Canada Drug Rehab

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for the Sunshine Coast Health Centre, discusses addiction and co-occurring disorders such as depression, anxiety and attention deficit disorder.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for Sunshine Coast Health Centre, discusses what you should be concerned about if your loved one feels they could handle drinking again after addiction treatment.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for Sunshine Coast Health Centre, shares ways to discuss having alcohol in your home or at family gatherings when a loved one is in recovery, without singling them out or making them feel “abnormal.”

By Daniel Jordan, General Manager
Sunshine Coast Health Center

It is often easy to overlook the damage alcohol causes in our society since, unlike other drugs like cocaine, it is legal. Alcohol continues to be encouraged as a social “lubricant” in our busy world as a way to unwind or to have fun. However, as Emergency Services prepares to gear up for another high school graduation, perhaps it is time to review some important statistics about the alcohol-related health and social harms in BC and Canada.

Types of Harms Related to Alcohol

According to the BC Provincial Health Officer, alcohol-related health and social harms derive largely from four properties or effects of consumption:

1. Toxicity - alcohol poisoning (overdose)

Death from acute cardiac arrhythmia or acute pancreatitis. More often than not, alcohol overdoses affect the inexperienced drinkers who tend to be under age.

2. Intoxication - injury or crime

Death or injury resulting from violence, sexual assault, crime, alcohol-involved traffic casualties, etc.

- According to the BC Injury Research and Prevention Unit, approximately one-quarter of the 400+ fatal motor vehicle crashes that occur every year in BC are alcohol-related (Rajabali & Pike, 2008).

- According to a 2002 study (Pernanen, Cousineau, Brochu, & Sun, 2002), one-third of all crimes, charges, and prison sentences in Canada involve alcohol.

- A recent study by the Canadian Medical Association Journal showed that more than 21 per cent of sexual assaults are facilitated by drugs, up from 12 per cent in 2003. While this is a huge increase, an equally important finding from the Canadian Medical Association Journal research is that almost 90 per cent of these victims had used alcohol before the attack.

- Deaths due to toxicity (poisoning) and intoxication (injury)combined accounted for 2.7 per cent of all deaths in BC between 2001 and 2005 (Source: BC Alcohol and Other Drug Monitoring Project).

3. Dependence - alcoholism

Long-term excessive use of alcohol is directly linked to cirrhosis of the liver, some types of cancers, diabetes, hypertension (high blood pressure), brain damage, and wasting of the limb and heart muscles.

- In a 2002 Canadian Community Health Survey, 3.6 per cent of the BC population (122,400 people) were estimated to be alcohol dependent.

- There is a strong correlation between heavy alcohol use and mental health conditions, such as major depression and anxiety disorders. It is estimated that 1.3 per cent of Canadians age 15 and older (approximately 336,761) reported experiencing co-occurring major alcohol use and mental health disorders in the previous year (Rush et al., forthcoming).

- Deaths due to chronic drinking accounted for 2.1 per cent of all deaths in BC between 2001 and 2005  (Source: BC Alcohol and Other Drug Monitoring Project).

4. The Intergenerational Effect of Alcohol - Fetal Alcohol Spectrum Disorder (FASD)

A fourth source of harm that involves alcohol is alcohol consumption by pregnant women. Fetal Alcohol Spectrum Disorder, or FASD, is the leading cause of preventable mental disability in Canada. FASD is unique in that the harm inflicted is to the unborn fetus rather than to the alcohol-consuming individual or other members of society. Estimates are for every 1,000 babies born up to 3 will have the full features of FASD, while an additional 5 or 6 will have significant long-term disabilities. In BC, between 200 and 320 infants may be born affected by alcohol each year (Provincial Health Officer, 2002). A substantial protion of the costs of special needs education, youth justice, adult incarceration, homelessness, and adddiction can be attributed to FASD (Provincial Health Officer, 2002).

Conclusion

The ripple effect of alcohol in Canadian society is revealed in the statistics. According to the 2004 Canadian Addiction Survey , 10 percent of Canadians reported at least one harm during the past year from one’s own drinking (age 15+) and nearly 4 in 10 reported at least one harm * during the past year from others’ drinking (18+).

