New Study Finds Insomnia Drug Might Prevent Oxycodone Relapse

Opioids, including oxycodone, are very effective medications for pain, but they have an unfortunate potential for addiction that could lead to misuse and dependence. However, researchers found a relationship between the FDA-approved suvorexant and opioid relapse, determining that it decreased the amount of oxycodone self-administered by opioid-dependent rats.

Now, following that same research, scientists from a Scripps Research study determined that an experimental medication for insomnia, known as DORA-12, could help prevent drug relapse in patients with oxycodone addiction by targeting this common but often overlooked side effect.

Let’s explore how DORA-12 could make opioid addiction treatment safer for everyone if it proves to be safe and effective.

The Cycle of Opioid Addiction and Relapse

The cycle of opioid abuse, addiction, recovery, and relapse has a firm grip on many people’s lives. Here’s how most people’s addiction develops after starting to take opioids:

  • Tolerance: As individuals use opioids over time, their brains adjust to the dose, needing larger amounts to achieve the same pain-relieving effects. 
  • Dependence: Continued opioid use leads to physical dependence, where the body relies on the drug to function normally. Withdrawal symptoms like shaking and headaches occur when attempting to stop or reduce usage.
  • Abuse: This stage involves the misuse of opioids, such as taking higher doses than prescribed or obtaining them illegally. By now, most people can’t control their cravings for opioids and might even say their bodies need them to function correctly.
  • Addiction or opioid use disorder: At this stage, people compulsively seek opioids despite being aware of the negative consequences.

At some point after addiction sets in, people may seek treatment through an inpatient or outpatient facility, but many relapse. In some cases, as much as 90% of people who go through residential opioid treatment relapse at some point, many within a week of leaving the facility.

The Role of Insomnia in Opioid Relapse

People with insomnia experience a higher risk of relapsing back into opioid use. Insomnia can be a condition the individual experienced before addiction, or it can be a result of addiction, a condition known as medication-induced sleep disorder.

Insomnia worsens the risk of relapse by:

  • Making people more vulnerable to stress.
  • Reducing cognitive functions which can lead to poor decision-making.
  • Exacerbating existing mental health conditions can, in turn, increase the risk of relapse as a means to numb negative emotions.
  • In cases of chronic sleep deprivation, increasing pain sensitivity (hyperalgesia) leads some to consume opioids to reduce it.

Despite not being as talked about as other factors, sleep disturbances play a significant role in the risk of relapse.  

Study Highlights: DORA-12’s Potential in Preventing Opioid Relapse

In August 2023, scientists found that the insomnia drug DORA-12 yields interesting results on rats who experience oxycodone withdrawal. 

The Study

The study involved administering the experimental insomnia drug DORA-12 to rats that were undergoing withdrawal from oxycodone to determine if the drug could reduce the desire to seek opioids. The researchers monitored the behavior of the rats to determine the effects of DORA-12 on opioid cravings.

The Results

Scientists noticed that rats treated with DORA-12 during withdrawal from oxycodone showed a reduction in drug-seeking behavior. The study doesn’t provide details for how DORA-12 could reduce oxycodone cravings, but the results suggest that the drug potentially mitigates the cravings for opioids.

The researchers also noted differences in responses between male and female rats, which suggests varying impacts based on sex. The drug was less effective in female rats, and males showed pronounced changes in neuron numbers. It could be possible that female animals are more sensitive to oxycodone’s effects and require different DORA-12 doses.

DORA-12 is similar to the FDA-approved drug Belsomra (suvorexant), and research shows that suvorexant decreased the amount of oxycodone self-administered by opioid-dependent rats during binge sessions.

Rats given DORA-12 during their withdrawal period show patterns of behavior and psychological activities seen in animals without opioid dependence, not showing any drug-seeking behaviors even when exposed to cues they had learned to associate with oxycodone. 

Implications for Treatment and Recovery

If the effects researchers observed translate to humans and DORA-12 is approved for safe use, the drug may have the potential to address insomnia as a relapse risk factor. Specialists could integrate DORA-12 into treatment plans for individuals struggling with opioid addiction, particularly those facing significant challenges with insomnia.

DORA-12 could:

  • Minimize insomnia in patients going through withdrawal symptoms. Patients who rest better could experience less severe withdrawals, reducing their chances of a relapse.
  • Reduce drug-seeking behaviors. The study found that rats treated with DORA-12 during opioid withdrawal showed reduced drug-seeking behavior, even after the treatment ceased.

Both factors have the potential to make withdrawal syndrome much more manageable for people in treatment for opioid addiction. However, it would be essential to consider how the drug affected males and females differently, being less in female rats. All this is currently theoretical, as it could be years before DORA-12 even sees human use in clinical trials.

Still, the research highlights the connection between sleep and addiction. Addressing insomnia during addiction treatment may have far-reaching implications for the prevention and treatment of various substance use disorders.

By recognizing the importance of sleep in addiction recovery and integrating innovative insomnia treatments into recovery programs, healthcare providers could offer more comprehensive and effective care to individuals struggling with addiction.

DORA-12 and the Future of Opioid Addiction Treatment

The research on DORA-12 is a promising breakthrough in treating insomnia as a risk factor for opioid addiction relapse. By targeting insomnia, DORA-12 has shown potential in reducing drug-seeking behavior and enhancing recovery outcomes in opioid-dependent rats.

While it could be years before we even start testing whether this drug could work in humans, innovative research like this shows just how complex addiction is and how many factors play a role in our recovery. 

Even though we need more research to confirm its efficacy and safety in humans, it’s encouraging to know that we have hard-working researchers exploring every possibility to understand opioid addiction and how to treat it.

Understanding Sobriety Milestones for Long-Term Success

Getting over addiction is difficult; partially because it involves a literal change of a person’s chemistry and physiology, partially because humans are hardwired to avoid difficult things (biologically, we’re all big fans of the path of least resistance). The key to overcoming our intrinsic resistance to challenging tasks is having the motivation to do so. 

This is especially true when it comes to drug addiction. Science has recognized that motivation is one of the best determinants of whether 1) a person will complete treatment and 2) make the long-term modifications to their behavior necessary to stay sober and avoid relapse. The tricky part about managing motivation is that it has to come from within; it’s not something a therapist can teach you, nor a feeling that a loved one can impart. 

