Wednesday, June 13, 2018

What Is a Functioning Alcoholic?

One of the hardest things to accept about an alcohol use disorder (AUD) is how everything can appear "normal" and someone can still have a serious problem.

After all, drinking is both legal and socially acceptable. People enjoy wine tours, craft beer festivals, and liquor pairings with gourmet appetizers. We pop a bottle of champagne to celebrate new babies, promotions, and other momentous occasions. Alcohol is a booming industry in the United States, generating approximately 210 billion dollars in sales annually.

For someone struggling with addiction, appearances are often deceiving. Just because a person isn't drunk all the time or doesn't experience the stereotypical life challenges of an addict doesn't mean his or her condition is less real. In a world where many people openly drink without any problems, a functioning alcoholic walks a delicate high wire.

Myths About High-Functioning Alcoholism

According to 2015 statistics from the National Institute on Alcohol and Alcohol Abuse, an estimated 15 million adults over 18 had AUD.

There are many myths about addiction that often make it difficult for people to release stigmas regarding substance abuse or AUD. These myths pose challenges for someone needing rehabilitation treatment or ongoing recovery support from family and friends.

Conversely, when someone seems to be functioning well based on society's perceptions, there may be a shadow hiding the real truth.

  • An individual working a "good" job can't be an alcoholic. A dentist who drinks vodka in his water bottle while seeing patients, a restaurateur who has nightly post-shift drinks with staff members, or a company executive who frequently treats clients to a "liquid lunch" are more common than most people believe. Alcoholism isn't limited to a particular segment of class or economic structure.
  • He or she is a loving and attentive parent/partner. This may be accurate. After all, not every person is angry, depressed, or obnoxious while drinking. Some people become more relaxed and less reactionary. Personality changes often depend on the type of alcohol, the number of drinks, and the duration of abuse.
  • Alcohol isn't a drug. The psychoactive effects of alcohol begin with just 0.05 percent of blood alcohol content—usually one or two drinks for the average adult. Once alcohol is in the bloodstream, it affects specific areas of the brain that react to chemical modification, such as the pleasure center and the amygdala. Over time, alcohol is the only substance that can stimulate these areas—an artificial enhancement characteristic of physical, behavioral, and psychological addiction.
  • He or she never has a hangover. When a chemical is introduced to the body on a regular basis, a strong tolerance develops. This can prevent the development of hangover like a casual drinker would experience. 
  • There aren't any problems, so there's no reason to drink. Here again, stereotypes fuel certain myths. Remember: some people drink to celebrate special occasions as much as others might drown their proverbial sorrows.
To dispel these and other myths, the National Institutes of Health identifies people in the high-functioning subtype this way:

  • They often have a stable job and supportive family.
  • They are usually middle-aged.
  • They hold an advanced level of education.
  • They often have an individual history of depression or anxiety.
  • They also may have a family history of addiction, whether alcoholism or substance abuse.

Functioning Alcoholism Warning Signs

No one wants to be the judge or jury of a friend or loved one. However, recognizing when someone may be in crisis and need help is a vital first assessment to further action.

Perhaps you've noticed a pattern of behavior for years. Maybe certain things, such as financial management or personal care habits, are starting to slip. Here are other critical symptoms of AUD apparent in many high-functioning individuals:

  • Quantity. WebMD classifies heavy drinking as more than three drinks daily or seven weekly for women. For men, heavy drinking is four drinks daily or 14 per week.
  • Habit. Someone suffering from AUD may drink alone, in the morning, during the workday, or when others aren't imbibing.
  • Denial. When someone doesn't see AUD for what it is, he or she may lie about consumption, or justify it as "no big deal" to have a beer or two each night after work. He or she may also get angry when asked about drinking, hide alcohol to avoid detection, or make excuses for drinking-related behavior.
  • Choice. If a friend or loved one chooses to drink instead of eat, socialize, or care for himself, AUD is likely the cause.
  • Jokes. Some people may suspect they have a drinking problem but because of fear or denial, simply joke about it or pass it off in other nonchalant ways.
  • Health. If you notice a friend or loved one's health declining, or spot key symptoms of drunkenness for the first time such as slurred speech, impaired mobility, and cognitive or behavioral changes, it might be time to speak up.
  • Problems. These vary considerably based on the individual. Relatable complications include a DUI offense, blackouts, loss of relationships due to drinking but continuing to do so, or shirking responsibilities.

