disaster movie. Try to limit your news consumption to once a day. Check the CDC website for information and updates, and otherwise keep calm and carry on.

Stay In Touch With Your Therapist

If you’ve had issues with anxiety, depression, or substance use, you may have a regular therapist. You may or may not be able to keep your regular appointments, depending on where you live. Be sure to contact your therapist and make some kind of backup plan. A lot of therapists are now offering HIPAA-compliant video sessions, so that may be an option.

Other people have been doing phone sessions or Skype sessions. If you don’t have a regular therapist or if you can’t get in touch with your therapist and you or someone you care about is feeling overwhelmed, sad, depressed, anxious, or possibly a danger to yourself or others, call 911 or call SAMHSA’s Disaster Distress Helpline at 1-800-985-5990.

Eat Healthy

Since the quarantine feels like something between a sick day and a holiday, you might feel tempted to splurge on junk food. However, it’s important to keep two things in mind. First, this might go on for a while and you don’t want your cheat day eating to become a habit. Second, what you eat has a pretty direct effect on your mental health. This effect appears to be especially strong for depression.

Try to eat meals that are mainly composed of whole foods, especially fruits, vegetables, whole grains, nuts, beans, legumes, and lean meats, especially fish. As much as possible, avoid processed foods, especially processed meats, which are highly inflammatory, sugar, and fried food. If you’re recovering from addiction, it should go without saying that you should avoid alcohol as well.

Try to Get Some Exercise

Exercise is one of the best ways to boost your mood and lower stress. It releases mood-boosting endorphins and serotonin as well as BDNF, which grows neurons in the hippocampus, a part of the brain that helps consolidate memories. Exercise also increases blood flow to the brain, especially the prefrontal cortex, which is responsible for executive functions such as planning, emotional regulation, foresight, and self-control--all of which are great to have in a crisis.

At the moment, it’s still considered safe to walk, run, or bike outside, since the risk of transmission is low in outdoor environments. There are also plenty of workouts and yoga routines you can do in a small space at home. Check out YouTube for some options that appeal to you.

Reframe How You Think About the Quarantine

The funny thing about the quarantine is that up until a few weeks ago, there seemed to be no end of complaints about how Americans never properly socialize anymore. We all just stay home and play video games and watch Netflix.

When we do go out, we spend all our time looking at our phones. Now that we have to stay home, it seems like a huge burden. Instead of feeling constrained, choose to focus on all the stuff you can do at home. Catch up on reading, cleaning, TV shows, or other projects that you seem to always put off.

Stick to Your Regular Routine as Much as Possible

Part of the stress of being quarantined is that it feels like the whole world has suddenly changed. Change is always a bit stressful, especially changes you can’t control. Part of the solution in this case is to take control of the things you can control and stick to your normal routine as much as you can while still complying with public health recommendations.

Keep getting up at your regular time and taking a shower, even if you don’t have to be anywhere. Eat your regular meals, do the things you normally do, and go to bed at your regular time. If you are recovering from addiction or a mental health issue, there are probably things you normally do at home as part of your recovery plan and there’s no reason why you can’t keep up with those.

Stay in Communication With Friends and Family

We have more ways to communicate than any people in history. Don’t get so much into your reading or binge watching that you don’t keep in touch with friends and family.

Remember, We’re All in the Same Boat

If you’re sitting home alone during the quarantine, it’s easy to feel like you are alone in the world. However, there are millions, perhaps hundreds of millions who are having very similar experiences at the moment. So first, consider that whatever discomfort you’re feeling as a result of the quarantine is a small sacrifice that you’re making willingly to help protect the most vulnerable people in our society.

Second, consider the welfare of other people under quarantine. Approaching the situation with compassion helps you feel less alone and you may think of some small way to help your neighbors too.

You never know what kinds of challenges you may face when recovering from a mental health issue or a substance use disorder. While we typically prepare ourselves to cope with more mundane sorts of stress, the same principles basically apply for outlier events like a pandemic. At The Foundry, we know that recovery from addiction is really about giving you the skills to lead a happier, more fulfilling life. To learn more about our treatment programs, explore our website or call us today at (844) 955-1066.

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Feeling socially connected is one of the most important ways of making recovery from addiction last. Social support improves your mood, reduces stress, provides more resources for dealing with problems, and makes you feel more accountable. However, staying socially connected can often be a challenge for people in recovery. At least 20 percent of people with substance use disorders struggle with major depression, an anxiety disorder, or both. Those conditions typically make you feel inclined to stay home and isolate yourself. 

Unfortunately, isolation only makes them worse, especially depression. The tendency to isolate can cause a downward spiral, turning a bad mood into a full episode of depression. You can often interrupt that spiral by making yourself do things that improve your mood, such as socializing or going to meetings. This is a well-established intervention called behavioral activation. However, socializing when you feel depressed or anxious is not easy and sometimes it’s impossible. The following tips can help.

Accept Invitations

Accepting invitations is a freebie. If people are reaching out to you and asking you to do things, you’re already in a pretty good position and it may be nice to take a moment to appreciate that there are people in your life who want to be around you. Unless there’s some specific reason for declining an invitation such as a scheduling conflict, go ahead and accept, even if you know for certain you won’t feel like going when the time comes.

If you accept the invitation, you will be more likely to actually go out and do something, whereas if you decline, you will almost certainly stay home alone. You can always cancel later, but if you accept now, you will at least have options.

Don’t Wait Until You Feel Like Socializing

Whether you have already made plans or not, don’t wait until you feel like socializing to actually do it. When you’re feeling down or actually depressed, you’re never going to feel like it. The whole point is that you do something to interrupt your current mental state. The trap we often fall into with socializing is that we expect it to be a pleasant thing that we actively want to do, so when we don’t feel like it, it makes sense just to stay home. 

However, when you’re depressed, anxious, or moving in that direction, the whole matter is different. You don’t feel like socializing because you don’t feel like doing anything. Socializing is something you have to do for your mental health so you have to draw on different resources. It’s more like going to work--perhaps you rarely feel like going to work but you usually go anyway. It may help to remind yourself that your resistance to socializing is mostly inertia and that once you’re with your friends, you will usually feel glad you came.

Do What You Can

You may have some default idea of what socializing looks like--maybe dinner with a group of friends, maybe a family outing, or a party. When you think, “I should socialize,” you immediately think of that default and you feel like you couldn’t possibly manage it. However, you are being subtly undermined by all-or-nothing thinking. When you’re in a funk, any social contact at all is better than none. If all you can manage is texting a friend or relative, then do that. If you can call them and have a chat, even better. 

This is especially important to remember as we’re all dealing with the pandemic and our social interactions are restricted anyway. Texting and FaceTiming might not be perfect but they still help. Often, frequent contact with different people throughout the day is better for your mood than minimal contact throughout the week and then a big gathering on the weekend. Too much alone time with no outside contact only gives you more time to ruminate.

Exert Some Influence Over Plans

When someone asks you to do something, it’s rarely a take-it-or-leave-it proposition. You can usually exert some control over the plan. This is important for two reasons. First, as discussed above, socializing isn’t all-or-nothing. Some socializing is better than none and you should only do what you feel like you can handle, which might mean asking your friends or relatives to modify plans.

For example, maybe your friend invites you out to a restaurant and you don’t feel like you can handle that, so you propose instead that your friend comes over and you order pizza. You get the social interaction and you let your friend know you actually do want to spend time with them but you avoid a supposedly fun thing that you’re just not up for.

Second, exerting influence over plans nurtures a sense of self-efficacy or the feeling that you have some control over your life. A common symptom of depression is helplessness--the feeling that nothing you do matters, that you’re just sort of dragged along by life. Exerting your will over your social plans reinforces that you do actually have some control over your life.

It may be worth making some small change to any plan, even if the plan is broadly acceptable, just to work your self-efficacy “muscle.” For example, bowling sounds fine but you’d rather go to a different place, or you’d rather go at eight instead of seven. Furthermore, having more control over plans makes you feel more engaged and less likely to skip out at the last minute.

Take a Break When You Need It

When you’re depressed or anxious, you may have very short battery life. If you’re already an introvert, then socializing when you’re in a bad mood can really take it out of you. It’s important to give yourself breaks. You can either step away from the group, or just have a way to leave early. As discussed earlier, shorter, more frequent interactions are typically more important than marathon social engagements. There’s no point in burning yourself out and dreading the next engagement even more. 

Staying socially connected is one key to a strong addiction recovery but an episode of depression or anxiety can make you want to isolate yourself from everyone, including your sober network. To combat this, it’s important to do what you can, even if it’s small and even when you don’t feel like it. Think of it like going to work or brushing your teeth. Exert some influence over plans when possible and be willing to give yourself a break.

At The Foundry, we know that no one recovers from addiction alone. We work hard to make sure our clients feel supported and develop bonds with other people in recovery. We also involve families in treatment because we know that a supportive home environment is a huge asset. To learn more about our approach to treatment, call us today at (844) 955-1066.

Compassion is simply feeling someone else’s pain and sincerely wishing to relieve it. In a previous post, we looked at how compassion benefits addiction recovery. Compassion allows you to forgive yourself for your past mistakes and form stronger bonds with other people. Perhaps most importantly, greater compassion leads to greater happiness.

Concern for helping others rescues you from your own fear and rumination and gives you a sense of purpose. However, you may not know how to be more compassionate, or even if that’s possible. We all know people who seem like they were born to watch out for other people, whether they’re first responders or preschool teachers.

You may think, “That’s just not me.” However, we’re all more adaptable than we believe. With persistent effort, you can become more compassionate and enjoy the benefits that come with it. Here’s how.

Keep an Open Mind

For some people, the benefits of compassion are obvious but others may be more skeptical. They may see kindness and compassion as forms of weakness, believing self-reliance is the only true form of strength. The good news is that you don’t have to flip the compassion switch forever.

You can try it out and see how you like it. Like most things, it takes a bit of work to make compassion a habit but you can try out compassionate thoughts and behaviors without too much effort.

Practice Gratitude

Most of the time, when we resist the idea of compassion, it’s because we feel like no one has done much for us, so why is it our responsibility to help others? However, no one makes it very far in life without help. We’re born helpless, so if you’re alive, someone had to keep you alive for at least a little while.

Other people have helped you along the way, whether you realize it or not. The first big step toward being more compassionate is understanding and feeling grateful for the help we’ve received, even if it was small. 

You can easily cultivate gratitude in two ways. First, keep a gratitude journal. Every day, just write down three things that you were grateful for that day. Eventually, you will start noticing things as they happen and feeling more grateful.

Second, write a gratitude letter to someone describing what they did for you and what it meant to you. Then you can deliver the letter if you want. These practices are not only the foundation for compassion, but they have also been shown to make you feel happier and more optimistic.

Start With Compassion for Yourself

When developing compassion, it’s typically easiest to start with yourself. Even if you don’t like yourself very much, at least you genuinely desire your own happiness. Many people struggle with guilt and shame as they try to recover from addiction and developing self-compassion will definitely help with that.

When you think about the mistakes you’ve made, try to have compassion for your past self. Imagine you’re talking to a close friend and trying to support them. It’s also important to have compassion for your future self. Compassion for your future self can give you the motivation to do the hard things now that will benefit you in the future. 

Practice Listening

Empathy is about half of compassion. If you are going to feel compassion for someone, you have to understand what they’re going through. The best way to do that is to listen. Give others your full attention and listen without judgment. Reflect back what they’ve said and try to put yourself in their place. Ask, “What was that like?” 

Try to Stay Present

Staying present is an often overlooked aspect of compassion. If you’re ruminating about the past or worrying about the future, you are necessarily stuck in your own head, and most likely worrying about your own problems. You’re not paying attention to the people around you. Compassion really only happens in the moment, when you become aware that someone else is having trouble.

You have to be present to listen too. One trick you can use to stay mentally present is to think about your feet. Your feet have a high density of nerve endings, yet we rarely pay attention to those sensations. Doing that will instantly bring your attention into the present.

Set Aside Judgments

We make quick judgments all the time and most of the time, we’re trying to answer the question, “Is this useful to me?” as quickly as possible. The problem is that applying these judgments to other people is basically the opposite of compassion.

Once you can stick a label on a person and put them in a box, you don’t have to think about them anymore. Try to be aware of when you're making judgments about people--including yourself--and pause before you do it. Instead of thinking, “they’re this or that kind of person,” just try to see them as they are.

Look for Commonalities

Whereas judgments oversimplify people for easy categorization, looking for common ground builds a bridge. You start to think about what it might be like to be that person. If you don’t know someone well or at all, you can start with some fairly universal assumptions, like that they want to be happy, they want to feel appreciated, they want to be free of pain, and so on, the same as you. Even if they seek these things in a very different way, you will have some points from which to build empathy.

Try Metta Meditation

Metta means something like loving-kindness and it comes from a Buddhist meditation practice. The idea is simple. It’s almost like lifting weights for compassion. You start with something relatively easy: feeling compassion for yourself. You direct a few positive thoughts towards yourself, something like, “May I be happy, may I be safe, may I be healthy,” and so on. When you feel a genuine sense of compassion for yourself, just allow yourself to rest with that feeling for a few minutes. 

Then, move on to someone close to you, perhaps a relative or your best friend, and do the same thing. Then, move on to a stranger, and finally a challenging person. You don’t have to do all this at once. You can work up to it over the course of weeks or months if you have to. The key is to challenge yourself to feel genuine concern for people you aren’t really close to or that you may even dislike. This is incredibly hard for most people, so don’t beat yourself up if you can’t do it right away.

Developing a greater sense of compassion is one of the best ways to strengthen your recovery because it makes you feel happier and more connected to others. Cultivating compassion is mainly a matter of intention and persistence. Remind yourself daily that you’re going to listen to others, try to understand what they’re experiencing, and try to be kind.

At The Foundry, we know that connection is one of the most important things in recovery. It makes you feel happier and gives you a sense of purpose and belonging. That’s why we promote a sense of community in our treatment program through group and family therapy, group activities, mindfulness meditation, and other methods. To learn more, call us at (844) 955-1066.

Most people with substance use disorders have one or more co-occurring mental health issues. Typically, the mental health issue comes first and drives addictive behavior, but drugs and alcohol also make mental health issues worse. Accurately diagnosing and effectively treating any co-occurring mental health issues is one of the most important parts of a strong recovery from addiction. Unfortunately, neither diagnosis nor treatment is as straightforward as one would hope. Mental health issues often come in clusters; symptoms overlap and present differently in different people. The following mental health issues are some that are both common in people with substance use disorders and are frequently misdiagnosed.

1.) Bipolar Disorder

Bipolar disorder may be the most commonly misdiagnosed mental health issue. Furthermore, treating bipolar incorrectly may have the most adverse effects. A number of studies have looked at the misdiagnosis of bipolar. One study found that 69% of people with bipolar disorder were initially misdiagnosed and about a third of those remained misdiagnosed for at least 10 years. 

Bipolar disorder is most frequently misdiagnosed as unipolar major depression--commonly known as depression. This is because the symptoms of a bipolar depressive episode--depressed mood, inability to feel pleasure, sleep disturbances, irritability, fatigue, sudden weight changes, poor concentration and memory, aches, slow movements, and thoughts of suicide or death--are indistinguishable from unipolar major depression. What’s more, when people seek help for bipolar symptoms, they typically seek help for depressive symptoms and they may neglect to mention manic symptoms, especially if they’re relatively mild. Depression is also more than twice as common as bipolar disorder, so it’s often a reasonable diagnosis.

As a result, people with bipolar are often prescribed antidepressants such as SSRIs, which help with depressive symptoms but may trigger manic symptoms. If you experience manic episodes, such as high energy, little need for sleep, delusions of grandeur or paranoia, hyper-productivity, or starting lots of new projects that you never finish, it’s important to mention those to your doctor or therapist when seeking help for depression.

2.) Borderline Personality Disorder

Borderline personality disorder, or BPD, massively increases your risk for developing a substance use disorder at some point in your life. Although it affects only about 2.7% of adults, about 78% of people with BPD will develop a substance use disorder. BPD is typically characterized by emotional volatility, sudden changes in self-identity, relationship problems, mood swings, suicidal thoughts or behavior, feelings of emptiness, and impulsiveness. 

Because these symptoms seem to be a mix of both depressive and manic symptoms, BPD can easily be mistaken for bipolar disorder. Although bipolar is also characterized by unstable moods, the changes tend to happen over longer periods, typically weeks or months. Bipolar is currently treated with some combination of therapy, antidepressants, and mood stabilizers, whereas BPD is treated with an intensive form of therapy called dialectical behavioral therapy, or DBT.

3.) PTSD

PTSD requires four kinds of symptoms for clinical diagnosis: re-experiencing symptoms such as nightmares or flashbacks, avoidance symptoms such as avoiding driving after an accident, changes in behavior such as becoming short-tempered or easily startled, and changes in cognition, such as becoming pessimistic or emotionally numb. There can be quite a bit of variation in the way these symptoms manifest and some kinds of symptoms may be far more prominent than others. It would be quite easy, for example, to mistake the behavioral and cognitive changes for symptoms of major depression.

While treating PTSD the way you would treat depression might help--some of the methods, such as cognitive behavioral therapy, or CBT, and antidepressant medications often help with both--PTSD is a more complicated issue and typically requires reprocessing the trauma for recovery. Considering that as many as 50% of people seeking help for a substance use disorder have symptoms of PTSD, it’s crucial to get this diagnosis and treatment correct. As with bipolar disorder, it’s important to tell your doctor or therapist about any trauma you may have experienced as well as avoidance or re-experiencing symptoms related to that trauma.

4.) ADHD

ADHD is a strange case because experts seem to agree that it is over-diagnosed in children but under-diagnosed in adults. If you happen to slip through the net of ADHD diagnosis as a child, it could be causing you problems as an adult. Typically, as we age, the symptoms of ADHD become less apparent. People learn to control their fidgeting and impulsive behavior to some degree so it’s not obvious they have ADHD but the cognitive symptoms, such as racing thoughts persist. Somewhere between 10 and 24% of people seeking help for a substance use disorder have ADHD, compared to less than 5% of American adults overall. 

ADHD isn’t usually mistaken for something else--it’s typically not recognized at all--but occasionally, the symptoms are mistaken for manic symptoms of bipolar disorder. This misdiagnosis might be confirmed if the person happened to have a depressive episode in the past, which is not terribly uncommon. The good news is that controlling ADHD with appropriate medication makes it much easier to stay sober.

5.) Depression

Like ADHD, depression typically isn’t misidentified as something else but rather isn’t recognized at all. While most of us are familiar with some of the symptoms of depression like depressed mood, lack of motivation, fatigue, excessive sleep, and thoughts of suicide, other common symptoms such as irritability, aggressiveness, reckless behavior, substance use, physical pain, and poor concentration are less often recognized. If these are your primary symptoms, you probably wouldn’t think to seek help for depression or any mental health issue and your loved ones might not recognize it either. This is especially true of men, who are both less likely to recognize depressive symptoms and less likely to seek help than women. 

It’s crucial to recognize that addiction isn’t only about substances. Most of the time, people with substance use issues have at least one mental health issue to go with it. Drugs and alcohol are often coping mechanisms. If you want to have a lasting recovery from addiction, then it’s vital to identify and treat the underlying causes, especially when those causes include a serious mental health issue. While we expect mental health professionals to diagnose and treat us correctly, it’s important to understand how murky the realm of mental health can be. Your doctor or therapist only knows what you’re willing to share with them. It’s important to be open about all of your symptoms so they can better help you. 

At Foundry, we know that addiction is complex, which is why we approach treatment from many angles, including DBT, 12-Step facilitation, family therapy, lifestyle changes, and more. We know that mental and physical health form the foundation of a strong recovery from addiction. To learn more, call us at (844) 955-1066.

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Despite increased media attention in recent years, there are still myths and misconceptions about addiction that won’t go away. These myths can have real effects on people’s lives, since they affect public opinion and public policy, not to mention they can make individuals reluctant to seek help. The following are some of the more common misconceptions about addiction.

“Addiction is a choice.”

Since substance use is typically a choice, many people assume addiction is a choice, as well. However, no one chooses to become addicted. What’s more, many people with substance use disorders want to stop but can’t. In fact, trying to quit but being unable to is one of the defining features of addiction. It’s important to remember that more than 86 percent of Americans have drunk alcohol at some point in their lives, but less than six percent develop an alcohol use disorder.

Even people who use highly addictive drugs like heroin don’t become addicted as often as you probably think. That means there are factors at work beyond choosing to use drugs or alcohol. It’s not possible to predict who will develop a substance use disorder and who won’t; and anyone who has seen addiction close-up would never believe someone would choose it.

“Addiction is caused by a lack of willpower.”

A lot of people think addiction is down to willpower — that if you resolve to quit drugs or alcohol, you can do it. A 2018 poll¹ by AP-NORC found that while a slim majority of Americans now see addiction as a disease that requires treatment, a large minority (about 44 percent) believe that opioid addiction indicates a lack of willpower or discipline.

While willpower and discipline can play a supporting role in recovery, they are not in themselves enough to keep you sober. The major risk factors for addiction include trauma, childhood environment, genetic factors, and mental health issues. Recovering from addiction requires addressing these issues, as well as creating a support system and making healthy lifestyle changes. Anyone who tries to stay sober using willpower alone is likely to have a hard time and a short recovery.

“Only a certain type of person gets addicted.”

A lot of people believe, perhaps on a subconscious level, that there’s a certain kind of person who develops a substance use disorder. They may think it depends on race, socioeconomic status, or personality type. In reality, addiction cuts across all of these. Ever since the beginning of the opioid crisis, this fact has become even more evident, due to the fact that millions of people who might never have otherwise been exposed to opioids were prescribed addictive painkillers by their doctors in large enough quantities to cause physical dependence. Addiction doesn’t discriminate.

“Once an addict, always an addict.”

This particular myth is doubly harmful. For one thing, it’s terribly stigmatizing. If someone has issues with drugs or alcohol, they get branded for life with the “addict” label, which isn’t fair.

More to the point, it just isn’t true. Research shows that the general public tends to vastly underestimate how many people successfully recover from substance use disorders. As noted above, addiction is often driven by other factors, including untreated mental health issues. Once you get these under control and learn some recovery skills, there’s a good chance you will be able to manage your addictive behavior.

Moreover, addiction often appears during early adulthood, between the ages of 18 and 25, when the brain — particularly the areas involved in judgment and self-control — isn’t fully formed yet. Substance use issues often get easier to manage after age 25. As we age, we also typically get less neurotic and more conscientious; a personality pattern that makes you less prone to harmful substance use. In other words, most people with substance use issues will recover with time and treatment.

“People with substance use disorders are typically unemployed and often homeless.”

A common stereotype of someone with a substance use disorder is that they are unemployed or even homeless. The corollary is that if you have a job, a family, and a place to live, that proves you don’t have a serious substance use issue. While it’s true that substance use issues are more common among unemployed and homeless people, it doesn’t follow that most people with substance use issues are unemployed or homeless.

Addiction is a largely invisible problem and many outwardly successful people struggle with substance use in private. In fact, most people with substance use issues are able to keep their lives together for at least a while. Professionals in particular will go to great lengths to keep their substance use from affecting their work. In the long run, though, most people can’t keep this up. Either they get help, or their substance use will affect their jobs and families.

“You have to hit rock bottom before you can recover from addiction.”

This is a particularly destructive myth because it probably keeps people from getting help in time more than any other myth. In reality, most people who get help for addiction aren't quite sure they’re ready to get sober. Sometimes they don’t even believe they have a problem and they just want to placate their families. However, this doesn’t mean they can’t recover.

‍For example, each year, more than 120,000 Americans opt for treatment in drug courts and they have significantly better outcomes than people who go to jail. Additionally, interventions are often successful in getting people to accept treatment. Once in treatment, most people become more motivated to stay sober and they often do well. If you wait to hit rock bottom, it may be too late.

Myths about addiction persist mostly because we tend to believe whatever fits in our worldview, not necessarily what the evidence tells us. There are mountains of evidence telling us that addiction is not a choice, that it is caused by factors such as mental health issues, genetic factors, and trauma, and that treatment — not punishment — helps people recover. At The Foundry, we know that treating addiction is a complex and individualized process and we use many evidence-based modalities to help our clients create a strong recovery. For more information, call us today at (844) 955-1066 or explore our website.

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Abuse is a major risk factor for developing mental health issues such as major depression and anxiety and for developing substance use issues. This can happen to both children and adults and while childhood abuse and neglect have a greater effect on people over the lifespan, abuse is a major concern for adults too.

When we think of abuse, physical and sexual abuse are typically the first things to come to mind. However, emotional abuse can be just as damaging and more insidious. While people are typically aware they are being physically or sexually abused, emotional abuse is often more subtle. Part of the power of emotional abuse is its deniability and emotional abusers are often adept at making you doubt your own judgment.

As with physical abuse, the goal of emotional abuse is to control you. However, while physical abuse mainly works through intimidation, emotional abuse gets inside your head and undermines your confidence and judgment. People who are emotionally abused often feel like they are incapable or unworthy of leaving an abusive situation. Although they may know they are unhappy, they may not be aware that what they’re experiencing is emotional abuse. The following are some common signs of emotional abuse and what to do about it.

What It’s Not

First, it’s important to clarify that someone is not being emotionally abusive just because they do something we don’t like or something that makes us feel bad. Arguing, for example, is common in almost every close relationship because it’s normal for people to sometimes have conflicting needs and desires. Even yelling is typically not a sign of emotional abuse. Breaking up with someone or otherwise protecting your own boundaries is not emotional abuse, nor is honest communication. Emotional abuse is done with the intent to make someone feel bad, inadequate, stupid, guilty, or weak and usually for the purposes of control.

Disparaging Behavior

Perhaps the most obvious sign of emotional abuse is disparaging behavior. This is an overt assault on your sense of self-worth. Disparaging behavior may include name-calling, such as outright calling you stupid, weak, ugly, hysterical, fat, and so on. A slightly subtler way is to use “pet” names that are played off as playful or affectionate but are really belittling. If you’re the object of such a pet name, you can easily spot it by how it makes you feel. Other ways of disparaging include making sarcastic remarks, making jokes at your expense, or making light of your interests or accomplishments. This is all intended to make you feel worse about yourself so you feel like you need the abuser’s approval and so you don’t think you could do better elsewhere.

Isolating or Controlling Behavior

As noted above, emotional abuse is primarily a means of control and therefore any controlling behavior – overt or covert – is also a form of emotional abuse. Controlling behavior can take many forms. One way that has become disturbingly common is checking your partner’s phone for incriminating texts. This implies your partner is untrustworthy and it makes unfair demands on their privacy. If you believe your partner is cheating on you, you should ask. If you feel like you can’t trust your partner, then break up.

Another common and subtle way to control is withholding affection unless the other person does what you want. This tactic can be used by romantic partners or by parents and it can be especially harmful to children. However, it’s not the same as not being affectionate because you’re arguing or angry about something specific.  

Isolating is another common control tactic. The idea is to keep the person dependent. The abuser might try to keep you from interacting with friends and family, for example. They don’t want you to have options they don’t approve of and they don’t want other people filling your head with ideas they don’t like.

Gaslighting

Gaslighting is a way of undermining your sense of reality. This is typically done by contradicting things they know to be true. For example, they might spring plans on you at the last minute and when you say you didn’t know anything about it, they might insist you talked about it last week. Over time, you start to doubt your own memory and start to rely on your partner, who seems to remember everything. Often, a gaslighter will lie about things that aren’t important at all just to undermine your confidence.

Having Unrealistic Expectations

Other tactic emotional abusers use to undermine your confidence is to have unreasonably high expectations. These might pertain to them specifically, such as expecting you to spend all your time with them or make unreasonable sacrifices on their behalf. It might also be more general, such as never being satisfied with anything you do, never complimenting you, always finding fault, and generally making you feel like you always fall short. If you set the bar high enough for someone you can always be sure they will fail, or at least feel like they’ve failed. This is especially damaging because it develops a sense of learned helplessness – nothing you do is good enough, so why try? It also keeps you seeking the abuser’s approval.

What to Do

Emotional abuse is hard to escape because much of the time, you’re not even sure it’s happening. Awareness is the first step. Pay attention to the patterns. Your parents, teachers, boss, spouse, or romantic partners aren’t supposed to make you feel bad about yourself. If you’re always walking on eggshells around them, something is wrong. Look out for the behaviors described above.

Next, know it’s not your fault. Emotional abusers often make a good show of being kind and supportive and it’s easy to fall for. If you experienced emotional abuse as a child, you probably just thought that it was normal. The sooner you realize it’s not, the better.

Get away from the abusive situation as soon as possible. If you can’t for some reason, work on setting boundaries. This can be incredibly hard and you may need the help of a therapist and possibly a support structure, which an emotional abuser certainly won’t like. What’s more, don’t fall into the trap of thinking you can fix an emotional abuser. They’re good at making apologies and promises, but they also have their own problems and they aren’t likely to change their behavior for good.

If you’ve been the victim of emotional abuse, it has probably caused you some problems, which might include depression, anxiety, or substance use issues. Of the 10 adverse childhood experiences, or ACEs, linked to increased addiction risk, emotional abuse accounts for two, each of which at least doubles your risk of addiction. Awareness is the first step.

At Foundry Treatment Center, we share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at 1-844-955-1066.

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Most people who struggle with substance use issues also struggle with at least one other mental health challenge. The National Institute on Drug Abuse estimates that at least half of people with substance use disorders have a co-occurring mental health issue. Typically, the mental health issue comes first and substance use is often a means of self-medicating.

However, drugs and alcohol only make symptoms worse in the long run. A strong recovery requires that you get integrated treatment for substance use and any mental health issues. The following are the most common mental health issues that occur with addiction.

Anxiety Disorders

Anxiety disorders include several specific conditions, such as generalized anxiety disorder, social anxiety disorder, phobias, panic disorder, obsessive-compulsive disorder, or OCD, and post-traumatic stress disorder, or PTSD. Anxiety disorders affect more people than any other mental health issue. The National Institute of Mental Health estimates that more than 30 percent of Americans will experience an anxiety disorder at some point in their lives.

Anxiety is also a significant factor in developing a substance use disorder. According to the National Epidemiological Survey on Alcohol and Related Conditions--a survey of more than 43,000 adults revealed nearly 18 percent of respondents with a substance use disorder also met the criteria for an anxiety disorder not related to withdrawal.

Perhaps not surprisingly, marijuana was the most commonly used substance among people with anxiety disorders. Perhaps more surprisingly, cocaine and amphetamine use was also common, while the association with alcohol was weaker. It’s important to note, though, that this survey didn’t include PTSD, which is a major risk factor in itself.

PTSD

Post-traumatic stress disorder, or PTSD, may be one of the single biggest risk factors for developing a substance use issue. PTSD is far less common than anxiety disorders generally, affecting less than eight percent of Americans, but its effect on addiction risk is huge.

Some studies estimate that as many as half of people with substance use disorders also have symptoms of PTSD. PTSD itself has a complicated relationship with other mental health issues such as depression and anxiety. For this reason, addressing trauma is often a crucial element of addiction treatment.

Major Depression

Just over seven percent of Americans will have a depressive episode in a given year and the World Health Organization estimates that depression is the world’s leading cause of disability. Depression also significantly contributes to addiction risk. One study found that among people with major depression, 16.5 percent had an alcohol use disorder and 18 percent had a drug use disorder.

In other words, depression roughly doubles your risk of developing a substance use issue. This is especially true of men, who are less likely to seek therapy and more likely to self-medicate with drugs and alcohol. 

Bipolar Disorder

Bipolar disorder is technically considered a depressive disorder, but it’s a much different challenge than unipolar depression and a much greater risk factor for addiction. The study cited above also found that among people with bipolar disorder, 56 percent developed a substance use disorder at some point in their lives.

Bipolar disorder also complicates addiction treatment since it often requires some trial and error with medications and people experiencing manic episodes sometimes believe they’re cured and no longer need treatment. Bipolar is also frequently misdiagnosed as unipolar major depression, which slows treatment and recovery.

ADHD

Attention deficit hyperactivity disorder, or ADHD, is a bigger risk factor than many people realize. It’s typically characterized by racing thoughts or jumping from one line of thought to another. In adolescence, this can lead to poor performance in school, social ostracism, and impulsive behavior--all risk factors for substance use.

One study found that more than 15 percent of adults with ADHD met the criteria for a substance use disorder, which is at least twice the rate in the general population. The good news is that that number appears to drop when ADHD is controlled with therapy and medication.

Borderline Personality Disorder

Borderline personality disorder, or PBD, is a condition characterized by volatile moods, unstable self-image, and turbulent relationships. While BPD only affects about 2.7 percent of adults, about 78 percent of people with BPD will develop a substance use disorder at some point in their lives. One reason that number is so high is that BPD also increases your risk of anxiety and affective disorders, including PTSD.

BPD also presents special challenges to addiction recovery, since people with BPD are more likely to drop out of treatment and remain sober for shorter periods. BPD requires special treatment methods and currently, dialectical behavior therapy, or DBT, is the best available treatment.

Schizophrenia

Schizophrenia affects just over one percent of Americans, but of those, around 50 percent have a co-occurring alcohol or drug use issue. The relationship between schizophrenia and substance use remains a bit more mysterious than that of other mental health challenges. For example, we aren’t quite sure why 70 percent of people with schizophrenia are nicotine-dependent, why they appear to use marijuana more heavily and at an earlier age, or why marijuana appears to precipitate symptoms in adolescents. As with bipolar and BPD, schizophrenia presents special challenges to addiction treatment since it often involves antipsychotic medication and difficulty sticking to a treatment regimen. 

Mental health issues significantly increase your risk of developing substance use issues, and they also increase your risk of developing other mental health issues. For example, major depression and anxiety disorders often go together. For this reason, it’s often hard to pin down the relationships between substance use and mental health issues and it’s often hard to pin down exactly what mental health issue is causing your problems. However, this is crucial to figure out if you want to sustain recovery from addiction and feel better in general.

At The Foundry, we understand the huge role mental health plays in addiction recovery. That’s why we employ a variety of proven methods to help our clients manage their mental health challenges. These methods include DBT, CBT, EMDR, and others. To learn more about our addiction treatment program, call us today at (844) 955-1066.

Foundry has been busy this month and February flew by! The Yampa Valley finally got some snow after a below average January and it feels like we are finally in the full swing of winter.All of this snow was vital to many of our Wellness Activities this month, and we made sure we got outside and enjoyed it! We planned some fun things this month, check out what we were up to in February!

Healthy Habits:

This month for Healthy Habits group we focused on meal planning. Before we dive in, let’s talk about what meal planning is. Meal planning is writing out what you are going to eat throughout the week. You can meal plan for all of your meals(breakfast, lunch, dinner and snacks), or just one or two meals (lunch and/or dinner). You can choose to plan every single day of the week or just pick a few days of the week, whichever is the most beneficial to your needs and schedule.

Meal planning is a great tool to help you eat healthier, introduce more variety to your diet, reduce waste, and save time and money! By planning your meals ahead of time, you have the opportunity to choose healthier meals, and plan on introducing a variety of fruits, vegetables and proteins throughout your week. With a plan in place, you can utilize leftovers for other meals, therefore reducing waste, as well as saving yourself some time and money. Having a game plan for your meals will save you the struggle of coming up with the answer to the question “what are we having for dinner?” every night and reducing the likelihood of resorting to fast-food or less nutritious food options.

Before you begin meal planning her eare some things you might consider:

-      How many people are you cooking for?

-      How often do you eat out? Include nights you eat out on your meal plan

-      Do you need to plan for packed lunches?

-      What is the busiest time of your day? Reserve quick or easy-to-make meals for these nights

-      What foods do I already have in my kitchen?

-      What is your food budget?

-      What foods are in season?

-      Cooking skills

-      What is on special?

-      Family likes and dislikes

Once you have taken the above list into consideration, it’s time to start meal planning! The first step is to choose the main meal for each of the days in your plan. Select the main course for that meal and then add other foods to balance the meal. Think about varying your proteins throughout the week and include a variety of foods from each food group. Remember to use leftovers when planning your other meals (breakfast and lunch) for the week as well as remembering to plan for snacks.

After you have come up with your meals and snacks for your week, begin working on a grocery list based on your meal plan. Make sure you look through what you already have in your kitchen to avoid food waste and to help save yourself some money. The last step is to go grocery shopping! When shopping, stick to your list and don’t go to the story hungry, your budget will thank you!

Below is a Sample 5-day meal plan for reference:

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Wellness Activity Highlight:

Steamboat Springs is a town full of tradition, and one of the best-known traditions is their annual WinterCarnival. This year Steamboat celebrated its 108th Winter Carnival, although in a much smaller capacity than normal, due to COVID restrictions.While in normal years, Foundry takes part in some of the tradition, we were unable to join in the public festivities this year. With some creative thinking, we decided to pay homage to the tradition of Winter Carnival and celebrated our own Foundry version here at the Ranch!

           Our main event was our friendly snow sculpture competition between staff and residents!The theme of the snow sculptures was “Get On Board!” Residents carved out a battle canoe, while staff worked on a two-seat rowboat.