Fortunately, there’s a pretty easy way to trick your brain into getting stoked about getting sober: celebrating your milestones in recovery, both big and small. It’s a simple but impactful practice that reminds us that monumental changes are accomplished by many tiny steps. 

What Are Sobriety Milestones?

Sobriety milestones can be anything you want. One of the most widely known is the sobriety chips given by peer-based support groups like Alcoholics Anonymous. Different colored tokens indicate how long a person has been sober, recognizing everything from the first 24 hours of sobriety to the first year. However, sobriety milestones can also be those that you are on your own. 

A milestone could be a mundane activity that would otherwise seem impossible before getting sober. It could be a major bucket list-type accomplishment that’s all about celebrating the life saved from drugs. All that matters is that it’s something meaningful to you. Here are a few examples of non-time-related milestones you might find to be worth celebrating while in recovery:

  • Going on a social outing without drinking (or better yet, without having the desire to drink)
  • Falling asleep naturally, especially after a hard day
  • Using a coping mechanism taught to you by your mental health counselor
  • Successfully confronting one of your triggers
  • Dealing with a stressful situation without resorting to using drugs

Take a second to think about what your past self would feel is a noteworthy accomplishment. What’s something that the drug-addicted you couldn’t even dream of achieving? Maybe it’s adopting a pet, repaying all the money you borrowed from someone, or mending a broken relationship. Write them down, no matter how grand or how minuscule, then put this list somewhere highly visible. It’ll serve as a great reminder of why you’re staying sober and give you something to look forward to. 

Sobriety Chips Colors & Meanings

Also sometimes referred to as medallions or key tags, sobriety chips are a custom that originated with Alcoholics Anonymous in the 40s. Here are the various colors and what they mean: 

  • White: 24 hours sober
  • Yellow: 1 month sober
  • Gold: 2 months sober
  • Green: 3 months sober
  • Purple: 4 months sober
  • Pink: 5 months sober
  • Blue: 6 months sober
  • Copper: 7 months sober
  • Red: 8 months sober
  • Purple: 9 months sober
  • Gold: 10 months sober
  • Green: 11 months
  • Bronze: 1 year sober or longer

Despite how ubiquitous the colorful tokens are with the organization, they’re actually an unofficial practice. Some chapters participate in giving out chips, others do not. If you’re not part of an Alcoholics Anonymous group that gives out chips (or a part of Alcoholics Anonymous at all) but want to commemorate your various time-based milestones, it’s possible to buy these chips for yourself. Note, that the colors used to denote certain amounts of time may vary based on the vendor or AA group. 

How to Celebrate Success in Recovery

There are all sorts of ways to celebrate sobriety milestones — sobriety chips or not. For many people, their first instinct is that celebrating = having a party. While sharing special moments with people you care about can be a wonderful experience, addiction recovery can be an intensely personal experience. If you’re still new to recovery, a party setting could be counterintuitive and end up creating a setting that isn’t conducive to sobriety.

When in doubt, a great way to celebrate is to share your accomplishments with others who are in your shoes. Find a local AA group near you today. You’ll be amongst compassionate and peers who understand the significance of what you’ve accomplished and are experts at celebrating sobriety milestones in a way that supports your commitment to living a healthier, drug-free lifestyle. 

What matters most isn’t how you celebrate these milestones or even what those milestones are, but rather that you feel proud about how far you’ve come and feel excited about the future. 

How Do Family Visits Work In Rehab?

Millions of people in the United States experience substance abuse every year, but significantly fewer people get the help they need with addiction rehab. The ones fortunate enough to go through rehab greatly benefit from having a solid support system, and family visits are one of the best ways to support a loved one during recovery.

When you visit family members in rehab, you provide emotional support and encouragement while gaining a deeper understanding of how they feel and how their recovery is progressing. However, if your loved one is in an inpatient facility, you may find many rules related to visits, all created to benefit patients.

Let’s explore how family visits work in addiction rehab and what you can do to ensure your visits contribute to your loved one’s recovery as much as possible.

Standard Visitation Policies and Guidelines

When visiting a loved one in rehab, the first thing to know is that inpatient rehab facilities have different rules. That means you should familiarize yourself with your loved one’s specific facility’s rules before visiting. You can usually access this information on the facility’s website.

Many of these policies and guidelines have a lot in common. Since they’re all created with your loved one’s comfort and recovery in mind, you will see some common patterns among them, including the following:

  • Visits are not allowed during the initial detox period. Many rehab centers do not allow visits or phone calls during the initial detoxification process. That’s because detox is a critical time for your loved one to focus on withdrawal recovery without external distractions​​​​​​. Even if your loved one doesn’t go through detox, there may be a period where visits are forbidden to help acclimate to their new routine. Some recovery centers allow letters as long as their content aids in recovery.
  • Visitor vetting. Many rehab centers conduct a vetting process for visitors to ensure they support the patient’s sobriety. This might include drug testing or other forms of screening​​​​. 
  • Pre-visit screenings. Once visitors clear the vetting process, they must undergo a mandatory pre-visit screening each time. This screening ensures visitors don’t bring prohibited items like drugs, alcohol, or sharp objects.
  • Patient consent trumps everything. Your loved one’s consent is crucial for every visit to be a positive experience contributing to recovery. Depending on their personality or stage of treatment, they may prefer to avoid having visitors at specific times.
  • Visiting hours. After the detox phase, facilities often allow visits during specific hours, in a particular room, on certain days of the week, and for a specified amount of time.
  • No food during visits. Many facilities prohibit bringing food during visits.
  • Smoking rules. Some facilities might prohibit smoking or limit it to designated areas.
  • Family therapy sessions. Many rehab facilities incorporate family therapy as part of the treatment process, providing a structured environment where family visits​​​​ are a tool that directly supports your loved one’s recovery.
  • Clergy visits. If your loved one practices a religion, the facility may allow a clergy member to visit them as a “compassionate care” visit.

Each facility has its specific policies, so it’s always good to check directly with the rehab center for their guidelines on family visits, whether via their website or by contacting them. The goal is for your visit to be the most positive experience possible for your loved one, aiding them in long-term recovery.

Dos and Don’ts During Rehab Visits

While every rehabilitation center has its rules, they have many things in common. While these policies may sound strict at times, remember that they exist to help patients ease their minds and focus on recovery.

