Quitting Drinking

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You should not stop drinking cold turkey if you’ve been drinking heavily for a period of weeks or months. This is because your body has adapted to the presence of alcohol and will go through withdrawal when the alcohol is taken away.

Instead of gritting your teeth and jumping on the wagon “cold turkey”, it’s really best that you have medical supervision during alcohol withdrawal, perhaps at a certified detox clinic or alcoholism rehabilitation centers. We outline the reasons below, and provide a list of risk factors for avoiding cold turkey alcohol cessation.

Alcohol Withdrawal Is Possibly Fatal

What happens when you stop drinking alcohol?  First, the body tries to seek homeostasis without alcohol.  During this period, withdrawal symptoms can be uncomfortable, scary and possible complications can arise.  This is why doctors do not recommend cold turkey withdrawal from alcohol, especially without medication or medical supervision. And even in cases of young healthy people, doctors medically supervise the detox.

The outcome of “cold turkey” treatments have not been established through scientific studies or evidence-based methods. Additionally, there are medications available for alcohol withdrawal, which help ease symptoms and make the experience more bearable. Plus, alcohol withdrawal is unpredictable and life-threatening complications are always possible. These complications are made more risky and you should not try to stop drinking cold turkey when you:

  • are in general bad health
  • are of increasing age
  • have been diagnosed with co-occurring medical, surgical, and/or psychiatric disorders
  • have consumed high amounts of alcohol in the weeks prior to treatment
  • have poor nutritional status
  • use medications (prescription, over-the-counter, or herbal)

 

Each of these factors can increase the severity of alcohol withdrawal symptoms. Proper medical management of alcohol withdrawal reduces the probability of withdrawal complications and can save your life.

Cases Which Require Medical Supervision During Detox

Additionally, there are other even more specific cases when you should definitely NEVER stop drinking cold turkey without medical assistance. Specifically, you should not stop drinking cold turkey if:

1. You are extremely intoxicated

When you are in the middle of alcohol intoxication, doctors need to monitor you in order preserve respiration and cardiovascular function until alcohol levels fall into a safe range. In other words, during a severe cass of intoxication, you can stop breathing or your heart can stop beating. Likewise, doctors need to monitor vital functions, protect breathing, and observe potential accidental sucking in of food particles or fluids into the lungs (aspiration), hypoglycemia, and thiamin deficiency.

2. You have been through withdrawal 3-4 times in the past

Doctors have noticed the appearance of severe withdrawal reactions in people who have experienced 3-4 previous alcohol withdrawals. In these cases, unless adequate medical care is provided, it is possible that you experience Complicated or severe medical withdrawal including: delirium, hallucinations, delusions, seizures, and/or disturbances of body temperature, pulse, and blood pressure.

3. You have a previous history of seizures or delirium tremens (DTs) during withdrawal

You should not stop drinking cold turkey if you have had seizures or DTs in the past. Instead, doctors can administer medications like benzodiazepine to help you avoid seizures and DTs. Why? Because untreated DTs or seizures may result in death and disability.

4. You have been diagnosed with co-occurring unstable medical and psychiatric conditions

Only young people in good health, with no history of previous withdrawal reactions, are considered for alcohol withdrawal without medication. Still, you need not go through detox without aid. Medications are available to help your body normalize to functioning without alcohol again.

 

The reasons why people drink beer, wine, and spirits are usually harmless at first.  But once your body builds an immunity (tolerance) to alcohol, and becomes dependent on alcohol, you have to address both medical and mental problems which compel you to drink.  Once your body is free from alcohol, the work of looking inside begins.  Got questions? Please leave them here. We’ll be happy to answer them.

Substance Abuse in Vancouver

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How does someone become addicted. In my CEO message I talk about how an addicted person is often associated with the picture of a person on skid row drinking out of a paper bag or poking a needle in his or her arm. When individuals first start to use addictive substances, it is never with the intention to become addicted. Substance abuse is a phenomenon that slowly seduces the individual with its false promises and deceptive illusions. Vancouver, partly because of our climate and our status of a port city, have combined with other factors to create a systemic substance abuse problem. Following are the typical pattens we see when it comes to substance abuse in Vancouver. If you or anyone you know is struggling with a substance abuse issue, HeartQuest provides some proven solutions. Call Cory personally at 604.818.1771 or  Click here to send Cory an email.


PATTERNS OF SUBSTANCE USE

1)         No Use

- approximately 20% of the people in our society do not use any mood altering substances for non-medicinal purposes.

 

2)         Initial Use

- motivation comes from personal curiosity & peer pressure

- this stage is highlighted by experimentation and adventure

- willingness of person to choose to use

- availability of substance of choice to use

- may be a separate and distinct experience for each substance tried

- recent trends show this pattern occurring most often in adolescence but also occurring at younger ages

 

3)         Irregular Use

- responsible use on an irregular basis

- no substance seeking behavior except monetary preparation

- the choice process is still heavily involved

- use of substances only during non-work periods

- substance use fun and enjoyable with very few side effects

- use generally motivated by larger event (party, holiday, special dinner, etc.) rather than individual need

- approximately 20% of people in our society are irregular users

 

4)         Regular Use

- use motivated more by personal initiation rather than by the event

- use mood altering substances more than 3 times per month

- substance seeking and substance use take up a larger amount of time

- substances are now being used to compensate for anxiety or stress

- more regular use of addictive substances (habit formation)

- loss of control over the use of the substances may begin to happen

- more severe side effects happen (blackouts, hangovers, etc.)

