When it comes to drug addiction, mental health can often play a significant role. The two can serve as cause and effect alternately.
“There are certain mental illnesses that really lend themselves to addiction,” said Lynne Grey, utilization management manager with Partners Behavioral Health.
Trauma survivors and those battling bi-polar disorder are often at high risk to become addicted to drugs. Alternatively, chronic users of drugs such as ecstasy or cocaine can wind up with mental health problems like depression or lasting psychosis.
“The way that drugs affect the brain can certainly cause mental illnesses like depression,” Grey said.
Addiction to prescription drugs, particularly opioid-based medications such as fentanyl or hydrocodone, also can cause a host of problems, including accidental drug overdoses. Addiction to these types of medications can result in mental health problems as well.
In 2014, about one in 10 Americans had used illicit drugs, according to the results of the National Survey on Drug Use and Health by the Substance Abuse and Mental Health Administration. Illicit drugs can include marijuana, heroin, cocaine, etc. as well as prescription drugs used nonmedically. Coming in at the top of the list, right behind marijuana is the nonmedical use of prescription pain relievers. According to the survey, 4.3 million people age 12 and older reported using prescription pain medication nonmedically.
Grey said it’s not uncommon to see addiction stemming from opioid use even when that drug was prescribed initially to treat a legitimate health condition.
“What’s different about opioids than other pain killers is that they do have this euphoric effect, so when they take them their pain goes away, but they also feel a little happier,” she explained. “You see a lot of people, when they come off the opioids, they experience depression and they have a hard time regulating their mood because the opioids were giving them that euphoric effect.”
Establishing realistic pain management expectations is an important conversation between doctors and patients in recovery from a surgery or other injury, Grey said.
“Pain management is tricky because as a human, I don’t want to feel any pain, but part of recovery is you’re going to feel some pain. What we want to do is manage the pain,” she said.
Grey said the latest recommendations from the American Medical Association for shorter prescriptions following surgery is a good start to reducing a patient’s risk of becoming addicted.
Following up with other recovery protocols such as physical therapy is also important to avoid potential opioid addiction. Grey said that in her 10 years in the mental health field she has seen this recurring problem.
“[Patients] often did not participate in their physical therapy and weren’t very mobile, they were very sedentary and taking their opioids. Prolonged use of opioids can make you a little more sensitive to pain so it’s a vicious cycle,” she said.
Education is extremely important when it comes to prescribed opioid use. Since the drugs are prescribed by doctors they are often viewed by patients as safe, despite the fact that these are very powerful drugs with dangerous side effects.
Those who become addicted to these powerful drugs quickly become adept at what is called doctor shopping, going to various doctors and even dentists to get additional prescriptions.
“Doctors are put in a bind when someone comes in and complains of all these symptoms, they are going to try to make them feel better,” Grey said. A new prescription drug registry is one way this problem is now being combated.
“One of the things we talk about a lot in treatment is that it is important to advocate for your needs, but we have to try to tease out what are your needs for your health and what are your needs to fuel your addiction,” Grey said.
Those addicted to prescription pain killers exert a great amount of energy on finding ways to get more medication, Grey said, energy that could be put to better use, but for those in the midst of addiction they can’t see other options.
“When you’re in it, it just seems like it’s too hard,” Grey said.
The same goes for those struggling with severe anxiety who become dependent on benzodiazepines.
“These are real conditions that people are suffering from,” Grey said.
“Addiction, especially opioid addiction, is a physical disease, we can use medication to help the withdrawal, but we have to treat the mental health component, too,” she added.
When it comes to treatment of mental illness and addiction, Grey said in years past that process was handled in a silo approach. Patients were sent to detox first, then treated for the mental illness. This process was ineffective in many cases.
“You’ve taken away their primary coping mechanism, but you haven’t helped them manage their underlying issue,” Grey said. “Now we’re moving into this really good direction of treating both at the same time.”
Treating the entire family, not just the person with the addiction, has become a trend as well as encouraging some exercise and getting the individual connected with a support system.
Those struggling with chronic pain and opioid addiction often don’t leave their house and can’t find things they can do anymore. Grey said that finding some activity a patient can be successful at is a good step in the recovery process. She has one group of ladies who learned to knit and that helped them considerably.
“It was something they could start and finish and feel good about themselves,” she said.
Yoga and meditation are some other techniques which have been used to aid in the addiction recovery process. Teaching grounding methods for those with anxiety has been useful also, Grey said.
“Anxiety is a future thing, one of the things we do with grounding is get pulled right back in the moment, such as physical grounding where you notice the space you’re in or count the tiles on the wall. There’s also mental grounding, playing games in your head like trying remember the words of a song or play categories in your head like naming all the cars you can think of. It sounds silly but when you’re in that moment, when your having panic, it gets your brain focused on something else.”
Those battling addiction are often in dire circumstances, such as having lost their children, or still living with other drug users, but Grey said they have found a unique practice that can aid those in these situations.
“One of the things we’ve had really good luck with is practicing gratitude. When they can’t find anything positive in their life, we get them to focus on very small positive areas that they’re grateful for. It’s really interesting how much it shifts their thinking. If the goal is we’re going to look for something that we’re grateful for every day, it shifts away from thinking about the bad things. It’s a tough sell at first, we have to ease into it, once we get there it’s amazing to see the change.”
For more information on the services available through Partners Behavioral Health, visit www.partnersbhm.org. Partners also has a 24-hour care line with trained clinicians to answer calls 24/7 to schedule urgent and routine appointments with local providers. The number is: 1-888-235-HOPE.
Kitsey Burns Harrison may be reached at 336-679-2341 or on Twitter @RippleReporterK.