With that in mind, these are the main things to remember when visiting a loved one in recovery. Here’s what you generally should and shouldn’t do when visiting a loved one in substance abuse rehab.

Dos

  1. Follow the facility’s rules and visitation guidelines. Every facility and rehabilitation center has different protocols for how visitations should go. Some require you to stay in a particular space and always have staff nearby to monitor the patient, for example. Speak with the staff for a full explanation and follow the rules.
  2. Be supportive. Recovering from a substance use disorder is incredibly difficult. It places mental and physical strain on the patient and more than likely has caused a lot of suffering by the point they begin their rehabilitation. Encourage their efforts and applaud their progress, no matter how small it seems.
  3. Respect your loved one’s routine. A predictable routine is essential to recovery, so visitations are usually limited to specific days and times. Do your best to follow this schedule, and if you can’t show up, inform the staff and your loved one that you won’t be there at the agreed-upon time to avoid any confusion or disappointment.
  4. Keep the conversation light. As difficult as it sounds, try to keep the conversation away from the heavy topics surrounding recovery. At this stage of recovery, such talk should happen in a safe and controlled environment. Find other topics to discuss to avoid stressing yourself and the patient.
  5. Bring them items from home. Familiar items, like blankets, clothes, or family photos, can help patients feel more at home, making their recovery easy. Speak with the staff first to learn what items are allowed.
  6. Get to know the staff. Familiarize yourself with the staff to better understand who’s helping your loved one recover.

Don’ts

  1. Talk about triggering subjects. Avoid talking about past events or the patient’s substance abuse as much as possible. Complex subjects like these can cause undue stress and hinder their recovery.
  2. Start arguments. Substance use disorders indeed create problems not just for the person experiencing it but also for those closest to them. However, bringing negative and volatile emotions into a visit during recovery is counterproductive. For your loved one’s sake and peace of mind, do your best to stay calm and level-headed.
  3. Smoke outside of designated areas. Some facilities may have smoking areas or forbid tobacco in the entire building. Make sure you know the rules beforehand.
  4. Talk about money. Recovery is often an expensive endeavor, between treatment, financial problems caused by addiction, and the inability to keep a job while staying at a rehab center. Avoid bringing up money troubles or the financial strain of supporting their treatment to the patient – it will only cause feelings of guilt and make it harder for them to focus on getting better.
  5. Bring alcohol or drugs to the facility. This is one rule you will find in every reputable rehabilitation center – do not bring the patient any substances, and don’t consume them yourself while in the facility.

Communication Tips and Strategies

Effective communication is critical in helping a loved one recover. Here are some strategies that can help make interactions more effective and supportive:

  • Try to put yourself in their shoes. Recognize the challenges your loved one is facing. Even when progress seems slow going, remain supportive of their efforts.
  • Give them your full attention. Be a good listener when they try to express themselves. Maintaining eye contact, nodding, and asking relevant questions are ways to practice active listening.
  • Respect their boundaries. Likewise, set your own. 
  • Maintain contact. Maintain as much or as little contact as you’re both comfortable with.
  • Keep an open mind. Always keep an open mind when approaching conflict, and don’t assume you have all the answers. This will help you find common ground and mutual understanding.
  • Approach communication with respect. Avoid nagging, guilt trips, bribes, and other sabotaging conversations. Learn to recognize these negative communication patterns not just in yourself but also in your loved one.

Consider therapy and group sessions to practice effective communication. A neutral third party, such as a therapist, can help bridge gaps in understanding and fix strained relationships.

Alternative Ways to Offer Support When You Can’t Visit

Whether it is because your loved one is going through the detox period because you’ve already visited them the maximum amount of times allowed this week, due to geographical distance, or any other reason, not being able to see them can be an emotionally challenging experience for both.

In those cases, it’s important to remember that recovery is multi-factored. As a result, there are many ways to offer support other than your physical presence. These are some of the alternatives you should consider.

  • Phone calls and video chats. Many rehab centers may allow phone calls or video chats in addition to visits. This can be a great way to stay in touch and offer emotional support.
  • Writing letters or emails. Sending letters or emails can be a personal and thoughtful way to communicate. It gives your loved one something tangible to hold onto and re-read when they need encouragement. As mentioned, keep in mind that letters may need to go through an inspection to prevent smuggling and ensure their content is appropriate for recovery.
  • Care packages. Care packages with items like books, journals, or personal care products can be a comforting reminder of your emotional and material support. Keep in mind that food is generally prohibited.
  • Attending family therapy sessions. While you can see family therapy sessions as visits, they play a structured role in recovery, so you should go into them with the mindset of adhering to the psychotherapy techniques provided by the counselor.
  • Educating yourself about addiction. Learning about addiction and the factors that may have led to your loved one’s substance abuse can help you understand what they’re going through and how best to support them.
  • Support groups for family members of people with addiction. Joining a support group for families of those in addiction treatment can be helpful. Groups like Al-Anon provide non-professional support that can help you gain insight from others’ experiences and even more alternative ways to support your loved one.
  • Post-rehab planning. As your loved one gets closer to completing the rehab program, you should plan to create a supportive home environment for when they return. You can work with the rehab facility or your loved one’s counselor to create a personalized plan for them.
  • Texting. Regular, encouraging text messages can help your loved one feel connected and supported.
  • Be positive. Keeping a positive outlook will influence how you interact with your loved one and behave when away from them, resulting in more consistent support for your loved one.
  • Financial support. If you are in a position to do so, help your loved one financially as they navigate recovery. You must be careful not to become a financial enabler or sacrifice your finances too much. Still, your financial support can also push them to set up a long-term recovery environment.

Everything you do counts as long as it benefits your loved one. Remember this whenever you feel like your inability to visit them is harming their recovery.

Supporting Your Loved One During Their Recovery

Recovery doesn’t happen in a vacuum. Everyone needs support, and the rehabilitation process involves more than reducing your loved one’s dependency on substances – it also means learning to function again without drugs or alcohol and mending strained relationships. Consider it a form of healing for your loved one and yourself, and know that your support is a crucial factor.

If you want to be more involved in the process, speak with the staff at the facility your loved one is staying in. They’ll likely be able to share many resources with you, point you toward support groups, or set up family therapy sessions. 