           In addition to our Snow Sculptures, CEO Ben Cort led us in creating our very own SnowShelter. Staff and residents took turns digging out and fortifying the shelter and when all was said and done, it could fit at least 4 adults sitting on folding chairs!

           We made the most of the beautiful weather that afternoon, and enjoyed some treats brought in by staff. Check out our social media posts for more pictures from this fun event!

 Yoga:

Yoga plays an important role in the Wellness program at Foundry Steamboat. Yoga is offered three times a week in addition to the fitness and core classes. Combining both strength training and yoga throughout the week, we aim to create a well-rounded and sustainable routine that can be easily translated into life after treatment.

           Having a regular yoga practice can boost overall health and is shown to provide stress relief, alleviate pain, increase energy levels, increase muscle endurance and strength, promotes flexibility, results in better sleep, increases self-awareness, encourages self-reflection, and fosters emotional healing.

Here is our Yogi Amanda’s go-to Breath and Flow!

My classes are more breath focused than posture focus. Yoga can be really intimidating, and the game changer for me in my personal practice was finding the breath and letting go of the idea that the poses were the goal. The asanas(postures) are really just stretches and we expand as we link the movement to the breath. In a trauma informed practice, the students won't hear a lot of the technical names for poses. We move at a gentle, restorative pace and the focus is letting the spine be long while we focus on the exhale.

I would like to share a breath practice that is my favorite technique to use in class. Typically, when we are in a flight/fight response our breathing is very shallow, and when we hear"take a deep breath and relax" we might notice that it doesn't actually help us relax. If we can actually focus on the exhale being twice as long as the inhale, our heart rate can slow, blood pressure can drop, and our muscles may begin to relax.

Unequal ratio breath practice:

-Find yourself seated, feet planted on the ground if you can and see if you might soften the shoulders.

-Notice your breath just as it is without judgement, and notice if it can slow as you focus on relaxing the shoulders away from the ears

-On an inhale through the nose, see if you can count as you fill up in the chest and then the belly. As you reach the max of your inhale, pause for a moment before releasing the exhale from the belly, then the chest and see if your out breath can be one count longer than your inhale was, and repeat this for a few minutes, maybe extending the out breath a little longer each round

Example:

Inhale 1 - 2 - 3; Exhale 4 - 3 -2 - 1

Inhale 1 - 2 - 3; Exhale 5 - 4 -3 - 2 - 1

Inhale 1 - 2 - 2; Exhale 6 - 5 -4 - 3 - 2 - 1

Namaste!

Thanks for stopping by to see what we’ve been up to inFebruary! We can’t wait to share what March will bring!

- Cait Mowris, Wellness Director – Foundry Steamboat Springs

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Cooking classes are one of my favorite things! Being able to express to people my favorite parts of cooking gives me so much joy! A lot of times cooking classes give me a chance to talk about my food philosophy; slow food vs. fast food and how cooking can have a positive impact on our earth. This month our Wellness Director, Cait Mowris, and I decided to do a collaborative cooking class! 

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A big part of my cooking involves breaking down the common misconceptions of certain foods; i.e. tofu is gross, veggies don’t have protein, or humans need meat to survive. Cait and I decided to base our cooking class around some common questions that arise around protein; how much protein is appropriate for a meal, can you get complete proteins from eating only veggies, or is there such a thing as too much protein? 

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Setting out to try and answer some of these questions Cait and I decided that a good meal to make during class would be Falafel Pita Sandwiches with a fresh Greek Salad! 

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Of course during our cooking class we focused on my usual idea of  “community cooking”. All of the clients got involved in forming the falafels and preparing veggies for the salad! Once the meal was coming together we started on trying to determine how much protein was actually on one plate of food. The clients initially thought there wouldn’t be much protein since our meal was completely vegetarian, but after finding serving sizes for our meal we determined there is actually about 50 grams of protein per plate! Some of the clients were now saying there could even be too much protein for one meal!

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In our findings during our cooking class we determined that falafels are a pretty protein dense meal. Since all of the protein comes from just vegetables though it ends up being almost the perfect amount of protein for the average male. After helping to make the falafels and actually eating them, most of our clients had changed their minds on vegetable protein. You can actually get enough protein from just plants AND the meal can taste good too! 

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Greenhouse/garden Update!!

Our greenhouse is just killing it! Bok choy, Kale, Arugula, Spinach, Radishes, and so much more! With the longer and warmer days of summer just around the corner our outside garden will soon be just as vibrant as our greenhouse!

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Catch us on Social Media!

If you are looking for more Foundry content check out our website, or look for us on social media; instagram (@foundrysteamboat), Facebook (Foundry Steamboat), or Twitter (@foundryrehab)! 

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Recipe Time!

Falafels and greek salad!

(this is a two day recipe only because you need to soak chickpeas)

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Serves: 5-6 people

Prep time: 30 minutes

Cook time 20 minutes

Total time: 50 minutes

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Ingredients

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For the falafels:

• ¾ pounds of dry chickpeas
• 2 small shallots diced into ¼ inch pieces 
• 2 raw cloves of garlic
• About a cup of chopped cilantro
• ½ - 1 cup of chickpea flour (or regular all purpose flour)
• ½ teaspoon of baking soda
• 1 tablespoon kosher salt
• 1 teaspoon of cracked black pepper
• 1 teaspoon of paprika powder
• 1 tablespoon of ground cumin
• Sunflower oil as needed for frying falafels (or use canola/vegetable oil/coconut oil)
• About 6-8 pita pockets (or make your own! Refer to my recipe in the foundry’s blog!)

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For the tahini salad dressing:

• ½ cup of tahini
• The juice from one lemon
• Salt and pepper to taste
• About 1 cup of warm water, or enough water to thin the sauce

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For the salad:

• ½ of a big box of mixed greens (whatever your favorite greens are)
• 1 15oz can of chickpeas
• One small container of cherry tomatoes 
• One red onion
• One small head of cauliflower
• Olive oil as needed

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For the tzatziki sauce:

• 1 ½ cups of unsweetened greek yogurt
• Juice of 2 lemons

• One cucumber shredded
• 1 teaspoon of dill seasoning
• 1 cup of chopped cilantro 
• Salt and pepper to taste

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Directions

• The day before you want to enjoy your falafels, put the ¾ of a pound of dry chickpeas in a large bowl and cover them with about three times the amount of water by volume. Let the chickpeas soak overnight or at least 8 hours.
• Start the next day by preheating your oven to 400 degrees.
• Working on the falafel mix first, begin by straining the chickpeas. Now dice your shallots and peel your garlic. Place the garlic and shallot in a food processor or blender. Add the cilantro, kosher salt, cracked pepper, paprika, and cumin. Pulse the food processor until all ingredients are minced and mixed together. Transfer your mixture to a large mixing bowl and set aside for now. Now, working with about 1 cup of chickpeas at a time, blend them in the food processor until the chickpeas are very finely chopped and paste-like (if using a blender you may need to scrap the sides down on occasion). When the chickpeas have been processed, place them in the bowl with the garlic onion mixture. Once all of the chickpeas are in the bowl with the garlic onion mixture, stir the mixture until combined. Add in the chickpea flour and baking soda (more chickpea flour may be needed to hold the mixture together). Form the falafel mixture into patties with your hands that are sized slightly larger than a golf ball. Place the patties on a baking tray and set aside for now.
• Now work on prepping your salad ingredients. Wash and rinse your salad greens, cut the cherry tomatoes in half, cut the red onion into strips (julienne), and cut the cauliflower into bite sized pieces. The red onions will be caramelized on the stove, so place them in a saute pan with a little olive oil and set over the stove to medium low heat. Stir the onions occasionally and cook until they are a nice dark caramel color on the outside. While the onions are on the stove, work on the cauliflower. The cauliflower will be roasted in the oven along with the can of chickpeas, so toss the cauliflower in olive oil, salt and pepper and place on a baking sheet.  Drain the chickpeas and place on a baking sheet with a little olive oil, salt and pepper. Place both the cauliflower and chickpeas to the side for now and work on your tahini dressing.
• For the tahini dressing start by juicing the lemon or use about 2 tablespoons of lemon juice. In a medium size mixing bowl whisk the tahini, lemon juice and warm water together. You are looking for a thinner consistency so add more water if necessary. Now add salt and pepper to taste. The sauce will be pretty tart but it will taste great on the salad! Set sauce aside for now.
• Work on the tzatziki sauce. In a medium bowl combine the shredded cucumbers, lemon juice, cilantro, and dill. Taste sauce and add salt/pepper to taste. 
• Alright! Now everything is prepped and ready to cook! The falafels will be shallow fried on the stove, so in a large skillet preheat enough sunflower oil to cover the bottom of the skillet plus a little more. While the pan heats up, place the cauliflower and chickpeas in the preheated oven and cook for about 15 minutes or until cauliflower is slightly charred and chickpeas are slightly crispy. When the falafel skillet has warmed up, place the falafels onto the hot oil. Cook for about 5 minutes per side or until the first side has been nicely browned. When the falafels, cauliflower, and chickpeas are all done, it is time to plate and enjoy! Place the falafels into the pockets of the pita bread and top with some tzatziki sauce. Lay some greens on a plate next to the falafel pita and then top the greens with; cherry tomatoes, caramelized onions, chickpeas, roasted cauliflower and tahini sauce. Enjoy! 

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Have a safe and clean month! - Chef Henry  

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A lot of fun changes have happened in the Foundry kitchen in the last month! First off we are very excited to welcome Cord Such as our new Culinarian! Having Cord around has been great! We are able to go the extra mile in the kitchen and give our clients an even better experience. Also another awesome thing that happened in our kitchen is our amazing new partnership with Hayden Fresh Farms!

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Hayden Fresh Farm is a local chicken, beef, and pork farm that is located in Hayden Colorado about 35 miles away from the Foundry. As some of us know locally sourced ingredients (especially meats) are way better in many ways. Not only are the ingredients fresher and oftentimes more quality, but buying locally is also more sustainable for our earth! I also find it really cool to know exactly where your food is coming from and have a good relationship with the people that grow your food! 

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It is all too easy to get caught up in our daily lives and forget about things that really matter. Like that our food is grown somewhere and not just produced in a factory. Many things in our lives are produced by some big corporation, and a lot of the food found in many grocery stores also unfortunately comes from big corporations. Oftentimes people say “the food industry” and it is just known what they are talking about, but years ago no one would have any idea why you would say food and industry in the same phrase. Food used to be something people worked for either by growing it themselves or by killing it themselves. Now we just get everything in plastic bags at the grocery store.

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Is it likely or realistic that people will be growing or killing all of the food that they eat in our modern civilization? Probably not, but the closer that we can get to the origins of our food the better. 

Greenhouse and garden Update!

Our greenhouse is getting taller! We have a cherry blossom tree inside of the greenhouse! That’s right, a tree inside! Why do we like our greenhouse so much? The greenhouse is more than just a big place with plants in it. It is quickly becoming a great place for people to gather and share with others. Oftentimes clients will seek out the greenhouse as a place to talk to staff or other clients about things they are dealing with.  

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Catch us on Social Media!

If you are looking for more Foundry content check out our website, or look for us on social media; instagram (@foundrysteamboat), Facebook (Foundry Steamboat), or Twitter (@foundryrehab)! 

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Recipe!

This month I thought it would be interesting to share a conceptual recipe with everybody! “All About Salads” is my attempt at getting more people to eat salads. A Lot of people get intimidated by “salads” or they think that there needs to be ranch dressing drizzled on a salad otherwise they can’t eat it. As you will read, salads are nothing more than ingredients put together so why not make those ingredients the very best ingredients!

All About Salads

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What do I put in my salad?

Great question! Salads are a great way to eat a ton of your favorite foods! That’s right I did say your favorite foods! Just think of foods that you really love to eat; bacon, chicken thighs, grilled veggies, croutons, any of the best cheeses, dried fruits, fresh fruits, roasted nuts, fresh herbs, and so much more! My favorite way to make a salad is to just put any of my favorite foods on top of mixed greens. 

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Good things to add into your salad

While adding your favorite foods to mixed greens is a great start to your salad, here are some good ideas to get you started;

• Grilled zucchini
• Aged cheddar cheese
• Bacon bits
• Grilled chicken breast 
• Smoked salmon
• Cherry tomatoes
• Olive oil, salt and pepper
• Pickled beets
• Roasted carrots
• Grains; Farrow, quinoa, or couscous 

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Final tips

Alright now that you have some ideas for a salad, just try it out! Start with maybe one or two of the items from the list above to see how it is! Eventually you will learn what your favorite salad toppings are and you can keep building off of that. Keep it simple at first and use your favorite salad dressings from the store (ranch, blue cheese, 1000 island, vinaigrettes etc.). All you really have to do is keep trying different salads! 

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As always, have a safe and clean month!

Chef Henry

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Recovery from addiction isn’t a steady progression. There are times when you are super focused on it and make a lot of progress and there are times when you are distracted, indifferent, or depressed and can’t be bothered. Motivation is never constant. Many people find they are motivated and engaged early on when they still remember vividly how bad life was when they were actively addicted, when they are most hopeful that life can change, and when they are making a lot of progress quickly.

However, as recovery gets easier, it can also get boring. You forget what the big deal is and it’s harder to see progress from day-to-day. When you get complacent, you are in danger of backsliding. The following tips can help you escape your recovery rut and start making progress again.

Review Your Recovery Plan

The first thing you should do is have a look at your recovery plan and see to what extent you are still following it. Instead of just looking down the list and mentally checking boxes, spend about a week actually keeping track, in writing, of how you spend your time. You may be surprised by the disparity between how you think you spend your time and how you actually spend it. When you find some way that you’ve deviated from your recovery plan, try to correct it. 

For example, you may discover that it’s actually been a while since you’ve been to a meeting or that your daily exercise has become weekly exercise. The whole purpose of a recovery plan is to help you stay physically and mentally healthy, maintain some accountability, and stay focused on recovery. It’s easy to start cutting corners when recovery gets less challenging and that can lead to trouble.

Pay Special Attention to Self-Care

Self-care is an especially important part of any recovery plan and it’s something many people find easy to neglect. It includes things like eating healthy and exercising, but it also includes things like taking time each day to relax, spending time with supportive friends, doing fun things, and getting enough sleep. We often sacrifice these things when we’re busy or stressed, but that’s when we need them the most.

Relapse is a process that typically starts with emotional relapse, and emotional relapse is typically caused by poor self-care. Fortunately, at this stage, it’s pretty easy to turn things around if you focus on self-care. Make sure you’re following your recovery plan, that you’re eating healthy and exercising, sleeping, taking time to relax, socialize, and have fun, and so on.

Talk to a Therapist

If you’re following your recovery plan and you still feel stuck, it may be time to talk to a therapist. Ideally, you’ll already be seeing a therapist regularly for at least the first year of recovery, but that’s often not the case. If you get to a point where you feel stuck, like you’re not seeing progress, or maybe you are seeing progress but you still feel awful, it could be that you have some co-occurring mental health issues that need to be addressed. At least half of the people with substance use disorders have co-occurring mental health challenges including anxiety disorders, major depression, PTSD, bipolar disorder, borderline personality disorder, and others.

These issues tend to drive addictive behavior and it’s very hard to stay sober with an untreated mental health issue. Even if you did have therapy as part of treatment, it’s possible that the issue persists or that something new has come up. If your mental health issue is well-controlled, your therapist may be able to help you figure out why you feel stuck.

Change Something

Having a regular routine in addiction recovery is a two-edged sword. On the positive side, a regular routine reduces uncertainty and stress, it helps you automate healthy decisions, and it helps ensure you’re giving adequate attention to your recovery priorities. On the downside, it can get boring. You feel like you’re just living the same day over and over without much challenge or engagement.

If it’s the monotony of your daily routine that’s dragging you down, change something, anything. It doesn’t have to be something big. In fact, too big of a change can be stressful and distract from the productive parts of your routine. But there is plenty of room for tinkering. You might decide to take a different route to work or text a friend you haven’t seen in a while. Maybe you can go on a media diet or read a book that’s outside of your usual tastes. A change in perspective can make a big difference.

Take On a New Challenge

Along similar lines to making a change, it may be time to take on a new challenge. The point of recovery is not that it’s supposed to be challenging for the rest of your life. It’s supposed to get easier with practice, allowing you to do more in other areas of your life. If you’re sticking to your recovery plan and managing your mental health challenges, maybe you’re just bored and need something to do.

Maybe it’s time to get a job or take on more responsibility at work. Maybe it’s time to pursue another goal, like going back to school or learning a second language. Striving toward meaningful goals may be the next step in your recovery and feeling bored or restless may indicate it’s time to take that step.

Volunteer

Finally, it may be time to change the way you engage with recovery. When you’re first starting out, you need a lot of help and support. Later on, you don’t need so much help but it’s still important to stay engaged with your recovery community. That might mean taking on a more active role, like volunteering.

There are plenty of opportunities to help out at 12-Step meetings. Even if you don’t volunteer in any official capacity, you can get to know new people and help them feel welcome. This strengthens the group and it strengthens your own recovery.

Recovery from addiction doesn’t stay the same all the way through and you can run into problems if you try to resist these changes. On the one hand, you have to keep paying attention to the basics, the things that work. On the other hand, you have to be responsive to changing circumstances and your own growth. 

At The Foundry, we know that recovery doesn’t end after 30 days of inpatient treatment. That’s why we include three to six months of partial care following treatment, to help clients transition back to normal life and deal with new recovery challenges. To learn more, call us today at (844) 955-1066.

We live in a culture where drinking is common and sometimes even expected. This can sometimes make it hard to know when our drinking is normal or excessive. We are particularly prone to misjudgment because our ideas about normal drinking are most strongly influenced by our immediate circle of friends and relatives. Unfortunately, this standard can be misleading. Furthermore, we are all different--we have different risk factors for addiction, different ability to metabolize alcohol, different states of health, and so on. Whether or not your drinking is excessive depends a lot on your personal situation and the following can help you determine if your drinking is a problem.

Yellow Zone

You don’t necessarily have to have an alcohol use disorder to have a problem with alcohol. Problem drinking comes in many shapes and sizes, including the following.

Moderately High Daily Drinking

When you get outside the green zone of moderate drinking--typically no more than two drinks a day for men and one drink a day for women--you can get into problems pretty quickly. First, it suggests an escalation in drinking, which means your drinking might continue to escalate. Second, over years of mildly excessive drinking, you are still at higher risk of a number of health issues, including heart disease, liver disease, stroke, obesity, diabetes, and cancer. Third, you can form a dependence more easily than you might think. For example, if you’re a woman, you may experience withdrawal symptoms after drinking five or six drinks a day for two months. 

Weekend Binge Drinking

You typically have to drink most days to develop a dependence on alcohol. A dependence is considered necessary but not sufficient for addiction. However, as noted above, problem drinking comes in many forms. If you don’t drink all week, but then go hard on weekends, you are still vulnerable to many of the negative effects of problem drinking, including alcohol poisoning, blackouts, accidents, fights, and DUIs. Even one such event can seriously affect your life.

Red Zone

The following are some of the clearer signs that your problematic drinking has become an alcohol use disorder.

Canceling Plans to Drink

One of the main indications of a substance use issue of any kind is if it takes priority over other things in your life. So if you’re making room for drinking, especially drinking alone, it’s a clear sign of a problem That includes canceling plans with friends, neglecting family responsibilities, missing work, and so on.

Lying About Drinking

When you’re lying about how much you drink or that you drink at all, it indicates at some level you either know you are drinking too much or you know other people will think you are drinking too much. Neither is a good sign. If you tell your spouse you’re running an errand so you have an excuse to go get a drink, if you’re “priming” before you meet up with friends, or if you’re hiding alcohol around your house or in other containers, it’s a pretty good sign you have an alcohol use disorder. Lying and deception are among the biggest reasons addiction is so harmful to relationships.

Borrowing or Stealing Money to Drink

Another clear sign of addiction is if you are violating your normal ethical principles, including borrowing or stealing money for alcohol. If you don’t have money for alcohol and you have to go to such lengths to get a drink, that’s a huge red flag.

Needing More Alcohol to Feel the Effects

Another word for tolerance is dependence. If you have to drink more than you used to feel the effects, it’s a sign that your body has adapted to the presence of alcohol. The flip side of that is that once you stop drinking--or try to stop--you’re going to experience withdrawal, which is often a major barrier to quitting.

Drinking to Relax

Drinking to relax can be a problem for two reasons: First, it can indicate that you are drinking to cope with stress, which is a problem in itself because it can mean drinking fills an emotional need. Second, it may indicate that you have developed a dependence and you are physiologically unable to relax without alcohol. You may even be feeling some mild withdrawal in the form of irritability, tension, headaches, and so on.

Legal Problems

For many people, running into legal problems is a clear sign their drinking has gotten out of control. It may be a DUI, a domestic violence call, a fight, or other problems that wouldn’t have happened if you weren’t drinking. It’s possible that you just happened to get caught on the one night you drank too much, but that’s very unlikely.

Health Problems

Health problems can be another wakeup call for many people. Drinking may lead to heart disease, liver disease, obesity, diabetes, and various kinds of cancer, as well as other problems. Some of these may appear more quickly than you think. For example, you may have fatty liver disease with no symptoms and at a relatively young age.

Work Problems

Work is often the last thing to suffer when someone has an alcohol use issue. Not only do you need some kind of income to pay the bills, but many people tie their sense of identity and self-worth to their work. They often feel like they can drink as much as they want, as long as they still perform well at their jobs. Therefore, it’s often a sign of a serious problem if you are drinking at work or skipping out early to drink.

Trying to Quit and Failing

Finally, it’s a pretty clear sign of addiction when you think you should quit or you actually try to quit but you can’t seem to manage it. This may take several forms. Perhaps you can’t even get through withdrawal. Maybe you can make it a couple of weeks and then you say to yourself, “See. I proved I can do it so now I can start drinking again.” Maybe you decide to quit and somehow find yourself drinking again the same night, the way smokers sometimes light up without any conscious awareness.

There are many possible signs that drinking has become a problem. If you’re asking yourself the question at all, it’s probably time to take a break. If you are showing some of the more serious signs of an alcohol use disorder, such as lying, borrowing, stealing, needing alcohol to relax, having legal or health problems, and so on, it’s time to take decisive action, whether that’s going to an AA meeting, finding a therapist, or looking into treatment programs. If you have tried several times to get sober and failed, it may be time for something more intensive like residential treatment.

 At Foundry, we know that addiction takes a toll on nearly every aspect of your life, including your relationships, your finances, and your health. We also know that recovery is a holistic process, which is why we treat addiction from many angles, including psychotherapy, diet, exercise, and spiritual wellness. To learn more about our approach to addiction treatment, call us today at (844) 955-1066.

Anxiety is a common problem for people with substance use disorders. Research shows that nearly 18 percent of people with substance use disorders also have an anxiety disorder. And that doesn’t include PTSD, which other research suggests may affect up to half of people with substance use issues. Often, substance use begins as a way to cope with anxiety, and learning to cope with anxiety will be a top priority for anyone recovering from addiction. 

Even if you don’t have a particular problem with anxiety, it’s easy to feel overwhelmed by ruminating over past mistakes or getting too caught up in worries about the future. There’s a good reason “One day at a time” is so often repeated in AA meetings. Whether you are prone to anxiety or just feeling overwhelmed by the idea of staying sober forever, the following grounding techniques can bring you back into the present moment and help you calm down. They aren’t a replacement for therapy but they can help you out in a pinch.

5-4-3-2-1

The crux of any grounding technique is that it takes your attention away from the thoughts and sensations that are causing anxiety and focuses it on something immediate and positive, or at least neutral. The 5-4-3-2-1 technique is a systematic way of bringing your attention to sensory input. You start by naming five things you can see around you, then four things you can feel, three things you can hear, two things you can smell, and one thing you can taste.

Take a moment and fully experience each item. This isn’t just a checklist; it’s also a mindfulness exercise, so try to make the most of it. If you don’t have time for the whole exercise, you can pick one of the senses and briefly bring your attention to that.

Deep Breathing

Deep breathing is an excellent way to calm down. First, it’s something that’s always happening in the present moment and you can bring your attention to the sensations of breathing. Second, you can actually slow your heart rate by slowing your breathing.

When you’re anxious, your sympathetic nervous system is overactive, which often creates a positive feedback loop, making you even more anxious. You can interrupt that by activating your parasympathetic nervous system.

When you breathe deeply, and particularly when you exhale slowly, you stimulate your vagus nerve, which activates your parasympathetic system. Any regular deep breathing with a focus on a long exhale will calm you down but research suggests that about six breaths a minute is the ideal pace to promote a sense of wellbeing.

Body Scan

A body scan is like an expanded version of “things you can feel” from the 5-4-3-2-1 technique. Close your eyes and put your attention at the top of your head, noticing any sensations there--an itch, tension, a slight breeze, warmth from the sun, and so on. Next, move down to your face and do the same thing.

Systematically move downward, feeling both internal and external sensations in every part of your body until you reach the bottoms of your feet. Again, this brings you into the present moment and it also serves as a mindfulness exercise.

You will probably feel physical sensations related to anxiety, such as tension in your face or neck, constriction in your chest, or a lump in your stomach. See if you can observe these sensations without judgment. Just be with them for a moment before moving on.

Think About Your Feet

If you don’t have time to do a whole-body scan, a short cut you can use is to just bring your attention to your feet. There are two main reasons this works. First, your feet have a density of neurons similar to your hands and face but we typically don’t think about them unless they hurt.

Therefore, they can be a source of new sensations--weight, heat, shoes, and so on. Second, they are at the far end of your body, so you will peripherally notice more body sensations by noticing your feet. 

Count Down or Up

Another way to divert your attention from anxiety-inducing thoughts and sensations is to give yourself a mental task that demands a bit of focus. It can really be anything--remembering the US presidents in order, retracing your route home from school in your mind, reciting a favorite poem from memory, and so on.

One handy task that anyone can do is to count down or up by some awkward number. Seven typically works pretty well. So, for example, you might count down from 100 by sevens. That’s usually challenging enough that you have to focus on it but not so challenging that you’ll give up quickly.

Imagine a Safe Place

Another way to occupy your attention is to use visualization. Visualizing something clearly is both cognitively demanding and it can have a powerful effect on your state of mind. If you’re prone to anxiety, visualizing a safe, calming place can be a powerful way to ground yourself.

What you imagine depends on you. You might think of your childhood room, a warm beach, a cozy cabin with a fire, anywhere that makes you feel safe. If it’s a real place that you know well, you can mentally look around the place and involve your other senses to make the experience more real.

Go for a Walk

Finally, getting a bit of exercise is a great way to ground yourself and boost your mood. You don’t have to do a serious workout; usually, just walking for a while is enough. The great thing about exercise is that you don’t really have to try to change your thoughts or your focus. You can continue worrying as you walk, but eventually, you will just start to feel better and worry less. Whereas other grounding techniques work by changing your focus, exercise works mostly by changing your physiology and a bit by changing your focus too. 

Grounding techniques are a great way to deal with anxiety in the moment. As noted, it’s not a replacement for therapy. Anxiety disorders are serious mental health issues and shouldn’t be dismissed as just worrying too much. If you try to recover from addiction without treating anxiety, you’re in for an uphill battle. However, finding one or two grounding techniques that work for you and practicing them regularly can go a long way.

At The Foundry, we know that addiction is often just one part of a larger issue. We use a variety of proven methods to help clients overcome common co-occurring mental health issues, including anxiety disorders, trauma, depression, and others. To learn more, call us today at (844) 955-1066.

Getting plenty of restful sleep is one of the best things you can do for yourself in recovery. A night of good sleep can mean the difference between meeting the day with energy and focus and just dragging yourself through. Even a minor sleep deficit can have a significant effect on your physical and mental health, and therefore your recovery.

‍Sleep deprivation and running a chronic sleep deficit have been shown to cause cognitive impairments such as poor concentration, poor working memory, poor long-term memory, and worse decision-making. In the long run, inadequate sleep can significantly increase your risk of anxiety disorders and major depression. Since these commonly occur along with addiction, it’s crucial to do what you can to get enough sleep.

Unfortunately, insomnia is a common withdrawal symptom and it may persist for weeks or months into recovery, making the process harder. If you’ve been having trouble sleeping, these tips might help.

First, See Your Doctor

Before you do anything else, it’s a good idea to rule out medical causes for your insomnia. Talk to your doctor about your insomnia and be sure to share your addiction history. Many sleep medications are just benzodiazepines and you should definitely avoid those if you have a history of substance use issues.

Next, See Your Therapist

There are two main reasons to talk to your therapist about your sleep problems. The first is that insomnia is a common symptom of several mental health issues, including major depression and anxiety. It could point to an issue that hasn’t been treated or hasn’t been treated adequately. If such an issue does exist, your sleep should improve as you get it under control.

Second, your therapist can help you sleep better. There is a specific cognitive behavioral therapy protocol for insomnia called CBT-I. It includes many of the tips mentioned here but also entails examining your assumptions about sleep and what you say to yourself while lying in bed awake.

Get on a Regular Sleep Schedule

The best tip for sleeping better is one no one wants to hear: sleep at a regular time, even on the weekends. There are a lot of reasons we hate this advice--we have too much to do, we don’t like being constrained by a regular bedtime, we need to catch up on weekends, and so on. However, your circadian rhythm is complex and it doesn’t know what a weekend is.

If you keep your body guessing about what time you’re going to go to bed, you just won’t be able to fall asleep as fast or sleep as deeply. Start by setting a regular wake-up time and you will find it easier to fall asleep at night.

Turn Your Bed into a Sleep Trigger

You want a clear connection in your mind between getting into bed and falling asleep. That means your bed should only be used for sleep and sex. Don’t watch TV in bed, don’t look at your phone, don’t read or eat or do anything else in bed.

If you lie down to sleep but you don’t fall asleep for 20 minutes, get up and do something low-key until you feel tired. Otherwise, your anxiety starts going up, you think, “Here we go again,” and you start to think of your bed as a sort of torture device, where you lie exhausted but unable to sleep.

Cut out the Naps

Naps can be tempting, especially if you can’t ever seem to get a good night’s sleep but they can also throw off your rhythm. Naps are especially disruptive if you sleep for more than twenty minutes or nap later than 2 p.m. When you’re trying to conquer insomnia, it’s best to cut out naps completely. Think of it as storing up your tiredness for bedtime.

Cut down on caffeine.

For most people, a bit of caffeine is fine and moderate coffee and tea consumption appears to have some health benefits. However, caffeine also has a half-life of between four and six hours. If you drink a cup of coffee at noon, as much as a quarter of that caffeine--plus whatever is leftover from the morning--might still be in your system at midnight, depending on how fast you metabolize caffeine. Even if it doesn’t keep you awake, it can disturb the quality of your sleep. If you can’t sleep, try cutting down on caffeine or setting a strict cutoff time.

Keep Your Room Dark and Quiet

This is an obvious bit of advice that almost everyone ignores. We evolved to sleep in dark, quiet environments but most of us now live in places where it’s hardly ever dark or quiet. There are street lights, traffic, noisy neighbors, 4 a.m. garbage trucks, barking dogs, and so on. Even low levels of light and sound can disturb your sleep even if they don’t completely wake you up. If you can’t keep your room dark and quiet, consider investing in some ear plugs and a sleep mask.

Turn Down the Thermostat.

Just as we evolved to sleep in dark and quiet, we evolved to sleep in slightly cooler temperatures. However, most of us now live in temperature-controlled buildings that are theoretically the same around the clock. One important sleep adaptation is that our body temperature drops. If you can, turn down the thermostat to between 68 and 70 degrees before bed, you should sleep a bit more deeply.

Have a Good Bedtime Routine

Finally, have a good bedtime routine. A regular sequence signals your body that it’s nearly time to sleep. A good routine can also help you wind down and relax before you get into bed. Try not to work or deal with other stressful things up to the time you go to bed.

Keep in mind that watching intense movies or TV shows right before bed can have a similar effect to real-life stress. Instead, do something relaxing. Listen to some music, pray or meditate, or take a warm--but not hot--shower or bath. You’ll sleep better if you lie down while in a good mood.

Getting plenty of sleep is one of the best things you can do for your physical and mental health, especially if you are recovering from addiction. Unfortunately, insomnia is one of the most common problems people face when dealing with substance use and mental health issues. There are no guarantees that you’ll get a good night’s sleep on any given night, but if you create the right conditions, you can tip the odds in your favor. At The Foundry, we believe that wellness is one of the most important parts of a strong recovery from addiction. That’s why we emphasize overall health, including restful sleep, in our treatment programs. To learn more, call us today at (844) 955-1066.

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Ask any gardener why he or she enjoys working in the soil, and you will get a multitude of answers: it’s satisfying to see plants grow under your care, it feels good to be outside, it’s exercise, the fruits taste better when they are home grown, it’s a money saver at the market, it has a calming and meditative effect, and so on.  But medical researchers in the past decade have indicated that gardening actually has scientific benefits to making us feel good!  

It seems that skin contact with a certain, specific bacterial microbe found in soil, Mycobacterium vaccae, may release serotonin.  Serotonin relaxes us, helps ward off depression and makes us feel happy.   Gardeners, as they toil in the soil, can inhale this microbe, ingest it on the food they harvest, and have it enter their bodies through little cuts or scratches.  

Natural serotonin boosts can be especially helpful for those who have experienced substance abuse or addiction, where happiness was previously sought through addictive habits.

For anyone who finds a passion in gardening, the pleasure and gratification opportunities are endless. Getting out early season to plan the garden, turning the soil and planting seeds, going to the local nurseries and perusing the aisles for this year’s treasures, bringing them home and squeezing them in next to the newly emerged seedlings, savoring fresh produce picked today, and of course the joys of admiring the lovely colors and shapes of flowers.

At the Foundry, we have been working hard to turn the ranch into a farm.  We have planted dozens of fruit trees, along with berry bushes, asparagus, and medicinal herbs, and are slowly turning compacted old hayfield soil into rich garden soil.  We have six low tunnels we are planting out with annual crops of peas, beans, carrots, beets, salad greens, potatoes, garlic, and squash.  Our participants claim to really enjoy it, and we certainly appreciate the help while working alongside them.

We plan to construct a greenhouse this fall, which will provide us with a place to start seeds next year.   This space will also be used as a gathering place for participants and staff, be it for therapy sessions, yoga, or gardening workshops.  In cold, dark January, it will definitely be a popular place on sunny days!

Gardening truly offers something for everyone, and for new gardeners, it’s best to pick a favorite or two and start small. If you need a more solid theory to put gardening into practice, knowing that the Colorado climate can be tough for gardening, the promise of a serotonin release will hopefully inspire. We are happy to show you the gardening ropes while you enter recovery. And we promise that if you just give it a try,  you’ll like it!

If you’d like to read more about how gardening can make you feel better and strengthen the mind and body, take a look at the articles below:

The Economist: Bad is Good

Medical News Today: Getting Dirty May Lift Your Mood

BBC News: Dirt exposure ‘boosts happiness’

USA Today: Farm living could arm kids against asthma

Kim Brooks is the Horticultural Facilitator at The Foundry, a rehab and substance abuse treatment center in Colorado, and oversees the garden care and plant harvest, which is used in The Foundry’s culinary creations as well as donated to the local community. Kim Brooks has been gardening in the Steamboat area since 2000.  She enjoys sharing her enthusiasm for growing food with the Foundry participants.

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At The Foundry Treatment Center Steamboat, a healthy lifestyle is an important part of complete recovery. The link between the body and the mind is powerful, and a healthy diet combined with regular exercise is an integral component of lasting recovery from Substance Use Disorder.

There is a common misconception that healthy food is bland, and without flavor or excitement. Our goal is to shift how clients define "healthy food", and shift their lifestyles towards sustainable nutrition. Serving bland, flavorless food would only set the stage for old eating habits and patterns to return.

Below is the recipe for Chef Scott's Black Bean Cake Eggs Benedict with Avocado Hollandaise - One of the many healthy meals served to clients at the Foundry Treatment Center Steamboat.

INGREDIANTS:

CORN CAKES1 box of Kodiak Cakes whole grain pancake/waffle mix

1/2 cup black beans

1/4 teaspoon salt

1/4 teaspoon freshly ground black pepper

3/4 cups cooked sweet corn kernels

AVOCADO HOLLANDAISE

1 ripe avocado

1 lemon, juiced

1/3 cup hot water

1/4 cup olive oil

1/4 teaspoon salt

1/4 teaspoon pepper

6 slices bacon, fried

6 eggs, poached

a pinch of red pepper flakes

fresh herbs for garnish

INSTRUCTIONS:

CORN CAKES

1. In a large bowl make pancake batter and fold in the drained corn and black beans.2. Cook cakes on a griddle until warm to the touch and golden brown.

AVOCADO HOLLANDAISE

1. Add the avocado, lemon juice and hot water into a food processor or high powered blender and blend until smooth, scraping down the sides if needed. With the processor running, stream in the olive oil slowly. Continue to blend until pureed and smooth.

2. Poach the eggs and assemble the corn cakes. Break a piece of bacon and set it on top of the corn cakes and cover with a poached egg. Pour the avocado hollandaise overtop and sprinkle on some crushed red pepper. Top it off with some fresh herbs if desired.