- some personal concerns (guilt) by the user may occur in this pattern and attempts at control and / or abstinence

- approximately 40% of people in our society are regular users

 

5)         Problem / Intensified Use

- frequency of use varies widely and may range from daily to binge use

- 10% of people in our society are problem users experiencing some of the following problems:

 

a) Loss Of Control

- use of substance beyond what was intended most of the time

- control lost to the point where the person can control onset of using but has little control over amount used

 

b) Compulsion

- when substance use takes up an extraordinary amount of time

- always an excuse to use the substance (always an alibi after)

 

 

c) Continued Use In spite Of Negative Consequences

- lots of denial (refusal to see facts as they really are and refusal to deal with consequences of their actions) 

- rationalization and blame help the person to justify the drug use in spite of nameless fears and anxieties (shame)

- substance use now has a bigger priority that relationships, friends, health, career, or other major life areas

- tendency to objectify relationships

- possibly suicidal

 

6)         Addicted / Dependent Use

- inability to predict or control consumption of substance

- entire life depends on the use of the substance (obsessed)

- can’t function without the drug and severe withdrawal reactions occur with abstention

- medical complications due to the substance use

- continued use even though this use threatens their life, health, job, marriage, and family

- completely physically and psychologically addicted

- death through complications or accident a real possibility

- approximately 10% of people in our society are substance dependent

The Nature of Addiction

 

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Amy Winehouse was a terrific talent and one of my favourite recording artists. She also struggled with substance abuse. To what extent remains largely unknown but her death has fueled debate as to the precise nature of drug addiction and how it should be addressed by society as a whole.

In other words, why do some people behave in the often self-destructive manner in which they do? And why are people addicted to drugs in the first place?  How, if at all, might they be helped?

Now, you might think that this is a spectacularly hard task to delve into the neuroscience of addiction to try to shed some light. Surely, drugs of abuse (such as amphetamines, cocaine, opiates, and alcohol) have a broad range of actions that are dissimilar from each other? Well, that is partly true, but when it comes to their addictive properties, they have more in common than you might think.

 

What Constitutes Drug Addiction?

Drug addiction, as most will know, develops as a result of chronic exposure to a particular substance. People who are addicted to a drug show similar patterns of behaviour. These include:

1. A compulsion to seek the drug

2. An inability to control the amount of drug consumption

3. A negative emotional state when subjected to periods of withdrawal

Neuroscientists have sought to understand the neural mechanisms underlying these behaviours for generations and emerging from these studies is the concept of the ‘reward circuit’ that seems to be involved in the development and maintenance of drug addiction.  In fact, research on the brain may be entering a golden age of discovery.

You see, the brain behaves a little bit like a factory with different departments responsible for producing a certain sort of feeling or behaviour. This means that there are distinct areas that are concerned with happiness, memory, movement and so on. This is, obviously, an oversimplification, however, it is useful to think of the brain in this way particularly when analyzing how brain circuits are altered as a result of drug use.

The Reward Circuit

The reward circuit consists of several brain regions that are heavily interconnected; each with distinct – but related – functionality. Dysfunction in each of these areas has been implicated in problematic drug use.

 

The Nucleus Accumbens: Pleasure Center

Now, the nucleus accumbens is known as the pleasure centre of the brain. This can be a result of taking drugs of abuse, or simply eating, engaging in sexual activity or indeed anything associated with pleasurable reward.

All drugs of abuse raise the level of a chemical known as dopamine in the pleasure center and it is this elevation in dopamine that is responsible for the feeling of euphoria associated with drug intake.

 

The Amygdala: Fear

On the flip side of the coin, the amygdala is a region of the brain situated right next to the nucleus accumbens, but is often associated with feelings of fear and anxiety.

As opposed to the positive reinforcement created by the pleasure center, it is during “withdrawal” that the amygdala seems to have its largest role. Basically, as access to the drug is taken away, stress-related hormones are increased in the amygdala, which can lead (at least partially) to the negative feeling associated with withdrawal.

 

The Hippocampus: Memory

The hippocampus is an area of the brain that is associated with learning and memory as well as the ability to perform tasks requiring navigation, such as finding your way around a building.

Activation of this memory center of the brain is implicated in initiating “cue-induced” drug-seeking behaviour. Indeed, it has been shown that “cue-induced” craving of drugs (e.g. the feeling of needing a drink in a pub or a cigarette with a cup of coffee) is associated with an increase in activity in the hippocampus (as well as the amygdala) in humans, indicating that normal memory function may be being encroached upon by drugs of abuse.