Winter-Related Factors Linked to Increased Risk of Addiction

Various factors make winter a potentially high-risk season for people with substance use disorder (SUD). First, research shows that opioid overdoses increase in winter. More specifically, fatal overdoses can spike by up to 25% after extended periods of freezing or below-freezing temperatures due to various social, behavioral, and environmental factors.

However, opioids aren’t the only substance that becomes more likely to be consumed in winter. That’s because the cold and lack of sunlight cause a series of emotional and physical changes that make people more vulnerable to mental illness and physical aches, both of which are significant risk factors for SUD.

1. Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder (SAD) is a type of major depressive disorder at the same time each year. People with this condition experience symptoms of depression in the same season every year, such as feelings of hopelessness, sleep problems, and unexplained weight changes.

While commonly related to winter, when the temperatures drop and there is less sunlight, SAD can also occur in other seasons. When SAD happens during spring and summer, it is called summer-pattern SAD and is less studied than winter-pattern.

When symptoms begin, some people may try to self-medicate with substances, a common gateway to addiction. Others may try to alleviate their lack of energy through stimulants or numb their negative emotions with alcohol or opioids.

2. Social Isolation

In addition to potentially contributing to mental illness, winter may also lead to less social interactions due to spending less time outdoors. Also, holidays can be isolating for people far from their families or who don’t have strong family connections.

While loneliness is expected in many life situations (moving out of a familiar environment, losing a loved one, etc.), there’s an undeniable link between sustained loneliness like the one some people feel in winter and substance abuse.

A lack of social connection and support can lead to unhealthy behaviors, and experts now recognize loneliness as a significant risk factor for several health conditions, including substance use disorder. It can also exacerbate co-occurring disorders like depression or anxiety, the most common mental illnesses that happen alongside substance abuse.

Furthermore, the cycle of loneliness and substance abuse perpetuates itself, with loneliness inciting substance abuse, in turn leading to further isolation.

3. Proneness to Opioid Use and Fatal Overdose Risks

Cold weather can cause body aches and pains due to changes in barometric pressure that expand and contract tendons, muscles, and scar tissue. This often leads to pain in joints affected by arthritis. Also, low temperatures can thicken the fluids inside joints, causing stiffness exacerbated by being physically inactive.

All these factors increase the risk of opioid use or relapse. Unfortunately, cold weather also increases the risk of fatal opioid overdoses, according to research. The study found a 25% increase in fatal opioid overdoses after periods of freezing temperatures.

The reasons aren’t obvious, but researchers suggest it could be a combination of factors. The main ones are opioids’ impact on respiratory function and body temperature regulation and behavioral changes during cold weather, like using opioids alone, which increases overdose risk.

This shows that a combination of social, behavioral, and environmental factors makes winter a potentially high-risk season for people who use opioids.

4. Holiday Stress

While we usually associate holidays with having a good time with loved ones, they can be stressful when managing family dynamics, budgeting for celebrations, etc. For people who actively experience substance abuse or are in recovery, these stressors can worsen their condition.

Holiday drinking, in particular, is widespread. As people face pressure to drink from peers and the mere presence of alcohol during social events, they may experience triggers and cravings.

Additionally, LGBTQ+ folks are more vulnerable to holiday stress and may resort to drinking to cope with depression, anxiety, and feelings of rejection for expressing their authentic selves.

A few ways to cope with holiday stress-induced alcohol consumption include:

  • Bring your non-alcoholic beverages to a social event or focus only on non-alcoholic drinks. 
  • Connect with friends and family members who understand and support your sobriety goals.
  • Exercise, sleep well, and focus on eating healthy during the holidays.

These strategies can help you manage the stresses of the holidays and the increased risks of substance abuse that come with stress.

5. Economic Hardships During Winter

Winter can be a financially difficult time due to the costs associated with home winterization, utility bills, holiday spending, potential injuries, car maintenance, winter wardrobes, property damage from ice and snow, and other expenses caused by the harsh weather. All these factors can strain your budget, leading to financial stress.

In addition to putting you in a difficult financial position, the potential economic hardships of winter can increase stress and anxiety, which are risk factors for substance abuse.

That’s because financial strain can lead to a low mood and a sense of hopelessness, making some people more likely to use substances as a coping mechanism, especially those with a history of substance abuse. 

According to research, older men are particularly vulnerable to heavy drinking due to financial stress.

6. Vitamin D Deficiency

Vitamin D deficiency, or hypovitaminosis D, occurs when people have a below-normal vitamin D level. One of our primary sources of vitamin D is sunlight, so winter’s short days make us more likely to develop a deficiency.

Low vitamin D levels deteriorate our bone health and immune system, leading to a higher risk of experiencing common colds, bronchitis, pneumonia, and other diseases. Additionally, research shows that low vitamin D levels are associated with more intense symptoms of depression and anxiety, which is why mental health professionals should perform vitamin D screenings when treating these mental illnesses.

A study suggests that low vitamin D levels increase the effects and cravings of opioids, potentially increasing the risk of addiction. Another study suggests that people with severe substance use disorders often also have vitamin D deficiency. The study suggests serum vitamin D concentration may influence the severity of substance abuse.

The relationship between vitamin D, mental illness, and substance abuse is complex and needs more research. However, based on what we know, vitamin D helps our tissues and organs work correctly, so a deficiency may lead to being more vulnerable to mental illness, facing more challenges when recovering from substance abuse, and experiencing higher risks of relapse.

It’s important to remember that substance abuse can potentially co-occur with many physical and mental illnesses, including nutritional deficiencies. As a result, it’s essential to see the bigger picture while also recognizing that vitamin D deficiency during winter can increase substance use and abuse risks.

7. Indoor Winter Lifestyle

Due to the harsh weather conditions, winter often leads to a predominantly indoor lifestyle. As we’ve explored, winter can increase social isolation, contribute to seasonal affective disorder (SAD), and minimize vitamin D levels because we’re less exposed to the sun, especially in cloudy regions.

All these factors, when combined with being effectively trapped indoors due to the weather, can lead to an increased risk of experiencing mental illness and substance abuse, especially in people with a history of addiction.

But the indoor winter lifestyle may also introduce boredom into the mix. Although boredom may initially seem a trivial feeling that passes by, it’s a complex emotional state that psychologists don’t fully understand yet. Boredom can have serious consequences, as people who get bored easily face a higher risk of developing:

  • Depression
  • Anxiety
  • Addiction
  • Problematic gambling
  • Eating disorders
  • Hostility
  • Anger
  • Poor social skills
  • Poor work and poor academic performance

Engaging in stimulating activities throughout winter can mitigate the risk of boredom contributing to a relapse.