Scott Przymus is the Executive Chef at The Foundry Treatment Center Steamboat, a rehab and substance abuse treatment center located in Steamboat Springs, Colorado.

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On April 18, I finished my 20th marathon. My time—4 hours and 16 minutes—was the slowest I’d ever run. But that didn’t matter—because this was the Boston Marathon, a dream of mine ever since I started running marathons in 1981. Now at 63 years old, I can check this off my bucket list. But why this is so special to me is not that it is my high point as a runner, instead it is the gift this has been for me as a recovering alcoholic.

Ten years ago, running a marathon, let alone running the Boston Marathon, was incomprehensible. My life was in shambles. I was awaiting transport to a regional prison in Glendive, Mont., where I would spend the next six months in a very intense alcohol and drug rehab program. Physically, my six-year binge had taken its toll on my legs; peripheral neuropathy was affecting my ability to walk. Somewhere in the middle of that prison stretch, I had a turning point. I thought about the classic line from the movie Shawshank Redemption when Andy DeFrain says to Red “It comes down to a choice really, get busy living, or get busy dying.”

My best thinking had gotten me into prison so maybe it was time to make a choice to live and go all in for the recovery program this place was offering. Once committed, I found the hope I so desperately needed, on page 152 of the AA Big Book: “The most satisfactory years of your existence lie ahead.”

There is another line in the AA Big Book that is also true. “Yes, there is a long period of reconstruction ahead.” I never liked that line because it reminded me of how difficult the process is after a person gets sober. Recovery is not about stopping drinking; it is about staying stopped and even more, about learning to live in sobriety. Recovery is truly a marathon. But I have discovered in the 10 years of working my recovery program that this can be the best marathon a person ever runs.

The most satisfactory years of your existence lie ahead! You can get all of your life back and more, much more than you ever imagined. And I am not alone. My wife went with me to Boston to cheer me on, as did a friend in recovery from my home group. Boston is where she grew up, and it was a chance to both see her daughter and celebrate how life can become so good in recovery. She camped out at the bottom of Heartbreak Hill, just before I had to start that climb at mile 20.5. She’d made a sign—in Bronco Orange of course, and had the others in my AA group sign it to cheer me on. That encouragement was what I needed to make that climb and finish strong.

I don’t know if I’ll ever run Boston again, or even another full marathon, but I do know that the marathon of recovery I am in now is worth every step. And the full life I’m experiencing now… I wouldn’t trade it for anything.

If you find yourself facing alcohol addiction rehab with trepidation and dread, I hope my message can offer some hope and inspiration. And if you join The Foundry, I hope I am able to talk with you about the vibrancy of life that comes with recovery.

-R.J. Koerper, Life Recovery Therapist Consultant with The Foundry

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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.

Check out the Heavyweight podcast featuring our very own Chief Operations Officer, Scott Kindel, as he shares his remarkable journey from addiction to recovery—including a valuable missing piece of his family's history. About the podcast: Heavyweight is a Gimlet Media production that explores a moment from a person's past that they wish they could change.

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Release date: October 23, 2019

Listen now ➝

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Anxiety is a common problem for anyone struggling with or recovering from addiction. The National Epidemiological Survey on Alcohol and Related Conditions surveyed more than 43,000 people and found that among people who had experienced an anxiety disorder in the past year, about 15 percent had at least one substance use disorder--about twice the rate of addiction as in the general population. And that didn’t include post-traumatic stress disorder, or PTSD, which is an even greater risk factor for substance use than generalized anxiety disorder or social anxiety disorder.

At the moment, most of us in the US and elsewhere are under lockdown to help slow the spread of the coronavirus, or COVID-19. If you are already struggling with anxiety, this only adds to the challenge, compounding uncertainty with boredom and isolation. Unfortunately, our own thinking is typically the biggest source of anxiety. The following errors in thinking may be making you more anxious than you need to be.

Trying to Eliminate Anxiety

The first thing to realize is that anxiety is a normal and useful emotion. You can’t eliminate it entirely, nor would you want to. Anxiety alerts us to danger and spurs us to prepare for upcoming challenges. People who never felt anxious left the gene pool a long time ago, which is why everyone feels anxious occasionally and as many as 30 percent of American adults experience an anxiety disorder at some point in their lives.

Trying to eliminate or avoid anxiety, ironically, just ends up making you more anxious. What does make sense is to think about anxiety--and things that make you anxious--rationally. When you do feel anxious, recognize that it’s just the ancient parts of your brain trying to protect you. Accept your anxiety for what it is--a feeling, a sort of warning signal. Then, try to figure out if the thing you are anxious about is really a threat or if you’re making it worse with faulty thinking.

Jumping to Conclusions or Predicting the Future

Worrying about the future is always an issue for people with anxiety issues because the core thinking of anxiety is always something along the lines of “Something awful is going to happen and I won’t be able to do anything about it.” At the moment, that kind of worry is both more concrete and widespread than normal. Right now, a lot of people have the same few worries--will they be able to keep working?

How long can they go without income? How long will we be quarantined? Will I or someone I care about catch the virus? And so on. It’s likely that most of us will face a challenge on one or more of these fronts but attempting to predict the future only makes you worry unnecessarily. No one knows what’s going to happen but when you think about it, the same has been true every day of your life.

When you have trouble with anxiety, you tend to imagine the worst possible outcome and assume that it is inevitable. In reality, the future is fundamentally unpredictable. All we can do is make sensible preparations right now and trust that we will find ways to meet challenges in the future.

Should Thoughts

Should thoughts come from a belief that you, other people, or the world should be different somehow and that it’s awful that they aren’t. When you apply should thoughts to yourself, the result is often depression, whereas applying should thoughts to other people and the world tends to increase stress, anger, and anxiety.

So, at the moment, a lot of people are thinking this quarantine is unfair, that they should be able to go to work, go out with friends, play sports, and so on. However, should is just a wall for you to beat your head against. It would be lovely if the world and other people conformed to our wishes but most of the time they don’t. Insisting they should, in the face of overwhelming evidence to the contrary, only makes you more miserable.

Black-and-White Thinking

Black-and-white thinking, sometimes called all-or-nothing thinking, is the idea that if an outcome isn’t exactly what you want, you shouldn’t bother. This is also sometimes called letting the perfect be the enemy of the good.

There are many ways black-and-white thinking can lead to anxiety. In our current situation, if you’re trying to figure out how to cope with being under quarantine, you may not bother with measures that can make you feel better if they aren’t perfect solutions. For example, many people have started doing therapy sessions and 12-Step meetings over Zoom and other online platforms. These are clearly not as good as in-person meetings, but they are considerably better than nothing.

Mental Filtering

Mental filtering is the habit of only seeing the bad things that happen. It’s a special case of the larger phenomenon of confirmation bias, which is when you only look for evidence that supports your current beliefs. When you do mental filtering, you’re only seeing evidence that supports your belief that something bad is going to happen or is already happening.

In times of crisis, it’s far too easy to focus on the negative, especially now, since all we see on the news is the rising death toll and the shortage of medical supplies to treat new patients. However, if you look for them, there are positive things too. As Mr. Rogers said, look for the helpers.

In addition to medical workers and people supplying critical goods and services, there are a lot of communities coming together to help each other and find ways to adapt. If you’re stuck at home, it might be a great opportunity to read, make art, or learn new skills.

Emotional Reasoning

Emotional reasoning is the belief that something is true because it feels true. It’s easy to fall into this trap when thinking about the future because ultimately, we don’t have much evidence to rely on. The central belief of anxiety--“Something bad is going to happen and I can’t do anything about it”--relies entirely on emotional reasoning. In reality, no one knows what’s going to happen; everything is a guess.

However, you may be able to refute the second part to some extent. Most of us have survived trying experiences. One thing you can do is to look back on those times and think, “If I made it through that, I can make it through this other thing I’m worried about--if it even happens.”

Anxiety is a common challenge for people recovering from addiction and right now is an especially trying time. Anxiety is normal and healthy, but our thinking often makes anxiety far worse than it needs to be. Learning to identify and change this faulty thinking is one of the main priorities of cognitive behavioral therapy, or CBT, and dialectical behavioral therapy, or DBT. It can be very hard to recognize your distorted thinking on your own and a good therapist will speed up the process. At The Foundry, we use CBT, DBT, and several other evidence-based methods to help our clients recover from substance use and co-occurring mental health issues. To learn more, call us at (844) 955-1066.

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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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AA has been around for about 85 years now and has helped millions of people get sober and stay sober. It has also spawned many other 12-Step programs based on the same format. These include Narcotics Anonymous, Debtors Anonymous, Cocaine Anonymous, and many others. Since these groups are free and widely available, they are often the first thing someone will try when they decide their drinking or drug use has become a problem.

These meetings are also helpful for people who have completed a professional treatment program. Meetings provide much needed social support and help keep you focused on recovery in the long-term. Therefore, they can help you transition from a treatment program back to regular life while providing support indefinitely.

Attending 12-Step meetings can be a great asset for recovery but many people are nervous about going to their first meeting. In addition to walking into a room where they don’t know anyone, they may have some mistaken preconceptions based on what they’ve seen on TV or in movies. The following should give you some idea of what to expect in your first 12-Step meeting.

What Not to Expect

Most people have seen a movie or TV show where a nervous first-timer is called on to introduce himself and share. Reluctantly, he stands up and says, “I’m Bill, and I’m an alcoholic.” The group says, “Hi Bill,” and then Bill proceeds to share the worst thing he’s ever done. While you will be given an opportunity to introduce yourself to the group during the meeting, you won’t be forced or even expected to. Still less will you be expected to share anything about yourself? Everyone there knows how hard it is to walk through those doors for the first time and they won’t pressure you to do anything.

Some people also expect to be swarmed when they walk in the door, as they might have been the first time they attended a church or youth group. For people who harbor some suspicions that 12-Step groups might be a sort of cult, an excessively warm welcome is the last thing they want. In reality, people will mostly leave you alone. Some people might introduce themselves to be polite but you are unlikely to feel like you’re in the spotlight.

How a Meeting Goes

There are several different kinds of meeting formats including a single speaker, speaker/sharing, step study, and round-robin sharing. They all follow the same basic structure. First, the chairperson will read the group preamble, then the Serenity Prayer, which you’re free to join in or not, then someone will read the 12 Steps and 12 Traditions. After this, the chair will ask if there are any first-timers who want to introduce themselves by their first name. You can introduce yourself if you want to. If you decide to introduce yourself, it doesn’t mean you have to share. Next, the chair hands out chips, another well-known part of 12-Step programs.

After that, the meeting proceeds according to what kind it is. If it’s a single speaker meeting, then one person will speak for most of the time. If it’s a speaker/sharing meeting, the chair will introduce the speaker, who will speak for most of the meeting and then other members will share. If it’s a step study meeting, the chair will introduce a speaker to speak on a step or topic and then members will share on that same topic. If it’s a round-robin sharing meeting, everyone who wants to shares.

The meeting concludes with welcoming newcomers, announcements, and a prayer.

After the Meeting

People typically stick around for a while to talk after the meeting. You can go if you like or you can stick around and have coffee and doughnuts. There isn’t much opportunity to talk to people during the formal meeting, so after the meeting is the time to chat with other members. When you feel comfortable enough, you might consider introducing yourself to the meeting chair and maybe volunteering to help clean up afterward. This is an easy way to get to know people and be more engaged in the group.

Open vs. Closed Meetings

Some 12-Step meetings are open and most are closed. If a meeting is open, it means anyone can come, whether or not they want to stop drinking or using drugs. This includes family and friends of members as well as students and counselors who want to understand addiction or how meetings work. If a meeting is open, it will be listed as “open.” Otherwise, assume the meeting is closed.

A closed meeting is only for people who want to quit drinking or using drugs. Most meetings are closed because members typically prefer to share in the company of people who understand what they’ve been going through.

Bring a Friend

It’s normal to be nervous about going into a meeting where you don’t know anyone. If that’s the case, then consider bringing a friend for moral support. The ideal situation would be to attend a meeting with a friend who is already a regular member. That way, you already know someone and they can introduce you to other people and let you know what to expect. If you don’t know someone who is already a 12-Step member, bring a friend who is also interested in getting sober. That makes it easier to walk into the meeting and you can help keep each other accountable. If you don’t know anyone who wants to get sober, bring a friend to an open meeting.

12-Step meetings are a great way to take your first steps toward sobriety and a great way to transition from a treatment program back to regular life. It’s normal to be nervous about going to your first meeting but keep in mind that everyone in the room has been in your position and no one is going to pressure you. You decide your own level of engagement and you can take as much time as you need to.

Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at 1-844-955-1066.

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Having a growth mindset is one of the best ways to enhance your recovery from addiction. As discussed in a previous post, a growth mindset can help you feel less resistant to change, make you feel more confident about the good possibilities for your life, and help you transform the many challenges you will face in recovery into opportunities to grow as a person. 

Unfortunately, it’s not always easy to change from a fixed mindset to a growth mindset. Our ideas about our abilities and potential are largely molded by our childhood experiences. If we’re frequently told by our parents or teachers that we’re stupid, lazy or whatever else, we often accept those assessments as limits to our possibilities.

Psychologist Carol Dweck, who developed and popularized the idea of fixed and growth mindsets, found that even well-meaning parents who praise their children as smart or talented may be doing them a disservice by reinforcing the idea that we’re all hardwired with certain abilities. Breaking out of this conditioning can be hard but it is possible. Here’s how. 

What Are Fixed and Growth Mindsets?

First, a brief description may help clarify what we’re trying to accomplish by moving from a fixed to a growth mindset. A fixed mindset is believing that whatever you are now is basically how you’ll be the rest of your life. If you’re good at playing the violin, for example, then you’ll probably get a little better but if you’re not good at it, then you’re just “not musical” and you shouldn’t bother.

The same is true of anything, whether it’s math, sports, socializing, thinking creatively, or anything else. The fixed mindset tells you to stay in your lane, do things you’re already good at, and don’t embarrass yourself by trying something new.

The growth mindset, on the other hand, operates on the fairly common-sense assumption that we get better at things we practice. We may not be very good at sports or the violin--or getting through a day without a drink--right now, but with consistent effort, we can certainly get better. That’s not to say you’ll ever be the best at something--few people ever attain that status--but you can certainly improve on the things that matter most to you and your quality of life.

Notice Your Thinking

Whenever we have a challenging emotion, there is typically a thought behind it, even if we don’t notice. Fear is often a result of fixed-mindset thinking. For example, a loved one suggests you talk to a therapist or consider getting treatment for your substance use and you feel a sense of panic, perhaps followed by anger. What was the thought behind that? Was it, “I can’t live without drugs or alcohol”? “I can’t go off to treatment alone”? There are many possible thoughts for which the subtext is “I can’t handle this.” 

However, treatment is not a test; it’s an opportunity to get help. You can’t fail at treatment or therapy; you can only fail to engage. The belief that you can fail or be exposed as somehow inadequate is only in your head. The first step is to become aware of these assumptions and challenge them. You may catch yourself saying something like “I can’t speak in front of groups,” perhaps because you believe you’re shy or inarticulate or whatever else.

However, in reality, plenty of people with varying personalities and skills are able to become effective at speaking in front of groups. Notice any thoughts or words that imply your abilities are fixed and make a conscious effort to challenge them.

Reframe Failure and Frustration

Too often, we take frustration or initial failure as a sign that we have no talent for something. In reality, every new thing is difficult and frustrating and you will have some failures. The challenge is to push through that initial frustration until you can acquire the minimum skills to start making real progress. One way to do this is to reframe failure and frustration.

You may have heard the expression, “The master has failed more times than the beginner has even tried.” Failure is just a part of the learning process. The important thing is to learn what you can from it and try again. This is an especially important lesson in addiction recovery since relapse is fairly common.

Similarly, don’t take frustration as an indication that you lack aptitude. Frustration is merely a sign that you’re having to push beyond your current limitations. What’s frustrating today will be easy later.

Remember Past Growth

When we’re born, we basically can’t do anything. We can’t talk, walk, read, stand, spell, feed ourselves, or do arithmetic. We can’t even focus our eyes. Pretty much everything we do all day that we don’t even have to think about took years of daily effort to master. Yet many people don’t even make it through a month of 12-Step meetings because they say it’s too hard or “not my thing.”

As adults, we take for granted the difficulty of most of our routine skills and so we doubt our ability to master comparatively easy new skills. Keep in mind that everything is hard at first but it becomes easier with practice.

Adjust Your Expectations

Related to the point above, we often underestimate the time and effort it will take to get good at something, often by orders of magnitude. For example, many people have had the experience of having had two years of Spanish in high school but then they take a trip to Mexico and they can’t even order lunch. So they throw up their hands and say, “Well, I guess I have no talent for languages.” 

However, consider what it took to learn your own language. For the first four years of your life, your brain is optimized for learning language. Everyone around you only speaks in your native language and tries to help you learn it. You desperately want to learn to speak in order to meet your basic needs and desires. And yet, how many four-year-olds speak their own native language with much fluency?

From that perspective, it’s not surprising that your two years of high school Spanish didn’t make you fluent. Often, we have to accept that reaching our goals is going to take a lot more work than we had originally estimated. It doesn’t mean you lack talent or ability; it just means you’ll have to do more work than you expected. 

View Challenges as Opportunities

Finally, practice viewing challenges as opportunities. Challenges are threatening to people with a fixed mindset because they are opportunities to fail. If you feel threatened by something, it could be that you fear it will expose you as weak, stupid, or somehow inadequate. People with a growth mindset view challenges much differently: They see opportunities to get stronger.

When you feel threatened by a challenge, pause and think, “Whether I succeed this time or not, it will certainly be an opportunity to learn and grow.” If you take this attitude toward challenges and even seek out new challenges, you will grow much faster.

It’s hard to change your mindset, especially since it was probably formed in childhood. However, the first step is knowing that change is possible. Everything we think or do changes our brains in some small way. If you make consistent efforts to change your brain in ways that encourage a growth mindset, you will start to notice all the possibilities that come with it.

At The Foundry, we want to help you recover from addiction, but we don’t stop there. We want you to have a more joyful, healthier, and more fulfilling life overall. We use a variety of evidence-based methods to help our clients grow and become the best versions of themselves. To learn more, call us today at (844) 955-1066.

Broccoli Quinoa Fritters with White Bean Puree Arugula Salad

Prep time; 20 minutes

Cook time; 50 minutes

Total time; 1hr 10 minutes

Serves; 5-6 people

Special equipment needed; food processor, immersion blender, or regular blender

Ingredients;

For white bean puree

• 2 16 oz can of cannellini white beans
• One 16 oz can of butter beans
• 2 cloves garlic
• About 2 Tablespoons of olive oil
• One Tablespoon lemon juice 
• Kosher salt to taste
• Black pepper to taste

For the fritters

• 2 heads of broccoli destemmed and broken into bite sized pieces
• ¾  cup of dry quinoa
• 1 ½ cups of water for boiling quinoa
• 5 eggs
• ½ cup of shredded sharp cheddar cheese 
• 3 cloves of minced garlic
• 1 cup of bread crumbs
• ¼ teaspoon of cayenne pepper
• 1 tablespoon of kosher salt
• ½ teaspoon black cracked pepper
• Olive oil as needed
• One small container of arugula salad greens for serving  

Directions;

For the white bean puree

• Open all of your cans of beans (the cannellini and butter beans)
• Pour the beans with the liquid into a medium saucepan and set on the stove over medium heat
• Mince your two cloves of garlic and add to the beans. 
• Let cook on the stove until the beans are very soft and tender, this should only take about 10-15 minutes. 
• Once beans are soft, transfer them to a food processor (or blender or immersion blend them in the pan) and add the olive oil, lemon juice, and salt and pepper.
• Blend the bean mixture until it has turned into a liquid sauce. (more olive oil may be needed to get the sauce to be the right consistency)
• Move the sauce back into the saucepan and leave on the stove covered over very low heat while you work on the fritters

For the Fritters

• Preheat the oven to 400 degrees
• Start boiling the 1 ½ cups of water and pour the quinoa into the water. Let the quinoa sit on the stove and reduce to a simmer when it starts to boil. The quinoa will take around 25-30 minutes to fully cook.
• Now prepare some of the ingredients; break/cut your broccoli into bite size pieces and peel/mince the 3 cloves of garlic
• Spread the broccoli onto a baking sheet, drizzle with olive oil, sprinkle with salt and pepper, mix to coat all the broccoli pieces
• Place the broccoli in the preheated oven and bake until slightly charred. (about 10-12 minutes) 
• Take your broccoli out of the oven and transfer to a cutting board. Cut your broccoli pieces into small pieces (around ¼ inch cubes).
• Check on your quinoa. Once the quinoa has fully absorbed all of the water, transfer it into a big mixing bowl. Add the broccoli, minced garlic, cayenne pepper, kosher salt, shredded cheddar, bread crumbs, and cracked pepper. Stir to combine. 
• Now crack the 5 eggs into the mixing bowl and stir to combine.
• Now you should be able to form the “broccoli/quinoa” mixture into patties. If your mixture is too dry and crumbly, crack a few more eggs into it. If your mixture is too wet, add some more bread crumbs.
• Preheat a large skillet over medium high heat with enough canola oil (or any other high heat oil) to coat the bottom. 
• When the skillet is hot, start forming the broccoli/quinoa mixture into patties and place them on the skillet. Continue to cook until the underside has browned, then flip and cook until that side has browned. 

Platting and eating

• Spoon a decent amount of the white bean puree onto your plate.
• Now grab a handful of arugula salad and place over the puree. Drizzle your arugula with a little bit of olive oil and sprinkle it with salt and pepper. 
• Lay your crispy broccoli and quinoa fritters over the arugula greens and enjoy!

Notes;

• If you are looking for a sauce or dressing to put on the fritters, a simple mayo based aioli is great! (mayo, lemon juice, salt and pepper)

Anxiety disorders are among the most common mental health issues in America and they are a common route to developing a substance use disorder. Panic attacks may be a symptom of a panic disorder or perhaps of post-traumatic stress disorder. People who experience frequent panic attacks are often prescribed a fast-acting benzodiazepine such as Xanax to cope with their symptoms or they may self-medicate with alcohol, marijuana, or other substances. If you have struggled with panic in the past, the thought of having to give up these crutches may sound intimidating but it’s possible to learn to control panic without them. 

If you have experienced panic attacks in the past--which are characterized by shortness of breath, racing heart, confusion or disorientation, squeezing in the chest, feeling of impending doom, or feeling like you’re about to “lose it”--then you should certainly seek professional help. In the meantime, the following tactics can help you weather a panic attack.‍

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Understand What Panic Is

‍Part of the reason a panic attack is so frightening is that people who experience them are often not aware of what’s happening. The symptoms are similar to a heart attack and, in fact, many people go to the emergency room because they think that’s what’s happening. If you believe you’re having a heart attack, that will clearly make you more anxious, which will only increase your panic. It’s actually pretty hard to distinguish between a panic attack and a heart attack based on symptoms alone. Context makes a big difference. For example, if you’re under 40 and you have had panic attacks before, your symptoms are more likely panic. Symptoms such as squeezing in the chest, pain that radiates to the jaw or arm, or a ripping sensation in the chest or back is more likely a heart attack. When in doubt, it’s better to err on the side of caution and seek medical help.

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More generally, it’s important to understand that panic is what happens when your fight-or-flight system gets out of control. Perhaps something causes a bit of anxiety--a test or a confrontation--and that bit of anxiety signals a threat, and then you get stuck in a sort of feedback loop. The first step in controlling panic is to realize that anxiety, in appropriate amounts and in appropriate circumstances, is a useful emotion. The next step is to understand the role your own mind plays in escalating anxiety.

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Identify Catastrophic Thoughts

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The next step is to identify the thoughts that are amplifying your panic. These aren’t typically hard to spot, but the trick is to remember to be aware of them when you’re under stress. For example, when you feel anxiety or panic coming on, you may be thinking something like, “Oh, I’m having a panic attack--or a heart attack!--this is awful, I’m going to die, I’m going to go crazy, why can’t I stop this?” and so on. These kinds of thoughts only make things worse. 
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When you find yourself thinking these thoughts, there are two ways to respond. First, you can challenge your catastrophic thinking. For example, if you’re thinking, “I’m having a heart attack! I’m going to die!” think instead, “I’m only 25, so it’s probably not a heart attack, there’s no radiating pain or other symptoms. If I still feel this way in half an hour, I can go to the hospital. It’s probably just anxiety and anxiety can’t hurt me,” and so on.

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The other way to cope with these kinds of thoughts is to step back and be an objective observer. This takes a bit of practice and regular mindfulness meditation might help. When you do this, instead of trying to guess what every sensation might mean, you just observe it. “Oh, I’m feeling anxiety and now I’m feeling short of breath, which is making me feel more anxious. I mainly feel it in my stomach,” and so on. By accepting your anxiety and experiencing it without trying to suppress it or push it away, you avoid compounding your distress. 

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Breathe Deeply

‍As noted above, an anxiety attack comes when your sympathetic nervous system or your fight-or-flight system gets out of control. The fastest way to get it back under control is to take some slow deep breaths. Since constricted breathing is often a symptom of panic, this may be challenging but if you can manage it, it will calm you down pretty quickly. The exhale is especially important for stimulating the vagus nerve, which activates the rest-and-digest system. 

Try taking 10 to 12 breaths with a regular rhythm such as inhaling for three seconds, exhaling for six seconds, and pausing for a second before repeating. Research suggests that a rate of about six breaths per minute is ideal for relaxing and synchronizing your pulmonary and cardiac rhythms. Again, it can be challenging to slow down and breathe deeply when you’re having a panic attack, so just do what you can; even if your breathing rate isn’t perfect, it’s the aspect of your physiology that you have the most control over.‍

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Pay Attention to Your Environment‍

Another good strategy during a panic attack is to connect with your immediate environment using a grounding strategy. The idea is to use sensory input to connect to the here and now. Panic is always about what might happen--you might pass out or lose it, and so on, and wouldn’t that be awful? The initial anxiety likely stemmed from worries about potentially catastrophic outcomes from failing a test or interview or whatever. Grounding yourself with sensory input allows you to forget about all of that stuff and focus on the present. 

One common grounding technique is the 5-4-3-2-1 technique: Identify five things you can see around you, four things you can feel, three things you can hear, two things you can smell, and one thing you can taste. Take a moment to really experience each thing you identify. If you’re in a hurry, figure out which sense helps ground you the fastest and focus on that. It’s generally a good idea to practice this technique--and the other techniques, such as breathing as well--regularly, at least once a day, so you are more comfortable using them when you need to.

Panic is not an easy problem to deal with. The essence of panic is that it undermines your ability to think clearly and regulate your emotions. The best approach to treating a panic disorder or post-traumatic stress disorder is to work with a professional therapist to uncover the roots of the problem and develop comprehensive solutions. These typically involve a mix of behavioral and cognitive strategies, possibly with the aid of non-addictive medications, such as SSRIs. The strategies outlined above can help in the moment, but it’s also important to practice them in advance. If you need to use a grounding technique, for example, you don’t want to be thinking, “What was that technique again?” You want to recognize the onset of symptoms and automatically use a strategy that works for you.

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‍At The Foundry, we know that emotional regulation skills and treating any co-occurring mental health issues are major factors in long-term recovery success. We emphasize the treatment of trauma, including PTSD, as well as other anxiety disorders. We know that mental and physical wellness is key to recovery success. To learn more, call us today at (844) 955-1066.‍

There are two things addiction will ruin very quickly: your relationships and your finances. Drugs and alcohol get expensive when you need them every day, but the secondary costs are even more expensive. These include debts, legal and medical bills, and lost income. You might find yourself facing a pretty bleak financial situation in recovery. Financial stress is one of the biggest sources of stress for most people, which makes it a liability for recovery. As stressful as money problems are, it’s important to remember that they can be solved with a good strategy and consistent effort. The following is a brief look at how you can recover financially as you’re recovering from addiction.

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Write Down All Your Debts

Before you can make a plan, you have to figure out exactly what your situation looks like. This part can feel incredibly demoralizing but it’s necessary. Write down all your debts, including credit card debt, private debts, past due bills, student loans, home, and car loans, as well as any money you owe people for damaging their property or stealing from them. It might help to sort of compartmentalize while doing this. Don’t worry about how you’re going to deal with all of this; you’re just taking inventory right now. In the end, it actually makes you feel a little better to know what all of your financial obligations are, rather than having them all lurking in the dark.

Contact Your Creditors

If you thought writing down your financial liabilities was unpleasant, wait until you have to contact your creditors and other people you need to repay. Talking to creditors and people you’ve wronged is one of the most humbling things you’ll ever have to do, but again, it’s a necessary step. At this point, you have two primary aims: let them know you intend to repay them and see if they’ll be flexible on terms. Many people underestimate how much their creditors are willing to negotiate on repayment terms. It’s important to understand that debt collectors often buy your debt for pennies on the dollar, so pretty much anything you’re willing to pay them is gravy and other lenders would much rather work with you than write off your debt or sell it for a big loss. 

Your friends and family will likely be the most flexible on repayment terms, although it largely depends on how mad they are at you. Some might be willing to forget it entirely, but this isn’t just about the money; it’s also about taking personal responsibility and putting things right. Let these people know you intend to repay them even if it might take you a while.

Prioritize Your Debt Repayment

Once you have a complete picture of your debts and repayment terms, it’s time to make a plan for repaying them. Start with debts that are both urgent and important. For example, if you’re about to lose your house because you’re behind on the mortgage, focus on that first, and make minimum payments on the other things until you get out of danger. Next, focus on debts that are important but not urgent. Typically, these will be things like paying off high-interest loans or credit cards. Nothing bad will happen immediately if you don’t pay them, but the longer you wait, the bigger they get. Debts with high interest are like having a very big hole in your bucket: No matter how much money you make or how well you invest your money, your bucket is very hard to fill. 

Another good strategy for paying off debts is the “snowball” strategy. With this strategy, you focus on paying off the smallest debts first. There are a number of reasons this is often a good strategy. First, it can give you a huge psychological boost. If you have a list of 10 debts but five are small enough to pay off in a month or two, you feel like you’re making great progress and it’s much easier to think about how to pay off five debts rather than 10. It’s a big load off your mind. Second, knocking out small debts frees up money that you can use to pay down larger debts--hence “snowball.” While focusing on getting rid of high-interest debt is often numerically superior, the snowball strategy is often less stressful and more sustainable.

Write Down Everything You Spend Your Money On

Next, you have to figure out where to get the money to pay off these debts. Just like you made a list of all your debts, make a list of all your expenses. The best way to do this is to actually track your spending in real-time. This includes big things like car payments and small things like candy bars. Online credit card and bank statements make this process easier but you might want to keep a notebook to record spending as it happens. We often spend more money than we realize on things that don’t really improve our lives. This will help you spot that kind of wasteful spending and recording each transaction as you make it will force you to reflect on whether you really need the thing you’re about to buy.‍

Eliminate Wasteful Spending

Once you have a clear picture of your spending habits, look for things you can get rid of. How deep you go will depend on your money situation. There are probably things you can get rid of and not even notice--magazine subscriptions, apps, the membership to the gym you haven’t been to in a year, and so on. The tighter your money situation, the deeper the cuts. You may have to consider finding a cheaper place to live or do without some things until you get your money situation under control.

Work on Increasing Income

Eventually, you’ll need some kind of income. For most people, that will be from a job. There’s a huge range of employment situations people find themselves in after treatment, from going right back to their six-figure professional job as if they had been on vacation, to having trouble getting any job because of their substance use history. If you’re in the former category, you’re probably doing fine in terms of income but people in the latter category are in a tighter spot. For the moment, any job will do but be looking to trade up as soon as possible. The main things are to establish your reliability and skills. It may help to volunteer for a cause you care about. This helps improve your reputation, builds skills, and broadens your network. If you can, it’s also a good idea to learn some new job skills, possibly at a university or community college. 

Start Saving as Soon as Possible

Once you have things basically under control, which means you're making regular, perhaps even automatic, payments on your debts and you have some kind of steady income, it’s time to start saving some money. Living hand-to-mouth is extremely stressful and the more savings you have, the less you’ll stress about money. You might feel like you should wait until your debts are paid before you start saving but that might take years and in the meantime, you’ll be working without a net. Put a little money in savings every time you get paid, even if it’s only 10 bucks, and don’t touch it unless it’s an absolute emergency. 

Getting your finances sorted out in recovery may take a while. The hardest part is taking an honest look at your financial situation and talking to creditors. However, once you get working on the problem with a good strategy, you’ll feel much better. Keep in mind that paying your debts isn’t just about money; it’s part of the recovery process and often explicitly part of making amends. At Foundry, we know that addiction is a problem that affects every area of your life and therefore requires holistic solutions. We don’t just teach skills to help you abstain from drugs and alcohol; we teach skills to help you live a happier, more purposeful, more connected life. To learn more, call us at (844) 955-1066.

Different people think of different attributes when it comes to addiction recovery. Some people may think of discipline or self-control. Others may think of social connection or spirituality.

One attribute that is critical for everyone involved--treatment professionals, family and friends, and people with substance use disorders--is compassion. Compassion plays a vital role at every stage of recovery for the following reasons.

Addiction Is Fueled by Pain

The most important thing to understand about addiction is that most of the time, it’s fueled by pain. Most people who struggle with substance use have some kind of trauma in their past, whether it was childhood abuse, neglect, domestic abuse, sexual assault, or some other traumatic event. The pain of trauma can last years, perhaps even your whole life. Many people use drugs and alcohol as a way to escape the pain in their own heads.

Typically, addiction treatment professionals are well aware of this, often from firsthand experience. Their compassion for people feeling that pain is what inspired them to work in this field. However, it’s also critical for family and friends to understand this. Seeing the pain behind addiction can be hard at times, especially since addictive behavior negatively affects family and friends.

For example, it can be hard to have compassion for someone when you feel like that person is manipulating, deceiving, or otherwise taking advantage of you. Addictive behavior can seem like the height of self-involvement, especially when the pain is buried beneath aggressive or secretive behavior. As challenging as it might be at times, family and friends have to remember their loved one is acting that way because they are hurting. Compassion, not criticism or judgment, is typically what helps the most in the end.

Compassion for Yourself Is Critical

It’s also crucial for anyone with a substance use disorder to develop compassion for themselves. People with substance use issues can often be extremely compassionate towards others and extremely harsh on themselves. This is especially true for people with co-occurring conditions like major depression and anxiety disorders. If you struggle with addiction, you are probably no stranger to self-critical thoughts.

You may think things like, “Why am I like this? Why can’t I stop? What’s wrong with me?” Often, the self-criticism goes much deeper than that and precedes substance use by years. You may feel a deep sense of shame or worthlessness. If you pay attention, you’ll probably notice that you say all kinds of nasty things to yourself, probably things other people have said to you and you accepted as true.

Perhaps worst of all, you may feel like flagellating yourself in this way will inspire you to be better. Unfortunately, that’s not how it works. It’s almost impossible to make positive changes from a place of shame and hopelessness. A much better approach is to work on being more compassionate and supportive toward yourself. Try talking to yourself the way you would talk to your best friend. Accept that we all make mistakes and know that even your really bad blunders don’t make you a failure or a horrible person; they just make you human.

Compassion Brings People Together

Finding a sense of social connection is an important part of addiction recovery. It gives you a sense of purpose and accountability, whereas loneliness, isolation, and alienation typically lead to depression, anxiety, and hopelessness. Connection makes you feel better about life and keeps you focused on recovery. Few attributes are as good for fostering social connection as compassion.

People like to know that you care if they are hurting and want to help. When you have compassion, you listen and try to understand rather than make judgments or just wait for your turn to talk. When you are part of a group that values compassion, you know you can talk to each other and rely on each other.

Compassion for others makes you happier.

One thing people are often surprised to discover about compassion is that it makes you happier. Too often, we get caught up chasing our own happiness and, as a result, end up feeling dissatisfied and miserable.

We may think of caring for others as an obligation or a burden, but in fact, it’s one of the best ways to boost your own happiness. There are even a number of scientific studies showing that participants who work on increasing their feeling of compassion through metta, or loving-kindness, meditation, report a long-term increase in positive emotions.

How to Develop Compassion

Nearly all of us have some baseline of compassion already. We wince when we see someone get hurt, we want to protect small animals, and we feel bad when we hurt people we care about. The main thing is to build on the compassion you already feel. Remind yourself periodically that you want the people close to you to be happy and safe and help when you can.

However, the real challenge is feeling compassion for people we don’t get along with or particularly dislike. Inevitably, there will be some of these people in your family, at work, in your therapy group, or at your 12-Step meeting. The key here is to recognize what you have in common. You both want to be happy and feel like you matter.

You both have suffered pain and disappointments. Perhaps the most important thing to remember is that behavior that seems obnoxious to you is usually caused by some kind of pain or insecurity. Being able to understand that pain and wanting to relieve it is what compassion is all about.

Compassion is critical at every phase of addiction recovery. No one recovers alone; everyone needs love and support. Compassion for yourself is always the place to start and sometimes this is the hardest to nurture. Compassion for others builds strong social connections.