At our treatment center, alcohol is still the drug of choice for over three-fifths of our clients. For those whose drug of choice is cocaine, alcohol is often their second drug of choice. Even though we don’t treat for date-rape drugs since few develop a dependence to them, our date-rape drug section accounts for four of our top 10 search terms for people visiting our Sunshine Coast Health Center website. We believe there is a need for public education on how alcohol is a factor in sexual-related assaults.

Hopefully, Canadians will begin to appreciate that there are many ways to get hurt, directly or indirectly, from alcohol. One does not need to develop alcoholism to be negatively impacted. This message needs to be conveyed to high school students who often have a very narrow understanding of the harms associated with alcohol.

(*) Note: Harms associated with others’ drinking include (1) being insulted or humiliated (22.1%), (2) verbal abuse (15.8%), (3) serious arguments or quarrels (15.5%), (4) being pushed or shoved (10.8%), (5) family or marriage problems (10.5 %), and (6) being hit or physically assaulted (3.2%).

Source

This blog article is a summary of Public Health Approach to Alcohol Policy: An Updated Report from the Provincial Health Officer issued in December 2008 by P.R.W. Kendall, Provincial Health Officer. 

Dedication

This blog is dedicated to Richie Dowrey who is in grave condition in hospital following a punch to the face from a fellow patron at the Fountainhead Pub on Davie Street in Vancouver on St. Patrick’s Day. Richie was punched without warning or any apparent reason. Richie has two children. Our prayers are with him and his family for a speedy recovery.

References

Du Mont, Janice; Macdonald, S.; Rotbard, N.; Asllani, E.; Bainbridge, D.; and Cohen, M. (March 2009)
Factors associated with suspected drug-facilitated sexual assault
Can. Med. Assoc. J., 180: 513 - 519 ; doi:10.1503/cmaj.080570

Pernanen, K., Cousineau, M., Brochu, S., & Sun, F. (2002) Proportions of crimes associated with alcohol and other drugs in Canada. Ottawa, ON: Canadian Centre on Substance Abuse.

Provincial Health Officer (2002) Public health approach to alcohol policy: a report of the Provincial Health Officer. Victoria, BC: Ministry of Health Planning.

Rajabali, F., & Pike, I. (2008) Alcohol-related motor vehicle crash deaths in British Columbia: 2003-2005. Vancouver, BC: BC Injury Research and Prevention Unit.

Rush, B., Urbanoski, K., Bassani, D., Saulo, C., Wild, C., Strikes, C., et al. (forthcoming) Prevalence of co-occurring substance use and other mental disorders in the Canadian population. Canadian journal of psychiatry.

By Cathy Patterson-Sterling, MA, RCC
Director of Family Services, Sunshine Coast Health Center

 The “make sure you look both ways before you cross the street” safety talk, the “Birds and Bees” and “where do babies come from talk”, and, of course, the dreaded talk about alcohol and drugs are a sampling of the many milestone talks that we will have with our children as they grow up through the years. For many of us as parents, the alcohol and drug talk can be one of the most challenging. The following includes five tips parents may wish to keep in mind that, besides the “don’t do drugs” talk, will help keep their kids safe from the harms associated with drugs and alcohol:

Tip #1: Be mindful of your relationship with alcohol/drugs/mood-altering substances

Remember that children’s greatest influence is their parents and parents are likely the first people to introduce to their children the meaning of alcohol and drugs by using substances themselves or through their comments. Therefore parents should be mindful of the meaning substances have in their lives such as: “I need a cigarette,” “Oh no! I’m out of coffee! I guess my morning is shot,” or “What a day! Someone get me a Tylenol.”

Tip #2: Teach your children to work through their feelings

Addicted individuals do not believe they can function without alcohol and drugs. Such people are “numbing feelings,” “escaping pain,” and “mood-altering in order to feel good.” Parents need to help their children understand that feelings are normal and need not be overwhelming. Furthermore, the problems or thoughts that created these undesirable feelings will still be there when the effects of the mood-altering substance fade away.