Some examples include new hobbies, learning healthy coping mechanisms, planning outdoor activities when the weather allows it, maintaining social connections, volunteering, and ultimately giving these activities enough time to grow on you and start making a difference in your emotional state.

Seeking Help During the Winter

Winter is a challenging enough season for most people without the added burden of an SUD. Arranging holiday plans, the drop in temperature, and the shorter days resulting in less sunlight can affect your emotional well-being and increase the risks and effects of substance use.

You should be able to enjoy this time of the year as much as anyone else, so if you or a loved one experiences any of the seven factors discussed in this article, seek help for substance use.

SUDs are complex conditions, and we all benefit from support, whether from family and friends or the healthcare system. Taking the first steps may seem impossible, but they will lay the groundwork for your long-term recovery.

How To Get Treatment For Your Spouse

Loving an addict is hard — for a lot of reasons. 

Drug addiction can erode trust, communication, and self-worth, inflicting emotional hardship on all involved. However, dealing with an addicted loved one can be especially difficult in romantic relationships when both parties live together and whose lives are deeply interwoven. 

Not only does the spouse of an addicted person have to grapple with their own emotions as they witness their partner intentionally harm themselves, but they must also deal with the financial burden of addiction as well. 

That’s why getting help for your partner isn’t just a matter of saving their lives but also looking out for your own well-being. Doing so is easier said than done, however. Here’s how to help an addicted spouse and support their recovery journey. 

What to Do to Help an Addicted Spouse

Educate yourself

The first step when seeking treatment for your spouse is to learn what treatment entails, from the treatment options available to how they work. Many facilities specialize in a certain approach (e.g., holistic, family-oriented, luxury), so there are many different options from which to choose. 

It’s also important to know the different levels of care. There’s detox, intensive inpatient (which is also referred to as residential treatment), partial hospitalization (PHP), and outpatient treatment. Each has a unique treatment structure, which will ultimately determine the time commitment and cost. 

Further, each program has its strengths; some are more flexible while others offer rigid structure, others provide an immersive recovery experience, whereas another makes it easy to make treatment a part of their existing routine. 

Knowing these details will be extremely helpful in the next step: choosing treatment facilities. 

Research treatment facilities

There are over 17,000 addiction treatment facilities in the United States (your city alone might have dozens of options to choose from), so it’s a good idea to have several options available before broaching the subject of going to rehab with your spouse. 

One reason this preparation is handy is that it’ll give you the opportunity to look for amenities, programs, or other perks that can make the idea of going to rehab more appealing. There are facilities centered around music, others around adventure and the outdoors, and others still specializing in animals. (We could go on and on.)

However, the main benefit of having multiple facility options is that if they agree to go to rehab, you won’t lose momentum by waiting the days, weeks, or months it can take to find a suitable program. 

Get advice about how to approach them

Talking about addiction can be a touchy subject, no matter how close or loving your relationship. Maximize your odds of success by getting advice on how to broach the topic. The key is to seek advice from a reliable source who can help you have a productive conversation with your spouse. 

One source can be your prospective addiction treatment center. They’re experts in working with people who aren’t always receptive to accepting help. It’s highly likely that their admissions team can provide professional guidance. 

Another great resource is Al-Anon, a support group for those whose loved ones have a substance abuse disorder. There, you hear stories of others who initiated similar conversations and get pointers and other feedback so you can anticipate what type of resistance you might face. Find an Al-Anon meeting group near you today.

Speak with compassion

Once you’re ready to initiate the conversation, go into it with a mindset of compassion rather than confrontation. If you’re feeling upset or angry, hold off and have this talk another time. It’s too important a subject to risk lashing out because of your temper and potentially pushing them away. 

Avoid using language that places blame (e.g., using sentences that begin with the word “you”) or involves negative labels like ‘junkie’ or ‘addict.’ Doing so will likely be counterproductive and only serve to make them defensive and resistant to your words.

Can I force my spouse to go to rehab?

If the situation is truly dire and you’ve exhausted all other options in trying to help your addicted spouse, there might be an option that can get your loved one into rehab despite their objections. It’s a process called civil commitment and can result in court-mandated addiction treatment. 

The process first starts with an evaluation by a mental health professional. If your spouse is deemed to be a danger to others and themselves, a petition can then be submitted to the court. A hearing will then be held where a judge will determine whether involuntary enrollment in a treatment facility is the best course of action.

High-functioning depression and substance abuse

Pop culture often portrays depression in the same way: a person who refuses to leave their home — or even just their couch — to shower, get out of their sweatpants, and otherwise function in a normal capacity. Their professional, social, and romantic lives are in shambles—just another good example of why you shouldn’t believe everything you see on TV. 

Not everyone experiences depression this way. Symptoms can vary wildly from person to person depending on the severity of their mental illness, which ranges from mild to severe. Then, some individuals appear to be fine outwardly; they can keep up with their daily responsibilities at work, keep their relationships intact, and may even be the first person to crack jokes. 

Consider Chelsie Kryst, a successful Division I track and field college athlete who earned her MBA and law degree and became a working attorney before being crowned Miss USA in 2019. From there, she became a host for a popular television channel, Extra, for which she was nominated for two daytime Emmys. Chelise was a very active, social, and, by all accounts, successful woman. 

Then, Chelsie committed suicide at the age of 30. 

It was only after her death that Chelsie’s closest friends realized she had a mental illness, and the condition commonly known as “high-functioning depression” began to enter the mainstream vernacular. It’s when people like Chelise appear perfectly fine on the outside and may even appear happy, but beneath the surface, they struggle and often do so alone.

Recognizing High-Functioning Depression: Symptoms & Signs

High-functioning depression isn’t included in the DSM, and therefore, it isn’t formally recognized as a clinical disorder even though the term is fairly commonplace. Instead, it’s typically referred to as ‘persistent depressive disorder’ by medical professionals.

Just because someone appears to be functioning well on the outside does not mean that they aren’t suffering on the inside. However, identifying high-functioning depression can be challenging, as individuals often mask their symptoms. 

High Functioning Depression & Drug Abuse

As you can imagine, high-functioning depression can easily go unnoticed and be difficult to detect. It might also evade formal medical diagnosis because the typical symptoms of depression aren’t there. 