At The Foundry, compassion is one of our guiding principles. We know that recovery from addiction is first and foremost a process of healing and our caring staff uses a variety of evidence based treatments to help our clients heal. To learn more about our treatment programs, call us today at (844) 955-1066.

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If you have a loved one struggling with a substance use disorder, you may feel incredibly frustrated that they won’t get help. Can they not see what drugs and alcohol are doing to them? Don’t they want to be happy? What’s important to understand is that your loved one may be miserable but they’re also afraid.

That may not be obvious since many people cope with their fear by becoming aggressive or disengaged but the fear is there. If you understand their fear, it can help you be more patient and supportive and you may ultimately have more success getting them into treatment. Here are some of the reasons people are afraid to enter addiction treatment.

They’re Afraid to Admit Having a Problem

It may be obvious to you and everyone else that your loved one has a problem with drugs and alcohol and you may believe it’s obvious to them, but denial can be powerful. Keep in mind that there’s no clear line when addiction begins. It’s a gradual process with a lot of gray area. That is to say, it looks very different from their perspective.

There is still a lot of stigma attached to addiction and when you admit to having a problem, you feel like you’re accepting membership in a rather dubious club. When you admit to having a problem, you also have to confront the possibility that you might need help, which leads to a bunch of new anxieties.

They’re Afraid to Give Up Control

One of those anxieties is giving up control. Often, people with substance use issues will accept that they have a problem but then insist on dealing with it on their own. They insist they are still in control, even though the most common symptoms of addiction include trying to quit but being unable to and not being able to drink or use drugs in moderation.

When you insist on doing it your own way, that’s usually an attempt to avoid the hard but inevitable aspects of recovery. They want things to change but they don’t want to be uncomfortable, which is really true of everyone. And in addiction recovery, there are plenty of opportunities to be uncomfortable.

They’re Afraid to Be Alone

When people imagine entering an addiction treatment program, they often picture some remote facility, not unlike a prison, where they’ll have to spend 30 to 90 days among strangers. In other words, they feel like they’re going to have to endure this ordeal alone.

While it’s typically true that people entering treatment don’t know anyone there, the loneliness will only last a few days at the most. The staff wants you to feel welcome and you may have a roommate.

Most importantly, good treatment programs know how important it is for clients to feel connected and supported and they facilitate that connection through group activities and group therapy. People often say they met their best friends in addiction treatment because it is a place where most of the people have experienced similar struggles.

They’re Afraid to Open up

Most people know that if they enter addiction treatment, they’ll have to talk to a therapist and participate in group therapy. This can be a frightening prospect. Men appear to be especially reluctant to seek help for mental health issues and talk about their feelings, but it can be hard for anyone.

Not only does it entail revisiting painful memories and emotions, but many of these experiences have been buried deep down for years or decades. Feelings of shame or a general reluctance to open up and be vulnerable can make someone want to avoid therapy entirely.

However, a good therapist won’t push a client to talk about anything before they’re ready. That often ends up being counterproductive. Eventually, most people discover that keeping things bottled up is more trouble than it’s worth. It’s often a tremendous relief for people to discover that their deepest, darkest secrets are not that uncommon and they no longer have to feel ashamed.

They’re Afraid of Living Without a Coping Mechanism

One of the most important things to understand about substance use disorders is that people typically start using drugs and alcohol for a reason and they continue to use them because they get something out of it. For example, at least half of people with substance use disorders have a co-occurring mental health issue, although they may not know it. Childhood trauma, abuse, and neglect are very common among people with substance use issues.

Although drugs and alcohol are a bad way to cope with emotional pain, they are the only coping mechanism many people have. When you say to someone, “You need to get sober,” they may be hearing you say that you want to deprive them of the one thing that makes life tolerable, even if it does cause other problems.

to replace unhealthy coping mechanisms with healthy--and more effective--ones. One reason therapy is such a central component of treatment is that it helps resolve many of the issues that drive substance use and teaches clients skills to cope with challenging emotions.

They’re Afraid to Disappoint You

Finally, many people resist entering treatment for addiction because they’re afraid of failure. Recovery can seem like an overwhelming challenge. They may have failed at it before, perhaps even several times. Failure is bad enough in itself but it’s even worse when other people are depending on us. What’s more, a lot of time, money, and effort goes into quality addiction treatment.

That adds up to a lot of pressure to succeed at a time when most people don’t feel equal to even the most mundane challenges. It’s important for them to know that sobriety is worth the risk of failure--even repeated failure, if necessary. Recovery never goes perfectly for anyone. There are always challenges and setbacks but you don’t fail until you quit trying.

There is plenty to fear when embarking on addiction recovery, but there’s even more to fear from not trying at all. People lose their money, their jobs, their families, and their lives to addiction, but they don’t have to. Some fears--such as the fear of being uncomfortable--are valid, but also an inevitable part of the process. The key to overcoming those is to realize the payoff is worth the price. Other fears, like being alone or having to live without a reliable coping mechanism are largely illusory. At The Foundry, we understand that getting help for addiction is a hard decision but we also know that quality addiction treatment changes lives. To learn more about our programs, call us at (844) 955-1066.

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Emotional regulation is one of the key skills to learn when recovering from addiction and anger is one of the most challenging emotions to regulate. Anger can come on quickly and feel overwhelming. It can lead to rash decisions, arguments, strained or broken relationships, or even accidents.

If you tend to repress your anger, you can avoid some of the consequences of anger but you may have other problems instead, including depression, cardiovascular disease, chronic pain, and more frequent illnesses. Whether you more often lose your temper or stuff it down, dealing with anger in the wrong ways can damage your health, your well-being, and your recovery from addiction. The following are tips for dealing with anger in a healthier way.

Know What Anger Is

First, it’s important to understand that anger, like all emotions, is not inherently bad and is useful in some situations. Fundamentally, anger is a response to a threat. In the simplest situation, someone attacks you physically, you get angry and fight back, and they leave you alone.

However, these days, anger is rarely the result of a direct physical threat. It’s the result of disagreements, obligations, criticism, unfair situations, and other kinds of frustration, most of which won’t respond to physical threats. As a result, unresolved anger becomes a kind of chronic stress. Resolving it is largely a matter of identifying the perceived threat and finding an appropriate solution.

Know Your Own Tendencies

As noted above, people tend to inappropriately respond to anger either by exploding or suppressing, neither of which is typically helpful. It’s important to be aware of which behavior is more typical for you. If you explode, you probably know it, but you may not be as aware of suppressed anger, especially if it’s a habit you formed in childhood. Depression, resentment, and chronic pain often involve an element of suppressed anger.

It’s also important to know what kinds of things make you angry--your triggers. Often, anger involves some combination of stress and insecurity. For example, if you’re under a lot of stress at work, you may be more likely to lose your temper with your spouse, especially in some area you already feel insecure about.

Learn to Pause

The first skill to master when it comes to managing anger is the pause. This means that when you are aware of becoming angry, you give yourself some time before responding. This isn’t suppression; it’s just collecting yourself so you don’t say or do anything to make the situation worse.

It often helps to have a go-to technique. Maybe you count down from 10 or take five slow, deep breaths. After the first wave of anger passes, you should be able to think a little more clearly and employ an appropriate strategy.

Practice Relaxing

Learning to relax has two important benefits for managing anger. First, it lowers your baseline. We all have a certain set point that is partly physiological. Also, stress tends to accumulate. If you practice relaxing every day, you shake off some of your accumulated stress and you gradually lower your set point for anger. Typically, relaxation will involve some deliberate routine, such as progressive relaxation, where you focus on each body individually and let it relax.

Or you may use some kind of visualization or some kind of breathing exercise. The second benefit of practicing relaxation daily is that you are better able to relax when you feel yourself getting angry. It’s easy to get swept away with anger, so practice is key when you need to relax under pressure.

Practice Mindfulness

Mindfulness meditation is a great practice for managing anger because it combines the relaxation and awareness of your own tendencies discussed above. Mindfulness meditation is just spending a few minutes every day keeping your awareness in the present moment, nonjudgmentally observing any sensations, thoughts, and emotions that arise. After practicing this for a few weeks, you’ll be more aware of the relationships between your thoughts, emotions, and physical sensations. 

You will also be able to use your mindfulness skills in the moment to manage your anger. For example, when you pause, you can watch the progression of anger without getting swept away by it. You can feel the physical sensations, such as your face getting hot, your throat getting tense, and so on. You can also notice what thoughts are associated with your anger, which brings us to the next point.

Watch Your Thoughts

As noted above, these days, we rarely experience anger as the result of a direct physical threat. Our anger is mostly a result of our thoughts and beliefs about a situation. Anger is typically caused by frustration, which is often associated with assumptions about how the world should be, “That guy should be more considerate,” “This process should be more efficient,” “That policy should be fairer,” and so on.

And maybe some of those things are true, but we have to take the world as we find it. Another common distortion is jumping to conclusions or assuming the worst possible outcome. That feels threatening, which can lead to anger, but in reality, the worst possible outcome rarely happens.

Improve Your Communication

Sometimes anger does actually signal that something needs to change. This is the kind of situation in which you want to express your anger but in the most constructive way possible. To do that, you typically need to pause and collect yourself before moving forward.

The next step is to communicate clearly. That means understanding what you want from a situation as well as being willing to listen to the other person. Communication is a huge topic but start by listening with an open mind and communicating your needs without accusing or condemning the other person.

Work on Solutions

Finally, not all anger is the result of direct interpersonal conflict. Forgetting your password can be just as enraging as being slapped in the face, but smashing your computer on the desk will only make you feel better for about three seconds. Instead, allow yourself to calm down and start working on a solution. Think of it as an opportunity to practice frustration tolerance, the core skill in managing anger. Pause as often as you need to but keep working steadily toward a solution.

Anger is a common problem and the nature of anger makes it a difficult problem to solve. It takes practice and it may take therapy as well. The good news is that anger appears to respond well to cognitive behavioral therapy, the most commonly used form of therapy today. Medication will also be part of therapy for some people with anger issues.

At The Foundry, we know that emotional regulation—including anger—is one of the most important aspects of addiction recovery. We use a number of proven methods to help you live a richer, more fulfilling emotional life, including cognitive behavioral therapy, dialectical behavior therapy, trauma therapy, mindfulness meditation, and more. To learn more, call us at (844) 955-1066.

Summer has come and before we knew it, it was almost over! There are so many reasons to love summertime and especially summer in Steamboat Springs! The clients have been able to enjoy; some of the best hikes in and around Steamboat, watching the garden flourish as Kim Brooks walks them through harvesting, and eating some of the best tasting vegetables that you could ever ask for. 

Sometimes summer offers so many exciting activities that we gloss over things that can sometimes give us the most joy in life, and that is food! What better season is there for food? So many fresh foods that were literally hand selected only seconds ago are now sitting in front of us on a plate. A lot of times there will be so many fresh things from our garden that Cord and I get overwhelmed (these are good problems!!). 

It is in these times of overwhelming fresh harvests that I am reminded of a phrase by my favorite author, Michael Pollen, “Eat food. Not too much. Mostly plants.”. If you were to mention this phrase to most of the clients that come through Foundry, you will probably get a response that has something to do with how much Chef Henry uses vegetables. Then that same client will also hopefully go on to say something about how a lot of those veggies Henry was feeding him “actually weren’t bad”. 

Probably the only way to cook and eat all of the veggies that we get from our garden/greenhouse is to cook with mostly plants. When I say “mostly plants” I’m not talking about never eating meat again, but I am talking about reducing the amount of meat consumed in a given meal. Imagine that you are going to make taco. How can you reduce the amount of meat consumed in a taco? Well instead of using only ground beef as a taco filling, consider cutting the amount of ground beef in half and then adding in some taco seasoned and roasted cauliflower. Hopefully you will find that you can still enjoy the beef flavor but only be eating half of the meat. 

Why would I want to even cut back on meat? There are many reasons to cut back on meat consumption, one of the reasons that clients hear me talking about all the time is that meat has a large impact on our earth. Meat (especially red meat) requires a lot of resources to grow due to such high demands by consumers, so by reducing meat consumption your carbon footprint will be reduced. Also maybe the most important reason is to reduce your food budget. Whole vegetables and plants in general are much cheaper than buying meat for every single meal. If you supplement your meat with a lot of plants it could stretch your meat for multiple days instead of just one meal's worth. 

This way of cooking and eating might be hard at first, but give it a try. Try the half beef half cauliflower tacos, try having a smaller portion of steak and then upping the amount of roasted veggies on the side, or try cutting up any leftover meat and putting it on a salad with some grains (quinoa, rice, farro…). 

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Garden Update

Wow! We have been talking so much about our veggies from the garden, let's just enjoy looking at them for a minute.

Recipe

Earlier we were talking about ways to reduce meat in our meals, so let’s take a look at some more ideas!

• What a lot of people don’t realize about eating vegetarian meals is that they are really just looking for a meal that has a good texture. So try adding in some chopped nuts, raw diced cauliflower, or chewy grains like farro to your next vegetarian salad. 
• Start thinking of your meals as more than just the meat, for example; “I’m going to eat steak tonight” vs “I am going to be eating a steak salad with roasted brussel sprouts served over some creamy farro”. If you are only thinking of the steak, you will eat more meat and hardly anything else. If you are thinking of all the sides along with your steak sometimes there are such amazing side that you hardly need any steak.
• Start eating your meals mixed together as opposed to separated. When you separate your meat from your veggies as well as other components of the meal you are more likely to not only eat more meat, but also eat more food in general. Some people do not like their food touching, so when cooking for yourself try to only use things you enjoy!
• Last of all! Remember what types of foods are classified as plants! It sounds easier than you would think, but a lot of people will associate the word plants with only vegetables, but there are so many more plants to eat than just veggies (more edible plants exist than animals we eat). Below is a list of plants for you to just remember how delicious they actually are.

• Grains (farro, rice, quinoa, barley…)
• Pastas (try to stick to whole grains)
• Fruits!! (berries, peaches, plums, apricots, apples, bananas…)

• Fruits are a great way to add some sweetness in your life.

• Baked goods! (we all love a little bit of carbs but let's make sure that it stays only a little bit)

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Catch us on Social Media!

If you are looking for more Foundry content check out our website, or look for us on social media; instagram (@foundrysteamboat), Facebook (Foundry Steamboat), or Twitter (@foundryrehab)! 

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**As always have a safe and clean month - Chef Henry

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“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.

Family members address and navigate through seemingly endless stormy waters once their family member enters treatment. Having a family member in treatment is demanding of our time and resources and most of all, it’s emotionally exhausting.

Our worry and anxiety fluctuate throughout the process and we often find ourselves in a constant state of “fight or flight.” This helps to keep us prepared to take action when dealing with a crisis or a threat. It is a constant state that keeps us striving to take “control” of the fear or worry. The challenge of taking “control” of a situation this way is that it really only works if we are in physical danger. When dealing with anxiety, perceived or real, our version of taking “control” becomes more of a problem…an emotionally exhausting problem.

There is no doubt that our fear is real, especially when our family member’s needs must be met through more intensive interventions. However, our tendency to allow our thoughts to create and exacerbate anxiety keeps us in this state of automatic response, constantly reacting to our perceived fears using ineffective tools to take “control.”  

Below are 10 useful ways to manage your anxiety more effectively as you engage in this journey with your family:

10 Ways to have Long-Term Success with Managing your Anxiety:

• Find control within ourselves to decrease the need to control “the situation”
• Change negative beliefs
• Cultivate new approaches to thinking
• Increase awareness of thoughts and storylines that we follow, especially those that always increase anxiety
• Learn how to stop replaying the past and rehearsing a dissatisfying future
• Decrease self–judgment and blame
• Distinguish between urgency and importance when it comes to situations that need addressed
• Increase self-awareness and identify patterns that are impacting our success as a parent
• Change language to change behavior to increase self-awareness
• Learn how to decrease expectations and truly allow for acceptance
• While it can seem challenging to change how we think and cope with difficult situations, we must also remember that a loved one is trying to learn an entirely new life without addiction. In our Family Program we can work with you and your loved one to create a new path together.

Jen Murphy, M.Ed., LPC is the Family Director at The Foundry, a rehab and substance abuse treatment center in Colorado, providing services specifically for Foundry family members to provide support and guidance throughout their family member’s treatment process.   In our work with families we continually honor the family’s therapeutic process and creatively support the unique needs of each individual family.  Jen Murphy can be contacted at jen.murphy@foundrytreatmentcenter.com

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Daily writing is one common element of addiction recovery plans. To some people, the reasons for this will be obvious. Others may be skeptical, especially if they don’t think of themselves as writers or they are skeptical of self-expression in general. However, daily writing can be a potent and versatile element of your recovery plan. Here are some different writing exercises and how they can help you stay sober.

Journaling

The writing exercise most people are familiar with is keeping a simple journal or diary. This is just sitting down for a few minutes every day and writing whatever you feel like. You might just write down what you did that day or what happened that was notable. Or you might go into depth about something you’re thinking about or challenging emotions. This simple practice can help you in several ways.

Most notably, it helps you relieve stress. Instead of stewing over a problem, you get it down on paper where you can think it through. You will probably find that after you write about something that’s been bothering you, you will feel better about it, even if you didn’t come up with a specific solution. Just writing about your day, your thoughts, your emotions, your challenges, and so on will help you spot patterns in your life. And, of course, you can also incorporate any of the following exercises into your daily journaling session.

ABCs

ABC stands for activating events, beliefs, and consequences. It’s a framework developed by psychologist Albert Ellis, one of the pioneers of cognitive therapy. The central idea is that events only bother us because we have certain beliefs or assumptions about those events. For example, if someone cuts you off in traffic, there’s no reason to be angry about it for the rest of the day.

That only happens if you have an irrational belief about it. You may think that guy shouldn’t have done that or that it was a deliberate insult to you. In reality, it was probably just a mistake; it happens all the time. 

The ABC exercise is a way to practice identifying the beliefs that disturb us. Whenever you feel angry, anxious, depressed, and so on, write down exactly what you’re feeling. This is C, the consequence. Next, identify the activating event, A--the guy cutting you off in traffic or the remark by a coworker, or whatever. Finally, identify the belief, “He shouldn’t do that,” “Everyone at work is against me,” and so on.

This is the trickiest part since we are often unaware of our own assumptions. You may need a therapist to help you identify your irrational beliefs at first. In fact, his exercise is often given as a homework exercise in therapy. You can use it that way or you can try it on your own. Either way, it’s a good way to get in the habit of identifying and challenging irrational thoughts.

Gratitude

In recent years, research in positive psychology has identified a range of benefits of gratitude. It improves relationships, lowers stress, improves sleep, makes people feel more optimistic, increases your sense of wellbeing, and it might even help you live longer. The problem is that when you’re starting out in recovery, you might not feel very grateful. Your life is likely at a low point and you have a lot of work ahead of you. The good news is that there are two easy writing exercises that studies have shown, can boost your gratitude. 

The first one is to keep a gratitude journal. This is simple and only takes a couple of minutes. Just write down about three things you were grateful for that day. It’s fine if they’re small--you slept unusually well, the weather was nice, you got a text from a friend you hadn’t talked to in a while. Not life-changing stuff but they make your day a little better.

Since we’re hardwired to notice pain and threats, training yourself to notice more of the good things makes you happier and more optimistic. You might want to do this exercise daily for about two weeks, then switch to doing it weekly so you don’t get overly accustomed to it.

The second exercise is to write a gratitude letter. This one takes a bit longer but research shows the effects last longer too. Think of something someone did for you that you never really thanked them for. Again, it doesn’t have to be huge, just something you truly appreciated. Describe in a letter what they did and what it meant to you. You can deliver the letter or not. Research suggests you get a happiness boost either way.

Anxiety

Writing is an excellent way to relieve anxiety. It takes those amorphous fears that are haunting your mind and gives them some definite form on the page. This is true whether your anxiety is caused by a past or future event. A number of studies have found benefits from expressive writing. This is where you choose a stressful event, one that’s at least six months in the past, and write about it on four consecutive days.

Set a timer for 20 minutes and write the whole time without censoring yourself or worrying about spelling or grammar. No one will read it but you. This exercise has been shown to reduce anxiety and even improve physical health over the following months. 

What’s more, an abbreviated version of this exercise can help relieve anxiety about an upcoming challenge. Research has shown that having students spend a few minutes writing about their worries just before a test reduced test anxiety and improved test scores. A similar strategy can help with other tasks, such as going to your first 12-Step meeting or going to a job interview.

Writing alone won’t replace therapy and solve all your problems but it can be a helpful tool to manage your mood, analyze your patterns, and generally understand yourself better. A regular writing practice can be a powerful element in your recovery plan.

At The Foundry, we believe that a strong recovery is built on mental health and self-knowledge. We use a variety of evidence-based methods, including CBT, DBT, family therapy, mindfulness meditation, and others to help our clients understand themselves better, regulate their emotions, and manage their behavior. For more information about our approach to treatment, call us at (844) 955-1066. 

There are many options on the spectrum of care for addiction treatment. For example, on one end, you could attend local 12-Step meetings. They are free, open to everyone, and provide structure and support to people trying to stay sober. However, that level of care isn’t always adequate. Many people, for example, are unable to detox safely or they may have co-occurring mental health issues. Those people might need a higher level of care, perhaps working with a therapist who specializes in addiction. A higher level of care might be entering an intensive outpatient program (IOP). 

The highest level of care is a residential treatment program, which may last anywhere from 30 days to six months or more. Since a residential treatment program is a fairly substantial investment of time and money, it’s a big decision whether to go for it. The following considerations can help you decide if a residential treatment program is right for you or your loved one.

You Anticipate a Difficult Detox

Residential treatment programs typically include medical detox. You don’t necessarily have to do medical detox and treatment in the same place, but it does streamline the process. There is more continuity and less opportunity to back out. Also, if you need medical detox, you are probably using drugs and alcohol at a level that could be considered a serious addiction.

While it’s not always possible to predict how detox will go, there are some factors that indicate medical detox is the wiser strategy. The biggest indicator is if you’ve had trouble detoxing before. Perhaps you experienced severe symptoms, such as DTs, or perhaps you only managed to make it a few days before giving up and returning to substance use. Detoxing in a facility helps keep you safe, increases the likelihood that you will complete detox, and helps ensure you will proceed directly to treatment after detox.

You Have a History of Relapse

Another solid indication that it’s time for a residential treatment program is if you have a history of relapse. Perhaps you have tried other options, such as 12-Step meetings, therapy, or IOP and nothing seems to stick. There are many reasons people relapse and it’s not certain that a residential treatment program is the only solution, but it also doesn’t make sense to keep trying the same thing if it hasn’t been working. 

A residential treatment program offers far more protection, structure, and support than even an IOP. You live in a place where drugs and alcohol are kept out, you are largely insulated from the everyday stresses of life, and you have a structured daily routine that helps you focus on recovery and wellness. This kind of program can help you break the unhealthy habits that keep you sliding back into substance use and replace them with healthier habits that not only make it easier to stay sober but make you happier and healthier overall.

You Have Co-Occurring Conditions

Co-occurring conditions are extremely common among people with substance use disorders. For example, mental health issues like depression, anxiety disorders, personality disorders, PTSD, ADHD, and schizophrenia significantly increase your risk of addiction. For some conditions, like mild or moderate depression or some anxiety disorders, therapy or outpatient treatment might be enough to get the co-occurring condition under control. However, some conditions are much harder to treat and some of those contribute most to addiction risk. For example, about 56% of people with bipolar disorder develop a substance use disorder at some point in their lives and as many as 75% of people with a borderline personality disorder will develop a substance use disorder at some point in their lives. 

These conditions often require more intensive forms of treatment than a weekly visit with the therapist. Borderline personality disorder, suicidal depression, eating disorders, and other serious mental health issues are often treated with dialectical behavioral therapy (DBT), an intensive form of treatment that is more easily done in a residential setting. Other conditions may require medication and observation early on and a residential setting is better for that too.

Also, people recovering from substance use disorders sometimes have medical issues that complicate treatment. Long-term drug and alcohol use can cause high blood pressure, heart disease, risk of stroke, liver disease, malnutrition, and other issues. Detox can put a lot of stress on the body, so it’s often a good idea to have easy access to medical treatment. Inpatient treatment can also go a long way to correcting any problems caused by lifestyle issues, such as malnutrition or sleep deprivation.

Your Environment Contributes to Your Substance Use

As noted above, there may be many factors contributing to your pattern of relapse. Dysfunctional family dynamics, job stress, peer pressure, exposure to triggers, and so on can make it very hard to make a good start in recovery. A residential treatment program is a chance to make a clean break. You are shielded from those negative influences while you learn new recovery skills and establish positive lifestyle habits. Insofar as you need friends and family to support your recovery, they can participate in the treatment process too. Getting the family involved is ideal because everyone can learn to communicate better, maintain healthy boundaries, and better understand how to support your recovery. 

There Are Few Treatment Options in Your Area

Generally speaking, you want to have the appropriate level of care to suit your needs, but sometimes you just have to make the best choice available. For example, some people need residential treatment but for economic or family reasons, they have to go with outpatient treatment instead. Similarly, many areas of the country--and many of the areas that have the most need of treatment--have few if any treatment options. There are more and more options becoming available but if you live in an area where there are few options and you need a fairly high level of treatment, your best strategy might just be to find a residential program rather than trying to manage a long commute or setting for too low a level of care. 

Entering a residential treatment program for addiction is a big decision. It probably won’t be the first thing you consider when you first notice you’re drinking a bit too much or relying too heavily on pills. More likely, you will have tried some other routes to recovery and had a hard time sticking with it for whatever reason. Maybe you’ve never even made it past withdrawal. Maybe there’s something in your environment that’s making it harder for you, such as a loved one who can’t seem to say no. Maybe you have a serious co-occurring condition that requires intensive, integrated treatment. Whatever the reason, residential treatment is the most intensive option. 

At Foundry, we know that entering residential treatment is not a decision anyone takes lightly and we’ll use every means at our disposal to help you start your recovery right and make a smooth transition home after treatment. We treat difficult conditions using proven therapeutic methods, including DBT, and we emphasize overall wellness to support long-term recovery as well as physical and mental health. To learn more about our holistic addiction treatment program, contact us at (844) 955-1066.

We all want to feel like we have a hold on our addiction. We try to do everything right. We avoid people, places, and things, go to the meetings where we feel comfortable, and work through the steps with a sponsor. Unfortunately, no matter what we do, life is going to happen. We will be triggered, and we aren’t always going to be working our program perfectly. To avoid relapse, it's essential to learn the early warning signs that we might be closer to picking up than we’d like and how to walk through those signs in a healthy way.

When thinking of relapse, we often think of the part where we pick up and start using again, but just like everything else, there are phases we can look out for before we pick back up. Relapse begins with our emotions, then it becomes mental and, finally, physically, putting the substance into our bodies. These phases can be very gradual and hard to spot if you aren’t looking for them and adequately dealing with each stage as it comes.

Phase 1: Emotional

Emotional relapse often happens before we even consider picking up a substance. This phase can manifest in many different ways. We could notice that we are becoming angry by situations that generally wouldn’t bother us; it could be that you are noticing that you feel anxious more often than is typical. We could even begin to start eating and sleeping in ways that don’t feel healthy.

These could all be signs that you are beginning to slip down into emotional relapse, but the only way we can realize that we are slipping is by motoring our emotions. If you notice these, get connected to your support group. Verbalize the way you feel to people you trust. Consider meditation to quiet your mind and calm down or, physical exercise can be a healthy way to let out a lot of emotions.

Phase 2: Mental Relapse

Most people in recovery have two parts of their brains that are constantly at war. One part is the part of the brain that wants to remain sober and continue to lead your life in such a way that you can look back with pride and contentment at all of your achievements. On the other hand, there is also the part of the brain that misses the old life.

This part of our mind tends to forget all of the harm we caused others; all of the pain we put ourselves through and tends to focus on the good times. Everyone in recovery struggles with this, but when your thinking shift and the part of your brain looking back on those memories fondly takes the steering wheel, you’ve slipped into mental relapse.

If you notice mental relapse happening, it's time to fight harder than ever. Try and remember how dark active addiction was. “Play the tape forward’ and think about what your life would look if you went back into active addiction. Talk about it with your sponsor, your support group, your dog, your cat, anyone who will listen and listen to their suggestions and let them help you.

Phase 3: Physical Relapse

Physical Relapse is what most people probably imagine when they hear the word relapse. It is the action of actually consuming any form of mind-altering substance. Even just using one time can bring all of the old cravings back. Without help, often time, people find themselves exactly where they left off, which can be deadly. Our bodies aren’t used to consuming drugs and alcohol the way we used to, so it’s very easy to take too much and find yourself hospitalized or even dead.

If you find that you have physically relapsed, it’s not too late. It’s going to be easier to get help early on, rather than waiting until things get bad again. Don’t be afraid to reach out to people you trust. Going back to treatment might be the best option. It’s never a sign of weakness. You now are that much more educated about your disease and have better ideas of what to look out for.

Recovery is not something that everyone gets on the first try. Relapse is a part of many recovering addicts' stories, and if it happens, there is no shame in starting over. Of course, we want to save ourselves from being dragged through all of that pain and torment, if possible. The best way to avoid relapse is to be aware of these early warning signs and to take appropriate action when they come.

The most important thing to remember is that this a team sport and we all have to work together to have long and happy sober lives. Get a group of other sober people to walk through life with, avoid triggers, and always be aware of your mental health and keep pushing forward.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body, allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at (844) 955-1066.

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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.

It’s not uncommon for people to feel lonely when starting out in addiction recovery. There are several reasons for this. If you’ve just come home from inpatient addiction treatment, where you were around people most of the time, you might suddenly find a normal amount of alone time rather stark. None of the people you are used to chatting with in the dining hall or rec room are around anymore.

Second, when you’re starting recovery, it’s a good idea to distance yourself from friends and acquaintances who use drugs and alcohol. Even if they don’t pressure you to drink or use drugs, the association might trigger a craving. Feeling this avenue of socializing is restricted in this way might make you feel lonely.

This loneliness can have real consequences for your recovery, your mental health, and even your physical health. Loneliness and boredom often trigger cravings. Feeling both bored and sad is a bad combination for recovery.

It’s important to remember that loneliness isn’t just the absence of companionship; it’s the presence of psychological stress. Studies have shown that loneliness is linked to a greater likelihood of high blood pressure, diabetes, depression, and psychological distress. If you’re feeling lonely in recovery, here are some suggestions for what to do about it.

Accept That What You’re Feeling Is Normal

First of all, accept that it’s normal to feel lonely sometimes. We’re a social species and we depend on each other for survival. From an evolutionary perspective, to be isolated is to be vulnerable. Part of coping with loneliness entails acknowledging the feeling, accepting that it’s ok, and knowing that it will eventually pass. Just labeling the feeling can help you feel a bit better. So, if you’re alone and feeling restless, bored, or sad, think, “Ah, that’s loneliness; it won’t last though.”

Go to Meetings Regularly

The best way to beat loneliness is obviously to have regular social connections. For people in recovery, that often means attending regular 1Step or other mutual-aid meetings. This is a time to connect to other sober people and it may also be a good time to discuss your feelings of loneliness. Most of the other members will know what you’re talking about.

Some people may even make themselves available if you feel like you need someone to talk to. Going to meetings regularly also gives structure to your day so that if you do feel lonely, you have a definite idea of when that might end. Keep in mind, especially if you’re relatively new, that engagement is key. While it might help just to be around other people, you still might feel lonely if you just sneak into a meeting and sit in the back.

At the moment, we’re all under quarantine from the coronavirus and that might put a damper on meetings in your area. If that’s the case, you may be able to connect with your group digitally. A lot of meetings are now being held on Zoom, Google Hangouts, and other platforms. Not only is this safer, but it also gives you a chance to get some different perspectives from different groups.

Work on Repairing Damaged Relationships

Another reason you may be feeling lonely is that you may have alienated some of your friends and family when you were actively addicted. If you’re feeling lonely, that may be an indication that it’s time to start mending those relationships. This may be a long-term project but it has to start somewhere. Reach out to the people you’ve wronged and who you want back in your life.

You may have already done this to some extent while working the 12 steps. If so, great. Try reaching out to some of those people. Relationships are typically built through frequent, low-intensity contact. If you still haven’t apologized and made amends to some people, now might be a good time to do that. An apology and making amends won’t fix your relationship right away but it’s a good place to start.

Get Involved in New Activities

People are often surprised how much harder it is to make friends as an adult. When you’re younger, you’re around other people your age every day in school and other activities. When you’re an adult, you’re around other people at work--sometimes. However, people at work have their own lives and concerns and you may or may not have any points of connection.

One solution is to get involved in some new activities. Join a cooking class or a yoga class. Find a running or biking group. Join a recreational sports league. Volunteer for a worthy cause. These are great ways to see the same people regularly and meet people who share your interests. Beyond that, these all aid your recovery by giving you a challenge and a sense of purpose.

Reframe Loneliness

Another important thing to remember about loneliness is that it’s really just in your head. Just because you’re alone doesn’t mean you are necessarily lonely. Loneliness only happens when you are alone and craving company. Being alone can also be an opportunity to do some things you can’t do when other people are around. It may be a chance for you to read, write, meditate, create, listen to music, and think about your values and priorities.

Many of these things require deep, uninterrupted focus, which makes alone time perfect for working on them. Under the current quarantine, we’ve all been reminded several times that Shakespeare wrote King Lear while under quarantine from one plague and Newton invented calculus while exiled from another plague. While we all need to socialize to various degrees to be healthy and happy, we can also use alone time to think, focus, and work.

Loneliness is a common challenge early in recovery but it gets better. You can build a sober network pretty quickly if you make a regular effort and stay engaged in meetings. You may also be able to salvage some old relationships. In the meantime, it’s important to accept that what you’re feeling is normal and that it will pass, and to make what use you can of your alone time. At The Foundry, we understand that a strong recovery is about treating the whole person—mind, body, and spirit. We incorporate many different proven treatment methodologies to help you stay sober long term. To learn more about our programs, call us today at (844) 955-1066.

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When people start thinking about quitting drugs and alcohol, they often imagine that recovery is only about abstinence. They believe they’ll be fine as long as they can resist drinking or using again. However, they soon discover that there’s a lot more to recovery. They encounter many unexpected challenges, and some of the biggest challenges are the tricks played by their own minds. The following are some of the most common challenges people encounter during their first year of recovery from addiction.

Difficult Emotions

For many people, staying sober isn’t terribly difficult as long as life is going pretty smoothly and they’re in a pretty good mood. Unfortunately, few of us get to abide in such a carefree state for long. Problems arise, bad things happen, and sometimes we just feel bad for no apparent reason. Dealing with difficult emotions is one of the biggest recovery challenges because drug and alcohol use often begins as a way of coping with these kinds of emotions. Stress is perhaps the biggest culprit but shame, anger, grief, sadness, and anxiety are major challenges as well. One of the most important parts of addiction recovery is learning strategies to manage stress and cope with challenging emotions.

Cravings

You might predict that cravings would be a problem when recovering from addiction since you no doubt experienced plenty of cravings during active addiction. However, coping with cravings when you intend to never use drugs and alcohol again is a next-level challenge because you often experience a craving as a sort of command that’s very hard to refuse. Learning to deal with cravings takes a multifaceted approach that includes identifying and avoiding triggers, behavioral strategies to keep from giving in to a craving, and emotional regulation strategies such as distraction, “surfing” the craving, and staying present. 

Relationship Problems

Your health and your career can survive addiction for a little while, but your relationships are usually the first to suffer. Substance use issues quickly lead to deceptive behavior, which undermines trust in a relationship. Your priorities become focused on drugs and alcohol and you neglect your responsibilities to your friends and family. You may even get to the point where you’re lying to them and stealing from them to feed your addiction. Drugs and alcohol impair your judgment, leading to more fights and faster escalation, and the list goes on. On the other hand, social support is one of the most important things in recovery. A lot of sober people find themselves examining all their burnt bridges, wondering which ones can be repaired.

Money Problems

After relationships, addiction is almost always hard on your finances. Drugs and alcohol cost money. Some drugs cost a lot of money. However, the really crippling expenses are secondary. They include high-interest debts, legal and medical costs, and lost income. It can be pretty demoralizing to come out of treatment, feeling like you’ve made a pretty good start turning your life around, only to realize your finances are in total chaos. It can certainly add to the stress discussed above. These problems can be overcome and they are certainly easier to overcome when you’re sober, but it will still take time.

Loneliness

People starting out in recovery often face a dilemma: They know that if they spend time with old friends who drink and use drugs, they will likely slide back into old habits, but they haven’t yet made new friends and so they often feel lonely. Loneliness itself is often a challenge because it can lead to boredom, depression, and anxiety, which are not helpful for recovery. As noted above, social connection is an especially important part of recovery, so loneliness is nothing to take lightly. Typically, the best way to deal with loneliness is to make friends within your recovery community. They could be people you went through treatment with or people from your 12-Step group. These are people you see regularly, who understand what you’ve been through and share your commitment to sobriety.

Boredom

People are often surprised how big of a challenge boredom is in recovery. There are two reasons boredom is so powerful. First, drugs and alcohol actually take up a lot of your time. You have to get them, which sometimes takes some effort, and you have to carve out enough time to use them with the least amount of trouble. When people quit, they suddenly find they have loads of free time and they aren’t sure what to do with it. 

