Tuesday, February 12, 2019

What Is Binge Drinking?

It's easy to think we'll simply bounce back after a lot of water and a good night's sleep. But what's the dividing line between having a little too much alcohol and actually binge drinking?

About Binge Drinking
The definition of binge drinking is consuming excessive quantities of alcohol in a short period of time—roughly two hours—at least one day per month. The amount varies between men and women: five or more drinks in a single session for men, and four or more drinks in a single session for women.

Binge drinking is typically associated with a younger demographic, and with good reason. The Foundation for a Drug-Free World reports that in the U.S., youth under 21 who drink alcohol binge approximately 90 percent of it.

However, there's a steady increase of adults who binge drink, with some statistics indicating one in six adults binge "frequently and with high intensity"—usually once a week. In fact, USA Today shared data from 2006–2014 regarding ER visits that pointed to a spike among middle-aged women admitted for "complications due to excessive alcohol consumption either from accidental binging, or intentional long-term use." And according to AARP, among the 65,000 respondents over age 60 to a National Health Review study noted about 13 percent were binge drinkers.


Which leads to another point: why do people do it?
In the National Health Review senior study, results revealed nearly three times as many older men than women binged, predominantly as a result of a lifelong alcohol problem. But senior women tend to develop a habit of binge drinking as a coping mechanism to deal with depression, grief, and mounting health issues. Middle-aged adults may overindulge as a form of escapism, especially from feelings of anxiety, depression, anger, or guilt. They also might not believe there's a problem, since their lives appear to be going so well.

Younger people have a desire to fit in and not feel awkward or anxious in social situations, and are often unaware of the effects of excessive drinking. They may also use what they view as "adult behavior" as a way to test boundaries.


The Health Consequences of Binging
Overconsumption of anything is never healthy, but high amounts of alcohol have both short- and long-term effects.

In the short term, the effects of binge drinking feel like a typical hangover, with many of the symptoms mentioned above. Temporary memory loss is also a common result of a "bender." But if somebody doesn't drink often and consumes too much alcohol at once, they run the risk of alcohol poisoning, which is quite severe and even deadly.

Symptoms may include:

  • Confusion
  • Slow or irregular breathing
  • Vomiting
  • Seizures
  • Hypothermia
  • Unconsciousness

Over the long term, chronic health conditions emerge, such as:

  • Addiction
  • Hypertension
  • Heart complications
  • Mental illnesses such as depression, anxiety, and paranoia
  •  Severe blackouts, as well as extensive and permanent memory loss
  • Liver damage, including cirrhosis
  • Brain damage, including dementia
  • Cancer

If somebody develops these conditions but continues to drink excessively, it's unlikely they'll regain their health. System failure is the likely result. 


Assess Your Risk
It's easy for people to initially think, "I really don't drink that often. Just some beers after work, or a few glasses of wine during the week." But there can be vast differences between the standard servings of alcohol—5 oz. for wine, 1.25 oz. of liquor, and 12 oz. for beer—compared to the actual servings someone might consume.

So, if you believe you or someone you love might have a problem with binging, take a few minutes to answer these questions:


  1. Do you feel the need to hide how much you drink because of shame or guilt?
  2. Do people make observations about how much you imbibe?
  3. Are there days when you have four or more alcoholic beverages?
  4. Is it a surprise when you realize just how much you've had to drink?
  5. Have you ever shrugged off responsibilities in order to drink?
  6. Do you frequently drink a lot at social functions?
  7. Have you ever thought that maybe it's time to cut down or stop drinking?

Even a couple of "yes" responses may indicate it's time to take a closer look at this behavior.

One way to do this is to complete a more detailed self-assessment than the one above. For example, Facing Addiction With NCADD provides a comprehensive questionnaire to help you evaluate your alcohol consumption. WebMD also offers a short screening regarding alcohol use disorder and suggestions for how to talk to a health professional. Drug Abuse.gov shares the AUDIT used by many health professionals during evaluations of binge drinking or alcohol abuse, which you can access online.