As a result, these individuals usually end up battling their mental illness on their own. Without access to prescription antidepressants, they may turn to self-medication through drugs and alcohol, a common coping mechanism even for individuals who aren’t suffering from a mental illness. 

Like most circumstances involving drug use — things can quickly go from bad to worse when drugs and mental illness are combined. There’s a very high likelihood of them exacerbating depressive symptoms, pushing a person deeper into depression and furthering this harmful cycle. 

Another potential cause of this correlation is a hallmark of high-functioning depression symptoms: feeling emotionally numb. Individuals with high-functioning depression often become masters at concealing their true emotions. Whether from fear of social stigma or the pressure to maintain a facade of normalcy, these individuals are highly adept at putting on a brave face. 

The result? People feel detached from their emotions and experience a persistent emptiness or lack of joy. These individuals then struggle to connect with their feelings and feel disconnected from those around them. This disconnect can lead to feelings of isolation — another common cause of drug use.

Treating High-Functioning Depression

Therapy and medication are the most likely to be prescribed for treating this illness. However, other interventions, such as lifestyle changes, stress management techniques, and self-care

practices can be beneficial as well. Though, when dealing with depression, the importance of a social support system cannot be overstated. 

Having a safe space to express emotions, share experiences, and receive validation can provide immense relief and reduce feelings of isolation. A support system can include friends, family members, or individuals from support groups like Alcoholics Anonymous. These support groups can also be a valuable resource for family and friends who suspect a loved one may be struggling with addiction. 

If you suspect that you or someone you know may be experiencing high-functioning

depression, the first step to take is to reach out to mental health professionals. However, in the case that your loved one is also simultaneously dealing with a drug use issue (regardless of whether it came before or after their mental illness started), the best course of action is to seek a drug rehab facility that specializes in co-occurring disorders. 

The Start Of A New Year: Don’t Trade One Addiction for Another

The New Year often brings high expectations for life changes, which can be particularly challenging for those in addiction recovery. In fact, statistics show that about 65% of individuals recovering from addiction face additional issues such as anxiety, depression, or impulse control disorders. This article delves into the complexities of addiction, highlighting how, even during treatment, individuals might struggle with alternative forms of addiction, underscoring the importance of comprehensive recovery strategies.

Understanding Addiction Replacement

Addiction replacement is a psychological phenomenon observed in individuals recovering from one addiction where they develop a new addiction as a substitute for the previous one. In this case, the addictive behaviors persist, but the object of addiction shifts to a different substance or activity.

This substitution often occurs when the underlying causes of addiction are not adequately addressed. Unresolved psychological and emotional issues continue to drive the individual’s desire for pleasure, relief, or escape. Although the new addiction may offer temporary fulfillment or distraction, it hinders the overall recovery process by perpetuating the cycle of addiction.

Common Types of Addiction Substitution

Addiction replacement often occurs unconsciously, meaning that the person is usually unaware of the development of a new addiction. They may even perceive it as a coping mechanism or a healthier way to redirect their addictive behaviors.

Let’s explore some of the most common forms of addiction replacement:

  • Substance Substitution: This occurs when a person replaces one addictive substance with another. For instance, someone recovering from alcohol addiction may turn to drugs or prescription medications as a substitute. 
  • Behavioral Addictions: Instead of substituting substances, individuals may develop new addictive behaviors. Common examples include gambling or sex addiction, compulsive shopping, excessive internet or gaming use, and workaholism.
  • Process Addictions: Process addictions involve becoming excessively reliant on certain activities or processes. These can include addiction to food, exercise, pornography, or even self-harm.
  • Physiological Dependencies: Addiction substitution can also manifest as dependencies on certain substances that try to replace the stimulating or soothing effects of the first addiction substance or activity. Some examples are caffeine, nicotine, and sugar.

Signs of Replacing One Addiction with Another

According to a study on substance use disorders, it has been found that approximately 1 in 5 patients develop a new addiction during the 3-year follow-up period after their recovery. 

Often, this new addiction goes unnoticed by the person. That’s why loved ones must remain vigilant and attentive to the signs. Here are some of them: 

  • Look for signs of intense engagement, such as spending excessive time and energy on the new addiction and neglecting responsibilities, relationships, or activities that were previously important.
  • The person in recovery may become less committed to their recovery efforts. This could include skipping support group meetings and therapy sessions or not following their treatment plan.
  • Be aware of substance dependence and substitution, such as substituting alcohol with prescription medications or illicit drugs.
  • Pay attention to any significant changes in mood, behavior, or emotional well-being, including increased irritability, anxiety, restlessness, or depression.
  • Just like the first addiction, life consequences escalate with the new one, such as financial difficulties, legal issues, deteriorating physical health, or strained personal relationships.

Strategies to Avoid Addiction Replacement

Although it’s expected in the recovery journey, relapse is a challenging experience. Regardless of whether you are currently undergoing treatment or have been in recovery for an extended period, it’s vital to take a mindful moment to recognize the reemergence of addictive behaviors. 

The key lies in discovering effective strategies to get back on track. Let’s explore some of these strategies below:

  • Engage in therapy, counseling, or support groups. Since underlying psychological, emotional, and social factors can trigger addictions, it’s crucial to address them professionally. 
  • Identify triggers and high-risk situations. Learn to develop strategies that help you manage and cope with your triggers healthily and constructively.

What’s Evidence-Based Treatment for Addiction Recovery?

At its core, addiction is a complex condition that requires comprehensive and effective treatment strategies. Evidence-based treatments (EBTs) stand out as one of the most effective solutions for addiction, offering a recovery path rooted in research and proven outcomes. 

Unlike traditional methods that may be based on anecdotal evidence or well-established practices, evidence-based treatment constantly evolves and is shaped by ongoing research and emerging data in addiction therapy.

Understanding what constitutes evidence-based treatment is crucial for anyone seeking help for themselves or a loved one. Here’s everything you should know about evidence-based treatments for addiction recovery. 

Defining Evidence-Based Treatment

Evidence-based treatment refers to approaches that are backed by scientific research and clinical trials, ensuring they provide the best possible outcomes for those struggling with addiction.

For a treatment to be considered evidence-based, it must undergo a series of evaluations and demonstrate consistent, positive outcomes in treating addiction. These treatments are often peer-reviewed and have a record of success in various settings and among diverse populations.