The second reason is that addiction actually restructures your brain. Drugs and alcohol become the most interesting things in the world and everything else is a bit dull by comparison. Drugs and alcohol can also enhance your experiences, so even things you liked to do that weren’t substance-related might suddenly seem flat. Again, coping with this is a matter of deploying smart behavioral strategies and to some extent just being patient while your brain adapts to sober life.

Mental Health Issues

The majority of people with substance use issues have co-occurring mental health issues. A quality treatment program will identify and begin treatment of any mental health issues, since managing them is essential to a long recovery. However, people who try to get sober on their own or by going to AA or NA meetings might find that getting sober throws their mental health issues into sharper relief. Often, some form of therapy is necessary if recovery is going to last.

Transitioning Home

Transitioning from a treatment facility back to normal life is often more challenging than people realize. They go from a highly structured, sheltered, and supportive environment back to basically the same environment where their drinking and drug use was out of control. There is a big difference between coping with problems in a controlled environment and coping in real life. For that reason, transitional care is especially important. This might take the form of stepping down to a lower level of care such as an intensive outpatient program, a sober living environment, or transitional services.

Relapse

Finally, it’s important to remember that addiction is a chronic disease and relapse is fairly common. It can be dangerous and demoralizing. You might feel like you’ve wasted all your time and money and disappointed everyone who cares about you. You might feel like since you already messed up, you might as well go all the way. However, a relapse doesn’t have to be a permanent failure. People do recover after several tries. The important thing is to minimize the damage and try again as soon as possible.

At Foundry, we understand that substance use problems are only partially about substances. Recovery doesn’t come from white-knuckled abstinence, but from creating the kind of life where you feel happier and more connected and no longer feel like you need drugs and alcohol just to get through the day. Our treatment program is a multifaceted process that involves treating mental health issues, learning effective behavioral strategies, learning practical life skills, and building social support to help you solve whatever problems you may encounter. To learn more about our approach to treatment, call us today at (844) 955-1066.

We’ve all heard someone say something like, “He’s fried his brain,” referring to someone whose drug or alcohol use has gotten out of control. If you have struggled with substance use, or someone you love has, you’ve no doubt seen changes in personality and cognition and wondered “Is this permanent?” It’s a distressing thought.

So much of who we are – our thoughts, memories, skills, and personalities – is encoded in the roughly three pounds of neurons in our skulls. Drugs and alcohol obviously have some effect on our brains, which is why people use them in the first place, and too much can have a pretty bad effect.

The belief that alcohol kills brain cells is widespread, but it doesn’t appear to be true. However, some drugs like methamphetamine, cocaine, and MDMA do appear to kill brain cells. While losing a few neurons among billions is not a big deal, it does add up over time. Heavy substance use can cause cognitive impairment, personality change, and behavioral change. If you’re worried that you or someone you love might suffer permanent effects from substance use, here are some things to consider.

Some effects fade quickly.

Most of the psychoactive effects of drugs and alcohol are temporary but if you’re using them all the time, you may not notice. In order to know what effects are temporary and which are longer-lasting, you actually have to go through withdrawal and get completely sober. This may sound obvious but a lot of people forget what their baseline even is after a period of continued substance use.

For example, alcohol is a depressant. If you are a heavy drinker, you may have depressive symptoms that are mainly caused by your drinking. These may include depressed mood, poor concentration, and poor memory. It’s possible that your depressive symptoms will abate once the alcohol is out of your system.

However, you may also have an underlying mental health issue to deal with too. The main point is that substance use interferes with the normal functioning of the brain and the first step in assessing your degree of impairment is to get the drugs and alcohol out of your system.

Some effects may last a year or more.

Unfortunately, the direct effects of drugs and alcohol on your brain are only part of the picture. Another part consists of the adaptations your brain makes to counter the effects of drugs and alcohol over time – in other words, you build a tolerance.

In the case of alcohol, for example, your brain gradually makes less of the inhibitory neurotransmitter GABA and more of the excitatory neurotransmitter glutamate. This is why you may feel like you need alcohol to relax and why you may experience irritability, shakiness, and even seizures when you quit drinking.

The worst of these symptoms – acute withdrawal symptoms – typically only lasts a week or two but other symptoms may last weeks or months. These are sometimes referred to as post-acute withdrawal syndrome, or PAWS. These symptoms may include emotional numbness, inability to concentrate, lack of interest in pretty much everything, and depressed mood.

This is thought to be the result of your neurotransmitters slowly returning to pre-addiction levels. Another factor likely has to do with changes in the limbic system. After months or years of using drugs and alcohol, your brain has gotten used to artificially elevated levels of dopamine so getting excited about having a nice dinner or going to the beach is pretty hard. It may take more than a year for that baseline to reset.

Some structural changes may never fully go back to normal.

As noted above, drugs and alcohol mainly mess with the brain’s limbic system, which is involved in pleasure, reward, and goal-seeking behavior. There appear to be three main brain structures involved with addiction: the basal ganglia, the extended amygdala, and the prefrontal cortex.

Areas of the basal ganglia are involved with motivation, reward, and creating habits. The extended amygdala regulates the brain’s reaction to stress and negative emotions like anxiety and irritability. The prefrontal cortex is responsible for “executive” functions like planning, prioritizing, and organizing – or “go” functions – as well as self-control and emotional regulation – or “stop” functions.

When we say addiction “hijacks” the brain, what we mean is that the massively disproportionate reward of substances causes the basal ganglia to tell the prefrontal cortex to organize its efforts in a way that prioritizes getting drugs and alcohol. At the same time, it undermines the “stop” functions of the prefrontal cortex, which get weaker from disuse.

This is the main area of debate when it comes to whether the brain ever fully recovers from addiction. On one hand, you have this miscalibrated basal ganglia that only goes back to normal very slowly and on the other hand, you have this impaired “stop” function in the prefrontal cortex.

The latter is much more malleable, which is why treatment strategies tend to focus on tools to regulate emotions and control behavior. There is also good news in that the urge to use drugs and alcohol typically declines the longer you stay sober. Most people say their cravings get noticeably weaker after one year and five years sober.

The brain is much more adaptable than we used to think.

If you’re concerned about whether your brain can ever fully recover from addiction, there is plenty of room for optimism. It has only been in the past decade or so that neuroscientists have come to believe that the brain keeps making new neurons in adulthood. We’ve also known for a long time that the brain has significant powers of adaptation.

Even people who have had strokes or experienced traumatic head injuries are often able to regain most or all of their cognitive functions. New technologies like transcranial magnetic stimulation may help heal brains even faster. The key is that your brain will adapt to whatever you consistently ask it to do. Your concentration, willpower, and memory will get stronger the more you use them, even after years of substance use.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body, allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at (844) 955-1066.

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One thing you’ll notice in pretty much any addiction treatment program is that structure and routine are important. Part of this is just practical; afterall, you can’t just have people showing up for group therapy and other activities whenever they feel like it, or nothing would get done. However, structure also plays an important part in treatment and recovery. Here’s why.

Structure in Treatment

In treatment, most activities are scheduled. You’ll wake up at a certain time and go to bed at a certain time. You’ll exercise and eat meals at certain times. There is free time, but there is also much to accomplish in a relatively short stay, so there are a lot of activities scheduled during treatment.

As noted above, this is practical, but it’s also therapeutic. By the time most people enter treatment for substance use disorder, their inner lives are fairly chaotic. This results in confusion, uncertainty, and anxiety. One way to bring those feelings under control is to impose some degree of outward order. With a reasonable structure in your day, you are less restless, bored, and anxious. You know basically what to expect from the day. This lets you focus on healing and sorting out your thoughts.

Structure in Recovery

Ideally, you should try to continue your treatment routine after you finish the program. While a month is typically not enough to make a new behavior automatic, it’s a pretty good start. If you make an effort to keep getting up at the same time and going to bed at the same time, going to meetings, eating healthy meals, and so on, it should be relatively easy to stay on track. The following are reasons having structure and routine in recovery makes things easier for you.

A regular routine helps manage stress.

Stress is a major issue for most people starting out in recovery on their own. This is especially true when transitioning out of an inpatient treatment program where they are mostly sheltered from everyday stressors. Stress is typically cited as the number one trigger of cravings, so it is crucial to manage stress in the first year.

Keeping a regular routine is a great way to manage stress. For one thing, it reduces anxiety resulting from uncertainty. When you have to constantly decide what to do next, or have no idea what each day might bring, you’re always a little anxious. Having a regular routine allows you to have some idea what your day is going to be like. What’s more, it’s a way of increasing your self-efficacy. How you spend your time is something you largely have control over. When you intentionally structure it in a productive way, you exert more control over your life, which reduces feelings of stress. Having a plan for the day, even a provisional one, even helps you deal with unexpected problems.

A routine makes healthy decisions easier.

Another major advantage of having a regular routine is that you don’t have to put so much effort into making healthy decisions. Once you’ve established a healthy routine, you make healthy decisions on autopilot. For example, it’s much easier to go to 12-Step meetings every day at the same time, rather than going at different times or just two or three days a week. That’s because you get into a routine. It’s time for your daily meeting, so you go to your meeting. The same is true for any part of your recovery routine — exercise, writing, getting up and eating breakfast, and so on. When you’ve established a good routine, it takes more effort to break it than it does to just do what you’re supposed to do.

A routine revolves around your priorities.

A good routine isn’t just about doing the same things every day; it’s about doing the important things every day and doing them first. This ensures that the things that will most benefit your recovery and your life don’t get lost in a sea of low-priority obligations. Incidentally, having clear priorities and making them part of your daily routine also reduces stress. If you don’t get to a low-priority task or you have to put it off to the next day, you don’t worry about it too much because you know it’s a low-priority task. By creating a routine around your recovery plan, you can be sure you are always prioritizing your recovery.

How to create a healthy routine.

For most people recovering from a substance use disorder, the whole idea of structure and routine will feel at least slightly irritating. It may feel restrictive or patronizing. If that’s the case for you, then trying to schedule your day in 15-minute chunks, like some productivity gurus advocate, will probably not go well for you. However, that doesn’t mean you can’t reap the benefits of living a slightly more structured life.

The first thing you have to do is adjust your thinking about structure and routine. Routine isn’t a cage; it’s a ladder. It’s a way to ensure you’re doing the things that matter to you and that you’re making some kind of progress. The first concrete step is to establish one anchor point for your day. It might be getting up at a regular time or it might be going to your 12-Step meeting at a regular time. If you have a job with regular hours, that’s a pretty good anchor point.

Next, you want to connect new behaviors to your anchor points. So, for example, you might get off work and head immediately to your 12-Step meeting. It shouldn’t take long for this to become routine. Now you have two solid points of structure in your day. For behaviors like exercise, don’t be afraid to start small. It’s most important to establish the habit; you can always scale up later.

Structure and routine are crucial elements of addiction recovery. They build conscientiousness, which is a personality trait that research shows protects against substance use issues. They reduce stress, ensure you address your priorities each day, and make healthy choices easier. At The Foundry, we strike a delicate balance — we provide enough structure for therapeutic purposes while changing things just enough to keep them interesting throughout treatment. To learn about our treatment options, call us today at 1-844-955-1066 or explore our website.

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At The Foundry Treatment Center Steamboat, a healthy lifestyle is an important part of complete recovery. The link between the body and the mind is powerful, and a healthy diet combined with regular exercise is an integral component of lasting recovery from Substance Use Disorder.

There is a common misconception that healthy food is bland and without flavor or excitement. Our goal is to shift how our clients define "healthy food", and shift their lifestyles towards sustainable nutrition. Serving bland, flavorless food would only set the stage for old eating habits and patterns to return down the line.

Below is the recipe for Ginger-Garlic Chicken Salad

- One of the many healthy meals served to clients at the Foundry Treatment Center Steamboat.

Dressing:

½ cup sesame oil

2 tbsp fresh ginger paste

1 clove garlic

1 TBSP coconut aminos

½ tsp salt

½ tsp black pepper

1/3 cup onion-diced

2 TBSP honey

1 TBSP lemon juice

1/3 cup rice wine vinegar

*Mix all ingredients and mix in a blender or in a bowl with a whisk

Salad:

1 cup kale shredded

1 cup cabbage shredded

½ cup carrots shredded

½ tbsp toasted peanuts

1 cooked chicken breast

Instructions:

1) season and cook chicken

2) mix greens, carrots and dressing

3) top with nuts

4) slice chicken and place on salad

5) ENJOY

Scott Przymus is the Executive Chef at The Foundry Treatment Center Steamboat, a rehab and substance use disorder treatment center located in Steamboat Springs, Colorado.

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Sobriety is no easy feat. Voluntary work is needed to get there and a focus on doing the work, one step at a time. One of the biggest fears of going into substance use treatment is facing life sober. These fears are not without warrant. Relapse statistics are alarming. However, it is possible to learn to live without substance use and experience joy and success. With a combination of supportive services, backed up by a strong prevention plan, there is hope and promise for people to recover.

Prevention Is Key

The difficult work of recovery does not start and end when the person decides to attend the program. It begins when the person finishes detox and starts to process the experience of a substance use disorder. Through therapeutic work, there are ways to look at the experience, uncover the issues, and identify triggers to avoid in the future.

The goal is to complete treatment with the right tools and confidence necessary to make healthier life choices. The proper aftercare and staying focused on goals helps ensure success.

Hitting Relapse Prevention Goals

Leaving a residential program may feel like going out into the world without support and it can cause some anxiety. It is important to connect with a network of people and continue with needed therapies to provide adequate support. Recovery is one day at a time, assisted by friends and supportive people who understand the journey and are available in times of need.

Defining and following a concrete plan that helps achieve set goals and instills self-confidence will only make success easier. Recognizing when these goals are met is added support on the journey. A relapse prevention plan is worked on in a group setting, sharing experiences, and receiving feedback.

It is a formal, written plan, but it may be hard to follow at first. Committing to the prevention of relapse takes intention. The person has to want to stay sober. Some common goals outlined in a relapse prevention plan include:

• Changing thought patterns and behaviors.
• Identifying and avoiding triggers.
• Knowing how to handle cravings.
• Managing life’s pressures.
• Facing life’s ups and downs efficiently.

Counseling helps people reflect on the mindset that builds dependence. It helps to formulate a plan in which major targets are identified with a clear plan for reaching them. The family can be part of the process, along with learning specific tools developed through cognitive behavioral therapy, role-playing, and other practices.

Three Stages of Relapse

Relapse does not happen overnight. It evolves slowly, beginning with emotions and ending in action. With the three stages of emotional, mental, and physical relapse, it helps to understand how each stage sets the foundation of relapse prevention.

Emotional Relapse

Emotions are a huge part of recovery. There is no escaping emotions; sometimes, they bubble up out of nowhere. Those relapse triggers are red flags. The emotional relapse plan can include how to deal with post-acute withdrawal symptoms, along with breathing exercises, meditation, and finding support during times of sliding into old patterns. It makes a big difference for someone to find healing in recovery if they can manage their emotional states better.

Mental Relapse

The intention is key with a mental focus on relapse prevention. Minimizing life’s ups and downs will not help. Focusing on mental preparation and trying to avoid a situation that may present surprise triggers requires planning.

Actions often follow thoughts when there is no redirection and support. Going back to the old days where the beast is, will result in a person finding themselves on the doorstep of addiction again. The last thing people need is to focus on the past. Keep focused on the present and future to find hope again in recovery.

Physical Relapse

During the mental collapse, the thought process jumps to “one drink won’t hurt,” and “I've done the work to drink like others.” Without a plan, it is just a short hop towards using drugs again. One slip can lead to feeling guilt, shame, fear, and failure. Physically the body is going through a lot. Give it time, rest, eat well, and get enough sleep to help in the healing process.

If a person finds themselves isolated, skipping meetings, and dropping out of their recovery lifestyle, they may be at risk of relapse. Finding the best place to get help means strategizing who to call when the flags are flying, and the warning signs are there. Ask friends to be aware of any issues and to help pull the person out of the pit they’ve found themselves in, which will help them get support when they need it the most.

The following keys will help practice as much as possible mindfulness, healthy habits of living, and being around positive people who support recovery. Without this, it will be difficult to stay clean and sober. With the right help, the person in recovery can find hope. Completion of a program is a start, but plugging into the community, finding a mentor, and seeking support are key to encourage the journey forward.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their own values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at (844) 955-1066.

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If you’ve had an episode of depression in the past, your chances of having another episode are about 50%. And if you’ve had two episodes of depression, your chances of another episode rise to about 80%. Depression is inherently miserable and no one wants to weather another episode. If you’re recovering from a substance use disorder, there is even more at stake, since depression is a major driver of addictive behavior. The good news is that there are things you can do to reduce your chances of another episode of depression or reduce the severity of an approaching episode if you are able to catch it early. 

1. Know Your Patterns

First, it’s important to know your patterns and triggers. Typically, the first episode of depression is triggered by something--a traumatic event, major stress, grief, and so on--and that can give you a clue to what might cause a relapse. Stressful events like having a baby, moving, a breakup or divorce, losing a job, getting a promotion, and so on are all things to watch out for.

Many people are also affected by seasonal changes, especially as winter approaches and the days get shorter. This is known as seasonal affective disorder and it can happen in the summer too. Finally, anniversaries are often a problem. It could be the anniversary of the death of a loved one or the first holiday after a divorce. Knowing your triggers and taking extra precautions can help prevent a relapse of depression.

2. Keep Track of What Works

Second, keep track of what works. If you had help from a therapist to get through your earlier episode, you have a headstart in this regard. Depression is different for everyone and it appears to have a variety of possible causes, which means it also has a variety of solutions. It’s a good idea to keep a record of what works for you someplace you can easily reference it.

For example, some people do really well on one kind of medication but not another. You may discover that there are two or three kinds of cognitive distortions that cause most of your problems. It can be hard to keep track of all these things so make a list and consult it often.

3. Stick to Your Treatment Plan

If you worked with a therapist during previous depressive episodes, you probably worked out a recovery plan, even if it wasn’t strictly codified. It might involve taking an SSRI, keeping up with therapy, making some healthy lifestyle changes, and so on. As you start to feel better, it’s tempting to start cutting corners.

You might be able to coast for a while but it will eventually catch up to you, especially if you suddenly have to deal with a lot of stress. Sticking to your treatment plan--or going back to it as soon as possible--is the single best way of preventing a relapse of depression.

4. Stay Connected

One common early symptom that depression is coming back is that you don’t want to be around anyone. People ask you if you want to go out but you’d just rather stay home. You feel like you can’t be bothered. Unfortunately, isolation is one of the things that will make you spiral down the fastest. The worse you feel, the more you want to be alone.

Staying connected is one of the best ways to improve your mood and feel better about yourself. It’s especially important when you feel tempted to isolate yourself. It’s crucial to resist that temptation, even if you’re only texting with friends and family.

5. Talk to Your Therapist

These days, psychotherapy isn’t typically like psychoanalysis, where you go every day for years. A course of cognitive behavioral therapy, or CBT, might only last a few months. It tends to be more targeted to specific solutions and when those goals are met, there’s no reason to continue meeting. However, you shouldn’t hesitate to resume therapy if you feel like you might be heading for another episode of depression.

The earlier you see your therapist, the better. Often, just feeling somehow “off” can be a sign that depression is returning. Maybe you feel irritable or that mundane tasks are extremely frustrating. It’s better to talk things over when you’re not sure exactly what’s wrong rather than wait until you’re in the middle of a crippling episode of depression.

6. Boost Your Mood

When you’re already in the middle of an episode of depression, advice like “Cheer up,” “get out of the house,” “do something fun” sounds hopelessly oblivious but if the feelings of depression have just started creeping in, a little boost in mood can go a long way. There are many ways to change your mental state. You can listen to music, go for a walk, go out with friends, watch something funny, do something creative, or try something new.

If you can, travel is often a great way to change your state. Even a short trip to a new place can interrupt a downward spiral. The key is to figure out what works for you and add it to the list, as discussed above. Having a few go-to tactics for improving your mood can make the difference between being in a bad mood for a day or two and being depressed for months.

7. Take Care of Yourself

Self-care is extremely important for avoiding depression, avoiding a relapse of substance use, and for staying happy and healthy in general. The three main pillars of self-care are a healthy diet, adequate sleep, and regular exercise. These all help reduce your sensitivity to stress, help you regulate your emotions, boost your mood, and reduce inflammation, which is a factor in more than half of depression cases.

In addition to these, it’s also important to take time each day to relax and do something fun, even just for a few minutes. Spending time with friends and family, as discussed above, is also an important aspect of self-care.

Depression is a major risk factor for substance use and it is also very likely to return after you’ve had one episode. Fortunately, it’s not guaranteed to return. If you know your patterns and triggers, are aware of early warning signs, and take action early, you can avoid future episodes or at least reduce their severity.

At The Foundry, we know that substance use is often just a symptom of other problems. Mental illness, substance use, dysfunctional family dynamics, and maladaptive behaviors all feed on each other and keep you trapped in the cycle of addiction. That’s why we emphasize mental healthcare such as CBT and DBT as well as healthy family dynamics and healthy lifestyle changes as part of our holistic treatment program. For more information, call us today at (844) 955-1066.

Served on Zoodles!

Serves: 5-6 people

Prep time: 20 minutes

Cook time: 45 minutes

Special equipment: Vegetable spiralizer (the Kitchenaid attachment works well but a simple handheld one works great!)

Yes, meatless meatballs! They are a thing, and they are not that fake processed soy stuff. These “meatballs” have a great texture that replaces the mouthfeel of meat well. The “meatballs” themselves are versatile and can be used with a lot of different pasta dishes. 

Ingredients 

For the “meatballs”

• 2 cups of dry farro grain
• About 6 cups of water for boiling farro grain
• 1 cup of pistachios crushed 
• ¼ cup of shredded parmesan cheese
• 1 Tablespoons of kosher salt
• 1 teaspoon of cracked black pepper
• 6 eggs 
•  ¾ -1 cup of bread crumbs (bread crumbs are the binder so more or less may be needed)

For the Zoodles and pesto pasta!

• 5 large zucchini
• 1 pound of ripe cherry tomatoes
• 1 package of small fresh mozzarella balls 
• One small package of fresh basil
• 5-6 cups of spinach leaves
• 2 cloves of peeled garlic
• ¼ cup of pine nuts (can substitute with toasted almond or walnuts)
• ½ grated parmesan cheese
• Salt to taste
• Cracked black pepper to taste
• Olive oil as needed

Instructions

• Preheat the oven to 350 degrees 
• Start boiling the 6 cups of water for the farro (I like to make farro similar to making pasta, by cooking it in excess water and then straining it off)
• While the oven and water are heating up, prepare your ingredients; 

• Cut the cherry tomatoes in half and place on a baking sheet and drizzle a little olive oil over them. Sprinkle with kosher salt and pepper. Set pan aside until they are ready to go into the oven. 
• Use a food processor or blender to crush your pistachios. (you can also crush them by putting them in a ziplock bag, wrapping it in a towel, and then use a mallet to smack the bag)
• Spiralize your zucchini! 
• Destem the basil if not already done.
• Peel the garlic. 

• When the water starts to boil, pour the 2 cups of farro into it.
• Now that your Farro has started to cook, begin to make your pesto;

• Combine basil, garlic, and pine nuts in a food processor or blender. Blend until a paste starts to form.
• Now add in spinach a little at a time (blending in between each add) until all the spinach has become part of the paste. You might have to use a spatula to scrape the sides of the mixer to ensure all of the leaves become ground.
• With the blender or processor spinning slowly pour olive oil into the paste until it becomes more sauce-like. You can make your pesto as thick or as thin as you would like by adding more or less olive oil. 
• Now taste your pesto and add in salt/pepper to your liking.
• Set the pesto aside in a bowl until the rest of the meal is ready. 

• Now check your farro. Just take a spoonful and taste it. The farro will be done when it is chewy but not crunchy. If the farro is done, strain off all of the excess water. 
• Put your cooked farro into a large mixing bowl and add in the crushed pistachios, parmesan cheese, kosher salt, and cracked pepper. Stir to combine.
• Crack the 6 eggs into the farro mixture and then add the bread crumbs. Stir the mixture to combine. 
• Once the mixture has been completely combined, take a small amount of the mixture with your hands (about the size of a golf ball) and try to form it into a round shaped patty. If your mixture is too dry and the round falls apart, add another egg into the mix. If your mixture is too wet and just sticks to your hands, add in some more bread crumbs. 
• Once you are able to make rounds without them falling apart, start to make the rounds and place them onto a baking sheet. 
• Now all of the different pieces of the meal are prepped and are just waiting to be cooked or put together. 
• The “meatballs” are going to be shallow fried in a saute pan, so start heating a saute pan over high heat coated in a decent amount of vegetable oil, coconut oil, or sunflower oil. 
• The “zoodles” are going to be steamed, so start preheating a large skillet over medium high heat. 
• The cherry tomatoes are now finally ready to go in the oven! Place them in the oven and cook for about 10-12 minutes or until the skin is slightly wrinkled. 
• Now start to fry the “meatballs”. They should take about 1-2 minutes per side, or cook until the outsides have been browned slightly. Place the finished meatballs on a pan that has been lined with paper towels and set in a warm place for a few minutes while you steam the zoodles. 
• Place all of your zoodles into the hot skillet, stir them around a little and make sure they all start to slightly soften. Pour about 1 cup of water into the skillet and cover it. Let the zoodles steam for about 1 minute and then turn off the heat. 
• Now you are finally ready to plate and eat! Using tongs, place some zoodles onto a plate. Then add the mozzarella ball and cherry tomatoes over the top of the zoodles. Now add the “meatballs” and a dollop of pesto over the top.
• Enjoy!

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Depression is one of the most common mental health problems worldwide. It is also a common driver of addictive behavior. One study found that among people with a mood disorder such as major depression or bipolar disorder, about 32% also had a substance use disorder--that’s about four times the rate of substance use disorders in the general public. Common symptoms of depression include depressed mood, inability to enjoy anything, irritability, disturbed sleep or sleeping too much, weight changes, inability to concentrate, fatigue, lack of motivation, slow movements, aches and pains, substance use, reckless behavior, and thoughts of suicide or death. If someone you care about has depression, you probably want to help but it can be hard to know how. The following are some things you should avoid saying to someone with depression.

1.)“Snap Out of It”‍

If you’ve never experienced depression yourself, it can be hard to understand why someone can’t get out of bed, can’t focus, never seems to enjoy anything, never seems to be motivated, and so on. You may feel like they’re just not trying or they need someone to motivate them or wake them up. However, that’s not how it works. Telling someone to “snap out of it” or “cheer up,” even with the best intentions typically just makes things worse. Depression is a complicated problem and more and more research is showing that many forms of depression have physiological as well as psychological components. Telling someone to snap out of it may be like telling them to snap out of the flu.

2.) “Why Should You Be Depressed?”

We usually assume that if someone is depressed, they must be depressed about something. Often, this is true. Major life stressors such as a divorce, a job loss, or the death of a loved one can sometimes precipitate an episode of depression. Even a seemingly positive event like having a baby can cause depression. However, you don’t necessarily need a reason to be depressed, especially if you have had one or more episodes of depression in the past. It can occur spontaneously. Also, we all have different brains and different bodies and we all react to stressors differently. Even people who appear to have very good lives can be deeply depressed.

3.) “It Could Be Worse”

Similar to the point discussed above, “it could be worse” assumes you have to have a good reason to be depressed. You may be trying to put things in perspective, perhaps pointing out that there are people in your own neighborhood who don’t know where their next meal is going to come from, so you should feel pretty good about your life. Typically, this kind of strategy backfires. Someone with depression is just likely to feel bad about feeling bad. Also, a typical feature of depression is that you can’t imagine life getting better but it’s very easy to imagine life getting worse.

4.) “It’s All in Your Head”

People who haven’t experienced depression often imagine it as a problem of perspective--a short-sighted gloominess that would go away if you only looked at life differently. While it’s true that your thinking often contributes to depression, such as when you get stuck in cycles of rumination, worry, and cognitive distortions, there are two problems with telling someone depression is all in their head. First, it’s not all in your head. As noted above, recent research has found that much of depression may actually be in your body, particularly in the form of inflammation. Second, to the extent that depression is in your head, it’s nearly impossible to think your way out of it. The bleakness of your outlook doesn’t seem like depression; it seems like reality and it’s hard to argue yourself out of something you believe is true. 

5.) “Don’t Be So Selfish”

From the outside, someone with depression can seem self-centered or even solipsistic--they don’t want to work, they don’t want to help out, they don’t even want to get out of bed because their life seems so uniquely horrible. However, there’s no sense at all in which depression is an indulgence. As discussed above, depression feels more like a trap and you can’t think or motivate yourself out of it. Calling someone with depression selfish only adds to their burden of self-loathing. Again, imagine calling someone with the flu selfish, and that’s similar to calling someone with depression selfish.

6.) “You Should Try Exercising”

While it’s true that exercise is excellent for your mental health and should be part of any treatment plan, it typically isn’t sufficient by itself. It’s not bad advice, exactly, it just falls woefully short. When you’re depressed, everyone has some advice for you and most of those people have never been depressed themselves. Advice either falls flat or it makes you feel like there’s one more thing you’re not doing. At the very least, it underscores how little someone else understands what you’re going through.

7.) “Have a Drink”

Some people assume that depression is just a matter of feeling stressed and having a few drinks will help them relax and cheer up. While a few drinks may temporarily make you feel better, in the long run, alcohol will make you feel worse. As discussed above, depression--and especially bipolar depression--significantly increase your risk of developing a substance use disorder. You get to rely on these temporary boosts--or moments of relief--and before you know it, you can’t get along without drugs and alcohol.

8.) “You Should See a Therapist”

As with the advice to exercise, telling someone to get therapy isn’t bad advice in itself but it tends to fall flat. There’s a good chance that someone with depression spends half the day thinking, “I should see a therapist,” but, again, it’s just one more thing they should be doing but aren’t. They probably don’t need you to remind them. 

What may be helpful instead is to offer to help. Even in a mid-sized city, there are possibly hundreds of therapists. The thought of finding a good one, making an appointment, and actually showing up may feel overwhelming to someone with depression. Instead of suggesting they see someone, offer to help them with the process of finding a therapist and making an appointment. Try to remember that depression attacks the very faculties--motivation, optimism, focus--that you need to make a treatment plan and follow through. Seeing a therapist may seem like a simple thing to you but it’s not to them.

Depression is one of the most common co-occurring mental health issues along with substance use disorders. Depression typically comes first and substance use is more often a symptom and a way to try to manage the symptoms of depression. Any plan to treat addiction that doesn’t also address depression is not likely to succeed for long. If you have a loved one with depression, it’s important to see things from your loved one’s point of view. Plenty of well-meaning advice will either make no difference at all or make them feel worse. It’s far more helpful to be there for them, to listen, to try to understand, and to help them get treatment. 

At Foundry, we know that there is usually a lot more to addiction than substance use. We use a variety of evidence-based methods to diagnose and treat any co-occurring mental health issues, including depression. Our methods include cognitive behavioral therapy, or CBT, dialectical behavioral therapy, or DBT, mindfulness meditation, yoga, Alpha-Stim, and others. To learn more about our comprehensive approach to treatment, call us today at (844) 955-1066.

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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Chronic pain is one of the hardest to manage conditions for people with a substance use disorder. Coping with physical ailments and pain can be the reason some people start using substances. They may start using substances for another reason and end up spiraling in their use of substances and alcohol as a means to cope with chronic pain. Either way, the treatment for chronic pain and substance use disorders is called a dual diagnosis. When more than one other thing is coinciding with a substance use disorder, both should be treated concurrently to ensure the person gets the best chance for recovery. Find out how chronic pain and substance use disorders are connected and why it matters.

Defining Chronic Pain

Pain starts in the brain. The brain sends signals that something is wrong and tells the body damage has occurred or may be occurring. Pain may last a short while or become chronic (long-lasting). Chronic pain is pain lasting beyond the healing of an injury, which continues for several months or longer, even years. Diagnosis and treatment often are required by healthcare professionals who can look at how the pain started, why it continues, and any pathways involved in sustaining the pain. The type of pain and its origin are determining factors in how to best treat the pain going forward. Narcotics are almost always a last resort because of how toxic they are to the body and the risk of developing an addiction.

Types of Pain

When it comes to types of pain, it is essential to know what kind of pain can develop and how it emerges. This knowledge can determine how a person decides to manage it on their own, typically with the use of substances or alcohol.

• Somatic pain: injury to muscles, bones, joints, or tissues can occur. Somatic pain is dull, aching, and localized in one area. It can be caused by inflammation, but it does not disappear after a reasonable period.
• Visceral pain comes from an ongoing injury to an organ or tissues supporting the organ.
• Neuropathic pain: believed to be caused by changes in the central nervous system that sustain pain after an injury. May be associated with physical or emotional trauma or any number of different diseases.
• Psychogenic pain: chronic pain linked to emotional upheaval. Depression or anxiety can create stressful situations. Emotional distress may be a consequence of pain or contribute to pain itself.

Addictive medications like opiates should be a last resort because they can cause lots of problems for people over time. Harmful substance use over time can have severe medical, legal, and social consequences for a person’s life. The only course of action to discontinue medications is to detox safely with a treatment center focused on helping people become healthy and whole after a substance use disorder.

Pain Disorders

Opioid and opiate medications are readily prescribed to treat chronic pain and physical injuries for different reasons. No matter how a person came to use the drug, they likely need it to help mask the pain symptoms and function normally in their everyday life. Substance use disorders are a pattern of compulsive behavior characterized by cravings for opiates and opioids. Cravings can become overwhelming and can result in loss of control or compulsive substance use, despite consequences, and obsessive behaviors regarding the use of a substance. Life may become pretty unmanageable by the time they are desperate enough to seek help. Even then, they may not be able to admit the need for help. A person with chronic pain has likely suffered from mental health disorders that are untreated because chronic pain is the primary symptom being treated. Many people fear the only solution to relieve chronic illness lies in taking opiates or medication indefinitely. Pain symptoms may become aggravated when they cannot sleep, are not eating well, or taking care of themselves because of substance use behaviors.

Dual Diagnosis Treatment

Treatment centers can provide counseling and support services for individuals with chronic pain and substance use disorders. These services help people in recovery control chronic pain using other techniques and coping tools without potent substances. It might mean a holistic approach to constant pain control that includes exercise, meditation, and breathwork. Substance dependence can develop, and discontinuation of opiates is not recommended alone due to withdrawal symptoms. Treatment of chronic pain and substance use disorders also includes support for mental health issues. A team of medical specialists and clinicians is needed to treat the person with care, dignity, and respect. In this way, they can find treatment for chronic pain but also support for substance use behaviors. Healing from all of it will take some time, even if chronic pain never completely heals. The goal is to find hope that things will get better, gradually, and that life is better when substance use disorders are finally in the past.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their own values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at 1-844-955-1066.

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Anxiety is one of the most common mental health problems in the world and it often goes with addiction. The National Epidemiological Survey on Alcohol and Related Conditions, a survey of more than 43,000 people, found that 15 percent of people who experienced an anxiety disorder in the past year had at least one co-occurring substance use disorder--more than twice the prevalence of substance use disorders in the general population.

Conversely, nearly 18 percent of people with a substance use disorder in the past year also had an anxiety disorder. As with any mental health issue, treating anxiety concurrently with addiction is crucial for staying sober long-term, as is taking care of your mental health. The following tips can help you manage anxiety while recovering from a substance use disorder.

Therapy

Anxiety is the mental health issue most likely to be dismissed as no big deal. People might just tell you to relax or calm down or you might even tell yourself that. However, an anxiety disorder isn’t just a matter of being nervous. It often has a physiological component and sometimes requires medication. Often, anxiety has roots in childhood environment or dysfunctional belief patterns and you need help fixing the problem. The following tips are meant to augment therapy, not replace it.

Don’t Avoid Anxiety

When you’re prone to anxiety, your natural tendency is to avoid situations where you might feel anxious. This is particularly true of people who experience panic attacks. Unfortunately, this strategy only shrinks your sphere of comfort to the point where you might be afraid to even leave the house. As hard as it may be, the thing to do is intentionally expose yourself to things that make you anxious in a graduated way.

It’s like doing a workout for your ability to handle anxiety. Your therapist can help you create a plan for doing this in a structured way but you can also look for opportunities to engage in activities that might make you anxious but not too anxious.

Deep Breathing

In the short term, deep breathing is one of the best ways to manage anxiety. There are two reasons it helps. First, focusing on your breathing brings your attention into the present moment, to the sensations you feel when you breathe. You’re not focused on the future or whatever thoughts are making you anxious. Second, taking slow, deep breaths is physiologically calming.

In particular, the long, slow exhale stimulates your vagus nerve, which activates your parasympathetic--or “rest and digest”--nervous system. Although any slow, controlled breathing will calm you down, research suggests that taking six breaths per minute, or one full breath every 10 seconds, helps synchronize respiratory and cardiac rhythms, optimizing calmness and wellbeing.