The Cottonwood Assessment Program
Maybe your self-assessments reveal that you've really only overindulged a time or two in the past few years. Occasionally, we may be overcome by the effects of alcohol, and often know how to rein in that behavior because it made us feel horrible.

However, if you noticed a pattern of binging, it could be time to let professionals ensure your good health. The Cottonwood Assessment Program (CAP) is a four-day intensive evaluation to determine your specific needs. This extensive approach identifies a number of physical and mental health factors. Here's what you should know.


 By Tracey L. Kelley

Tuesday, January 22, 2019

Choosing a Treatment Center for Your Recovery Journey



Seeking treatment for substance abuse or behavioral disorders is a brave decision. Whether you or a loved one needs care, there are some ways to be certain you're selecting the right facility.

Integrated Approach

Working with professionals who have a philosophy of care that includes treating the whole person, not just a disorder or disease, creates an atmosphere of true, lifelong healing. The staff members at Cottonwood Tucson believe your wellness depends on full integration of physical, mental, emotional, and spiritual connectedness. This philosophy may already align with your core beliefs and desire to create a new life.

Drug or alcohol abuse not only affects the body, but also the mind and the spirit. Behavioral health issues, such as co-occurring disorders, mood disorders, and binge eating, may be rooted in trauma or grief. In the recovery process, it's not enough to simply remove someone from an unhealthy environment. It's important to address how each individual can heal from within.

Often referred to as holistic treatment, this approach allows you to create your own reality. You have the ability to consider sobriety and other aspects of recovery as an extension of a decision to deliberately foster health and wellness. Our individualized treatment methods help you acquire tools and techniques that inspire complete care for life. It includes:
  • Medical management
  • Evidence-based treatment
  • 12-Step concepts
  • Experiential, individual, group, and family therapy
  • Nutrition counseling
  • Eye Movement Desensitization and Reprocessing
  • Mind-body and trauma therapy
  • Equine-assisted therapy

With these and other applications, you have the opportunity not to fix what's broken, but reveal what's good and whole.


Qualified Personnel

There are aspects of recovery that, when unknown, may seem frightening at first. For example, someone seeking treatment for substance abuse may not understand what happens during detoxification. An individual suffering from traumatic experiences might have trouble trusting people outside of normal circles.

As you evaluate treatment centers, learn more about the staff. This collective of addiction professionals and clinical personnel will be instrumental in helping you regain wellness. They'll guide your path to recovery for a month, two months, or even longer. You have a right to be treated with dignity, respect, and kindness; and should expect privacy and confidentiality regarding all aspects of your care.

The members of our interdisciplinary clinical team include an extensive list of professionals:
  • Board-certified psychiatrists and addictionologists
  • Clinicians and nurses
  • Psychiatric nurse practitioners
  • Clinical psychologists
  • Licensed professional counselors, social workers, and mental health workers
  • Marriage and family therapists
  • Registered dieticians
  • Acupuncturists and massage therapists
  • Exercise and recreational counselors
  • Equine therapists
  • Spiritual guides

This team ensures each resident receives caring and personalized comprehensive behavioral health care.

Cottonwood Tucson is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). Our accreditations are in detoxification and inpatient treatment for adults. CARF is a non-profit organization that establishes standards of quality for organizations, and uses them to determine how well an organization serves its clients.


The Cottonwood Assessment Program (CAP)

If you or someone you love simply can't comprehend the depth of treatment required in the 
moment, finding a facility that can personally assess your specific needs before entering rehabilitation may help.