Evidence-based treatments often include several key components:

  1. Scientific Validation: The treatment has been tested in controlled settings and has shown positive results.
  2. Standardized Protocols: These treatments follow a consistent approach that can be replicated across different settings.
  3. Continuous Monitoring and Adaptation: Evidence-based treatments are not static; they evolve with ongoing research and adapt to new findings in addiction science.

Common Evidence-Based Treatments in Addiction Recovery

Several evidence-based therapies are popular in addiction treatment, including:

  • Cognitive Behavioral Therapy (CBT): Focuses on identifying and changing negative thought patterns and behaviors. CBT helps individuals recognize triggers and develop coping strategies to deal with cravings and avoid relapse. Its effectiveness is well-documented in treating a range of substance use disorders.
  • Medication-Assisted Treatment (MAT): Medication-assisted treatment combines medications, such as methadone, buprenorphine, or naltrexone, with counseling and behavioral therapies. This approach is particularly effective in treating opioid addiction, as it helps to reduce withdrawal symptoms and cravings, making it easier for individuals to engage in therapy and recovery activities.
  • Contingency Management (CM): Contingency Management is a behavior-based treatment that rewards positive behaviors such as staying drug-free. This method has shown success in increasing treatment retention rates and promoting sobriety, especially in cases of stimulant and opioid addiction.
  • Family Therapy: Family therapy addresses the impact of addiction on relationships and helps rebuild trust and communication within the family unit. This approach often involves educating family members about addiction and teaching them ways to support their loved one’s recovery.
  • 12-Steps: Based on the principles of Alcoholics Anonymous, 12-step Facilitation Therapy is a structured approach that encourages participation in 12-step self-help groups. It promotes abstinence through spiritual, psychological, and social support, fostering a sense of community and shared experience in recovery.

Each of these treatments brings a unique perspective to addiction therapy, catering to different needs and situations. 

Benefits of Evidence-Based Treatment for Addiction

Choosing evidence-based treatments in addiction recovery offers several significant benefits, such as:

  • Improved Success Rates in Recovery: Evidence-based treatments are linked to higher recovery success rates and a reduced likelihood of relapse, thanks to their solid scientific foundation and proven methodologies.
  • Tailored to Individual Needs: These treatments can be customized to suit individual circumstances, considering factors like the type of substance used, duration of addiction, co-occurring mental health issues, and personal life situations.
  • Holistic Approach to Treatment: Many evidence-based treatments provide a comprehensive approach, addressing not only the physical but also the psychological, emotional, and social aspects of addiction.
  • Supported by Ongoing Research and Development: The dynamic nature of evidence-based treatment ensures that the therapies used are continuously updated and refined with the latest research and developments in addiction science.
  • Increased Credibility and Trust: For those seeking treatment, the credibility and proven track record of evidence-based methods offer reassurance and hope, contributing to a more secure and promising recovery journey.

Challenges and Considerations in Evidence-Based Treatment

While evidence-based treatments offer numerous benefits, there are also challenges and critical considerations that come into play, such as:

  • Access to Treatment: Factors like location, availability of specialized care, and financial constraints can limit access for many individuals seeking help.
  • Stigma and Misconceptions: Misconceptions about addiction treatments, especially regarding medication-assisted therapies, can prevent people from pursuing these effective options.
  • Personalization of Treatment: While evidence-based treatments are adaptable, finding an individual’s right combination of therapies can be challenging. Each person’s journey with addiction is unique, and it takes skilled professionals to tailor treatment plans effectively.
  • Training and Expertise: Ensuring practitioners are adequately trained in evidence-based methodologies is crucial. Continuous education and training are necessary to maintain a high standard of care in addiction treatment.

Finding the Right Evidence-Based Treatment Program

Choosing the right evidence-based treatment program is a critical step toward successful recovery from addiction. Here are some tips on how to choose the right program:

  • Research and Inquire: Start by researching available treatment programs. Look for facilities that explicitly state their use of evidence-based methods. Ask questions about their treatment approaches, success rates, and staff qualifications.
  • Consider Personal Needs: Each individual’s journey with addiction is unique. Consider personal needs, such as the type of addiction, any co-occurring mental health issues, and personal preferences when selecting a program.
  • Verify Credibility: Ensure the program is accredited and has a solid reputation. Look for reviews, testimonials, and success stories that can provide insight into the program’s effectiveness.
  • Support Systems: Evaluate the support systems in place, both during and after the treatment. Aftercare and ongoing support are vital components of long-term recovery.

Evidence-based treatments continue to be considered the best option for treating addiction. If you or someone you love is struggling with addiction, remember that help is available. Contact a healthcare professional or addiction specialist to learn more about evidence-based treatment options.

Is Rehab Covered Under FMLA?

Substance use disorders (SUDs) affect your life in many ways, including your ability to work. That’s why US law provides employment protections for rehab from substance abuse. It’s called the Family and Medical Leave Act (FMLA), and it exists to help you retain your job while navigating addiction recovery. Let’s explore how you can use FMLA to take much-needed time to start your recovery journey.

What is the FMLA?

The Department of Labor’s Family and Medical Leave Act (FMLA or the Act) provides employees up to 12 weeks of job-protected unpaid leave under certain conditions:

  • Treat a serious health condition as defined by the Act.
  • Assist your spouse, children, or parent with their own health conditions.
  • Care for and bond with a newborn or recently adopted child.

Is Substance Use Disorder a Serious Health Condition?

According to the Act, a serious health condition requires inpatient care or continuing (ongoing) care by a healthcare provider, such as pregnancy, prenatal care, and treatment that leads to a period of incapacity longer than three days.

Serious health conditions include chronic illnesses that occasionally make you unable to work but also more immediate conditions that would require overnight stays at a hospital.

Based on its potential consequences and the realities of treatment, you can see how SUD can be considered a serious health condition. Moreover, SUD often results in further health complications that call for immediate medical attention and recovery time, which would also fall within the FMLA’s definition of “serious health condition.”

Who is Eligible For FMLA?

Not all businesses are covered by the FMLA; even if they are, you might not qualify if you’re very new to the company. For your employer to be legally required to comply with medical leave under this Act, it must meet any of the following requirements:

  • It’s a private company that has employed 50 or more employees for at least 20 workweeks in the current or preceding calendar year.
  • It’s a government agency.
  • It’s an elementary or secondary school. It can be either public or private.