Grounding

As noted above, one of the ways deep breathing helps calm you down is that paying attention to the sensations of the breath grounds you in the present moment. You can use this principle with pretty much any sensation though. For example, you can pay attention to just the sensations in your feet or just pay attention to ambient sounds. You can go through all the senses systematically. The more you engage with your immediate environment, the less you worry about the future.

Exercise

Exercise is great for addiction recovery in at least a dozen ways. High among those is that it helps reduce stress and anxiety. There are a number of ways exercise helps accomplish this. It increases levels of endorphins in the brain, as well as the feel-good neurotransmitter, serotonin. Exercise also increases blood flow to the brain and creates structural changes in the hypothalamic-pituitary-adrenal, or HPA, axis, which is connected to areas of the brain involved with identifying threats and fear.

These structural changes make your brain less reactive to stress and anxiety. Research suggests that 20 or 30 minutes of moderately intense aerobic exercise each day is ideal for improving mental health, but really, any exercise should provide some benefit.

Get Enough Sleep

As with exercise, there are plenty of reasons to get enough sleep in addiction recovery and in life, generally. A major reason for anyone with anxiety issues is that too little sleep worsens anxiety. We’ve long known that anxiety leads to insomnia, but it appears the reverse is also true. Research suggests that sleep deprivation leads to more symptoms of both depression and anxiety.

One study suggests this is because sleep deprivation leads to maladaptive activity in the brain’s anticipatory responses, leading to more rumination and worry. Sleep deprivation also weakens the brain’s prefrontal cortex, which acts as a brake on anxiety. Therefore, it’s crucial to sleep at least eight hours a night. If you have problems with insomnia, talk to your doctor or therapist.

Cut Down on Caffeine

Current research suggests that, on the whole, moderate consumption of tea or coffee isn’t bad for you and it might even have some mild health benefits. However, if you have problems with anxiety, it might be a good idea to cut down on caffeine. The physiological effects of caffeine are identical to those of anxiety.

Even if a few cups of coffee don’t directly lead to an anxiety or panic attack, they raise your baseline of arousal, making you more vulnerable to stress. Furthermore, caffeine has a half-life of between four and six hours, so even if you cut off your coffee at noon, you might still have a lot of caffeine in your system at bedtime. This may keep you awake and cause you to sleep less deeply when you do fall asleep. As discussed above, insomnia and sleep deprivation significantly increase symptoms of anxiety.

Anxiety issues can be challenging to deal with because they are rooted in our primitive survival instincts. They often don’t respond to reason, which can be terribly frustrating. Overcoming and managing anxiety starts with a good therapist. After that, it’s a matter of challenging yourself to get comfortable with anxiety and finding techniques to help you manage it.

At The Foundry, we know that addiction is about far more than physical dependence. Most people have co-occurring mental health issues that need attention if recovery is going to last. That’s why we use a variety of methods to foster mental health, including evidence-based treatment methods, outdoor activity, mindfulness meditation, and healthy lifestyle changes. To learn more, call us today at (844) 955-1066.

For most of us, interpersonal conflict is one of the biggest sources of stress in our lives, perhaps second only to financial stress. In fact, interpersonal stress and financial stress often overlap. People starting out in recovery typically identify stress, and interpersonal conflict in particular, as a major trigger of drug and alcohol cravings. The early days of recovery following might also have more conflict than you’re used to.

As you try to make some big changes in your life, some people will resist. However, you have to live your life and maintain healthy boundaries if you want to stay sober. The following tips can help you resolve conflict, reduce stress, and generally reduce the amount of friction in your recovery and your life. 

Be Aware of Your Tendencies

As with most aspects of emotional intelligence, being more self-aware will help you resolve conflict more effectively. Many people tend to avoid conflict, even when doing so makes them worse off, while others tend to create and escalate conflict unnecessarily. It’s always good to be aware of your own tendencies, learn to take a step back, and ask yourself objectively if there is a problem you need to address.

Acknowledge a Problem

If there is a problem, the first thing is to acknowledge it, even if you don’t know how to resolve it or you don’t feel like you can handle it. If there is a real problem, ignoring it won’t make it go away. Just because you aren’t yet sure how to deal with it doesn’t mean a resolution isn’t possible.

Proceed Calmly

Don’t try to resolve conflict while you’re feeling overly emotional, whether you’re feeling angry, scared, hurt, sad, or whatever else. When you’re feeling that way, you will be focused on expressing yourself. That’s fine, but it also makes it harder to listen and consider the other person’s point of view and you are more likely to say or do something to make the situation worse. Give it a day before you try to work out the problem with the other person. If that’s not possible, take a few deep breaths, let yourself calm down, and try to proceed objectively.

Listen

The first step in actually resolving the conflict is to listen to the other side. Any satisfactory solution will have to be based on mutual understanding. It’s hard to listen to someone you feel is your adversary but it’s a crucial step. You gain information and often the other person will become more reasonable if they feel like you’re listening and taking their considerations seriously.

Conflicts often begin with a communication from the other party, such as an angry phone call or a demanding email. You might feel ambushed. As noted above, let yourself cool off before responding. Take some time to think about what the other person really wants or needs. Often, they are under pressure too, and understanding that will be important for resolving the conflict.

Define the Problem

Having a clear understanding of the problem is necessary for a good solution. You can move toward a clear understanding by practicing reflection. This is when you summarize the situation as the other person has explained it to you. This shows you were listening and taking them seriously and it also helps resolve any potential misunderstandings. Often, just clearing up miscommunications is enough to resolve a conflict. If not, you can at least start with an agreed understanding of the facts.

Find Common Ground

As noted above, it’s hard to listen and have an open discussion with someone you view as an adversary. Most of the time, your disagreements will be with people who are actually on your side--relatives, coworkers, friends, and so on. Although you may want different things in this specific situation, it’s important to remember that you’re not actually enemies.

Even if someone isn’t actually on your side--and perhaps especially when they’re not--finding common ground is a great way to start working toward a solution. Agreeing on facts, as noted above, is good. Even better is if you can identify any aspects of the problem that are not actually in conflict. 

Be Willing to Compromise

There’s an old saying that the sign of a good compromise is that no one is happy. That may not sound reassuring, but sometimes you have to be prepared to make sacrifices to achieve your larger goals. Know which aspects of the conflict are most important to you and which are secondary and be willing to compromise on those secondary aspects. Also, keep the context in mind. For example, it’s typically not worth sacrificing a friendship over a minor argument.

Work Toward a Solution, Not Vindication

While working on a solution, don’t get too hung up on being right. Being right or getting credit are typically not worth very much in the scheme of things. Wanting vindication, wanting to have things your own way, and so on, typically just get in the way of a resolution. Stay focused on what outcome you want and don’t get distracted by the cosmetic stuff.

Be Ready to Forgive

When you have finally reached a solution or resolved an argument, be willing to let it go. If you don’t let it go, then the problem hasn’t really been resolved. If you tell the other person that you are satisfied with whatever compromise you decided on, continuing to complain about it, even if you’re just silently resentful, is essentially like reneging on an agreement. That’s bad for your own mental health and it’s bad for the relationship.

Conflict is inevitable and it’s not necessarily a bad thing. Nor does it mean that the person you’re in conflict with is bad. It’s normal for people’s legitimate needs and desires to clash from time to time. With a little patience and empathy, conflict can usually be resolved satisfactorily, if not perfectly. 

At The Foundry, we know that a strong recovery from addiction is about far more than just abstinence from drugs and alcohol. That’s why we focus on skills such as emotional regulation, interpersonal effectiveness, family relationships, and building social support as part of a holistic approach to addiction recovery. To learn more, call us today at 844-955-1066.

You’re feeling tired, achy, can’t sleep, coughing and maybe have a runny nose to boot. It’s that time of year for those pesky bugs that have us singing the blues and wondering if our symptoms are those of the cold or the flu. Both the common cold and the flu are respiratory illnesses. Each is caused by a different virus but result in similar symptoms making it hard to tell the conditions apart. Here’s a primer on the difference between these two ailments and what to do to send them on their merry way.

In general, the flu causes greater complications with more intense symptoms which come on rapidly. These include bodily aches and pain, sore throat, fatigue, fever, chills, dry cough, sore throat, stuffy nose, sneezing and watery eyes and an overall miserable feeling. Symptoms of the common cold are typically milder than those of influenza and usually characterized by sneezing, a stuffy or runny nose, scratchy throat, and watery eyes.

A cold will usually run its course, leaving you tired and maybe a bit cranky, but symptom-free. You can be vaccinated against the flu but there is no vaccine (yet) which prevents the common cold. In addition, there are antiviral medications to treat the flu. Both the flu and a cold can lead to a bacterial infection resulting in sinusitis, bronchitis, pneumonia or an ear infection which could require antibiotic treatment. Unfortunately, complications of the flu, such as pneumonia or bacterial infections, can require hospitalization.

What Can You Do to Avoid These Unwelcome Winter Visitors?

The viruses that cause flu and cold are typically spread when infected individuals cough, sneeze, or talk, dispersing droplets through the air, and the virus can also be picked by touching an object which has viruses on it. The U.S. flu season can start as early as October and continue into May.

Avoid big groups of people – For you introverts out there, this is an easy one. The more people you expose yourself to, the more likely you are to get the flu. The flu spreads fast in confined groups of people. This is just good life advice, but stay away from sick people and stay away from strangers who are sneezing and coughing.

Please wash your hands like you mean it! – The flu can live on surfaces for 24 hours, so make sure that you are washing your hands as much as you can, especially before you cook food that you are going to eat or after using the restroom. When you wash your hands wash them with warm water for at least 20 secs and make sure to dry them before leaving the sink area.

It's not a bad idea to carry around a bottle of hand sanitizer – It might be considered rude to wash your hands immediately after shaking someone's hand, but you can probably inconspicuously apply hand sanitizer when they aren't looking. Make sure you aren't sneezing into your hands, always sneeze into a napkin or your elbow. Also, use hand sanitizer after touching things other people are touching a lot, such as doorknobs or light switches.

Strengthen Your Immune System

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If your immune system is sleeping at the wheel, your chances of getting sick go up a lot. So, make sure you are getting enough sleep, exercising at least 30 minutes, 3 days a week, and consider taking a multivitamin.

You are what you eat – Avoid eating out, just because you are doing everything you can to make sure you don't get sick doesn't mean everyone working in your favorite burger joint is doing the same. Stick to healthy, nutrient-dense foods as much as possible.  

Get your shots – The flu changes every year, so every year, you need to get a flu shot.  The flu shot lessens your chance of getting sick by 40-60 percent. It takes about two weeks for the flu shot to be active, but even if you do get the flu, the flu shot can make you get better fast and be less sick during the process.

Keep it clean – Wipe down surfaces in your house, such as counters, doorknobs, light switches, and shared telephones if you still have one for some reason. If someone in your home does become sick, it's time to quarantine them in their own section of the house. It's not overkill to wear surgical masks and gloves when attending to them.

What if the Worst Happens?

If you get the flu, get to a doctor right away. There is no cure for the flu, but the doctor can prescribe antiviral medication like Tamiflu to help you get back on your feet faster with an easier road to recovery.

This is a lot of information to take in, but it can really help to keep you healthy. Obviously, no one can do all of these things all of the time. You can't walk around in a hazmat suit and bath in hand sanitizer all of the time, but if you can find a few of these things and implement them into your life, you will have a leg up on the flu and be ready to beat flu season into submission.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body, allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at (844) 955-1066.

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My son is an addict. It's not the first thing you’ll hear me say if you ask me about my kids. Truthfully, I’ve never said it until now. I usually skirt around the subject, saying my oldest son has had some struggles with drugs and alcohol.Not because I am ashamed or embarrassed, but in my eyes, my oldest son is not one thing. He’s a million things — an amazing living, breathing, walking, talking human being with a "heart so big it could crush this town," to borrow a few words from Tom Petty. (For future reference, my mind is prone to bust out in a song lyric at any time.) Yes, I’m his mother and his biggest fan, but I’ve never liked the smallness a label dictates. I don’t even like to label myself as a writer, songwriter, musician, wife, or any other word that defines a role I play. Instead, when someone asks, I say I write stories and songs and do stuff. That pretty much sums it up.

I’ll be the first to admit that I like to look at the bright side. I see the good in others and especially my children. At times, I’ve been accused of being too damn optimistic. But I’m a believer. I know, that's a label, but it’s also what I do. I believe there is always a way, a solution, a miracle waiting around the corner, and that things will get better. This doesn't mean that behind these rose-colored glasses, life is always beautiful. I've spent many sleepless nights and cried rivers of tears. I've also had times when it felt like my heart was physically being ripped out of my chest. But most times, I try to “keep on the sunny side.” I did tell you about the song lyrics. Right?

Being the mother of a son who is an addict has taught me a lot of things. But first, what is an addict anyway? There is such a stigma attached to the word. When I used to hear the word addict, my mind conjured up the image of a guy lying in a dirty New York City back alley, fighting off rats, surrounded by syringes and needles - thank you,Al Pacino. But now, I know better. Addicts are brothers and sisters, sons and daughters, nieces, friends, acquaintances, and ancestors. Many have very successful careers. Some give TED talks, climb mountains, play big stages, and shine bright…at least for a while. Recently, when my son lost a close friend to addiction, I wrote a song to try and bring some comfort into the raging sea of heartbreak.

           Some stars shoot across the sky and light the world on fire as they go by

           Some fade out of sight, while others still burn bright and keep on shining,

           They just keep shining, I’ll shine on for you, and I’ll shine on for me

                                                                                            - lyric from Shine On

Addiction is painful on all sides. It's not something you can sweep under the rug and talk about later or chalk up to “sowing a few wild oats.” I wish I would have known that a long time ago.Addiction is real. It’s not some phase that people go through with a clear beginning and end. It’s a disease, a dragon that can bare its teeth at anytime. And it runs in my family, in my blood, a gene that can be “on or off.” I didn’t know any of this back then.

I just kept believing. I believed my son when he said he didn’t leave the pipe in my glovebox. I believed him when he said he was camping in a blue tent on the Colorado River. I even went to the place where he said he was with a care package of food and supplies and a guitar for him to play. There was no blue tent. The other people camping there said they hadn’t seen or heard of him — I believed them, maybe. For a year, I didn’t know where he was. I thought I saw him everywhere — the face of a homeless man in San Francisco, or hitchhiking on the side of the road. I believed I could help. What I didn’t know was that my love wasn’t enough to save him. He needed more than I could offer.

When he did surface again, I got a phone call from jail. Letters followed, and I began to understand. I’ll never forget the first time I went to visit him and saw him behind the glass, dressed in orange. I couldn’t stop crying. I wish I could have held back the tears and offered an encouraging word, but I wasn't that strong. I just bit my lip, tears streaming down my face. He apologized over and over. I didn’t need an apology. I just wanted him to be okay. I studied his letters and tried to read between the lines. When he decided to goto an addiction/behavior modification treatment center, at a cellmate's suggestion, I took him there. The 24 hours between the time he was released from jail and admitted to the treatment facility felt like an eternity. He was so fragile, fractured, and torn.

As his mother, I wanted to take the blame, and for a while, I did. I wasn't a perfect parent. I have a laundry list of things I could have done differently. I tried to mold my children into what I thought they should be. Ouch, that truth still hurts. To top it off, during a crucial time in his life, I walked out on my marriage of 18 years, shattering the illusion I had created of the perfect "Leave it to Beaver" family. I often wonder why children are given to the young, who don’t know what they’re doing. But as I get older, I realize age doesn't matter all that much. I still don’t have all the answers. I know more things, but for the most part, I’m making it up as I go. However, what I do know is that my children never suffered from a lack of love.

So what has all this taught me about addiction? Forgiveness is key. Always. Every day, all day — especially when it comes to forgiving myself. And to never stop believing. Ever.

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Written By:

Trisha Leona Sandora

Words & Music

www.trishaleone.com

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At Foundry, we know that addiction is a problem that affects every area of your life and therefore requires holistic solutions. We don’t just teach skills to help you abstain from drugs and alcohol; we teach skills to help you live a happier, more purposeful, more connected life. To learn more, call us at (844) 955-1066.

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At The Foundry Treatment Center Steamboat, a healthy lifestyle is an important part of complete recovery. The link between the body and the mind is powerful, and a healthy diet combined with regular exercise is an integral component of lasting recovery from Substance Use Disorder.

There is a common misconception that healthy food is bland and without flavor or excitement. Our goal is to shift how our clients define "healthy food" and shift their lifestyles towards sustainable nutrition. Serving bland, flavorless food would only set the stage for old eating habits and patterns to return down the line.

Check out this fabulous recipe to add to your menu tonight.

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Chimichurri Sauce:1 bunch parsley1 bunch cilantro1 tablespoon garlic, chopped1/2 cup olive oilSalt and pepper to taste2 lemons, juicedCombine all ingredients except for olive oil and lemon juice in a blender. Start to slowly add olive oil and lemon juice. Adjust seasoning to your liking.Asparagus:

2 bunch asparagus

1/2 stick butter

1 tablespoon lemon juice  

Combine ingredients together and wrap with foil. Cook in oven with steak.

Brown rice and quinoa:

1/2 cup quinoa*

1/2 cup brown rice*  

*Cook according to instructions on package

Steak:

1 flank steak seasoned how you likeCook steak in oven at 375 until desired doneness. Place rice blend on plate, top with the asparagus. Slice steak and cover with the chimichurri sauce. ENJOY!

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“Your hardest times often lead to the greatest moments of your life. Keep going. Tough situations build strong people” - Roy T. Bennett

The human brain has the nightmarish propensity to dwell on the negative experiences of the past. Defeats, losses, shame and guilt construct an intellectual quagmire of negativity, often waded into hip-deep at 2am (usually when you have something important to do early the next morning). For many years, my life prior to recovery (and even in early recovery) was entrenched in this quagmire, chronologically stored and miscategorized beliefs under the banner of shame and guilt.

I am a better man because of my years of struggle. I am a much better father because of my years in recovery. Recovery has forced me to prioritize and redefine my life. To roll my sleeves up and mold the person I want to be. Picking and pressing together the values and traits I see around me; forging a template of the person I want to be. I see someone exhibiting altruistic kindness, I make a mental note and add that trait to the template. I see wisdom, and a hunger for understanding, I make a mental note and add that trait to the template. I started building my template 9 years ago, and it is still in a perpetual state of construction. With every day of sobriety comes additional clarity on the patterns of my addiction - AND the path of my recovery.

It turns out the template of the man I want to be doubles as the template of the father I want to be. Honesty, willingness, humility, love, responsibility, discipline, service - These are all foundational principals of recovery - And they are also values that I want to both demonstrate and instill into the young, moldable minds of my children.

Recovery has given me a lens unto which I can recognize, accept and work on my flaws. It has given me a roadmap for addressing these issues as I go, and the ability to accept that neither my failures nor my successes define me. I strive to model this process for my children. Gift them with the ability to see the middle ground in life; the place that lies between perfection and failure. I am human. I am able to exhibit an extensive amount of patience and love, while occasionally succumbing to moments of impatience and anger. The trick is owning those deficiencies when they pop up, especially when I inadvertently direct them towards my kids.

Every parent has their occasional moment. Moments where emotions and circumstances coalesce. Moments where I am not the father I want to be. The work truly lies in recognizing this when it happens, looking my kids in the eye, and not only explaining what happened, but going a step further and explaining the emotions behind the action. “I was scared when I saw you being rude to the server at the restaurant. Scared that I am not a good father - That fear turned into anger, and I yelled at you. That wasn’t right. It’s important to treat everyone the way you want to be treated. This applies to the way we treat someone serving us food, but it also applies to the way that I treat you. I’m sorry”. 

The idea outlined above is straight from the pages of the AA Big Book, specifically Step 10:

“Continued to take personal inventory and when we were wrong promptly admitted it." 

The interwoven philosophies, ideals and guidelines of a solid personal recovery program have become ubiquitous with my personal parenting philosophy. In the early days of my recovery, shame and guilt bent my thoughts towards the hypothetical wish that I had never tried drugs or alcohol. I wished more than anything that I had never experienced the strife and pain of active addiction. I am now blessed with the gift of perspective. If the hypothetical wish of my early recovery had come true, I can all but guarantee my parenting would be significantly different, and significantly worse. I think about this often. I can say without hesitation that I am a better person, and a better parent because I went through active addiction.

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At Foundry, we know that addiction is a problem that affects every area of your life and therefore requires holistic solutions. We don’t just teach skills to help you abstain from drugs and alcohol; we teach skills to help you live a happier, more purposeful, more connected life. To learn more, call us at (844) 935-1508.

This article discusses suicide. If you or someone you know is at risk of suicide please call the US National Suicide Prevention Lifeline at 1-800-273-8255, textHOME to 741741, or go to SpeakingOfSuicide.com/resources for additional resources.

Many American men have a friendship problem.

In a 2021 Saturday Night Live sketch called “Man Park,” a young man waits anxiously for his female partner to return from work. He has few if any friends and has had little social interaction all day. She listens, barely feigning interest in his verbal torrent about the events of his day. She responds by mothering her partner, suggesting he go outside and play with his friends. When he replies that he has no friends, she takes him to the “man park”—a dog park for men—to play with other males. Like cute little puppies, the men enjoy each other’s company as the women cheer them on from the sidelines.

This is meant to be comedy, of course, but as with all good satire, the sketch touches on a very real issue: the loneliness that too many men experience. Avrum Weiss confirmed the SNL scenario in an article on Psychology Today:

“In heterosexual couples, women tend to handle all the social relationships for the couple and the children. This may fall to women because they are aware that their male partners do not have substantial relationships outside of the family as they do. The women may pull their partners into socializing with other couples so that the women can have more time socializing with each other without that becoming an issue in the marriage. They may even arrange ‘play dates’ with their friends’ partners so that their partner will be more interested in socializing as a couple.

Approximately one in five American men say they do not have a close friend, according to the Survey Center on AmericanLife's May 2021 American Perspectives Survey. “Only 30 percent of men reported having a private conversation with a close friend when they divulged personal emotions in the past week,” wrote psychiatry professor Charles Hebert in Newsweek in February.

This comes at a cost. “Loneliness increases the risk of mental illness among men,” warned Hebert. “Persistent loneliness independently predicts risk of Alzheimer's disease. Additionally, psychiatric illnesses such as major depressive disorder often go unrecognized in men due to reluctance to discuss one's symptoms.”

Loneliness can also induce substance misuse. When people feel lonely, misunderstood, or unloved, they frequently turn to drugs or alcohol to suppress their emotional pain. Unfortunately, their substance misuse may isolate them even further from the people who are still on their side. Any ensuing addiction will create havoc with their careers and personal relationships. Thus, the maladaptive coping mechanism of substance use is likely to backfire—making them very sick and even lonelier than before.

As the COVID-19 pandemic converged with widespread loneliness and the addiction epidemic in the US two years ago, public health and mental health experts predicted further dramatic increases in substance misuse and mental health conditions.

“Even before imposed COVID-19 social restrictions, loneliness had been gaining attention as a public health crisis,” wrote Horigian, Schmidt, and Feaster in their 2020 study on loneliness, mental health, and substance use among young adults. “Distinct from objective social isolation and solitude, loneliness is the feeling of lacking needed social connections, and has been associated with depression, suicidality, substance abuse, and cognitive decline, as well as overall health and mortality.”

Isolation and social distancing brought on by the COVID-19 pandemic may have exacerbated the male friendship crisis but “broader structural forces may be playing a more important role,” reportedDaniel Cox on the findings from the May 2021 American Perspectives Survey:

“First, Americans are marrying later than ever and are more geographically mobile than in the past—two trends that are strongly associated with increasing rates of self-reported social isolation and feelings of loneliness. Second, American parents are spending twice as much time with their children compared to previous generations, crowding out other types of relationships, including friendships. Finally, Americans are working longer hours and traveling more for work, which may come at the cost of maintaining and developing friendships. In fact, perhaps reflecting its central place in the hierarchy of American social life, Americans are now more likely to make friends at work than any other way—including at school, in their neighborhood, at their place of worship, or even through existing friends.”

“It is typically only when they are divorced or widowed those men realize how few relationships they actually have that have not been arranged or managed by their partner, and how vulnerable they have been in depending entirely on their partners for all of the connection in their lives,” wrote Weiss.

Addiction and mental health journalist Johann Hari famously declared that the opposite of addiction is connection. Hari has also suggested that depression is largely driven by lost connections. If men are socially more disconnected than women, they face particular mental health and substance use consequences as a result.

According to the Mental Health Index published in January, men now face a significantly increased risk of addiction—up an alarming 80 percent between September and December 2021. In just three months, depression among men was up 118 percent, and social anxiety by 162 percent. When looking specifically at men ages 40-59, general anxiety was up 94 percent.

Using national data, other researchers noted a 21 percent increase in excessive drinking during the pandemic. The scientists simulated the drinking trajectories and liver disease trends in all US adults and estimated that a one-year increase in alcohol consumption during the COVID-19 pandemic will result in 8,000 additional deaths from alcohol-related liver disease, 18,700 cases of liver failure, and1,000 cases of liver cancer by 2040.

Loneliness, social disconnection, anxiety, depression, and substance misuse can have another tragic consequence for men: suicide.

Even before the highly stressful COVID pandemic, Princeton economists Anne Case and Angus Deaton suggested in a 2015 paper (and a subsequent 2021 book), that working-age white men and women without four-year college degrees were dying “deaths of despair” by suicide, drug overdoses, and alcohol-related liver disease at unprecedented rates.

Wyoming’s “prevention specialist” Bill Hawley believes that too many men are unwilling or unable to talk about their feelings. As Jose A. Del Real reported in the Washington Post, Hawley’s “official mandate is to connect people who struggle with alcohol and drug abuse, tobacco addiction, and suicidal impulses to the state’s limited social service programs.”

Some sociologists have cynically nicknamed the Mountain West America’s “suicide belt.”

“Across the United States, men accounted for79 percent of suicide deaths in 2020, according to a Washington Post analysis of new data from the Centers for Disease Control and Prevention, which also shows Wyoming has the highest rate of suicide deaths per capita in the country,” wrote Del Real. “A majority of suicide deaths involve firearms, of which there are plenty in Wyoming, and alcohol or drugs are often a factor.”

Some researchers blame the pitfalls of toxic masculinity for the gender gap in suicides.

Toxic masculinity frequently turns outward in the form of violent behavior against others, but it can also turn inward.

“Talk saves lives,” Bill told the WashingtonPost — because it has saved his own life many times since he tried to kill himself two decades ago after a cascade of bad behavior and mental anguish led to a divorce, hopelessness, and estrangement from his two older sons.

Hawley now talks to other men “about that brokenness we all feel inside,” about “whole health: mind, body, and soul.”Some men feel uncomfortable with being vulnerable but others respond by openly“talking about their addictions, about their problems with middle-aged bullies who still taunt them about ‘acting gay,’ about their search for scarce therapists in rural America who can help them heal.”

Christopher Williams, LMFT, the founder and CEO of Renovari Counseling in Orange County, California, treats a significant number of high-performing men experiencing mental health conditions who feel disconnected from family and friends. “It is increasingly common to find men who appear highly successful and present an outward appearance of ‘having it all together’ to be carrying around significant emotional and relational struggles in their internal world,” Williams reports. “One of the most important aspects of our work is showing men the heavy cost and suffering due to the lack of meaningful relationships in their lives, while helping them build healthy, life-giving connections.”

The problem of men lacking meaningful relationships was so apparent to Williams that he teamed up with FoundrySteamboat CEO Ben Cort to offer a series of men's retreats. These four-day experiences bring together small groups of male professionals who tend to be in executive leadership positions and who are experiencing loneliness, anxiety, and a reduced spiritual aspect.

“The retreat may be the first time in years or even decades that these men have openly talked about their emotional state or relationships with other men, realized that they shared these issues in common, and heard others with similar experiences and perspectives. This can be an incredibly cathartic and life-changing experience. Attendees come away feeling that they have made connections that can blossom into real friendships and understanding the importance of reconnecting deeply with partners, family members, and other people who are important in their lives outside of their work environment. I know this from direct experience. I attended one of Chris’s retreats three years ago as a participant and came away a better person. The time was cathartic because Chris is a master of his craft, and the environment, food, and fellow participants were so amazing. I’m always ‘too busy’ for things like this but I made time and remain thankful that I did. If you get the invite, do what it takes to attend,” says Cort.

The retreats are carefully planned to combine enjoyable activities like fly fishing, hiking, campfires, and meal times with lightly guided conversations directed and moderated by Williams and Cort. “We are here to start meaningful discussions and stimulate the discovery of important insights,” says Cort. “But the men do most of the work. They realize that when they allow themselves to explore the relational areas of their lives, which they often put aside, they have a lot to offer and a great deal of common ground to share with their peers.”

Cort and his colleagues at Foundry Treatment Center Steamboat regularly encounter men seeking help for behavioral health problems who feel isolated and alone. A lack of friends is a common factor affecting the program’s clients, and the program helps men understand how and why they lack friends and how to make change. Lifestyles of people with active addictions tend to make the affected person isolated. The side effects and behaviors of substance use disorders can alienate friends and family members. But it is equally important to understand that loneliness and isolation can also be the causes of substance misuse — these issues are directly connected. Often, helping men manage their addictive disorders and mental health conditions requires finding ways of healthily connecting with other people who can be supporters of recovery and add meaning and joy to life.

WOW!! I really struggled with this month’s article. I scribbled ideas on paper for a few weeks throwing ideas around. Should we talk about COVID FOMO?! Is that really a thing?! People feeling like they should be cleaning out their closets or learning a new language because everyone else SEEMS to be doing it. Should we talk about the things we CAN control, our fitness, our food intake, our own positivity?!Should we talk about the amazing resources that have come to light during such a dark time?! Should we make a top ten list of things we can do right now, get good sleep, keep a routine, reach out to loved ones?! Should we talk about what kind of humans we will come out on the other side as, more compassionate, more aware, with better hand washing skills?! You can see my dilemma, right?!

All of these things are justas important as the next. We scroll through social media, we watch the news, we listen to those we trust and respect yet the fear still looms. How long will it last?! What will happen to my job?! Will someone I know get sick?! What will normal look like?! Will I ever hug my friends again?!

We can only rely on what we know now more than ever. And, that my friends, is COMMUNITY! This is your crew, your squad, your family, your town, your world, your community. Helen Keller’s famous words, “Alone we can do so little, together we can do so much,” hang right above us.

We are truly in this together more than ever and more than anything we have ever faced. It is time to unite and fight as one. Do you part.

So, here is your go to list of how to connect, be compassionate, and help serve or ignite YOUR community all the while practicing your best shelter in place and hand washing skills.  

Remember to keep it simple.Don’t overwhelm yourself with huge to do lists to add to anxiety. Pick one thing and make it great.

1.     MOVE DAILY (alphabet movement, dog walks, zoom workouts)

2.    CONNECT (try calling a friend this week that you haven’t touched base with in a while or setup a FUN zoom happy hour or game night with friends)

3.    LIMIT YOUR SCREEN AND NEWS TIME (schedule these things in as if they were an appointment, when time is up, move on)

4.    GET OUTSIDE (as much as you can, fresh air is an instant mood lifter)

5.    CALL YOUR PARENTS(they will LOVE hearing from you)

6.    HAVE SOME SCHEDULED DOWNTIME (just like the screen time, schedule it, make it happen and get creative-this might mean learning something new to some and a nap for others)

7.    SHOP LOCAL (buy a gift card to support a local business or get some take-out food, even better get some take-out food for a neighbor)

8.    OFFER HELP (seek out those who can’t shop or offer to help someone in need)

9.    SMILE (it will help your mood instantly and remember to smile at others even if that is from your window)

10.  MAKE A SIGN (sing at 7pm, howl at 8pm, whatever it means to you, show your support for those working the frontlines)

For those of you struggling mentally or physically, reach out! There are so many online resources to connect and meet-up.  On the walls of many AA or NA rooms, we see these words, “We don’t heal in isolation but in community.” S.Harrell

WE GOT THIS COMMUNITY! Try asking yourself these daily questions to remember all the things we are grateful for. See you on the other side for a GIANT hug!

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Sarah Coleman

Wellness Coach, Foundry Treatment Center

Personal Trainer, CrossFitter andCoach, Steamboat CrossFit

Food connoisseur /Culinary Artist, Bitchin’Kitchin’

Outdoor Enthusiast, Everywhere

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A lot of people assume that completing an addiction treatment program is all they really need to do in order to recover. Unfortunately, treatment isn’t like taking your car to the shop. Treatment gives you a great start in recovery. It gets you away from bad influences and bad situations, helps you detox safely, gets you started in therapy, and it teaches you some crucial recovery skills.

However, all of this is just a beginning. Addiction is a chronic condition that requires you to stick to an ongoing treatment plan. As with high blood pressure or diabetes, when you abandon your treatment plan, the condition gets worse. Transitional care is a way of making sure that the positive changes you make during treatment continue long after you leave.

Structure

When you leave treatment, you go from a highly structured environment to an unstructured environment. When you’re in inpatient treatment, pretty much everything is scheduled such as sleep, meals, therapy, activities, and free time. While this clearly has a practical purpose, it also has a therapeutic purpose.

You know what to expect from each day and you don’t have to put much energy into deciding what to do, making healthy decisions, and so on. Having structure in your days minimizes boredom and restlessness and it fosters conscientiousness. This self-awareness is a personality trait that helps protect us against substance use.

It can be rather jarring to go from a highly structured environment like treatment to one where there is essentially no structure at all. Usually, a month is not long enough to make your treatment routine automatic, but it is a pretty good start. It’s a good idea to try to keep to that regular schedule as much as possible after you leave.

Support

When you’re in treatment, pretty much everyone around you is invested in your recovery. The staff is paid to help you get sober and stay sober. Beyond that, most people choose that work because helping people with substance use issues means something to them. Most of the other people in treatment want to stay sober and many of them will support your efforts too.

It’s very different after you leave. Most people will have no idea you are recovering from addiction and some will actively make it harder for you to stay sober. There is also a lot more stress in regular life, which you were mostly shielded from during treatment. One of the first things you’ll have to do after leaving treatment is to create a sober support system as quickly as possible. Social support is one of the most important factors in a strong recovery.

Applying Recovery Skills

There’s often a big difference between theory and practice. During treatment, you’ll learn a lot of skills. You’ll learn how to manage your emotions, cope with stress, and to interact more effectively with others. You will even be able to practice these skills to some extent.

While this is great preparation, life often surprises us with new problems. It’s always important to have a plan but it’s also important to realize that no plan survives first contact with the enemy. We face new challenges all the time and having someone to help you apply your new recovery skills to real-life situations can make a big difference.

What Is Transitional Care?

Having seen some of the issues that make transitioning back to normal life after treatment so difficult for many people, what can be done about it? There are many different modes of follow-up care but they mainly fall into the three categories below.

Creating Social Support

The lowest level of follow-up care involves helping clients create some degree of social support. For example, many programs help clients get situated in external 12-Step programs so they will have an established meeting when they leave. Some programs offer alumni services that connect program graduates to alumni in their area.

Some programs offer counseling services or virtual group sessions for a period following the formal program. These are not only helpful for clients but they often provide useful feedback for treatment programs.

Step-Down Care

Another common strategy is step-down care. For example, if you’ve just completed a period of inpatient treatment, you might continue on in an intensive outpatient program. This continues much of the intensive support and therapy and provides a bit of structure while giving you more freedom to live at home and work or go to school.

Even if you don’t enroll in a formal program following treatment, you should find a good therapist and go to appointments at least once a week. For many people, daily 12-Step meetings help them stay on track during the first few months following treatment. The basic idea is that whatever level of care you’ve recently completed, you move down to a slightly less intensive form of treatment rather than heading straight back to normal life.

Sober Living Environment

Finally, you might consider a sober living environment to help you transition back to normal life. These are typically houses where only sober people live. Structure is a condition of living there and you can usually enjoy some support from your housemates. Usually, there is a curfew, and residents are required to do some chores, attend 12-Step meetings, and work or at least look for work.

Intensive treatment is a great start to recovery, but it’s important to keep in mind that addiction is a chronic condition that will require management for years, and possibly for life. You typically have to make a lot of changes during treatment and making these part of your normal life will take a bit of time, practice, and social support. At The Foundry, we know that the transitional period after treatment is a difficult time for people. That’s why we do everything we can to smooth that transition and make it successful. To learn more about our transitional care and our treatment programs in general, call us at (844) 955-1066 or explore our website.

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It’s hard when you have a loved one who is struggling with a substance use disorder. Not only are you constantly worried about their health and welfare, but their substance use and resulting behavior probably affect you directly in various ways. They may get belligerent, ask to borrow money, keep strange hours, bring around suspicious people, and disrupt your life in countless other ways.

You want to help them but they may not be ready for help yet. The situation is a source of chronic stress as you try to deal with your own conflicting motivations. If you have a loved one with a substance use disorder, the following are some ways to take care of yourself.

Know That It’s Not Your Fault

First of all, know that whatever struggles your loved one is dealing with, it’s not your fault. Addiction is complex, typically involving genetic factors, mental health issues, childhood environment, or trauma. Sometimes these things combine in just the wrong way and most of the relevant factors are beyond anyone’s control.