For example, Cottonwood Tucson has a four-day intensive inpatient program that assesses addiction and/or mental health threats and issues. The CAP is designed to personally address:
  • Cases of differing and potentially complex diagnoses
  • Individuals with mental health issues or substance disorders who aren't progressing in therapy
  • Persons who experienced an intervention and may be open to receiving a comprehensive evaluation, without the intention of committing to a full inpatient residency
  • People who would like a second opinion to a previous diagnosis
  • Individuals who require a supportive and gentle yet firm process to move past denial of behavioral addictions, mental health issues, or substance abuse

The CAP assessment team is comprised of the same quality care personnel who would help provide guidance and methods designed for lifelong recovery.

To discover whether treatment is the right next step, try a self-assessment quiz.

Full Transparency of Fees and Services

Misunderstanding the scope of care and the costs of rehabilitation can sometimes prevent people from getting the quality treatment they deserve. During this critical time, it's important to know not only what you have to pay for, but how to pay for it and what you'll receive for your investment.

Make sure to compile a comprehensive list of questions when researching facilities, and call each one to get answers. Ask:
  • How rates are established based on length of stay
  • What's included in the foundational rate, and what services have additional fees
  • Accepted insurance plans and other forms of payment, including financing
  • Costs of follow-up care and relapse prevention services

To learn more about what services you may be able to expect at a treatment center and what questions to ask, review Cottonwood Tucson's adult program and detoxification services.

Not Just for Now, But Always

There's a lot of uncertainty surrounding recovery treatment, but you don't have to go it alone. If you or a loved one decides to enter a rehab center, that's only one part of the process.

What's learned during an inpatient stay should be reinforced by a structured and individualized continuum of care plan, which often features lifelong resources to help you continue to be your best self. These touchstones may include sober and/or transitional living options, relapse prevention techniques, onsite and in-community support groups, facility alumni meetings, and other methods to ensure your wellness for life.


By Tracey L. Kelley

Monday, January 7, 2019

Creating Balance in Your Body After Addiction

One crucial component of recovering from addiction is to eliminate toxins from your body and enable its natural healing processes. It's not always enough to simply stop abusing drugs or alcohol: the body has to be restored with proper hydration, nutrition, immunity, pH balance, regular exercise, and good sleep hygiene.

Medical Detoxification

Medical detoxification isn't always necessary for some people. However, it may be mandatory if your substance abuse:
  • Lasted for an extended period of time or was particularly intense
  • Compromised existing co-occurring mental or physical conditions
  • Involved daily use to help you function
  • Involved multiple substances
  • Reoccurred after a period of prior rehabilitation
This first step toward wellness is nothing to fear. Detoxification administered and supervised by certified medical personnel helps purge your system of harmful chemicals. This release will also enable your brain begin the process of relaying proper signals instead of those caused by the false stimuli of drugs or alcohol, thus improving cognitive function and behaviors.

Substance abuse often results in damage to your nervous system; vital organs such as the liver, pancreas, lungs, kidneys, and heart; metabolic and digestive processes; and cellular structure. Without a proper physical detox, it may be harder to help your body return to its normal regulatory ability and natural cleansing processes.

Does detoxification make you uncomfortable for a while? Sometimes, but only for a few days up to a couple of weeks. There are many variables that contribute to how you may differ in the procedure compared to someone else, but an evaluation by a clinical care team assesses your need and how the process should go. Under no circumstances should you attempt to detoxify your body after substance abuse without guided medical supervision.

If your addiction was quite severe, such as involving excessive use of narcotics or alcohol, your initial detoxification may be part of a series of components your care team will use to help you on the road to recovery. You may require additional medical intervention to recalibrate your system at various intervals to make sure you're returning to an effective position of physical wellness, especially if you have other major health concerns caused or exacerbated by substance disorder. This may mean you'll have more difficulty handling cravings or have an acute awareness of physical pains and other chronic health symptoms than you did before, but only for a short time.

Proper Nutrition and Hydration

We've written a number of articles about the necessity of proper nutrition in recovery in our blog, including:
Scientific research supports wellness through a whole foods diet for everyone, not just people coming out of addiction. However, your body and mind need additional vitamins, minerals, antioxidants, and other nutrients to recover from the harm caused by addiction. This boosts your  immune system and provides greater wellness.