Assuming your employer meets any of these criteria, you still need to meet all of the following requirements to be eligible for unpaid leave under the FMLA:

  • You’ve worked for your employer for at least 12 months.
  • You’ve worked at least 1,250 hours for your employer in the last 12 months.
  • Your employer has 50 employees within 75 miles of your worksite.

You are eligible for FMLA leave if you and your employer meet these requirements.

Still, your employer may ask you to provide certification from a healthcare professional that explains why you need time off work and when you’ll be back. When you return, you must also submit a fitness-for-duty certification.

Can You Take Leave for Addiction Rehab Under FMLA?

Yes. Substance use disorder meets the criteria for a serious health condition, and you can use the FMLA for any necessary treatment, including rehab, inpatient treatment such as hospital stays, and treatment for other conditions caused by SUD. Note that the keyword here is treatment. A medical professional must justify your absence, and you’ll need to provide proof that you went through said treatment.

FMLA also ensures that, although the leave is unpaid, you still have access to the health benefits your employer provides. FMLA protects you from demotion and refusal of promotions, too.

Can an Employer Deny Your FMLA Rehab Leave?

Not all leave requests under FMLA are automatically granted. There are specific criteria and situations where an employer can legally deny FMLA leave, including:

  • Eligibility Requirements: Not all employees are eligible for FMLA leave. An employee must have worked for the employer for at least 12 months, have at least 1,250 hours of service for the employer during the 12 months before the start of leave, and work at a location where the employer has at least 50 employees within 75 miles.
  • Exhaustion of FMLA Leave: If an employee has already used up their 12 weeks of FMLA leave in the 12-month period, the employer can deny additional leave.
  • Insufficient Information: Employers can deny FMLA leave if the employee fails to provide adequate documentation or sufficient medical certification to support their leave request.
  • Non-Qualifying Reason: If the leave is for a reason that doesn’t qualify under FMLA (e.g., non-serious health conditions or matters unrelated to immediate family or medical emergencies), the employer can deny the leave.

It’s important to note that the specific circumstances of each case can vary, and both employers and employees should consult with HR professionals or legal experts to understand their rights and responsibilities under FMLA. Employers must also comply with state-specific leave laws, which can sometimes provide additional protections or requirements beyond the federal FMLA.

Take the Next Step in Your Recovery Journey

If you or someone you know is considering rehab for substance use disorder and is concerned about job security, remember that you are not alone in this journey. The Family and Medical Leave Act (FMLA) is there to support you, but navigating its provisions can be challenging. 

Talk to an expert to help you understand your rights under FMLA, assist in coordinating with your employer, and provide essential resources for your rehabilitation process. Don’t let uncertainty hold you back from taking the crucial steps towards recovery and well-being.

Life After Rehab

Completing a drug rehabilitation program is an important step toward reclaiming your life after addiction. It’s exciting, but transitioning from the structured environment of rehab to the outside world where you have near total freedom can also be a bit nerve-wracking. Here are six things you should do to support your recovery after rehab, plus expert tips on overcoming any challenges you might face along the way.

Have the right mindset

Keep in mind that recovery is a lifelong journey that can have its fair share of twists and turns. You’ll need to give yourself grace when you make mistakes, backtrack, and stay flexible as you encounter aspects of your old life that no longer fit the healthier and happier you. This will also help you stay motivated in recovery and give you higher odds of success.

Develop a relapse prevention plan

Set yourself up for success by preemptively creating strategies that will help you maintain your sobriety in the face of triggers, stressors, and cravings. These can include ways to distract yourself, like learning healthy coping mechanisms such as mindfulness techniques, exercising, or engaging in hobbies, which can provide alternative ways to deal with stress or cravings. It might entail thinking of ways to involve people or places associated with past drug use or other accountability measures. 

Have a social support network

Surrounding yourself with people who understand your journey and are committed to your sobriety can significantly impact your chances of long-term success. Every relapse prevention plan should also include a list of emergency contacts you can reach out to in times of need. This person could be your therapist, Alcoholics Anonymous sponsor, or a trusted friend. Make sure that they know this responsibility so that they can assist you when the time comes. 

However, your support network doesn’t have to be restricted to those who know you are in recovery or have been in recovery themselves. Your support system can include friends, family members, support groups, and anyone who contributes positively to your recovery.

It’s also helpful to surround yourself with positive influences and seek inspiration from others who have successfully overcome addiction. Reading success stories, attending recovery-related events, or listening to motivational podcasts can help fuel your motivation.

Develop healthy habits

Regular exercise, eating nutritional foods, and being well-rested will go a long way towards improving overall wellness. Physical activity helps reduce stress and releases endorphins, which can improve your mood and overall sense of well-being. You don’t need strenuous exercises to get these benefits either. Even just a short walk can be enough to get a mood boost.

And nutrition and sleep go hand-in-hand. It’s common for people with a drug use disorder also to have some level of malnutrition, which prevents the body from being able to function as normal or to repair itself. Sleep also plays a vital role in restoring the body and is when the bulk of things like muscle repair and tissue growth occur. It also plays an important role in regulating emotion — not to mention that a lack of sleep can impair cognition mood, and elevate stress levels.

Prioritize self-care

Recovery can leave a person in a sensitive state — both physically and mentally. It’s important to minimize activities that cause stress while also actively seeking people, places, and things that make you feel safe, secure, and relaxed. This is particularly important as drugs are often used as a coping mechanism for dealing with stressful situations, and leaving yourself vulnerable to stressful things can put you at a higher risk of relapsing. 

Celebrate milestones

Through the ups and downs, take time to recognize all you’ve accomplished and how far you’ve come in your journey. Celebrate your achievements, whether completing a certain number of sober days or reaching a specific goal. Acknowledge your progress, reward yourself, and continue to set goals to keep yourself on track.

Don’t be afraid to ask for help

Even after you’ve finished your treatment program, you could still benefit greatly from working with a counselor or therapist. Many drug rehabs have support programs for alumni that can offer resources and opportunities to connect with others who have gone through the program. 

If you feel that you’re losing your way, you can always find support at Alcoholics Anonymous and Narcotics Anonymous meetings. These are people who have been in your shoes — or are still currently in them. Don’t go through life after rehab alone. Find a meeting near you today.