THRIVE Substance Abuse Toolkit

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Substance use and mental well-being Click the circles below to learn more.

Opioids

Alcohol Stimulants Sedatives

Struggling with substance use? • Talk to your primary care physician • Call My Life Resources (EAP): • U.S.: 1.800.327.0795 • Outside the U.S.: Country-specific phone numbers • Reach out to a family member or friend 1


Opioid overuse is a worldwide epidemic. In the United States specifically, opioid overdose deaths have quadrupled since 1999.1 Overdose rates are highest among those ages 25 to 45.2

Opioids

Although opioids are typically prescribed for pain, they are frequently used to self-medicate for symptoms of anxiety, which is considered using prescriptions “non-medically,” or not as prescribed. Even when used properly, many people find the effect so pleasing that it becomes easier to take the substance recreationally. Studies have shown that long-term misuse of opioids is linked to a higher risk of depression which can result in feelings of hopelessness, despair and guilt.

Opioids lower the number of pain signals your body sends to your brain, slows breathing and reduces immune response. Indicators of opioid abuse include developing an increased tolerance, having multiple prescriptions from different providers or refilling prescriptions early. There is always a risk of addiction when taking one of the below opioids. If you are prescribed an opioid for pain related to an injury or illness, communicate with your provider about any concerns, take the medication as prescribed and be aware of how the medication affects you over time.

Prescription* opioids:

Illicit opioids:

• • • • • • •

• Heroin (use often begins after prescription painkiller use)

Fentanyl (Duragesic) Oxycodone (Oxycontin, OxyIR) Codeine (Tylenol 3) Hydrocodone (Vicodin, Norco) Morphine (Kadian) Meperidine (Demerol) Hydromorphone (Dilaudid)

*If you are misusing a prescription, it is considered an illicit use of a medication. 1 2

https://www.cdc.gov/drugoverdose/epidemic/index.html http://www.hazeldenbettyford.org/advocacy/opioid-data

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Alcohol

Alcohol is a commonly used and abused substance that is socially accepted and often promoted. Acting as a central nervous system depressant, alcohol affects every organ in the body. Every person experiences the effects of alcohol differently due to multiple factors such as age, sex, race, family history, health, etc. While alcohol is often used to alleviate feelings of stress and anxiety, the rebound effects during withdrawal can actually increase these feelings. Use can interfere with mood stability and increase feelings of depression. If you feel you have a problem with alcohol, please seek professional help. Detoxification from alcohol can be fatal and should be closely monitored by a health care professional. A person may experience convulsions, seizures, hypertension or heart failure.

Understanding alcohol abuse versus dependence3,4: Alcohol abuse is drinking too much, too often. The pattern can lead to inability to fulfill responsibilities at home, work, and other areas of life and may cause a person to also put themselves at risk related to drinking behaviors. Alcohol dependence is the inability to quit drinking alcohol, including an increased tolerance (the need to drink more to get the same impact), potential withdraw symptoms, loss of control related to drinking. With dependence a person may have repeated unsuccessful attempts to quit, compulsions around drinking behaviors, and engagement in risky drinking behaviors no matter what the consequences. This may also be called alcoholism or alcohol use disorder. Alcohol has both short and long-term health risks. Short-term risks include injuries, alcohol poisoning and risky behavior. Long-term effects include heart disease, stroke, liver disease, increased risk for cancer, memory impairment, dementia and mental health problems including depression and anxiety.

Moderate drinking recommendations: • 1 drink per day for women • 2 drinks per day for men

Binge drinking is the most common, costly and deadly form of alcohol misuse, and is defined as the following: • Women who consume 4+ drinks in 2 hours • Men who consume 5+ drinks in 2 hours

The above recommendations for moderate and binge drinking are per the Centers for Disease Control (CDC). 3 4

http://www.hazeldenbettyford.org/articles/what-is-the-difference-between-alcohol-abuse-and-dependence https://www.ncbi.nlm.nih.gov/books/NBK44358/

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Stimulants

Stimulants increase your alertness and awareness. They can often be unknowingly abused when people are sleep-deprived or wanting to increase productivity. Stimulants can raise blood pressure, heartrate and breathing rate. They can also lead to irregular heartrate, heart failure, or seizures, while increasing hostility, paranoia and psychosis.

During the withdrawal from stimulants, many people will report feelings of depression (which some report to steadily increase), occasional suicidal ideation, feelings of paranoia, and, in some cases, hallucinations.

Sedatives

Sedatives are taken to promote calm and induce sleep. Often taken for their tranquilizing effect, sedatives reduce and relieve anxiety, stress, tension and irritability. Long-term use and abuse has been linked to increased symptoms of depressed mood, impaired perception of space and time, slowed thinking and slurred speech. Overuse, followed by a discontinuation, can cause racing thoughts and possible seizures.

Withdrawal from sedatives often results in feelings of anxiety, but can be quite dangerous if an individual attempts to quit without medical supervision.

Non-illicit stimulants: • • • • • •

Adderall Ritalin Caffeine Ephedrine Nicotine Pseudoephedrine

Illicit stimulants: • Methamphetamine • Ecstasy • Cocaine

Prescription sedatives: • • • • • •

Xanax Klonopin Valium Haldol Ativan Sleep medications (Ambien, Halcion, Lunesta)

Non-prescriptive sedatives: • Benadryl • Dramamine • Marijuana

If you think you are overusing/abusing any of these medications, please speak with a professional health care provider to determine if you need medically-supervised detoxification. A sudden stop after overuse of sedatives can be dangerous and even life-threatening.

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Signs of dependence, addiction or misuse • Do you take a prescribed substance for longer or in larger amounts than your prescription? • Have you tried to cut back your use unsuccessfully? • Do you spend a lot of time using, obtaining or recovering from the substance? • Do you experience cravings to use the substance? • Does the substance use interfere with work, school or home life? • Do you continue using even though the substance causes problems in relationships? • Do you use the substance in situations where it is physically hazardous to do so? • Do you need an increasing amount of the substance to create the desired effect?

Struggling with substance use? • Talk to your primary care physician • Call My Life Resources (EAP): • U.S.: 1.800.327.0795 • Outside the U.S.: Country-specific phone numbers • Reach out to a family member or friend 5


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