Category: substance abuse

Drinking during COVID-19

When governors across the U.S. were shutting down states due to COVID -19 they labeled liquor stores as essential businesses.  Many of us laughed at this and said jokingly, “Oh yah, liquor stores are essential lol.”  The reality is that liquor stores were not designated as essential just because people like to drink.

They were designated essential because many people drink so much that if they stopped suddenly it would be dangerous. Most of us consider alcohol as a pretty safe substance after all it wouldn’t be legal if it wasn’t, right?

The reality however is very different. Alcohol can actually be more dangerous to detox from than heroin is.  Someone who is detoxing from heroin feels like they have a really bad case of the flu but as long as they stay hydrated they will usually be ok (should still detox under medical supervision). 

Someone detoxing from alcohol however risks experiencing Delirium Tremens (DT’s). Someone experiencing DT’s may experience shaking, confusion, high blood pressure, fever, and hallucinations to name a few symptoms. They can also experience cardiac issues. The bottom line, alcohol is actually the most dangerous substance to detox from.

Now most of us are not going to become severe alcoholics from this pandemic but reports indicate that there has been a significant increase in alcohol use during the pandemic. 

After all, we’ve been isolated at home either by ourselves or with small groups for a long time. Things can get pretty boring and a few drinks can definitely make it less boring. While there is no initial harm in having a drink or two, ask yourself if the frequency of your drinking has increased? 

Has the amount of your drinking increased?  If you answered yes to either or both of these questions ask yourself if you are beginning to look forward to a drink? Ask yourself what that drink will do for you and more specifically how will it change the way you feel?  You see the reason we use substances is very simple. They change our feelings and they do it quickly.

So what changed feelings do you experience when you drink? There is nothing wrong with wanting to be less bored, less anxious, happier, etc., the risk however is that if we begin to recognize alcohol as a quick path to these desired feelings there is a pull to turn to alcohol more quickly and more often. 

So what’s the harm? Besides the physical damage excessive alcohol use dues to your body, there are other negative psychological consequences. For example, the more you use alcohol (or other substances) to change your mood the less likely you will be able to change your mood without them. In addition, as your body develops a tolerance to alcohol you need to drink more to get the desired effect.

Eventually, however, your drinking just to feel normal. No one plans on becoming addicted to alcohol or another substance but it happens insidiously, little by little until one day you realize you’re no longer in control of your life, instead, the alcohol or substance is in control. The best solution is to avoid substance use completely, but if you aren’t going to do that at least pay attention so you can realize early on if your substance use is changing. 

Larry Blackwell, LCSW, AADC

Substance abuse prevention program for teens

The truth is that the pandemic is increasing substance abuse by adults and teens. I could easily modify this to help adults be aware of their own substance use during these difficult times and to also give them pointers about talking to their teens about potential substance abuse.

The key concepts 

  1. Parents and teens need to know why teens are at such high risk for substance abuse including nicotine.  This is extremely important.  The reality is that because teens’ brains are not fully developed yet, they physically lack the ability to accurately judge the consequences of their behavior (think of some crazy things you did as a teen that you would never do now). This goes for every teen to a greater or lesser extent, even the class valedictorian. In other words I.Q. Has nothing to do with this. 
  2. Teens are more motivated by both emotional and physical rewards (rewards equal excitement) than either adults or younger kids.  This means that teens are basically wired to engage in highly risky behavior such as vaping, drug use, and risky driving, etc. This same motivation for rewards can be used by parents to minimize risky teen behavior. 
  3. Families need to know the protective and the risk factors that help shape if a teen will develop a substance abuse problem whether it be nicotine, alcohol, weed, opioid, etc… Parents need to know the fact that healthy parental involvement is the number one protective factor for teens when it comes not only to preventing tobacco use but preventing other high-risk behavior as well.  Parents need to be educated on how to capitalize on their unique role as the number one protective factor.
  4. Teens need to understand how activities such as vaping can quickly reduce stress and anxiety. As teens experience the benefits of their substance use they increase the risk of using more dangerous substances. Teens don’t realize the dangers of self-medication, they only know it works.  
  5. Parents need to be aware of their own substance use and what message they are sending their teens. I’m not saying they have to abstain (unless they want to) but they should use legal substances responsibly.  If parents smoke or even if they engage in excessive drinking it sends the message to teens that tobacco use is no big deal. 
  6. Most parents don’t know how to talk to their teens about difficult topics like substance use.  I’d like to help parents and teens learn some collaborative problem-solving techniques to help both teens and parents to communicate with each other so both can feel heard.  
  7. Most teens and their parents don’t think that they will end up with serious substance abuse issues. After all, a thing like opioid use is a big leap from vaping or even smoking weed. While most teens will not end up with a substance abuse problem they and their parents need to understand that even things like cigarettes and vaping are not harmless. Nicotine affects the growth of the teen brain and primes it for further substance abuse. We also know that the younger a person starts using things like cigarettes and e-cigarettes the higher the risk they have for developing a serious substance abuse problem.
  8. Teens/young adults can be taught  motivational intervention techniques to shape their beliefs and attitudes about substance use. This is extremely important. These motivational intervention techniques can actually create a level of “inoculation” for teens against high-risk substance use. The motivational techniques don’t tell teens what to think about substance use, instead, they help the teens ultimately make up their own minds about drug use. This happens at a deeper level and can actually circumvent the underdeveloped executive processing. A great example of this is back at the height of the AIDS epidemic. Despite teens being much more impulsive than adults, teens actually practiced safe sex at a higher rate than adults. Once they got it solidly in their heads that AIDS would kill them, they were able to begin to plan ahead to protect themselves. 
  9. Families need to know the benefits of contracting with teens around substance abuse. Now a simple contract on its own is not worth the paper it’s written on. Instead, the contracts I am talking about are more like living treatment plans. For example, parents and teens would discuss what the teen is willing to commit to
    For example if a teen vapes they may not be willing to commit to stop and parents need to respect that but parents can add in incentives if their teen cuts back. Since we know that rewards work better than punishments parents can reward their teens for all abstinence. I realize that it can at times be hard to know if your teen has been abusing substances but by providing parents with the tools to talk to their teens about substances as well as educating them on warning signs they can have a pretty good idea. 
    Another part of the contract covers things like If your teen gets drunk. While there should always be consequences for teens getting drunk the consequences should be less severe if the teen were to call the parent for a ride than if the parent finds out on their own. Consequences would also be spelled out so if a teen calls mom or dad for a ride they shouldn’t have to worry about a lecture at the time of pick up. Instead, the consequences are preset so the parent can focus on acknowledging the thing their teen did right which was to call them for a ride.

Larry Blackwell