Whole foods nutrition also helps the body reduce the acidity caused by substance abuse. A low pH level due to fatty foods, artificial sweeteners and sugary substances, and processed meals, as well as drugs and alcohol, leaches vital compounds from muscles and bones while the overall physical system breaks down. This prompts excessive mood disorders and a greater risk for chronic diseases and pain. A more alkaline system, or a higher pH level, is supported by lean protein choices, leafy greens and other vegetables, low-glycemic fruits, healthy fats, and complex carbohydrates.

Cottonwood Tucson has behavioral health dieticians who work directly with patients to develop individual healthy eating plans. Our experts believe a moderated whole foods diet helps people:
  • Regulate moods
  • Have ample energy
  • Improve concentration
  • Deal with cravings more efficiently to avoid relapse
We have a comprehensive approach to nutrition designed to make it easier to feel healthier more quickly.

Hydration is another important factor for creating balance in the body. Every organ, tissue, and cell needs water to function properly. Your entire system uses water to eliminate waste, maintain temperature, and keep joints mobile. It's not always necessary to drink the often-touted eight glasses a day, as everyone is a little different. But most people need four-to-eight glasses a day, usually about eight ounces each.

It's best to drink non-caffeinated, non-sweetened water when you first feel thirsty. However, you should also drink a few ounces before, during, and especially after a workout.

How can you tell if you're not having enough water? The first indicator is your urine. If you only visit the bathroom once or twice all day, and eliminate very little, that's a sure sign you're dehydrated. Also look at the color: the darker your urine is, the more dehydrated you are. Some people also experience symptoms of dehydration such as confusion, headaches, dizziness, or fatigue.

Regular Exercise and Good Sleep

These two wellness efforts often go together, because someone who exercises even three times a week develops better sleep hygiene, or healthy sleep habits.

In fact, the National Sleep Foundation indicates that a whole foods diet and as little as 10 minutes of some type of cardio exercise daily can "drastically improve sleep quality." Since many people in recovery frequently have trouble with insomnia in their first year, it might be good to create an exercise and sleep plan, and see how the two affect each other.

You don't have to become an Ironman triathlete—unless you find Todd Crandall's recovery story particularly inspiring—but you should dedicate 30 minutes a day to walk, jog, swim, strength train, play basketball, do yoga, garden, bicycle, or play Frisbee—whatever makes you happy to be moving. Keep a record of your activities and your sleep patterns for six weeks, and see what changes.

Cottonwood's Holistic Adult Program

Our experts can help you find new ways to recover from substance abuse through a variety of holistic approaches designed to treat your entire being. See what we can do for you.

By Tracey L. Kelley

Thursday, December 20, 2018

Explaining Your Recovery to Relatives

Choosing to share your journey of addiction and recovery is probably one of the most personal revelations you'll have in life. It's important to remember that you decide what to talk about, what details are important, and how much to discuss.

When we're at family gatherings, we're often not sure who knows what. Since people are fallible, it's quite possible there's a bit of gossip involving any number of family members, their circumstances, and their actions. If you don't want to be part of the rumor mill, you may have to step forward and talk about your journey.

You're in total control of your narrative. To do this effectively, you may have to establish some boundaries, determine appropriate topics, and offer other resources to reduce myths and stigmas not only about your situation, but also addiction in general.

Establishing Boundaries


You're under no obligation to discuss your addiction and recovery with anyone. What someone else perceives of you isn't your concern—but that's a difficult concept for most of us to accept, even in the best of circumstances. If you decide it's fitting and helpful to talk about your experiences, however, you still have the right to make your boundaries clear.