What to Do

Although it may be a difficult conversation, there's no point in waiting to address someone's drinking problem if you feel it jeopardizes his or her health or compromises the safety of others. MedlinePlus has a guide to help you know how and when to talk with a medical professional and steps you can take to start the process with your friend or loved one.

Also, please review our site more thoroughly for additional resources. Our blog and services pages provide in-depth information to help you understand addiction and what options are available for healing.

By Tracey L. Kelley

Thursday, June 7, 2018

Adapting to a Healthy Diet During Recovery

Healthy diet

We all function at our best when we eat fresh, whole foods. The body is an intricate machine and the mind a complex computer. Junk food, substance use, dehydration, and other harmful practices contaminate our systems, creating malfunctions.

Poor eating habits and lack of physical exercise have a cumulative effect. In fact, the Office of Disease Prevention and Health Promotion (ODPHP) released statistics in its 2015-2020 Dietary Guidelines that indicated half of adult Americans—approximately 117 million people—have one or more preventable, chronic conditions related to physical inactivity and substandard diets. Some of these diseases include type 2 diabetes, cardiovascular problems, obesity, high blood pressure, and certain cancers.

When someone is addicted to drugs or alcohol, proper nutrition isn't part of daily life. Reasons often include:

  • A constant cycle of use and abuse doesn't allow time for grocery shopping and preparing quality meals.
  • Mental health issues may compound substance use and reduce healthy habits.
  • Drugs or alcohol can cause increasing depletion of vitamins and minerals.
  • Certain addictive substances often reduce appetite when they are abused.

The Substance Abuse and Mental Health Services Administration (SAMHSA) acknowledges that people suffering with addiction also struggle with many of the chronic conditions outlined by the ODPHP. To help draw attention to this health crisis and what to do about it, SAMHSA hosts a National Wellness Week every year during the third week of September, and created the Program to Achieve Wellness to help people with substance use disorders learn wellness best practices.

Make the Shift Slowly

As people learn in recovery, healing doesn't happen overnight. As frustrating as this might be sometimes, it also helps body and mind stabilize after months or even years of abuse.

It's easy to think that suddenly dropping French fries and ice cream from the menu and replacing them with salads and a lot of water wouldn't be a big deal. Surprisingly, there's also a subtle detox that needs to happen from junk food before adapting to a healthy diet.

Anyone can go through a simple carb, sugar, caffeine, and fat withdrawal. Just as with other chemical substances, a high intake of these properties artificially enhances the brain's pleasure center and increases levels of the stress hormone corticosterone.

Studies purport people suffer symptoms such as:

  • Depression
  • Anxiety
  • Jitteriness
  • Headaches
  • Lethargy
  • Anger
  • Sadness
  • Disorientation

Some symptoms may last only a few days, but others can linger for weeks. And similar to substance abuse withdrawal, individuals may have to learn how to manage cravings for certain foods and beverages until vitamins and minerals from whole foods repair their systems.

Step-by-Step Approach to a Healthy Diet

By slowly changing habits, you'll find you eventually feel fit and alert on a new diet, and manage your recovery more effectively. Here are some ways to build a new path of wellness:

Step 1: Drink more water. This is one of the easiest changes you can implement almost immediately. When you're hydrated, your body performs better, you improve brain function, and you may even be a bit happier. Try to drink an average of 7–12 glasses a day.