 

The Prefrontal Cortex: Decision

The prefrontal cortex are often described as being critical in carrying out decision-making, a process known as executive function; the activity of decision making is extremely disrupted in subjects who are addicted to drugs. This may go some way to explaining why drug users often make poor decisions regarding drug intake (e.g. pursuing a drug whilst fully aware of the negative impact drug intake will have on them and the people around them.)

 

What Goes On In The Brain Of A Drug Addict

So…

As complicated as this may have sounded, it represents a general idea of what actually goes on in the mind of a drug addict. In other words, drugs mess with your head. If you or anyone you know is struggling with an alcohol or drug addiction, click here or call Cory at: 604.818.1771.

Intervention Services


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An intervention is an orchestrated attempt by one, or often many, people (usually family and friends) to get someone to seek professional help with an addiction or some other kind of serious problem. The term intervention is most often used when the traumatic event involves addiction to drugs or other items.

Interventions have been used to address serious personal problems, including, but not limited to, alcoholism, compulsive gambling, drug abuse, compulsive eating and other eating disorders, tobacco smoking, "workaholism", and various types of poor personal health care. Interventions have also been conducted due to personal habits not as frequently considered seriously harmful, such as video game addiction, excessive computer use, and excessive television viewing.

Intervention Models

The use of interventions originated in 1960s with Dr. Vernon Johnson. The Johnson Model was subsequently taught years later at the Johnson Institute. There are some pockets of thought within the substance abuse treatment and intervention industry that the un-informed alcohol or drug dependent person is negatively affected by so-called "ambush" inherent in the Johnson Model direct intervention. However, beyond anecdotal evidence, there are no scientific studies which confirm that theory.  

Two of the major models of intervention that are utilized today are known the Systemic Family Model and the A.R.I.S.E. model of intervention. While the A.R.I.S.E utilizes a predominantly invitational approach, in practice many of the same aspects of the Johnson Model are used. Systemic Family Model interventions may use an invitational approach but often utilize the direct approach. Both models rely heavily on having the family as a whole enter a phase of recovery. This helps take the focus off the addicted individual and notes the need for the entire family unit to change in an effort for everyone who is involved to get healthy.

Plans for direct intervention

Plans for an intervention are made by a concerned group of family, friends, and counselor(s), rather than by the drug or alcohol abuser. Whether it is invitation model or direct model, the abuser is not included in the decision making process for planning the intervention. A properly conducted direct intervention is planned through cooperation between the identified abuser's family or friends and an intervention counselor, coordinator, or educator. Ample time must be given to the specific situation; however, basic guidelines can be followed in the intervention planning process. (Note that an intervention can also be conducted in the workplace with colleagues and with no family present).

Prior preparation

Prior to the intervention itself, the family meets with the interventionist. Families prepare letters in which they describe their experiences associated with the addict's behavior, to convey to the person the impact his or her addiction has had on others. Also during the intervention rehearsal meeting, a group member is strongly urged to create a list of activities (by the addict) that they will no longer tolerate, finance, or participate in if the addict doesn't agree to check into a rehabilitation centre for treatment. These consequences may be as simple as no longer loaning money to the addict, but can be far more serious, such as losing custody of a child.

Family and friends read their letters to the addict, who then must decide whether to check into the prescribed rehabilitation centre or deal with the promised losses. 

HeartQuest Interventionists

If you or anyone you know is struggling with problematic substance use, click here or call Cory at: 604.818.1771.

Addiction Counselling

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Alcoholism and drug addiction are serious problems that cause numerous problems in Canada. If you or anybody you know are struggling with an addiction, it is imperative that you help the affected individual to a reputable
Substance Abuse service provider where professional help is provided at a reasonable cost. 

When selecting a good Canadian addiction service provider, make sure that you do your due diligence so that your loved ones get the best possible treatment. A thorough clinical assessment with an Internationally Certified Alcohol and Drug Counsellor (ICADC) is your best bet.



Definition of Internationally Certified Alcohol and Drug Counsellor:

An Internationally Certified Alcohol and Drug Counsellor is a person primarily involved in assessing individuals who are experiencing problematic substance use, and then providing recommendations re a course of treatment.

Setting the international standards for competency-based certification programs through testing and credentialing of addiction professionals for since 1981, the International Certification & Reciprocity Consortium is the largest credentialing organization in the world for substance abuse counsellors. Incorporated in 1981, the International Certification & Reciprocity Consortium represents 22 countries and six Native American territories, encorporates 76 Member Boards, including 44 U.S. states, the District of Columbia, two U.S. territories, and three branches of the U.S. military.

In order to earn the designation ICADC, each counsellor must accomplish the following:

Experience

6000 hours of supervised work experience specific to the Alcohol and drug field. 
Education
270 hours specific to the substance abuse.  Six hours must be specific to counsellor ethics. 
Supervision
300 hours specific to substance abuse must be supervised by an individual with at a minimum an ICADC designation.
Examination
Applicants must submit a Case Presentation for review, and then must pass the IC&RC International Written Examination.
Code of Ethics
Applicants must sign a code of ethics statement or affirmation statement.

 

 

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