Jennifer Rollin, a mental health therapist, wrote about boundaries for Psychology Today. She suggests three ways to establish boundaries:

  • Tap in to your innate knowledge of yes and no
  • Develop a way to tolerate others' reactions
  • Continue to practice self-care

How might you put these methods into practice if you choose to explain your recovery to family members? Here's an example:

You decide you're going to talk to a small gathering of relatives about your sobriety. You ask everyone to take a seat, and you explain the facts: you once had a problem with substance abuse; you sought and completed treatment for it; and you appreciate their understanding when you choose not to partake in certain actions or events you feel compromise your decision to stay sober.

If people want to ask questions, you can answer the ones you feel comfortable with in whatever language and detail feel appropriate for you. If you choose not to answer particular questions, simply say, "I don't have an answer for that right now. Perhaps we can talk about it another time." This "I" statement is non-confrontational, maintains your yes/no boundary, and leaves the door open for discussion in the future so the other person feels heard as well.

If some people in the group have negative reactions, or start making comments of blame or shame, remember: those responses are more about them and less about you. You can redirect the conversation by saying something like, "I understand this news may initially be upsetting. I wanted to be honest with all of you. Maybe after some time passes and we've all had time to process this information, I can answer some of your questions." This "I" statement allows you to acknowledge their reactions without taking responsibility for them, and makes a point that you'll return to a more reasonable discussion without debating anyone in the heat of the moment.

If this initial reveal triggers you in some way, stay calm. Deep down, you probably expected this, especially from people who don't know you well or see you often. They may need more time to accept what you've told them, process it, and see you in a new light. Again, this isn't your concern or responsibility, which is why you need to maintain your approach to sobriety in all the meaningful ways you've used so far.

Determining Appropriate Topics

Just because you've dealt with substance abuse and are now in recovery doesn't mean your life is the proverbial open book. Again, you can choose to be as open as you like. However, if there are family members who were involved somehow before your treatment or after, it may be necessary to have a frank talk with them about what happened and where you are now.

Here are some reasons why:

  • Making amends. If you're using a 12-Step program to help maintain sobriety, acknowledging your wrongs and righting them if possible is a critical component of this process.
  • Continued recovery. As part of your wellness journey, you may have to address causation factors such as abuse, dysfunction, neglect, and other conflict that may be part of the family history and require healing.
  • What you need from them. Whether it's support to avoid triggers or distance to reduce negative influences, this conversation is critical to address your needs in a direct and rational manner.

Be prepared for people to offer all sorts of opinions and advice. Try to stay gracious and understanding, but be open to discussion. However, you're under no obligation to do anything outside of what your treatment plan outlines.

Offer Other Resources

It may be helpful to encourage your family members to learn more about addiction without you being the only source. This neutralizes the topic a bit more, eliminates some of the stigma surrounding addiction, and helps all of you find more common ground. Some books that may help include:


Also consider directing loved ones to qualitative scientific sites that discuss facts regarding addiction and recovery.

Find More Resources Through Cottonwood Tucson

While Cottonwood Tucson doesn't endorse specific companies or programs, it offers an extensive list of resources you can use to enable clear communication with members of your family.

By Tracey L. Kelley

Monday, December 3, 2018

Equine Therapy and How It Helps Recovery


A frequent remedy for mental health issues is to be in a situation where you're not being judged and you have the opportunity to express your true self. However, talk therapy may not initially be the best course of action for someone if he or she has difficulty accessing deep feelings with other people.

Animal-assisted therapy changes this dynamic: you have a chance to simply love and be loved. The interplay between you and your animal companion is one of pure spirit, as two beings find their way to each other. The animal senses your energy and emotions, and this may pose a challenge at first to connect. 

The animal will also continue to exist in its own way, and there's little you can do about this behavior. But each encounter allows you to overcome your fears, change your perceptions, and gain confidence by stepping into a caregiver role and doing what you can to put the animal at ease and understand its nature. As trust develops, the animal responds with an open heart. This connection helps guide you along your healing process.