Step 2: Cut out sugar. This is a big deal. Sugar is its own type of addiction, and creates similar neurological differences as illicit substances. Major studies conclude that if there's one primary change we can make for a healthier diet, it's to reduce sugar as much as possible. Start by paying attention to foods and condiments—sometimes the sugar content per serving in two tablespoons of ketchup is as high as a can of soda! Then move on modifying what you add to beverages or prepared foods.

Step 3: Adjust your pH. Your body tries to maintain a neutral pH level. A higher pH indicates greater alkaline properties; a lower pH reflects greater acidic properties. Substance abuse, along with too much sugar, fat, and caffeine, contributes to high acidity. You want your pH to be neutral to alkaline overall. By introducing more fruits and vegetables to your meals, drinking more water, and maintaining regular meal times for good digestion, you can start to normalize your pH.

Step 4: Focus on nutrition density, portion sizes, and variety. ODPHP offers guidelines for shifting awareness to more wholesome nutrition. For example, a fresh apple is better for you than a cup of canned applesauce, because the fruit provides more fiber and has fewer calories. When deciding on portions, use the handy serving size card from the National Heart, Lung, and Blood Institute. And remember to make meal time more enticing by trying new things and rotating through the vast selection of produce, protein options, and whole grains.

Step 5: Create a healthy eating plan. Sometimes it's important to simply see it all on paper. Many nutritionists recommend keeping a food diary for two weeks to track every meal and snack so you have a clear picture of what works and what should change. Then, create a healthy eating plan to determine what each meal contains, recipes for what you like most, an allowance for special treats, and ways you can prep ingredients ahead of time.

Cottonwood Helps the Whole Person, Not Just the Addiction

Rediscovering wellness is, as is often said, an inside job. The professionals at Cottonwood Tucson drug rehabilitation use nutrition as a primary component of addiction detox, along with counseling, individualized medication protocol, and holistic practices such as Tai Chi, yoga, and meditation.

During the medically-managed detox phase, residents replace toxic chemicals with a specialized diet and hydration plan. This helps ease physical discomfort and support healing. Our facility is also proud to offer residents a scrumptious daily menu designed with complete nutrition in mind. Contact us today to learn more.

By Tracey L. Kelley

Tuesday, May 22, 2018

Why EMDR Helps Recovery

Man in therapy
For many people, addiction is a co-occurring disorder with mental health issues. These conditions range from anxiety and depression to childhood trauma and PTSD.

Too often, the severity of the underlying issue prompts a greater likelihood that other disorders will present. For example, if someone was sexually abused, he or she may also have depression, social anxiety, and panic attacks. This is why substance abuse is a common self-medicating behavior to deal with the symptoms and triggers of such conditions.

Your brain has incredible resilience to handle traumatic experiences, but certain circumstances such as abuse, assault, rape, and war may overwhelm its coping capacity. Some people, according to Psychology Today, develop the ability to be more "stress resilient" over a lifetime, while others don't. The reasons for this variance are multi-faceted, and researchers continue to be fascinated by the possibilities of not only understanding resilience, but also helping the brain recover.

One possible approach for stress, trauma, and addiction recovery is Eye Movement Desensitization and Reprocessing (EMDR).

What Is EMDR?

EMDR is a psychotherapy treatment developed in 1989 by Francine Shapiro, Ph.D, an American psychologist interested in more effective techniques for addressing PTSD. She noticed a correlation between eye movements and thought patterns. She believed the body's natural physical healing processes could be applied to the brain's replay of painful experiences and memories.

Over time, trauma and chronic stress may decrease neuronal connections in the brain. For example, if you cut your finger, your body works to heal the wound. This process is usually effective unless there's a foreign object embedded in the cut. If the object isn't removed, the body is unable to repair the wound. When someone is traumatized by a situation or event, the mind replays the experience through painful dreams and flashbacks—the foreign objects preventing healing.

Research has shown an association between PTSD and functional changes in the amygdala, a part of the brain involved in the formation of emotional memories, especially fear-related memories.