Tip #3: Allow your children to experience consequences and learn from their mistakes

In life, we as people will make good decisions and mistakes. We need to experience consequences for our decisions so that, depending on the outcome, we repeat or avoid making the same decision the next time.  There are natural consequences for all of our decisions in life. As parents, we can help our children reflect on their decisions at each stage so that they learn to take responsibility for their behaviours. This critical thinking skill will be necessary for when they go through the teenage experimental years and are exposed to drugs/alcohol.   

Tip #4: Teach your kids self-preservation

People do not have to be addicts or alcoholics to die from booze and drugs. Many do so by accident, particularly youth. Drug and alcohol use can easily become a self-destructive activity especially if people are drinking/using drugs in excess and are making poor decisions such as driving while impaired. Statistics show that many deaths and harms associated with drugs and alcohol are committed by accident by the inexperienced drinker or drug user (i.e. fights, car crashes, falls, poisonings, etc.) *. As parents, we can teach our children to practice self-preservation by taking care of themselves and making personal safety a priority.

(*) Source: Public Health Approach to Alcohol Policy: An Updated Report from the Provincial Health Officer (December 2008) P.R.W. Kendall, OBC, MBBS, MSc, FRCPC

Tip #5: Connect your children to positive activities

Youth with dreams, goals, and a sense of belonging will move more quickly through the stage of experimentation with alcohol/drugs. Essentially, drugs and alcohol are “dream-stealers” and youth need to know that if they stay in this alcohol/drug mis-use stage long enough that they will depend on substances to cope in life as they slowly start to give up on more ambitious goals for themselves.

Conclusion

By practicing these five tips at home, parents can begin to plant the seeds of prevention where kids will naturally start to make the right choices. Parents need not concern themselves with becoming experts or worry that their past experimentation with drugs or alcohol will make them sound like hypocrites. By being a positive role model, expressing concern for their safety and health, and involving them in positive activities, parents can help insulate their kids from alcohol- and drug-related harm.

When people with addictions quit drugs or alcohol, they are usually left with a huge hole in their lives. They often feel lost. What do you do on a Sunday afternoon when no one is about and you have to entertain yourself? In active addiction, the answer was easy. But in recovery, it is a lot more challenging.

This posting offers some useful tools to overcome boredom. A famous psychologist, Mihaly Csikszentmihalyi (pronounced chick-sent-me-high-ee), developed a theory that he calls “Flow.” The basic idea of ‘flow’ is that when we are in the flow we are totally absorbed in whatever activity we are doing. In fact, being in the flow is much more than simply giving you something to occupy your time with. It’s much more than simply cutting the grass or watching TV. It is necessary for contentment, accomplishment, and creativity. In short, being in the flow makes life worth living.

To give you a sense of how powerful flow is, one psychologist has described flow this way: “Flow reminds us that the truest approach to making ourselves feel and function better is to look within.” Another said that flow is a “prescription for happiness in our indifferent universe.” We are at our best when we are totally absorbed in something: listening to music, working on a challenging problem, learning how to fly, dancing, making love, and on and on.

Addiction as being in the flow

Csikszentmihalyi, himself, said that flow is what gives meaning to an individual’s life. But here’s an interesting thing: when we’re high on alcohol or drugs, we are also in the ‘flow’; in fact, being in the flow is the very power of drugs. Lots of things become fascinating when we’re high: addicts can play video games for hours, think about life, become one with a motorcycle when riding, enter a trance-like state while dancing, make love at the level of ecstasy, discover music that makes the hairs on the back of your head stand up, and so on.

The idea of flow was developed by studying how contented, creative people live their lives. Csikszentmihalyi noted that flow has eight components. One example is that the experience is intrinsically interesting (what he calls “autotelic”). Another is that our perception of time changes.

Remember back to being high. Likely, you had the feeling of being totally absorbed in the drug high, the passage of time might have slowed down or sped up, the experience of doing something seemed to be interesting for its own sake. For example, chores that might bore you when you’re sober can seem fascinating when you’re high.