For someone in recovery from substance abuse, learning to trust, share feelings, recognize a surety in the present moment, and make valuable connections are just a few benefits of animal interactive therapeutic treatments.

Equine Therapy for Healing

One of the most successful forms of this process is equine therapy. Mounting scientific and anecdotal evidence points to the success of this experiential therapy method: a more hands-on approach for working through negative thoughts, feelings, behaviors, and experiences by doing enjoyable activities. For example:
  • A study sponsored by the Animals and Society Institute revealed that individuals participating in equine-assisted therapy "reported significant improvements in psychological functioning immediately following [this therapy] program, and these changes were stable at a six-month follow-up."
  • In a 2018 report by CNN, equine therapy experts relayed information about its success with a number of individuals, including those with autism, chronic pain, PTSD, depression, and other conditions.
  • Psychology Today referenced nearly 50 studies that indicate benefits from working with equine and other animals in therapeutic settings include emotion stabilization, improved socialization and communication skills, better self-regulation or impulse control, reduced depression and anxiety, realignment of stress responses while doing something pleasurable, and increased feelings of calm, comfort, and safety.
  • Counseling Today shared an in-depth story of one equine therapist's experiences helping children and teens with mental and behavioral issues.

A lot of drug and alcohol rehabilitation facilities use some type of equine therapy. As herd animals, horses frequently need to create bonds and form new relationships. If an individual in recovery has attachment or trust issues, working with a horse helps him or her acknowledge these circumstances, and learn to move beyond them in a healthful way. Additionally, a horse's innate hypersensitivity is the perfect mirror for someone's verbal and nonverbal communication. Therapy experts believe the way a person interacts with a horse is an indicator of how he or she is with humans. This awareness can be a pivotal point to explore later in group or individual counseling.

Aspects of an Equine Therapy Session

There are usually three types of equine therapy programs:
  • Therapeutic riding: Considered a recreational activity guided by a non-therapist instructor who helps someone learn to control a horse while riding. Often used with people to build self-confidence and work on communication skills.
  • Hippotherapy: Incorporating the expertise of physical or occupational therapists, language and speech pathologists, or recreation therapists, this practice uses a horse's movements to help a rider improve sensorimotor systems, balance, coordination, and other aspects of movement. Frequently a course of treatment for people with cerebral palsy, autism, or brain damage.
  • Experiential interactivity: Although sometimes riding is a component, most engagement is conducted through ground exercises such as grooming, massaging, leading the horse in a training circle, and a variety of human/horse activities that may be metaphors for what a person is feeling or experiencing. This is the most common method used at drug and alcohol addiction treatment centers.

What people learn during experiential equine therapy for substance abuse treatment may include:
  • Evaluating addiction and its impact
  • Addressing trauma-sensitive issues
  • Improving self-esteem and confidence
  • Using grounding methods to help manage triggers, depression, and anxiety
  • Establishing better relationships and defining necessary boundaries
  • Trying mindfulness and other stress-relieving or coping techniques

What's more, individuals learn that other creatures suffer, too—and that it's within their ability to ease their pain and help them recover. The award-winning documentary Buck follows the life and experiences of trainer Buck Brannaman and how his humanity, vulnerability, and compassion helped him find new purpose, overcome past trauma, and change the lives of hundreds of horses. Watch the captivating movie trailer here.

Cottonwood Tucson's Equine Program

As part of our holistic recovery services, we offer equine-assisted therapy as a means to help an individual develop a better sense of feeling alive in the present moment, and to regain peace and connectivity.

The horses in our therapy team are retired from previous careers, and demonstrate the importance of second chances. Each relationship between horse and human starts on the ground with various activities and exercises to foster trust and communication. A horse can easily detect human emotions, and provide biofeedback to help people establish new ways of understanding their behaviors, perspectives, feelings, and beliefs.


By Tracey L. Kelley


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