Using a combination of eye and hand movements, as well as audio stimulation, patients in EMDR therapy re-engage with the trauma and essentially reprogram the brain to acknowledge, accept, and finally resolve those experiences. Much more quickly, many proponents say, than traditional talk therapy sessions might ever complete. There are numerous positive results, according to the EMDR Institute:

  • A study funded by health system Kaiser Permanente discovered that "77 percent of multi-trauma victims and 100 percent of single-trauma victims were no longer diagnosed with PTSD after only six 50-minute sessions."
  • Other studies indicate up to "90 percent of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions."
  • Another study of combat veterans determined that "77 percent of them were free of PTSD after 12 sessions."

Due to this and other qualitative research, the Department of Defense, the World Health Organization, and the American Psychiatric Association are some of the organizations that recommend EMDR as effective trauma, depression, and anxiety treatment. Mental health professionals trained and certified in EMDR conduct approximately eight phases of treatment ranging from history and treatment planning to closure and evaluation. The process may also include learning new coping mechanisms.

How EMDR May Help Break the Addiction Cycle

Addiction is often associated with environmental factors and trauma, especially in early development years. This exposure at a young age establishes certain thought patterns and behaviors. While one person may experience trauma and not be affected, another individual may choose to cope with the circumstances with drugs or alcohol.

Again, aspects of brain resilience, environment, genetics, social network, and other factors play a large part in someone's mental health and the propensity for substance use disorder (SUD).

In cases where trauma is a root cause for mental health disturbances and SUD, EMDR therapy provides the opportunity to focus on this catalyst, resolve it, and move into more effective treatment and behavioral modifications. This may enable someone to embrace sobriety with clear confidence and reduce the risks for relapse.

How We Use EMDR for Progressive Treatment

At Cottonwood Tucson, we offer EMDR treatment in individual and companion trauma interventions for residents with PTSD and trauma issues in order to reduce distress, build skills, and develop stronger resources for healing. It's another component in our overall approach to help people heal emotionally, physically, mentally, and spiritually.

By Tracey L. Kelley

Wednesday, May 9, 2018

Helping a Loved One with Binge Eating Disorder

It's often difficult to determine if a loved one has a problem with binge eating. You may feel you're comparing someone's behavior to your own, passing judgement, or being critical.

Binge eating disorder (BED) has key signals that help make it easier to determine if you should be concerned. If there's a problem, it's treatable, especially with caring methods such as interpersonal therapy and cognitive behavioral therapy.

Understanding BED

Binge eating is the most common eating disorder. When a person has recurrent episodes of this behavior, the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) characterizes it as:
  • "Eating, in a discrete period of time (within any two-hour period) an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances."
  • "A sense of lack of control over eating during the episode—a feeling that one cannot stop eating or control how much one is eating."
BED is often associated with:
  • Serious trauma
  • Childhood and adult obesity
  • Anxiety
  • Depression
These co-occurring disorders often contribute to loneliness, worry about body image and weight, and low self-esteem—possible causes of binge eating. Other potential factors may be exposure to a relative's particular eating patterns and genetic or environmental contributors.

Interestingly, many people who are obese don't have BED. However, of those diagnosed with BED, nearly two-thirds also have clinical obesity.

BED episodes may have three or more of the following behaviors:
  • Consuming large quantities of food even when not hungry
  • Eating more rapidly than usual
  • Ignoring feelings of fullness or satiety
  • Feeling guilty, depressed, or disgusted afterward
  • Eating alone due to embarrassment about the amount of food eaten
A professional may also look for signs such as someone feeling distress over the behavior or how long it's been happening. People suffering from BED usually have a recurrence at least weekly for three months or longer. Additionally, while binging is often associated with other conditions such as anorexia nervosa or bulimia nervosa, someone may have BED and not these other conditions.

Once binging behavior becomes a pattern, it's a compulsion that's hard to control—just like drug or alcohol abuse. The pattern over stimulates the brain's reward center.