But there’s one component necessary for flow that is missing in addiction. Csikszentmihalyi emphasized that the activity must have meaning and purpose every step of the way. Because addiction lacks any meaning and purpose (we go against our values and beliefs when in active addiction), all the effort getting and using drugs accomplishes little more than make us suffer in the end.

Living Creatively in Recovery

Now that you’re clean and sober, it’s important to make your world come alive. And this demands that you be creative. Being in the flow is essential for creativity. In fact, to help us find this creativity through flow, Csikszentmihalyi wrote a book called Creativity: Flow and the Psychology of Discovery and Invention.

Creativity is what makes us human. It is what separates us from animals. science, art, religion, and so on are the work of creative people throughout the ages. Culture is creative effort. All this creativity is the product of individuals being in the flow.

You don’t have to paint or play music or discover a cure for cancer to be creative, although talented artists and scientists experience flow all the time. You can be creative, says Csikszentmihalyi, even while brushing your teeth or organizing a party. Being creative provides a sense of accomplishment, a sense of having spent time in a worthwhile activity. If you learn to play the guitar, you will take great pride in your achievement, and others will be impressed. If you learn another language, you will find great satisfaction as you progress. If you learn to fly a plane, you will find that you feel better about yourself. If you can make dull activities more interesting, such as brushing your teeth, you will feel better.

Tip One: Live Each Day with Childlike Wonder

The first thing you have to do is to reawaken a sense of wonder at the world. Children are much better than adults at this. Kids seem fascinated by all sorts of things: watching an insect crawl, the wrapping on a birthday present, a tool in Dad’s toolbox. Many adults have lost that sense of childlike wonder.

It’s important for you to regain this sense of wonder, and one of the best ways to accomplish this is to open yourself up to new experiences.

“Try to be surprised by something every day,” is one bit of Czikszentmihalyi’s advice. This is an attitude that you have to practice because most people assume that they already know about things. When you look at an unusual car, examine why it appears unusual to you. How is it different from other cars? When you go to a restaurant, order something new. Or order the same dish at two different restaurants: how are they different? Examine the color scheme at a fast-food restaurant; why did the interior designer choose these colors?

Tip Two: Plan to Accomplish Something Each Day

Figure out one thing you’d like to accomplish each day. Most people don’t do this, yet every person is quite capable of finding something. Think about meeting someone new, buying something that interests you, googling a new recipe and picking up the ingredients at the grocery store.

One more trick is to realize that to maintain interest, an activity must get more complex. If it doesn’t, you’ll get bored of it. So if you’re doing something you enjoy, make it more complicated. For example, if you like to watch movies, start watching the interviews with the director and actors on the DVD, and then watch the movie. Or start watching the camera angles: why did the director choose the angles that he did?

Tip Three: Experiment with new “Internal States”

By ‘internal states’, Csikszentmihalyi means certain personality traits that you have developed. Most people develop personality traits in their early years: shy or outgoing, quiet or talkative, intellectual or intuitive, safe or reckless. We hold on to these traits because they provide safety and predictability in our lives. Changing an internal state doesn’t mean that you lose your current internal states; what it means is that you become more than simply what you currently are.

Changing internal states takes courage and time; we have to be aware of our unique internal states and then challenge ourselves to change. Think about yourself. On a piece of paper, write down words or phrases that describe you. If you are struggling to do this, think about what makes you different from someone you know well.

Once you are aware of some of your internal states (shy, quiet, loud, and so on), then choose one trait and make a deliberate effort to do the opposite. For example, if you are normally quiet and shy at parties, then at the next party, go out of your way to tell a joke. If you are normally shy at an AA meeting, make a deliberate effort to speak up at the next meeting.

About the Author

Geoff Thompson, MA, is the Program Director at Sunshine Coast Health Center, a private addiction treatment facility for adult men. His book, A Long Night’s Journey into Day, explores Eugene O’Neill’s life to uncover the truth of addiction and recovery.