Maintain Healthy Boundaries

Maintaining healthy boundaries is good for both of you. Healthy boundaries mean you expect your loved one to respect your values and autonomy and you respect theirs. Healthy boundaries are also a safety issue. If your loved one is going to live with you, they need to respect certain rules, like not bringing drugs or alcohol into the house, not bringing people over, and so on. They also need to respect you and your property by not trying to manipulate you, lie to you, or steal from you.

Boundaries are a way of protecting yourself and a way of not enabling their addictive behavior. Maintaining healthy boundaries may also be a way of improving the situation. Dysfunctional family dynamics, including poor communication and weak or nonexistent boundaries, often contribute to addiction.

Stay Healthy

Dealing with a loved one’s addiction can wear you down and take a toll on your health. Chronic stress produces hormones like cortisol and adrenaline that weaken your immune system and make you more vulnerable to various health issues over time.

To reduce stress and maintain health, three things are most important: sleep, diet, and exercise. Try to get at least eight hours of sleep every night. Even a modest sleep deficit can lead to increased anxiety, poor concentration and memory, poor planning, and lack of self-control. Over a longer period, a sleep deficit increases your risk of major depression and anxiety disorders.

Diet is the next important aspect of staying healthy. There are now many studies connecting a good diet with better mental health. One meta-analysis with data from more than 45,000 participants found that a healthy diet significantly reduces your risk of depression. Healthy diets in the various studies typically included mostly whole foods such as fruits, vegetables, and whole grains, with very little processed grain, meat, or sugar.

Exercise is the third leg of the stool. It improves your physical health, especially your cardiovascular health, and helps you maintain a healthy body weight. Perhaps more importantly, it helps improve your mental health, particularly by making you less reactive to stress. All you really need is to walk 30 minutes a day to notice improvements.

Find Ways to Relax

Some people have trouble relaxing because they feel like it’s just doing nothing. However, relaxation helps you reduce stress and recover from the stress of the day. Find something that works for you whether it’s meditating, listening to music, reading, or taking a hot bath or shower. Schedule some time to relax every day.

Talk to a Therapist

Having a loved one with a substance use disorder is a difficult situation to deal with. You may have trouble dealing with guilt or setting boundaries. You may have trouble coping with the associated stress or communicating effectively. A therapist can help you with all of these issues.

As noted above, family dynamics often drive addiction and it’s possible that by improving your communication skills, learning to set and respect boundaries, and resolving your own issues, that you might have a positive effect on your loved one.

Seek Social Support

Finally, seek social support. One of the hardest things is feeling like you are dealing with this situation on your own. People with substance use issues will sometimes deliberately try to isolate you as a means of control. Connect with others who are facing the same challenges.

Consider attending Al-Anon or Nar-Anon meetings in your area. You can talk to people who have been through the same thing and understand. Having that sense of connection makes you feel less stressed and more confident about dealing with the challenges related to your loved one’s addiction.

Having a loved one with a substance use disorder is always a difficult situation. It’s hard to know to help without enabling. Many people feel personally responsible for their loved ones’ addiction and recovery and the ongoing stress can have a serious effect on your health. While it’s great to want to help your loved one and encourage them to get help, remember that ultimately, they have to make their own decisions and that you can’t help them if you are sick and depressed. At The Foundry, we know that family is one of the most important elements of a strong recovery and we want you to play an integral role in your loved one’s treatment. To learn more, call us at (844) 955-1066 or explore our website.

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The man who taught me to fly-fish said something our last time on the water together before he died that I have always remembered; “it’s all a big circle” he told me with a smile as I was bragging about the day I’d had fishing versus his.

Dr. Barnes was walking out of the Foundry office this morning as I was parking to go in and I laughed a little remembering those words, it’s all a big circle. I was walking into an office next door to Dr. Barnes, again. We had the same setup working together at CeDAR a few years back, and sharing/problem-solving/listening/laughing with him in the morning is well-practiced and something I have missed. I didn’t expect to work inside of this field again but here I am and I’m here with some remarkable people.

After a few laughs and a few problems discussed/solved Dr. Barnes told me again why New Years day is his favorite day of the year. He talked about intentional practices he has to plan for improvement and growth in the new year and forward as well as refocused efforts in certain areas of self-improvement. He talked to me about how this is a time to reset and refocus, to break cycles…..

Working inside of the treatment and recovery world we often find ourselves straddling a line. On one side, it’s all a big circle, things will repeat and on the other, there is breaking a cycle and changing trajectory. This duality is something that I want to hold walking into 2020.

This year marks my 13th in the field. Ten years into my sobriety I had never imagined that my vocation would be tied to my recovery until I found myself sitting in Scott Strode’s living room trying to write policy and conduct codes for what would ultimately become The Phoenix. Back then this whole scene was totally new, I knew nothing of treatment other than the county mandated programs I was ordered to attend a decade earlier. For me, recovery from my own addiction came through the rooms of a 12-step community. In those early days at The Phoenix, we thought it would be cool to try to extend the sober community outside of church basements and into gyms, races, climbing crags, etc. The five years I spent doing that taught me a great deal about recovery and a little about treatment. We embedded inside of several programs and even helped our friends at West Pines build a gym with a great climbing wall that integrated what we did into their treatment program. I started to learn more about treatment working with and inside of programs and saw how different programs approached the same goal. Much of my job at Phoenix ended up focused on these relationships and programs and through this, I was able to spend real time inside of most of the programs that were in Colorado in those days (Harmony, CeDAR, Jaywalker, Raleigh House, West Pines, Arapahoe House, Stout Street, Parker Valley, and AIM House) building programs to integrate fitness and putting together events. I made good friends inside of those programs and am so grateful for all that they taught me about why they did what they did. Most of those leaders have moved on, retiring or taking smaller or larger roles, a few have passed away. Their knowledge and insight persist and I am proud to do my best now to contribute.

After The Phoenix and through my time at CeDAR (University of Colorado Hospital) where Steve Millette showed me how much I still had to learn about this field, I started to work more nationally and gained exposure to what Treatment looks like throughout the country and internationally. One of the most brilliant psychologists I have known, LaTisha Bader, used to say that CeDAR in those days was like Camelot, as good as it got. My last day there was exactly three years ago today, 12/31.

Since leaving CeDAR I have learned even more about how treatment works nationally. Building approved provider lists for professional sports leagues and teams as well as labor unions and consulting inside of a handful of programs outside of Colorado has taught me a great deal, as has working with local and state governments and agencies that they support. I have had a chance to go onsite and assess well over 100 of the finest (and not so fine) programs in the country and learned something on every visit.

In 2020, it is my hope and intention to help the Foundry Steamboat Springs to become an even better treatment program. I never considered working for a program again but have been drawn to this place and these people. They have a genuine desire to help and provide healing as well as a team in place that is equipped to do just that. While our footprint is small, a men’s only program in the mountains of Colorado, the idea is huge; We will demonstrate that the best of services can be provided in-network with insurance. With enough money, anyone can get comprehensive treatment but the reality is that replicating these services in a program that is insurance-based has been near impossible. To do so takes work, a good deal of work. It also means accepting much lower margins than are traditionally seen in this field but we are convinced that it can be done and are off to a strong start doing so.

Hopefully, I have helped to elaborate on why I find myself holding those two contrasting ideas; It’s all a circle and dramatic change is possible. My hope is to draw on the knowledge and experience that exists collectively inside of the treatment world to help those we serve to find new and hope-filled lives.

I have already learned so much in this role as CEO and know that 2020 will both teach and humble me further as I look for these opportunities. May your 2020 see you both enjoying the circle and embracing the change.

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Ben Cort is the Chief Executive Officer at the Foundry Treatment Center Steamboat, a rehab and substance use disorder treatment center located in Steamboat Springs, Colorado.

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Having a loved one with a substance use disorder is often painful and frustrating. If you’ve never struggled with substance use issues yourself, it’s very hard to understand the behavior of your addicted loved one. They may ignore the overwhelming evidence that they have a problem or, if they admit they have a problem, they may resist getting help. This stubbornness can be baffling, especially since it often comes off as anger. What’s important to understand is that the prospect of going to treatment and fundamentally changing how you live can be terrifying, even when your life isn’t going that well at the moment. Seeing your loved one’s resistance as fear rather than stubbornness can give you insight into their behavior and help you be more patient. The following are some common fears people have about entering treatment for addiction.

Fear of Losing Control

Just getting to the discussion of treatment can be a long road. You might think that when someone admits they have a problem, getting treatment is just the next logical step. Clearly, if they could quit on their own, they would have done it by now. However, many people with substance use issues don’t see it that way. They’ll admit they have a problem but insist on dealing with it on their own.

This is another form of denial because they’re denying the full implications of having a substance use disorder. It doesn’t just mean that you use drugs and alcohol excessively and to your own detriment, but also that you don’t have control over it. Insisting you can deal with it on your own is denying the nature of addiction. Again, this is typically motivated by fear. No one likes to give up control of their life. Admitting you need help means admitting that you really don’t have control over your drug and alcohol use. In the context of treatment, it also means you will have to do some things you don’t want to do. The key is to emphasize that they have already lost control of their lives and that seeking help is a way to get it back.

Fear of Withdrawal

You can’t start recovery until you go through withdrawal, and for many people, the prospect of withdrawal is intimidating. Many people try to quit on their own but give up when withdrawal symptoms get too bad. The thought of having to see it through with a supervised withdrawal may be frightening. This is especially true for people addicted to substances that have intense withdrawal symptoms. Opioids, for example, have symptoms that people often compare to the worst flu they’ve ever had, with runny nose, watery eyes, nausea, vomiting, diarrhea, shaking, sweating, aching, and chills. It’s no wonder people aren’t eager to go through that.

Withdrawal after heavy alcohol use is no joke either and can include headache, irritability, shaking, seizures, vomiting, and, in a small percentage of cases, death. Anyone facing those symptoms would be anxious. The key is to emphasize the safety of a supervised detox. Detox staff can make you a bit more comfortable and respond quickly if symptoms become dangerous.

Fear of Loneliness

When people think of going off to treatment, especially an inpatient program where they will spend at least a month, they are often bothered by the prospect of being locked away in this facility where they don’t know anyone. They fear embarking on this adventure with no support. While it’s true that they probably won’t know anyone at first, it’s the staff’s job to make sure they have everything they need and that they feel comfortable. They will be talking to a therapist very soon after arrival and they will probably have a roommate. Since people in treatment share a lot of traumatic experiences, they often form deep bonds. A lot of people say they’ve met their best friends in treatment. If you feel lonely at first, it probably won’t last more than a few days.

Fear of Sharing

Group therapy is a common feature of both professional treatment programs and mutual-aid groups like AA. Many people feel intimidated by group therapy because you have to speak in front of people and often share things you’re not particularly proud of. However, there are good reasons group therapy is part of nearly all addiction treatment programs. One of the biggest reasons is that members quickly learn they have nothing to be ashamed of. Other people in the group have probably had similar experiences and they learn they aren’t alone. This is important for dispelling the stigma attached to addiction as well as related issues like having been physically or sexually abused. People tend to find a lot of support in their group sessions and despite their initial trepidation, find it rewarding.

Fear of Coping

For many people, drugs and alcohol are a way of coping with challenging emotions and memories. Someone with PTSD, for example, might use alcohol as a way of coping with intrusive images. The thought of getting sober and having to go through life without a trusted coping mechanism may be too much to bear. This is why treating co-occurring conditions is so important. Long-term recovery entails figuring out the underlying causes of addictive behavior and finding more productive ways of coping.

Fear of Failure

When someone agrees to enter treatment, especially for the first time, everyone gets a little hopeful. The person’s history of increasingly problematic behavior might be about to turn around finally. What’s more, treatment represents an investment of time, money, and effort. What if it doesn’t work? Everyone will be disappointed and it will have been a waste of resources. This is an understandable fear but all you can do is try and make an honest effort. If it doesn’t work out the first time, it may work out the second or third time. You don’t fail at getting sober until you quit trying.

Fear of success

Ironically, success can be just as frightening as failure. If you do manage to get sober and stay sober – then what? You can no longer blame your failings as an employee or a parent on drugs and alcohol. You are responsible for yourself and you have to make decisions about what kind of life you want to live, whereas before, drugs and alcohol were making those decisions for you. While this can be a lot to deal with at first, it’s by far the better problem to have. You will, of course, make mistakes, but you will gradually learn to live the kind of life you want to lead.

Fear is normal when it comes to entering treatment for addiction. You fear losing control, you fear to be vulnerable, you fear the pressure of living without drugs and alcohol. However, that fear is a good sign. It means trying something new and taking responsibility for the results. At Foundry Treatment Center, we share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at 1-844-955-1066.

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For many people who struggle with substance use, especially opioids, pain is a major barrier to recovery. Perhaps you’re afraid that without drugs or alcohol, you won’t have a way to manage pain, or perhaps you’ve already gotten sober and the pain is a major challenge to staying sober. Pain is still frustratingly elusive and although it’s the subject of intensive research, there is still a lot we don’t know about what causes pain, especially chronic pain. However, we do know something about managing pain, and that knowledge grows by the year. The following are some ways you can reduce and manage pain in addiction recovery without drugs or alcohol. 

1. Talk to Your Doctor

When it comes to pain management, talking to your doctor is always the place to start. Make sure you are honest about your addiction history. This might feel uncomfortable, especially if you have been in the habit of bamboozling doctors for opioid prescriptions. People with a history of substance use also know that doctors sometimes take them less seriously once they know about their addiction history. However, in this case, you are specifically saying that you need help managing pain without addictive drugs. 

What your doctor suggests will largely depend on your circumstances, specifically whether you’re dealing with acute pain, such as from an injury or medical procedure, or chronic pain, especially if it has no apparent cause. Over-the-counter medications such as NSAIDs are often more effective for acute pain than many people realize--especially in combination--even for pain resulting from surgery. Chronic pain can be trickier. However, one important thing to understand is that opioids are actually not very good for treating chronic pain since long-term use increases your pain sensitivity and may even spontaneously cause new pain.

2. Try Physical Therapy

For some kinds of pain, physical therapy can be a powerful treatment. There are primarily two ways physical therapy helps. First, movement is good for pain. When you have pain, your natural reflex is to limit your movement to prevent pain. This is good in the short term, as it allows an injury to heal, but in the long term, your mobility becomes limited and your pain increases. Physical therapy is a way to improve mobility under the care of an expert. 

Second, chronic pain is often caused by weak or unbalanced muscles. This is especially common in knee pain and lower back pain. Strengthening and balancing the muscles around the affected area reduces stress on the area, which reduces pain. It often takes someone with a detailed understanding of anatomy to help you strengthen the right muscles.

Finally, there are newer methods that rely on electrical stimulation in specific areas that can help reduce pain. This has been shown to be especially effective for neuropathic pain, or pain that’s caused by nerve damage. 

3. See a Therapist

It sounds a bit counterintuitive, but there are several reasons you should see a therapist if you’re struggling with pain. First, and perhaps most importantly for people recovering from addiction, pain is often a symptom of depression--one people typically don’t think of. It may manifest as headaches, muscle aches, chest pain, or joint pain. In fact, pain is one of the primary reasons people seek medical attention leading to a diagnosis of depression. This is especially common among men. Effectively treating depression should also reduce pain.

However, even if you don’t have major depression, your therapist can help you cope with pain. There are cognitive behavioral therapy, or CBT, techniques that can help you cope with pain. Another form of cognitive therapy is acceptance and commitment therapy that is also helpful for pain. Typically, these help you change your thinking so that the pain isn’t worse than it needs to be and it allows you to better function despite the pain.

4. Exercise

Exercise also seems like a counterintuitive way to cope with pain, however, it can be tremendously helpful. First, it’s important to consult with a doctor to make sure exercise won’t aggravate an injury. It may also be good to consult a physical therapist for the reasons described above. However, exercise is good for reducing pain overall.

It trains your nervous system to be less sensitive to stimuli and to re-categorize the sensations associated with exercise as normal sensations rather than pain. It also helps in a peripheral way by improving your mood and reducing your sensitivity to stress, and perhaps reducing depressive symptoms, as discussed above.

5. Pay Attention to Your Diet

Diet is too often overlooked when it comes to managing pain. An anti-inflammatory diet is particularly important. Inflammation is the redness and swelling that occurs at the site of an injury or infection and the pain associated with inflammation helps immobilize the injured area. Therefore, it only makes sense that if you want to reduce pain, you also want to reduce inflammation.

That means reducing or eliminating inflammatory foods such as sugar, alcohol, processed flour, processed meats, and vegetable oils, and most fried foods. It also means eating a healthy diet rich in anti-inflammatory foods instead. Research shows that a Mediterranean-style diet is especially good for reducing inflammation. This diet is rich in whole grains, nuts, beans, legumes, fruits, vegetables, olive oil, and fatty fish, such as salmon. 

6. Maintain a Healthy Weight

It’s also important to note that excess body fat is highly inflammatory. Fat cells promote the release of inflammatory molecules and the extra weight often contributes to joint pain and lower back pain, while reducing mobility. We’ve already looked at how exercise and a healthy diet can help reduce pain and those benefits are compounded insofar as they also help you maintain a healthy weight. 

Pain is a real concern and chronic pain is one of the few things that reduce your happiness long term. It’s no wonder that some people fear the thought of living without drugs and alcohol if they believe it will leave them vulnerable to pain. However, unless you have a terminal illness, opioids are not a good long-term solution to pain and they will probably make it worse. Instead, work with your doctor and therapist to develop a comprehensive plan to manage and perhaps even eliminate pain.

At The Foundry, we know that both mental and physical pain are the primary drivers of addictive behavior and we help our clients deal with pain in a holistic way, using cutting edge therapeutic methods like CBT, EMDR, and Alpha-Stim as well as healthy lifestyle changes including exercise, mindfulness meditation, yoga, and healthier eating. To learn more about our program, call us today at (844) 955-1066.

Living with depression is never easy and that’s especially true during times of stress. At the moment, we’re all coping with the coronavirus pandemic. Although the quarantine is beginning to be lifted in some areas, the virus remains a threat and the economic impact has been huge. However, it doesn’t take a global pandemic to cause a personal crisis.

We all go through stressful times and whether it’s buying a house, getting a divorce, or being quarantined at home, stress can trigger a depressive episode, especially if you have a history of depression. If you have struggled with depression in the past, or are struggling with it now, here are some tips for keeping it together during stressful times.

Stick to Your Treatment Regimen

First of all, if you are already on a treatment regimen for depression, keep it up. Keep taking your medication, if that applies to you, keep doing your writing exercises, keep meditating, and keep exercising. If you’re seeing a therapist, keep seeing them, even if you have to see them remotely. If you haven’t been seeing your therapist lately, now is probably a pretty good time to resume. Reach out either through the phone or email and see if they can fit you in.

Set a Strict Limit on Media

This especially applies to news and social media. While it’s understandable that you want to stay informed, it’s easy to get sucked into the vortex of divisiveness and negativity that is the 24-hour news cycle. Set a strict daily limit on how much time you spend consuming news. Try to remember that in a week, 90 percent of it won’t matter anyway. 

The same is true of social media. When you don’t have anything else to do, it may be especially tempting to endlessly scroll through Facebook, Twitter, Instagram, Reddit, and so on. A number of studies have found that excessive social media use is terrible for your mental health, mainly because it promotes comparisons and fragments your attention.

One study found that participants who limited their social media use to 30 minutes a day for three weeks reported significantly lower levels of depression and loneliness by the end of the three-week study.

Try to Follow a Routine

Sometimes, when you’re feeling depressed and overwhelmed, all you can do is put one foot in front of the other. Having something like a regular routine can help you get through the day in several ways. First, a regular routine reduces anxiety because you feel more in control and less uncertain about what’s ahead. Second, a routine breaks your day into manageable chunks.

The whole day might be too much to think about all at once but maybe you can think about just taking your shower, then just having breakfast, and so on. Your regular activities can serve as signposts throughout your day.

Get Some Exercise

Getting a bit of exercise is one of the most important things you can do if you feel depressed or if you want to avoid feeling depressed. Exercise helps improve your mood and it improves your stress tolerance. Many studies have found that exercise improves mental health outcomes overall. Of course, when you’re depressed, summoning the energy to do anything, much less exercise, is a big ask. Whatever you can do, even if it’s just a five-minute walk, will make you feel a little better.

Eat Healthy

There are now quite a few studies showing that diet has a significant effect on depression and depression risk. A number of studies have shown that dietary interventions can even improve depressive symptoms. The most beneficial diets typically include mostly whole foods, such as fruits, vegetables, whole grains, nuts, beans, legumes, and fish. They are also low in processed meats, refined flour, sugar, and fried foods. It may be that such a diet helps reduce inflammation, which recent research suggests may be a significant factor in some forms of depression. 

Look for Ways to Help Other

Part of the trouble with depression--especially during the current pandemic--is that it too often leads to isolation. You end up sitting alone feeling awful and even feeling awful about feeling awful. You may feel like you have very little control over the situation or anything else in your life. One way to fight both of these feelings is to look for ways to help other people.

For example, in the current crisis, just staying home helps, but you may also be able to do other things, like check on neighbors and relatives, donate to food banks, or sew masks. This helps take your mind off your own problems and allows you to contribute in some way, which boosts your sense of self-efficacy.

Try to Stay Present

As noted above, operating on a short time horizon can help you get through your day. The more you can stay in the present moment, the better you will feel in general. It’s too easy to get swept up in ruminations about past mistakes or worries about the future. The more you can stay present, the less you will fall into either of these traps. This is easier said than done.

It may help to practice mindfulness meditation, which is essentially just training yourself to be present for 20 or 30 minutes a day. In a pinch, you can also use grounding techniques, such as closing your eyes and paying attention to all the sounds around you or feeling sensations such as your breath or your weight in your chair. These things help you connect to the present moment and worry less about the past or future.

Avoid Drugs and Alcohol

If you’re recovering from a substance use disorder, this one is obvious, but if you feel depressed, trying to cope with it using drugs or alcohol is a huge red flag. Depression significantly increases your risk of developing a substance use disorder. One study found that among people with mood disorders such as major depression or bipolar disorder, 32 percent also had substance use disorders--nearly four times the risk than in the general population. 

Men are especially prone to self-medicating depression with drugs and alcohol. Even if you don’t have a substance use issue, drugs and alcohol are likely to worsen depression. If you quit drinking, for example, you’re likely to feel better pretty quickly. If you can’t quit drinking, reach out for help, whether it’s to a therapist, a 12-Step group, or an addiction treatment program. If you have substance use issues and depression, you will need a program that can treat both.

At The Foundry, we know that substance use disorders are usually accompanied by other mental health challenges, such as trauma, anxiety, and depression. We use a variety of proven methods, including dialectical behavioral therapy, or DBT, eye movement desensitization and reprocessing therapy, or EMDR, and mindfulness meditation to help our clients heal and sustain their recovery long term. To learn more, call us today at (844) 955-1066.

If you have a loved one with a substance use issue, it can be hard to understand why they won’t get help. It may be obvious to everyone that their drinking and drug use is having a negative effect on their lives and the lives of everyone around them, but they still refuse to do anything about it. If you care about someone, it’s important to encourage them in a supportive, nonjudgmental way to get help for addiction. To that end, it helps to understand some of the most common reasons people give for not seeking help, as identified by the National Survey on Drug Use and Health.

Most Don’t Believe They Have a Problem

Of all the people with substance use issues of various degrees, relatively few seek help and even fewer get the help they need. Of the people who never get help, more than 95 percent just don’t believe they have a problem. Why they believe that is a whole other issue. Many could be in denial. It’s hard to come to grips with the idea that you’ve lost control of your substance use and that it's a problem that you can’t solve on your own.

Rationalization is also a defense mechanism that protects addictive behavior. The remaining five percent of people know that drugs and alcohol have become a problem but they either haven’t sought help or they have sought help but were unable to get it for some reason. The remaining obstacles apply to both groups, although not necessarily in the same order.

Many Just Aren’t Ready to Quit

Of people who know they have a problem but don’t get help, the bigger group is the one comprising people who know they have a problem but haven't sought treatment. This can be incredibly frustrating for loved ones because it seems so obvious that if drugs and alcohol are a problem, you should seek help to quit. However, it’s crucial to understand your loved one’s ambivalence.

If they know their substance use is hurting them but they keep doing it anyway, there is probably a reason. Often, people with substance use issues are self-medicating for trauma or mental health issues. They feel like getting sober would deprive them of their only coping mechanism. Whatever their reasons, it’s important to listen and try to understand.

Cost Is Often an obstacle

We tend to think that addiction treatment is only for the rich and famous. We hear about celebrities doing long stints in rehab and assume it’s not for regular people. However, treatment is more affordable than most people realize. First, there is a continuum of care, ranging from outpatient services to extended inpatient treatment and most people can afford some level of professional care.

Even if it’s not the level of care you think you need, it’s important to know that any amount of work put towards recovery is worth it in the end. If you can only afford to go to 12-Step meetings, then do that and supplement with therapy if necessary. Many therapists work on a sliding scale for people who need it.

Second, there are more ways to pay for treatment than there have ever been. Most insurance will pay for at least some of treatment and quality treatment centers typically accept several forms of insurance. Recent changes in the law also allow federal money, such as from Medicare and Medicaid to be used for more addiction treatment options. Before you assume you can’t afford treatment, call some programs you like and see if they’ll work with you.

Many Are Afraid It Will Affect Their Jobs

There are several ways that treatment might affect your job. The most obvious is that people are afraid they’ll get fired for taking a month or more off of work to get treatment. According to the Family Medical Leave Act, your employer can’t fire you for taking up to 12 weeks off for addiction treatment. That doesn’t protect you from violations such as drinking or using drugs on the job, but it does guarantee time off for treatment.

Many people can’t afford to take time off work, even if they can afford treatment. In that case, it’s important to be aware that most treatment options don’t actually require you to miss work. An intensive outpatient program, for example, allows you to live at home and work while still receiving a high level of care.

The Stigma of Addiction Is Real

Many people are just afraid of being stigmatized as an “addict.” They don’t want their friends, neighbors, or coworkers to know they have a problem. Unfortunately, addiction is a progressive disease and at some point they will likely find out due to circumstances beyond your control. Declining work performance might lead you to lose your job, for example, or you might get a DUI.

It’s better to address the problem on your own terms. Keep in mind that addiction treatment programs have to follow the same strict privacy rules as hospitals and doctors offices, so there’s no reason anyone needs to know you’re getting treatment.

It’s Hard to Know Where to Get Treatment

These days, it feels like we’re constantly inundated with ads for addiction treatment. There are more than 14,000 addiction treatment facilities in the US and it can be hard to choose. Many of these facilities are mediocre and some are really bad. If you want your loved one to get help, you’re probably going to have to do most of the research to find them a good program. Look for accreditation, qualified staff, and evidence-based treatment methods. Good programs will want a lot of information about potential clients to know whether they are a good fit.

Some Want to Handle It on Their Own

Finally, some people don’t seek help because they think they can handle the problem on their own. This is another form of denial, since addiction is typically characterized by trying to quit but being unable to. When someone insists on handling it on their own, they are either stalling or they are slightly delusional about the amount of control they have over their situation.

As they often say in AA, your best thinking is what got you here. If you want to get sober, you will have to tolerate some level of discomfort and loss of control in the short term.

There are many reasons people don’t seek help for addiction; these are just some of the more common ones. When encouraging a loved one to seek help, it’s important to listen without judgment and try to understand what substance use does for them, what’s stopping them from getting help, and what might motivate them to get sober. At The Foundry, we know that every client is different and that individualized care is essential to long-term success. To learn more about our treatment programs, call us at (844) 955-1066 or explore our website.

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Much of your addiction risk is influenced by your family history. Genes and the environment both play a significant role in how addiction is passed down in families. Research has identified many gene variations that appear to be related to substance use disorders.

These aren’t “addiction genes” per se but rather they affect different aspects of your physiology. For example, genes related to how well you metabolize alcohol and its intermediate products, how your dopamine system responds to alcohol, and how active your brain’s fear centers are may all contribute to your risk of developing an alcohol use disorder. 

However, there is also a saying that genes load the gun but the environment pulls the trigger. In other words, having a genetic predisposition to substance use issues doesn’t necessarily mean you’ll develop an addiction. Your odds are significantly higher if you grow up in an environment where you feel unsafe or neglected, where you’ve experienced trauma, or where your parent or guardian had substance use issues.

Children are especially sensitive to trauma and chaos and they often learn substance use behaviors from their parents. As a result, if you have a parent or sibling with a substance use disorder, you are at much greater risk for developing a substance use issue yourself. The following tips can help limit your risk.

Ask About Your Family History

Addiction, even now, is a largely invisible disease. Families want to protect their loved ones’ reputations and people with substance use are often very good at hiding it. However, if your relatives have struggled with substance use, you need to know about it. Ask your relatives about your family history. Be curious about that aunt that no one ever seems to hear from, what your parents were like before you came along, or that grandparent who died at a suspiciously young age. 

Limit Your Exposure to Drugs and Alcohol

If you’re concerned about your own addiction risk, the safest bet is just not to drink or use drugs. If you do drink, set strict limits for yourself. What those limits are, depends on your situation and how worried you are about your risk.

If both of your parents had an alcohol use disorder, you might not want to drink at all but if you had an uncle with a drinking problem and your other risk factors are low, perhaps you’ll feel safe having a drink with dinner now and then. When in doubt, err on the side of caution. It’s much easier to avoid addiction than to recover from it.

Know the Red Flags

It’s also important to know the red flags of addiction. This is true even if you have decided to abstain completely. Depending on your risk factors, you may also be vulnerable to process addictions, such as gambling, shopping, sex, or eating, so being aware of addiction red flags, in general, is a good idea. The trouble is that really clear signs tend to come too late. These are things like getting a DUI, losing your job, having serious relationship issues as a result of addiction, and so on. 

Addiction typically creeps up on you slowly and by the time you realize what’s happening, it’s already hard to get clear of it. If you pay attention, you might notice addictive behavior before it becomes very hard to change course. For example, you might notice that you’re drinking every day, even if you’re only having one or two drinks.

That might be fine for most people but if you have an elevated risk, it might be time to take a break. If you feel like you need drugs or alcohol to relax, that’s another pretty clear sign because it indicates you may have begun to develop a physical dependence. 

Needing more to feel any effect is another sign of dependence, as is feeling achy, jittery, shaky, or irritable when you go for a few days without drugs or alcohol. Also, beware if you find yourself lying or being deceptive about your drug or alcohol use. If you notice any of these signs, take action immediately, whether it’s talking to a therapist, addiction counselor, or doctor, or going to a 12-step meeting.

Talk to a Therapist

One of the best ways to preempt a substance use disorder is to talk to a therapist, even if you’re not sure if you need therapy. As noted above, genes are only part of the equation. Most people seeking help for addiction also have a co-occurring mental health issue, such as major depression, anxiety disorder, PTSD, bipolar disorder, ADHD, and others.

Substance use often begins as a way of self-medicating these conditions. If you did grow up in a house with addiction, it’s likely that you have some issues stemming from that experience and it’s better to address them on your own terms rather than wait for addiction to derail your life. If you don’t know what to tell your therapist, just say that your parents struggled with addiction and you don’t want to fall into the same trap. You certainly won’t be the first.

Make Your Doctor Aware of Your Concerns

Unfortunately, much of the opioid crisis in the US is a result of people using prescriptions as directed by their doctors. They would get these prescriptions for chronic pain or pain following a medical procedure, use them for far too long, and end up addicted, often switching to street drugs like heroin.

Doctors are typically far more cautious about prescribing opioids these days but it’s still important to make your doctor aware of any family history of addiction, just as you would make your doctor aware of any family history of cancer or heart disease. There are often non-addictive treatment alternatives and at the very least, you can take precautions against overusing potentially addictive medication. 

Talk to Your Kids When They’re Ready

Finally, make sure your own kids know about the family history of addiction when they’re ready. This should be part of an overall approach to teaching your kids about drugs and alcohol from a young age. For example, when you give a young child cold medicine, you can remind them that they should only take medicine from you or a doctor, and scale up the lessons as they age.

At a certain point, they will need to know if they have a genetic vulnerability to addiction. This point may come much sooner than you realize since early experimentation with drugs and alcohol is another major factor in addiction risk.

Genes, epigenetics, and early environment play a major role in our lives, but they aren’t destiny. By taking sensible precautions, keeping an eye out for warning signs, addressing problems early, and taking care of your mental health, you can avoid the trap of addiction. If you do end up developing a substance use issue, help is available.

At The Foundry, we know that the roots of addiction are complex. We involve the entire family in treatment to create a supportive home environment through healthy boundaries and better communication. We also use evidence-based methods to treat co-occurring conditions and help you live a happier, more fulfilling life free of drugs and alcohol. For more information, call us at (844) 955-1066.

Compassion Fatigue and the Need for Trauma-Informed Legal Practice

When earning my doctorate at Florida State University, my faculty mentor asked me and a group of my peers to assist in preparing the first book on Compassion Fatigue. Dr. Charles Figley’s Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized (1) was published in 1995. Since that time, compassion fatigue and helping helpers to maintain their health and job satisfaction has been a focus of my career. I have trained many groups of helping professionals to better understand the relationship between burnout and secondary trauma and to look inward at the emotional and physical cost of working with traumatized clients in stressful situations.  

Since 1995, recognition of the significant incidence of trauma in clients and families who seek assistance has magnified the importance of working within a trauma-informed culture where employee and organizational health, compassion fatigue, self-care, and honest organizational assessment are necessary. Over the years, I have wondered if other professions are starting to adopt similar trauma-informed practice.  

My son Patrick is an attorney. Since passing the Bar in 2012, he has specialized in Workers Compensation and Personal Injury law. We have had many conversations about the rewards and struggles of working with clients who have experienced significant workplace injuries or serious and life threatening accidents. We have talked about the difficulty of working with clients who often present as controlling, hypervigilant, and who frequently respond to the legal process with frustration, anxiety, and emotional dysregulation.  

A little over a year ago, Patrick and his family moved to Florida. As he prepared to take the Florida Bar, he began to consider the impact of his work with traumatized clients. As he identified the emotional cost that he and many of his peers have incurred as a result of their work as lawyers, he began to identify ways that he could assist other attorneys who have also struggled in this regard. As we discussed his desire to assist others (2), we researched trauma as an issue within the practice of law. It quickly became evident that lawyers, bar associations, and law school faculty were beginning to investigate the concept of Trauma-Informed practice (3,4,5).  

Based on our findings it is clear that working with traumatized clients can impact every area of legal specialization. Personal injury attorneys assist clients who have experienced life-altering automobile accidents or work-related injuries. Civil litigators assist victims of violent crimes. Family lawyers assist victims of domestic violence and abuse. Veterans attorneys assist service members with combat-related struggles. Judges and other officers of the court are exposed to cases where testimony and other evidence requires almost constant emersion in traumatic material.  Legal professionals in each specialty spend hours interacting with traumatized clients, listen to emotional stories of traumatic events and reviewing graphic photos and medical records.  

The potential impact of trauma on legal professionals is significant and multifaceted. First, traumatized clients often present symptoms that challenge the legal team and its efforts to successfully represent their concerns. Traumatized clients typically enter the legal process with a strong need to feel safe. As the legal process is unfamiliar and potentially threatening, traumatized clients often enter the relationship with a need to be hypervigilant, to feel heard and believed, and in control of the process. Failure to recognize this need can result in distrust, manipulation, and conflict between the client and the legal team.  

Second, trauma memories are often fluid and can change over time. A client's inconsistent accounting of what happened during the event can make case conceptualization, completion of a thorough and accurate assessment, and preparation for deposition or trial difficult. As members of the legal team become frustrated, they may avoid interacting with clients, which creates even greater conflict and increased efforts on the part of the client to regain control of the situation.  

As caseloads build with traumatized clients, team members become more vulnerable to stress, burnout, and secondary trauma from their daily work responsibilities and client interactions. As a result, professionals can experience reduced job satisfaction and increased emotional consequences. In all helping professions these struggles can result in increased turnover, the desire to leave the profession, and increased problems with mental health and addiction issues. Recent research on turnover rates in law firms found that 44% of new associates change firms within the first three years of practice. This turnover rate is estimated to cost firms over $9 billion annually (6). Large numbers of attorneys are also leaving the profession. A 2014 report (7) stated that 24% of attorneys who were licensed in 2000 were no longer practicing law in 2012.  

Addiction and mental health struggles are also evident in the legal profession. A 2016 survey (8) of 12,825 attorneys found that 20.6% screened positive for "hazardous, harmful, and potentially alcohol-dependent drinking." In this same survey, 28% of the respondents reported depression, 19% reported anxiety, and 23% reported significant levels of stress in the work environment. Issues associated with addiction and mental health struggles have implications that go beyond the attorney’s wellbeing. Attorney impairment is not a mitigating circumstance for failing to provide clients with appropriate representation (9).  

All of these issues are not directly associated with working with traumatized clients, but the importance of these growing concerns should be carefully considered!  