Although eating disorders are often associated with women, the numbers aren't as skewed as you might think. Roughly 3.5 percent of women and 2 percent of men suffer from BED.

BED Warning Signs to Note

The National Eating Disorders Association (NEDA) outlines the significant warning signs that help you determine if someone you care about has a problem with binge eating.

  • Frequent digestive distress such as constipation, stomach cramps, and acid reflux
  • Noticeable weight fluctuations
  • Trouble concentrating
  • Feelings of low self-esteem or a lack of self-worth
  • Noticeable depression, disgust, or guilt after overeating
  • Fear of eating with others or in public
  • Withdrawal from normal activities and usual friends
  • Extreme concern over or a distorted view of shape or weight
  • Hoarding or stealing food
  • Frequent dieting or following fad diets
  • Secret, recurring episodes of binging
  • Eating too quickly at each meal
  • Developing unusual food rituals, such as not allowing foods on the plate to touch, chewing too much, or eating only a particular type of food

How to Talk to Your Loved One

If you have reason to be concerned, it's important to speak up. Yes, it might not be a pleasant conversation at first, but it's a step in the right direction toward a more healthy life. offers a number of tips for how to—and how not to—talk with your loved one about a possible binge eating disorder.

  • Choose a time that's best for both of you without distractions or limitations. Make sure the conversation is on a calm day in a quiet place.
  • Use "I" statements and caring language. Explain why you're concerned by using factual examples and ask how you can help. An "I" statement is something like, "I've noticed that eating with the family is more difficult for you lately, and you seem really down. I'd like to know how I can help."
  • Be supportive. You're just now opening a line of communication. Even if your loved one is initially resistant or in denial, remain respectful and calm.
  • Fight fire with fire. With what you’ve learned so far about BED, you now understand your loved one may be struggling with a lot of conflicts. Arguing, shaming, blaming, or criticizing weight or appearance may make the situation worse.
  • Oversimplify. Not everyone responds to "Just get over it!" or "Accept yourself for who you are." Recognized that BED is a complicated condition that can't be wished away with platitudes.
  • Extend ultimatums. If you have a minor child, you may have more control over whether he or she seeks treatment. Otherwise, you can't force someone to do it your way. They have to believe they have options for wellness.

Seeking Help for Binge Eating Disorder

NEDA stresses the importance of a proper DSM diagnosis of BED so insurance companies may assist with treatment. This assistance removes any barriers to choosing the proper care providers to improve quality of life.

At Cottonwood Tucson, we specialize in treating BED through a comprehensive program that includes nutritional, physical, and exercise evaluations. We provide a variety of clinical techniques designed to help your loved one change his or her relationship to food from addictive to healthy. Our treatment continuance of care plan may also include holistic modalities to support recovery and healing from within.

By Tracey L. Kelley

Wednesday, April 25, 2018

Debunking the 6 Top Myths About Addiction

People struggling with drug or alcohol addiction not only have to face the consequences of their actions, but also the social stigma surrounding their disease. The myths associated with addiction contribute greatly to the reasons why people may not seek effective medical treatment. If you or someone you love suffer from addiction, learn why the myths exist and how to enable better wellness with knowledge about this disease.

Myth #1: Willpower Is All You Need to "Get Over It"
Willpower is an aspect of self-control that helps us in numerous ways. When you resist the temptation to scroll through social media in order to finish work on time or choose a healthy salad instead of a fast food burger, this is a small example of willpower in action.

The American Psychological Association offers extensive research about willpower and why it's important for us to understand. On one hand, we can all improve our ability to control impulsive actions. On the other hand, a consistent barrage of challenges depletes willpower. Some studies indicate this depletion causes drops in glucose levels and changes to brain function, which affects self-control.

Yes, the initial choice to use illicit substances or drink to excess may be a slip in willpower. However, research also supports addition as a brain disease. Drugs and alcohol negatively impact the brain's neurological structure and how it works. These physiological damages compromise a person's ability to maintain self-control. 

Continued substance use will only further damage cognitive function, even if his or her actions have disastrous consequences in daily life. The American Society of Addiction Medicine (ASAM) indicates that "dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations."

Once people have proper detoxification and treatment, they can utilize techniques that boost self-control and develop greater awareness of triggers that erode willpower. 

Myth #2: Addiction Is a Moral Failing
Another constant challenge to drug and alcohol rehabilitation is the notion that addiction is somehow a moral failing. For example, someone might suggest that an addict would be able to stay sober if he or she only had a stronger demonstration of faith or didn't associate with the wrong crowd.

While it's true that spirituality can be of great support, addiction isn't a form of punishment for not believing the right way. And, it's important to acknowledge that while environmental influences, including associations with people or places, may contribute to an individual's addictive behavior, there are often deeper factors at work that result in the chemical dependency. Co-occurring psychiatric disorders, trauma, and genetic predisposition may also be underlying catalysts for addiction.

Some people can use substances and never suffer from addiction. And, throughout the United States, partaking of alcohol or marijuana isn't against the law and, thus, not against a moral 

The conscious intent of someone using alcohol or drugs, even prescription drugs, isn't to become addicted. But, as neurological changes occur with continued use, a "motivational disturbance" happens. This doesn't mean someone is weak or lacking character. It indicates that addictive behavior, driven by a brain chemical shift, will:
  • Prompt greater compulsive need
  • Trigger response reward
  • Inhibit normal decision-making ability
This same type of brain-altered compulsivity presents in other forms of addiction, such as eating disorders, gaming, sexual excessiveness, and gambling.

Myth #3: Once You're Addicted, You'll Always Be Addicted
ASAM clarifies that as society continues to understand what really happens to someone with an addiction, it's apparent that good people can do bad things. This doesn't mean they always will, but myths like this linger.

Addiction may not be curable, but it's absolutely treatable. Treatment enacted by qualified professionals is designed to help people regain whole body wellness.

Depending on the contributing factors and the state of the condition, recovery may require some effort. However, with proper treatment and support, an individual is ready to take personal responsibility for managing their illness for the long term. This creates a path of success.  

Myth #4: Rehab Doesn't Work
At some point, individuals with addictive tendencies need to realize that while they may not be responsible for their disease, they are in control of their recovery. This doesn't happen in a vacuum.

First, the safe environment of a rehabilitation center provides the security and personnel necessary to deal with the physical, emotional, and mental challenges associated with recovery.

Second, a holistic facility that treats the individual, not just the condition, provides effective treatment. A specialized program is crucial to address individual medical needs and includes identifying contributing factors. This dual approach helps someone make qualitative changes in wellness in order to establish control; utilize new techniques for managing behavior and overcoming challenges; and create a life of purpose and value.

Myth #5: A Relapse Means There Is No Hope
A relapse doesn't mean rehab failed, a person is a failure, or he or she will always be addicted. The National Institute on Drug Abuse indicates that approximately 40 to 60 percent of people experience a relapse. If this happens, treatment modifications are required to help an individual advance to a more stable state of being. Qualified health professionals recognize that a relapse can be debilitating to someone's spirit, but they have the resources necessary to help him or her progress beyond it.  

Myth #6: A Support System Isn't Necessary
Another myth associated with rehabilitation is the support of family and friends doesn't matter. Again, addiction recovery requires compassion, understanding, and knowledge. A strong network constructed of people who don't believe the myths and instead, believe in the individual, is critical to recovery. This network may start in a treatment facility, then extend into the real world post-rehab.

In addition, choosing a facility such as Cottonwood Tucson with a strong family program enables everyone to learn, change, and grow. This fosters a community focused on essential healing and establishes a journey of complete wellness.

By Tracey L. Kelley

CARF - Commission on Accreditation of Rehabilitation FacilitiesNATSAP | National Association of Therapeutic Schools and ProgramsNBCCNAADAC