Recommendations for law firms and County, State and Federal courts:  1.   Accept the reality that trauma and frequent interaction with traumatized clients can harm outcomes, reduce work performance and job satisfaction of employees, and create emotional and behavioral consequences for employees and the organization as a whole. 2.   Work with a consultant to assess the impact of trauma, compassion fatigue, and organizational trauma on the overall health of the organization. 3.   Develop trauma-informed policies and procedures for working with all clients. 4.  Provide training for all employees on trauma, best practices for working with traumatized clients, and prevention of compassion fatigue, burnout, and secondary trauma. 5.  Provide resources for employees who are struggling with compassion fatigue, burnout, or secondary trauma, addiction and other mental health issues. These resources should include coaching, therapy, treatment and access to an Employee Assistance Program. It is also important to provide preventative opportunities for self-care, consistent utilization of PTO, etc.  

Recommendations for Law Schools: 1.    Provide training in trauma, best practices for working with traumatized clients, preventing and addressing compassion fatigue, burnout, and secondary trauma for all students.  2.    This training should be mandatory for all students regardless of the student's stated areas of interest.  

Recommendations for addiction professionals and other mental health professionals: 1.  It is critical to remember that working with attorneys and other legal professionals should include a thorough trauma assessment, assessment of compassion fatigue, and burnout.  2.   It is important to remember that Trauma-Integrated Legal Practice is relatively new concept in most legal practices, courts, and governmental legal environments. Trauma education, including education on compassion fatigue (i.e., burnout and secondary trauma) is critical for attorneys to accept the serious impact of trauma in their work environment.  3.   From this perspective, all addiction and mental health treatment should be trauma-informed and trauma-integrated. Working with attorneys and legal professionals should be seen from the same perspective of working with other helping professionals (i.e., medical professionals, first responders, therapists, etc.).  

Special Thanks to Patrick Barnes, Esq. for providing input and feedback on this blog post. · For more information on Trauma-Informed Legal Practice, go to Wave of Change Coaching and Consulting, LLC (www.waveofchangecoaching.com).  

Footnotes 1     Figley, C. R. (1995). Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder In Those Who Treat the Traumatized. Brunner/Mazel. New York: NY. 2     https://www.waveofchangecoach.com/ 3     https://www.lawcare.org.uk/news/lawyers-and-vicarious-trauma 4 https://www.lsc-sf.org/wp-content/uploads/2015/10/Article_Establishing-a-Trauma-Informed-Lawyer- Client-Relationship.pdf 5 https://www.aals.org/wp-content/uploads/2015/06/Katz-Haldar.pdf 6 https://www.attorneyatwork.com/confronting-lawyer-turnover-in-law-firms/ 7     http://www.abajournal.com/magazine/article/after_the_jd_study_shows_many_leave_law_practice 8    Krill, P. R., Johnson, B. R., & Albert, L. (2016). The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys. Journal of Addiction Medicine. January/February 2016, 10(1), 46-52. 9 https://www.lawpracticetoday.org/article/evaluating-impaired-attorneys/

Dr. Mike Barnes is the Chief Clinical Officer at the Foundry Treatment Center Steamboat, a rehab and substance use disorder treatment center located in Steamboat Springs, Colorado.

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It’s hard living with a loved one with a substance use disorder. You may have put up with years’ worth of bad behavior, including lying, stealing, violent behavior, manipulation, and general unreliability. You may find that even when your loved one gets sober that you still have trouble forgiving them for everything they put you through when they were actively addicted.

If you want to repair and preserve the relationship, it’s necessary to forgive them at some point, so you can move on, but that can be a huge challenge. It’s hard to let go of the hurt. The following tips can help you forgive a loved one for their sake and yours.

Remember That Forgiveness Is Not Approval

One reason people find it hard to forgive is that they feel like forgiving someone is the same as condoning their behavior, that it’s like saying that they really didn’t do anything wrong after all. That’s not what forgiveness is about.

Forgiveness is nearly the opposite. It’s saying, “You certainly did something wrong but I’m not going to continue being angry about it.” Forgiveness is not approval and it’s not forgetting. You should certainly retain the lessons you learned from your loved one’s addiction, but in forgiving them, you let go of your resentment.

Remember That Forgiveness Is for You as Much as Them

Your loved one may want your forgiveness and even ask for it but that doesn’t mean forgiveness is only for them. In fact, forgiveness is primarily for you. Holding on to anger and resentment is bad for you. It’s a form of chronic stress that impairs your immune system, disturbs your sleep, and generally makes you less happy.

Resentment also means you are continually reaffirming your status as a victim in this situation since you still feel harmed by the person’s past actions. Forgiveness means taking responsibility for your own mental state, leading to greater freedom and well-being.

Try to Understand Addiction

If you’ve never experienced addiction for yourself, it can be very hard to understand from the outside. Every bad thing your loved one does seems like a choice--something they deliberately do to you. It’s easy to take their actions personally and hard to forgive. However, as you learn more about addiction, the role of choice in addictive behavior appears to shrink significantly.

Addiction often causes structural changes in the brain that optimize your thinking for drug or alcohol-seeking behavior while ignoring collateral damage. The roots of addiction are also complex, involving genes, childhood environment, and mental health issues. Being angry at someone for a substance use disorder is like being angry at someone for having diabetes. It’s not something anyone chooses.

Listen

In addition to understanding addiction better in general, it’s important to understand your loved one’s particular experience. For that, listening is important. Becoming a better listener is a whole skill in itself but the basics include giving your loved one your full attention, reflecting back what they say, “So, what you’re saying is...” and trying to put yourself in their place.

That means suspending judgment at least temporarily and trying to imagine what it must have been like for them to struggle with substance use and related behaviors. Often, you’ll find that their experience has been far worse than yours, which will engage your compassionate instincts.

Talk to a Therapist

Forgiveness isn’t something you have to work through on your own; you can always enlist the help of a therapist. Your therapist can help you untangle the difficult emotions you feel related to your loved one--love, hurt, anger, sadness, fear, concern, compassion, resentment, and so on. You may be having trouble with your own feelings including guilt, shame, and anger towards someone you’re supposed to love and care for.

Validating these feelings is just as important as understanding what your loved one has been through. It may also help to participate in family therapy as part of your loved one’s treatment. Many programs like to involve the families in treatment as much as possible. It helps untangle unhealthy family dynamics, improve communication, and educate families on the recovery process.

Seek Social Support

If therapy isn’t an option for you, or even if it is, you may consider attending a group like Al-Anon or Nar-Anon for families of people with substance use disorders. Forgiveness is a common theme of these groups and you can talk things over with people who have had many of the same experiences as you’ve had.

Maintain Healthy Boundaries

As noted above, forgiving doesn’t mean forgetting. In fact, remembering how bad things got can give you ancentive to maintain healthy boundaries with your loved one. Part of the ongoing resentment is the fear that you’ll be hurt again. If you are able to insulate yourself from the consequences of your loved one’s substance use, you will be better able to forgive their past behavior.

Be Patient With Yourself

Finally, be patient with yourself. Often, the anger and resentment you feel towards a loved one with a substance use disorder is a habit of mind built over years of pain and disappointment. You can’t expect to let it all go overnight. The point of forgiveness is to allow yourself to be free from that anger and resentment but if you criticize yourself for being slow to forgive, you only add to your own pain. Give yourself time. The important things are that you want to forgive and that you’re actively working on it. 

Forgiveness can be hard. It feels like you’re condoning your loved one’s past behavior or leaving yourself vulnerable to being hurt again. In reality, you’re letting go of an unnecessary burden, even if you have to do it one brick at a time.

At The Foundry, we know that recovery is stronger when you have the support of friends and family. That’s why we promote family involvement and building a strong recovery community as well as addressing the underlying causes of addiction. To learn more, contact us today at (844) 955-1066.

Many people starting out in recovery face a dilemma when it comes to friends: They want to distance themselves from their old associates who are drinking and using drugs but then they struggle with loneliness, which, in some ways, is almost as bad. Having a strong support network gives you a feeling of belonging and reduces stress.

It’s one of the most important factors in a strong recovery. However, few people actually have much practice making new friends as adults. The following tips can help you make the kind of friends that will help you stay sober.

Have the Right Attitude

First, you have to have the right attitude. Mainly that means being willing to take some risks in terms of going into unfamiliar situations and reaching out to others. If you’re naturally outgoing, this is not a big deal, but if you’re reading a post about making friends, you may need to prepare yourself to step outside your comfort zone. Keep in mind that if someone isn’t interested in being your friend, you shouldn’t take it personally.

We all have our reasons or lack thereof for who we’re friends with. Think of it this way: If you talk to enough people, you will eventually make some good friends. Also, keep in mind that you don’t necessarily need your new friends to be sober; you just need them to respect and support your sobriety.

Find Good Situations

The other part of the new-friends equation is to put yourself in circumstances where you are more likely to make friends. The best circumstances are those where you are in frequent contact with the same people and you all share a common interest or value. Frequent contact allows you to build familiarity and trust, while sharing an interest gives you something to talk about and possibly collaborate on. The following are examples that typically provide both of those elements.

Treatment

People often say they meet their best friends in treatment and that shouldn’t be surprising. You spend a lot of time with those people and you all share certain core experiences around addiction and trauma. Being open about these struggles is cathartic and it’s often a bonding experience. The only thing is that people often travel to attend treatment so you may have to make an effort to keep the friendship alive after you all leave and go back home, but it’s well worth the effort.

12-Step Meetings

The next logical place to make sober friends is at a 12-Step meeting. These aren’t quite as intense as treatment since you typically won’t be living in the same space as your group members, but you do share similar experiences and a commitment to staying sober, just like in treatment. The more regularly you go to meetings, the more quickly you will get to know people, and the sooner you will make new friends.

People just starting out in recovery often go to a meeting every day, or even several meetings a day. The environment is typically welcoming and supportive, making it one of the easiest places to make new friends.

Try a Meetup

If you want to meet people who share your interests, try looking for things that interest you on meetup.com. This is a site that lists special interest groups in your area by subject. There are groups for art, music, film, sports, wellness, finance, languages, travel, dance, careers, and so on. These groups often meet regularly and they aren’t too big so it’s not hard to talk to people.

Join a League

There are many reasons to be physically active in addiction recovery. Regular exercise is one of the best things you do for your physical and mental health and it can also be a great way to make friends. Joining a recreational sports league is one of the most fun ways to exercise and it’s a great way to get to know people without a lot of awkward conversations and even more awkward silences.

If you’re not a team sports kind of person, there are other ways to be social with exercise. You can join a running or biking group. Exercise classes are also great, whether you’re into spin, yoga, or boxing. 

Take Some Classes

Most people didn’t find it too hard to make friends in school since you see the same people every day for years and most of them are near your own age. The closest experience most of us have as adults is work. While, for some people, work might qualify as a shared interest, for most people it doesn’t.

Furthermore, most of your coworkers, even your “work friends” have their own lives and families to worry about and may not be interested in making new friends. However, you can take classes as an adult. And unlike when you’re a kid, you don’t have to take a class in anything that doesn’t interest you.

You can take an exercise class, as noted above, a cooking class, an art class, and so on. You see the same people for weeks or months, you share at least one interest, and you may get to work on a project together. It's a great recipe for making new friends.

Use Your Existing Network

Finally, make sure you’re using all the resources that are right in front of you. Your friends and relatives probably know people you would hit it off with but it may not occur to them unless you ask. Making friends through common acquaintances is good because those people have already been vetted, in a way, and you already know someone who can introduce you.

This is especially helpful if you are living in an unfamiliar area--say, for example, if you are staying in a sober home after attending treatment out of state. You can ask the people you live with and your friends and family back home if they happen to know anyone in the area. Most won’t, but you might get lucky.

Making friends in recovery takes some initiative and perseverance but it’s mainly a matter of talking to a lot of people and putting yourself in the right position. If you find situations where you see the same people a lot and you share interests, it should only be a matter of time before you make some good friends. The main thing is to be patient; friendships have to develop on their own schedule.

At The Foundry, we know that no one recovers from addiction alone. Connection is the key to a long recovery. We promote social connection and healthy relationship skills through group therapy, family therapy, dialectical behavioral therapy, and various activities. To learn more, call us today at (844) 955-1066.

Many people assume college students are too young to be recovering from addiction, but the fact is that the age of the typical full-time college student coincides with that age at which drugs and alcohol typically become a problem. It’s also sometimes the case that substance use issues force people to delay their life plans, including education. Therefore, many people find themselves attending college after getting sober. College can be a challenging place for sober people, since drinking is typically considered integral to the college experience, especially in the US. More than half of college students report drinking at least once in the past month and more than a third report binge drinking in the past month. However, that also implies that at least half of college students drink moderately or not at all. What’s more, being sober will give you a significant advantage when it comes to your studies and extracurricular activities. The following are some tips for staying sober in college.

1.) Stay Near Your Support System If Possible

First, try to stay connected to your existing sober support system, whether that’s friends, family, 12-Step group, or whatever else. Social support and connection are some of the most important parts of a strong recovery. People who move away to go to college often face the difficult combination of loneliness and the stresses of school and generally being in a new place. If you can stay where you are, you retain your emotional support system and minimize new stress. To this end, it may be better to attend a college or community college in your area or even comm

ute if it’s not too long of a drive. That assumes there is a college near you and that it’s a reasonable option. If you can stay where you are, at least for the first semester, it will make the transition to college life much safer.

2.) Choose Your Residence Wisely

If or when you do decide to move to attend college, it’s important to choose your residence well. Certainly, avoid living in a frat or sorority house or even in the same neighborhood. Although some groups are certainly better than others, it’s going to be hard for you to avoid drugs and alcohol. Off-campus student housing areas are often just as bad.

The best options for sober housing will usually be either stay on campus or live in a part of town without many students. Most dorms prohibit drugs and alcohol, although how strictly that is enforced varies widely among institutions. Generally speaking, a dorm will probably have less drinking if it’s not exclusively male or not exclusively first-year students. Also, many universities have family housing available. These are typically small apartments occupied mostly by graduate students and foreign students. Therefore, family housing is typically pretty quiet and affordable. 

Whatever housing option you choose, it’s also a good idea to find a sober roommate. University housing services may be able to help you with that or you might have to find someone through a service like MySoberRoommate.com. Or perhaps you know someone through your 12-Step meetings or elsewhere who also needs a roommate. 

3.) Find a Local Support System

Whether or not you remain living at home while attending college, it helps to have social support on campus. This may or may not be a group of sober people but it will certainly be a group focused on something other than drugs or alcohol. For example, you might find a 12-Step group near campus or you might get involved with activities that support your recovery. For example, most colleges and universities have tons of opportunities to get involved in volunteering, which, in addition to being a positive activity and a great way to meet friends, is one of the 12 steps. 

However, campuses have groups of all kinds--languages, games, academic disciplines, sports, activism, and more. These are all great opportunities to make new friends around activities that are more constructive than drinking.

4.) Manage Your Course Schedule

One of the biggest challenges for anyone recovering from addiction is managing stress, which is typically a major trigger of cravings. Managing stress is a whole topic in itself but in the context of college, one of the best ways to manage stress is to manage your schedule. New college students are often surprised by how much they have to study when they first start college. Also, high fees often make students try to pack as many courses as they can into every semester. Unfortunately, that’s a great way to feel stressed, overwhelmed, and helpless. It’s much better to keep your schedule as light as you can within the constraints of academic and scholarship requirements. 

Keep in mind that class time is only the tip of the iceberg. Many classes, especially in your first year, will also have study sections and labs, both of which may assign their own homework. Then, there’s just the regular studying you’ll have to do for each class. You’ll typically get more mileage from putting more effort into mastering a few core subjects than by trying to take a huge variety of classes and you’ll feel less stressed that way too.

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‍5.) Practice Self-Care

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College students aren’t known for their self-care. Rather, they tend to be known to eat a lot of pizza and stay up late. These kinds of habits are bad for both your grades and your recovery. As much as possible, try to maintain any healthy lifestyle changes you’ve made as part of addiction recovery. Try to eat a diet mostly composed of nutritious whole foods with a minimum of sugar and fried food. Get regular exercise, even if it’s just walking a lot. 

Most importantly, don’t skimp on sleep. Sleep is when new skills and information are consolidated into long-term memory, so staying up late to study is really counterproductive. Sleep deprivation also impairs your concentration and short-term and working memory. If you’re tempted to stay up all night studying for a test, the reality is that you’ll probably benefit more from a good night’s sleep. Most importantly, consistently getting enough sleep is crucial for emotional stability, so resist the urge to cut corners by cutting sleep.

Although college is known for parties and drinking, that’s only a small part of the college experience. When you consider all the opportunities college offers--not only for classroom education, but also for gaining broader cultural knowledge, meeting interesting people, volunteering, and getting involved in new activities--using the opportunity just to drink seems like a waste of time. Staying sober starts with creating the right conditions, such as where you choose to live, and associating with the right people. There is a fairly strong inverse correlation between grades and drinking, meaning that more serious students tend to drink less. There are always exceptions, of course, but by associating with other people who want to learn as much as they can, you are likely to end up around relatively sober peers.

 At The Foundry, we know that recovery from addiction is a process of continuous learning. We also know that the best reason for getting sober is so you can live the kind of life you want to live, which may involve higher education. To learn more about our comprehensive approach to addiction recovery, call us at (844) 955-1066.

People want pets for many reasons. They’re cute, they’re friendly, and they can keep you company. If you are in your first year or so of recovery, there may be ways that having a pet can actually help you out and make your recovery stronger. However, it’s not a decision to be taken lightly. If you’re not in a good place, a pet may be an unnecessary liability. It may be better to wait. Here are some things to consider if you’re thinking about getting a pet.

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How a Pet Can Help

Pets Are Good Companions

One of the most common reasons people want a pet, especially a dog or a cat, is that a pet is a good companion. They don’t judge, they’re affectionate, and they’re always around. Loneliness is a common problem early in addiction recovery because people often cut ties with old friends who drink and use drugs. However, making new friends can take time and meanwhile, people often feel lonely. Loneliness isn’t just unpleasant; it can worsen issues like depression, anxiety, and other mental health issues that commonly occur with addiction. Finding ways to feel connected is essential to recovery success and having a pet around is one such way. It’s not a substitute for human companionship, but it’s certainly an improvement over isolation.

Pets Can Make You More Conscientious

We typically don’t think of responsibility as a selling point but for people recovering from a substance use disorder, it can be. Conscientiousness is a personality trait that appears to protect against substance use disorders. Conscientiousness includes things like being responsible, being organized, following rules, following a regular routine, and so on. While personality traits are inherently difficult to change, conscientiousness is more related to action than other personality traits are, which means you can become more conscientious by behaving more conscientiously.

Having a pet exercises your conscientiousness muscles in mainly two ways. First, having a pet is quite a bit of responsibility. You have to feed it, make sure it gets plenty of exercise, and make sure it has basic things like toys, a carrier, and somewhere to sleep. You have to make sure your pet is vaccinated and you have to take it to the vet when it’s sick. You’re responsible for the well-being of another living thing, which means you will get plenty of practice doing mildly annoying and unpleasant things. While this doesn’t seem very appealing, learning to care for a pet can help you cultivate compassion and get you outside of your own head, which may not always be a nice place to be.

The second way a pet will help you be more conscientious is that it will help you have a more regular routine. You have to feed a pet regularly and a cat, dog, or bird will even wake you up when it’s ready to eat. You are aware that you have to be home at night to feed your pet, so you’re less likely to stay out late or stay over with friends. This routine can help with other things like having a more regular sleep schedule and generally keep you tethered to the normal rhythm of the world.

Pets Are a Way to Connect With Others

Having a pet means you have an easy conversation topic most of the time. Everyone wants to talk about their pets because they love them, it’s rarely a controversial topic, and it’s more interesting than the weather. Having a dog is especially good for promoting social connection because you have to walk them and you are much more likely to meet and talk to your neighbors. Even people without dogs will be more likely to strike up a conversation. While most of these interactions will be superficial, it’s good to have more points of contact, especially with the people who live around you. As noted above, loneliness is a common problem in early recovery, and having a sense of social connection is one of the best ways to ensure your recovery lasts.

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Pets Encourage You to Be Active

This is mainly true of dogs, who have to be walked. Some dogs need a great deal of exercise, which means you’ll get plenty of exercise, whether it’s walking them, running with them, playing fetch, and so on. Having a dog usually means you get more activity spread throughout the day and it means you will be less likely to skip exercise if the weather isn’t perfect. While a short walk with the dog doesn’t seem like a big deal, many short walks throughout the week add up to quite a bit of exercise. Not only is that good for your health, but it’s also good for your recovery. Many studies have linked regular exercise to less stress, lower anxiety, better mood, and even longer periods of sobriety.

When You Might Want to Wait

Pets Can Be Expensive

Pets are a lot more expensive than you think. There are sometimes adoption fees, vaccinations, accessories like beds, carriers, toys, grooming items, and so on, vet bills, and food. A lot of people aren’t in the best shape financially when they start recovery and the financial stress of taking care of a pet certainly won’t help. 

Pets Entail Responsibility

As discussed above, responsibility can be a good thing for recovery, but it can also be too much. Keep in mind that if you drop the ball, it’s your pet who will suffer. It’s also possible that the responsibility of caring for a pet will be too much stress too soon. Stress is a major cause of cravings, so it makes sense to only increase your responsibilities gradually to avoid feeling overwhelmed.

Pets Can Be an Emotional Liability

The emotions involved in having a pet aren’t always positive. Animals have much shorter lifespans than people. They get sick and they have accidents. If you’re attached to a pet, its death can be devastating. If you feel like that’s not an emotional shock you’re prepared to handle--meaning you’re not sure you could stay sober if your pet dies--then it might be better to wait until you’re in a more stable point in your recovery.

Pets can be great companions. They can help us learn to be more compassionate and responsible, both of which improve your recovery and make you happier and more fulfilled in life more generally. However, once you adopt a pet, you’re responsible for its welfare. If you think there’s any chance that you will forget about it, neglect, or not be able to afford to care for it, it’s better to wait. You can always get a pet later. It’s also important to remember that as emotionally rewarding as caring for a pet can be, it creates an emotional vulnerability as well. Getting a pet is just one of many life choices that will affect your recovery from addiction and your overall well-being. 

At Foundry, we know that drug and alcohol use is just the tip of the iceberg when it comes to addiction. Mental health issues, trauma, stress, and isolation are often the real driving forces. That’s why we emphasize a comprehensive approach to recovery, one that doesn’t just emphasize abstaining from drugs and alcohol, but also addresses the root causes of addiction and gives clients the skills they need to live happier, more fulfilling lives. To learn more about our addiction treatment program, call us today at (844) 955-1066.

Depression is both widespread and one of the most common risk factors for addiction. One study found that among people with a mood disorder such as major depression or bipolar disorder, 32% had a substance use disorder, while in the general population, only about 8% of people had a substance use disorder. Substance use helps people cope with the symptoms of depression in the short term, but in the long run, drugs and alcohol only make depression worse. An effective addiction treatment plan must include treatment for any mental health issues, including depression. Depression has gotten a lot more media attention in recent years but unfortunately, there are still a lot of misconceptions about depression. These misconceptions can prevent people from recognizing, acknowledging, and seeking help for depression.‍

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1.) Depression Mostly Affects Women

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It’s true that depression appears to affect women at a higher rate than men but the difference is largely overstated. For example, in 2017, about 8.7% of women had a depressive episode compared to about 5.3% of men. By comparison, only about 0.54% of men get schizophrenia, 2.9% of men develop bipolar disorder--which is also considered a depressive disorder--and about 4% of men develop post-traumatic stress disorder (PTSD). That is to say, that even if men are slightly less likely than women to experience depression, depression is still one of the most common mental health issues men are likely to face. 

2.) Depression Is All-Or-Nothing

You may have an image in your mind of what depression looks like--perhaps someone who can’t get out of bed, can’t hold a job, doesn’t shower, has attempted suicide, and so on. This can be a fairly accurate picture of severe depression but depression can vary widely in both symptoms and severity. Most depression is mild or moderate. The problem with fixating on severe depression is that someone with moderate symptoms that are causing significant impairment might think, “Well, I’m not that bad, so maybe I should just stop complaining.” It’s important to keep in mind that just because someone has it worse, that doesn’t invalidate your own experience. If depression is affecting your life and your recovery from addiction, it needs to be addressed.

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3. If Someone Has Depression, It’s Obvious

As noted above, depression comes in all shapes and sizes. Certainly, there are cases of people who can’t function but the truth is that most people with depression still manage to get by. Often, you wouldn’t even know they’re depressed by looking at them. Many people with depression are good at keeping up a front, either because they fear being stigmatized or they feel like there’s no point in letting others know how miserable they are. High profile cases of suicide, like Robin Williams and Anthony Bourdain, are clear examples of how well some people can hide their pain.

4.) Depression Is a Kind of Prolonged Sadness

Another myth that keeps people from recognizing the symptoms of depression is the belief that depression is mainly just intense or prolonged sadness. Depressed mood is a symptom but it is not the only symptom and it may not be the most prominent symptom. You have to have at least five symptoms, including depressed mood and inability to feel pleasure, for a clinical diagnosis of depression. However, you may more often feel irritable or hopeless, wake up in the middle of the night and have trouble going back to sleep, feel unable to concentrate, or feel unusually fatigued. If you have these kinds of symptoms but wouldn’t exactly say you feel sad, you may be depressed and not realize it.

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5.) Depression Is All in Your Head

Similar to the misconception above, many people think depression is all in your head, that if you could just think a little more positively, you would feel better. While it’s true that fixing cognitive distortions is often a useful part of treatment for depression, recent research suggests that depression may be more of a physical problem than previously believed. In particular, inflammation has been implicated in about half of depression cases. In other words, people with depression often have some of the same markers of inflammation you would find in someone with an infection or autoimmune disorder, suggesting that the immune system may have a significant effect on the mind.

6.) You Need a Good Reason to Be Depressed

As discussed above, you can’t always tell who is struggling with depression, and part of the reason is that some people just don’t seem to have a good reason to be depressed, such as the death of a loved one, losing a job, or getting divorced. However, you don’t need an immediate or obvious reason to be depressed, and sometimes you don’t need a reason at all. Childhood abuse or neglect can increase your risk of depression, years later, for example, and people who have had two or more episodes of depression may have recurring episodes for no reason.

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7.) Everyone Gets Depressed Sometimes

Everyone gets sad sometimes but not everyone gets depressed. About one in five people will experience an episode of depression at some point in their lives, which makes depression one of the most common mental health issues worldwide, but it also means 80% of people won’t experience it. It’s fairly common--even among people with depression--to assume that people with depression are just not handling normal emotions very well. This assumption can be frustrating for people with depression and their families who don’t quite understand the condition.

Depression is one of the most common mental health issues in the world and it is a major risk factor for developing a substance use disorder. Getting addiction under control requires integrated treatment for depression. Unfortunately, common misconceptions about depression, especially about who can get it and what the symptoms are like can prevent people from recognizing they’re depressed and prevent them from seeking help. Depression can be treated effectively in most people and even when it can’t be eliminated completely, the symptoms can be reduced. 

At Foundry, we know that mental health is the key to a strong recovery and a happier life. We use a variety of methods including cognitive behavioral therapy, or CBT, dialectical behavioral therapy, or DBT, family therapy, Alpha-Stim, as well as healthy lifestyle changes including diet, exercise, yoga, and meditation as part of a comprehensive approach to mental health and wellness. For more information, call us today at (844) 955-1066.

We’ve all heard a lot about mindfulness in recent years. It has gone from a fringe practice to a common, even obligatory wellness practice. It has even been incorporated into mainstream treatments for addiction and other mental health issues. Treatment modalities such as mindfulness-based cognitive therapy, or MBCT, and dialectical behavioral therapy, or DBT, use mindfulness to help clients become more aware of their thoughts and emotions in general and better tolerate challenging emotions. Mindfulness meditation is often incorporated into addiction treatment programs, too. There are a number of reasons mindfulness is such a powerful addition to any recovery program, including the following.

Mindfulness reduces stress and anxiety.

One of the most publicized benefits of mindfulness practice is that it can reduce stress and anxiety. This is crucial for two reasons. First, having an anxiety disorder such as generalized anxiety, panic disorder, social anxiety disorder, or PTSD, significantly increases your risk of addiction. If you want to have a long recovery, you must find effective ways to manage your anxiety. Second, most people identify stress as their biggest trigger of cravings. Therefore, learning effective ways to manage stress will also reduce the number and severity of drug and alcohol cravings.

One of the first clinical uses of mindfulness meditation was to reduce stress. Programs like Herbert Benson’s relaxation response and Jon Kabat-Zinn’s mindfulness-based stress reduction, or MBSR, are perhaps the two most prominent examples. If mindfulness were only about spending 20 or 30 minutes a day sitting quietly and relaxing, that in itself would help reduce stress. However, there’s more to mindfulness meditation. Perhaps the most important effect in terms of stress and anxiety is that mindfulness trains you to stay in the present moment, rather than worrying about things that might happen. This effect will eventually extend into your regular life, not just when you’re deliberately practicing mindfulness.

Mindfulness improves metacognitive awareness.

Another useful aspect of mindfulness meditation is that it builds metacognitive awareness — or being aware of what you’re thinking about. This doesn’t seem like a big deal, but it is. Much of the time, our thoughts, beliefs, assumptions, and even emotions, lie beneath the level of conscious awareness. Other times, we get so swept up in some train of thought that we’re not even aware of what’s going on. Both of these can be barriers to insight and recovery.

Most treatment programs and therapists use techniques from cognitive behavioral therapy, the premise of which is that our thinking, rather than external events, is what causes disturbing emotions. If you adjust your thinking to be more objective, you will naturally suffer less, emotionally. The problem is that thoughts can be evasive and slippery. Practicing mindfulness will make you more aware of what you’re thinking and how it affects your emotions. This makes therapy much more effective.

Mindfulness improves behavioral awareness.

Part of the challenge of overcoming addiction — and bad habits, more broadly — is that a lot of our behavior happens on autopilot. If you’ve ever tried to quit smoking or quit biting your fingernails, you’ve probably noticed your body seems to engage in these behaviors without your consent or awareness. This automatic behavior happens on an even deeper level with addiction.

It’s hard to change your behavior when you’re not even aware of what your behavior is. Mindfulness helps you bring more attention to what you’re doing at any given moment. You are more aware of what you’re doing and also how you feel about it. For example, smokers who are asked to smoke mindfully are often surprised to discover that they don’t like the taste or smell of cigarettes or the feeling of smoke in their lungs. Getting off of autopilot through mindful attention gives you more control over your behavior.

Mindfulness changes patterns of avoidance.

Substance use is often a symptom of avoidant behavior. That is, you may use drugs or alcohol as a way of avoiding some kind of emotional stress rather than deal with it. While this offers temporary relief, it makes the problem worse in the long run and causes new problems to go with it.

Mindfulness is really the opposite of avoidance. Instead of trying to ignore or suppress a challenging emotion, you accept it and observe it without judgment. You notice what the emotion is like, what thoughts arise with it, where you feel it in your body, how it changes over time, and so on. Several studies have found that people who are more accepting of their emotions suffer less distress and fewer negative outcomes, such as depression when they’re under stress. This isn’t only limited to emotions like anxiety or pain from traumatic memories, but it can help you get through cravings, as well. This is sometimes called “surfing” a craving.

Mindfulness can improve your relationships.

Having strong relationships is one of the most important parts of addiction recovery. Social connection reduces stress, gives you a sense of purpose, and helps keep you accountable. Mindfulness helps improve your relationships in several ways. First, from a practical perspective, it helps you pay attention when someone is talking. We’re often too distracted by our phones or by our own thoughts to listen properly. Just making an effort to give someone your full attention will improve your relationship.

Second, one of the challenges of communicating is that we are often too reactive. We get angry, defensive, or critical and a conversation quickly devolves into an argument. When you learn to be more mindful, you’re aware of these emotional reactions within you but you don’t necessarily take them too seriously. You can entertain different interpretations and consider things from the other person’s point of view before you respond.

Mindfulness is not a replacement for therapy or treatment, but it can be a powerful addition to any recovery program. It reduces stress, helps you to be more aware of your inner life and outer behavior, and improves your relationships. At The Foundry, mindfulness meditation is one of many modalities we use to treat substance use disorders. For more information about our programs, explore our website or call us today at 1-844-955-1066.

Recovery from addiction is complicated. You have to learn new coping skills, make new friends, make lifestyle changes, and other big changes in a relatively short period of time. There are plenty of chances to make mistakes, especially early on. The good news is that these mistakes don’t have to derail your recovery.

You can avoid many of them, if you know to watch out for them. If you do make mistakes, you can usually get back on track if you catch them early enough. The following are some of the more common mistakes people make in addiction recovery.

Thinking You Can Do It Alone

Perhaps the hardest step is admitting you have a problem, but it’s also hard to ask for help. Many people admit they have a problem with drugs or alcohol, but they want to deal with it on their own. This is usually a bad idea. The thinking that got you into addiction is unlikely to get you out. At the very least, you would benefit from social support like what you would find at 12-Step or other mutual-aid meetings. Additionally, many people need much more support and guidance, such as from a therapist or an addiction treatment program.

Not Treating Mental Health Issues

When most people decide to get help for a substance use issue, the first thing they think of is going to a 12-Step meeting. This is a great first step, and groups like AA and NA have helped millions of people get sober over the decades. However, it’s also important to be aware that most people with substance use disorders also have co-occurring mental health issues such as major depression, anxiety disorders, personality disorders, PTSD, and others. If you try to get sober without addressing these issues, it’s going to be much, much harder.

Expecting Too Much Too Soon

Recovery from addiction is possible — and even likely, with the right help — and life will certainly get better when you’re sober, but it won’t happen all at once. It takes time to form new habits and get used to different ways of thinking. It also takes time for your brain chemistry and body to adapt to life without drugs and alcohol. The early months are typically challenging, and often uncomfortable.

If you expect life to turn around right away, you’ll likely be disappointed. You should probably expect to notice a difference by the end of the first year of sobriety, and then again at five years. In the meantime, you just have to commit to the process.

Comparing Your Progress to Others

It’s normal to want to know how your recovery is progressing, but comparing your progress to others is counterproductive. First and foremost, these comparisons are never accurate. Everyone in recovery is facing different challenges and you only know what others allow you to know. Also, recovery is a cooperative effort. Everyone benefits when they support each other, but making comparisons turns it into a competition. It’s hard to celebrate other people’s successes when you feel like they come at your expense.

There’s plenty of sobriety to go around. Finally, something about the act of comparison itself makes you less happy. It’s far better to judge your progress based on your own goals and values, as well as whether you did better today than yesterday.

Dating Too Soon

Most experts typically recommend that you have a solid year of recovery before you think about dating again. This can be challenging, since substance use issues typically first appear in early adulthood, when people are dating most actively. However, there are good reasons to hold off. First, it distracts from recovery.

Dating can be stressful and time consuming, and if you meet someone you like, you are likely to prioritize that person over recovery. That may be fine as long as things are going well, but it can be a huge liability if the relationship starts having problems. What’s more, people often fall back into unhealthy relationship patterns if they start dating again too soon. A year seems like a long time, but it’s really not.

Thinking You’re Cured

It’s easy to get complacent after a while if recovery seems to be going well. You might start to cut corners like skipping meetings or neglecting other parts of your recovery plan. You might even start to think it would be ok to have a drink every once in a while.

This is much like when people stop taking their medication for a mental health issue because they feel good. You feel good because you’re taking care of yourself, so it’s important to keep doing what you’re doing. Addiction is a chronic condition, and you’ve got to stick with your recovery plan.

Drinking

If you’re recovering from alcohol use disorder, drinking is an obvious blunder, but many people in recovery don’t see alcohol as a serious problem. They may have issues with cocaine or opioids and see alcohol as more or less incidental. However, alcohol is often a powerful trigger, since most people combine drugs and alcohol. Not only that, alcohol impairs your judgment and self-control, making you more vulnerable to relapse. If you’re recovering from a drug use disorder, it’s important to stay away from alcohol, too.

Hanging Out With the Same People

We are all more vulnerable to peer pressure than we like to think. Even if your friends who drink and use drugs don’t pressure you to use, just being in that environment can trigger cravings and make it easier to relapse. People often struggle with loneliness early in recovery, which is why they hang out with old friends when they know they shouldn’t. The important thing is to create a sober network as soon as possible. Typically, attending regular 12-Step meetings is a good place to start.

Thinking Recovery Ends With Treatment

Finally, a lot of people assume that they can go into a treatment program, have their addiction problem fixed, and not have to worry about it too much after that. In reality, addiction is a chronic condition, and it takes about a year for your relapse risk to fall to 50 percent, on average. It’s especially important that you make a smooth transition from treatment back to normal life, perhaps by stepping down to an intensive outpatient program after you finish inpatient treatment, or by spending some time in a sober living environment. A strong recovery is really about changing your approach to life and not just about abstaining from drugs and alcohol.

Recovery from addiction is hard and everyone makes mistakes. The good news is that mistakes, even serious mistakes and relapses, don’t have to be final. You can learn from your mistakes and try again. At The Foundry, we use a variety of modalities to help our clients address co-occurring issues and make lasting change. For more information about our treatment programs, call us today at (844) 955-1066 or explore our website.

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