Where to Find Help with Addiction

After reading the last few posts about alcohol, drugs, and addiction; do you think you know someone who is struggling with some or all of these behaviors and symptoms? Watching someone you care about abuse substances can be painful. And it can also lead us to feel helpless in knowing how to help them. Obviously, we cannot force someone to abstain from use and become sober. Likewise, we cannot force them into treatment against their will. What we can do, however, is offer support, knowledge, and resources around addiction treatment.

Navigating the world of addiction recovery and treatment is tricky, so by becoming informed yourself, you can aide your friend or family member in understanding where to go to get help when they’re ready.

Luckily, there are a wide range of treatment options available for those wanting to achieve and maintain sobriety. Many experts in addiction treatment recommend that folks have more than one resource or treatment modality on board for the best chance of success. Here are the options:

Detoxification: “Detox” is a service offered by some addiction treatment and    hospital facilities. A stay in detox typically lasts three to seven days and is intended to help you safely withdraw from drugs or alcohol with professional medical help. At the end of the stay, patients are referred on to other, longer-term treatment    facilities or programs.

Inpatient Treatment: Residential/live-in treatment for addiction is the most intensive  option for treatment of alcohol and/or drug addiction. Inpatient treatment can last anywhere from several days to one month or longer.  While participating in residential treatment, you can expect to receive: individual psychotherapy, group   psychotherapy, psychiatric/medication services and possibly family psychotherapy in one place. 

Intensive Outpatient: Intensive outpatient treatment is a form of addiction treatment in which you continue to live at home while attending treatment sessions three to four days per week, two to four hours at a time. The idea behind intensive  outpatient treatment is that you learn to live a sober lifestyle, while also going to   school, maintaining employment, taking care of family members - whatever you normally do in life. Intensive outpatient treatment usually includes psycho-educational and psychotherapy groups, family therapy groups, and individual psychotherapy.

Individual Psychotherapy: For people wanting to achieve and maintain    sobriety, individual psychotherapy is often recommended. Working one-on-one with a licensed mental health professional can allow you to explore, in a more  individual way, your substance abuse and family history. These individual sessions  also allow the mental health provider to assess for any underlying mental health disorders (anxiety, depression, etc) that may have been either exacerbated or   masked by your substance use.

Group Support: Alcoholics Anonymous (AA) is the most well-known example of  group support available to alcoholics. AA is a free, peer-led support group that has been around since 1939. AA’s 12-step program has been used for a long time, by  many people and is very well established all across the world - making it easy to   access for most people. Narcotics Anonymous (NA) is a very similar program that     is specifically for people who struggle with drug (heroine, prescription painkillers, cocaine, etc) addiction. There are many other free, peer-led support groups in  most communities across the country. For more information about what is available in your area, try asking your physician, mental health care provider, faith     community, employer, or school.

Medication-Assisted Treatment: Medication-Assisted Treatment (MAT) programs combine medications and supplements, together with psycho-education to help you achieve and maintain sobriety. Naltrexone,  Acamprosate and Disulfiram are some of the medications that are often used to help ease the discomforts of withdrawal symptoms, as well as decrease cravings 8.

If you need assistance immediately, you can always call 9-1-1, or go directly to your nearest emergency room.

Do You Have A Problem With Drugs or Alcohol?

With the prevalence of alcohol and drug abuse so high, it stands to reason that most of us will know someone, at some point in our lives, that we suspect is struggling with addiction. So how do you know if your loved one (or you) might have an addiction? Here are some signs of problem use:

Drinking more or longer than you meant to (“I was going to stop drinking by 8pm, but before I knew it, it was midnight and I still had a drink in my hand.”)

You tried to get sober, but it only lasted a few hours or days

You have engaged in risky behavior while under the influence of drugs and/or alcohol more than once (for example: driving while impaired, engaging in risky sexual behavior, etc)

You need to use more and more of the substance to feel the same effects (this is also known as tolerance)

You continue to use alcohol or drugs, even though you know it is making another physical condition worse (for example: continuing to vape/smoke cigarettes even though you have lung cancer).

You spend a lot of time using drugs or alcohol, thinking about using, preparing to use, and recovering from your use

You experience conflicts with family, friends, and co-workers over your drug and/or alcohol use, but you continue to use at the same rate anyway

You used to enjoy other things (movies, football, skiing) but you rarely – or never – engage in those activities anymore because your alcohol and drug use takes up so much of your time

You experience symptoms of withdrawal (nausea, hallucinations, tremors) when you stop using your substance(s) of choice

You have gotten in trouble with the law more than once or twice because of your use

Identifying signs and signals of alcohol and drug use and abuse is difficult. Whether we are trying to assess ourselves or someone else, it can be a tricky process that involves honesty and candor. It’s important to remember that only a mental health, substance abuse, or health care professional can accurately and thoroughly complete the diagnostic process.

Options for Treatment for Alcohol Addiction

In my last post I wrote about how to determine if you (or someone else) is using alcohol in a problematic way. In this post, I would like to talk about options for treatment. Because there are a lot.

We all know about AA, and 30 day residential programs, but there are so many more options available as well. In a recent article over at Health eCareers, I outline several of the most common treatment options, including: detox, inpatient, intensive outpatient and medically-assisted treatment. I also talk about individual psychotherapy, which is often an important part of a treatment plan:

For more information, check out the entire article at:

In my practice, I often work with folks struggling with addiction. If you would like to talk more about how individual psychotherapy can help with sobriety, please give me a call at 303-828-3080.

Do you have a problem with alcohol?

I hear a lot of people in my practice ask themselves whether they have a problem with alcohol. Questions like:

Do I drink too much?

Could I stop if I wanted to?

Could I stand it if I had to stop drinking forever?

Has my drinking changed significantly over the past year or so?

It’s difficult to ask these questions, and ever tougher to answer them honestly. So how do you really know if you (or someone close to you) has a problem with alcohol that needs to be address?

I recently wrote an article over at Health eCareers outlining how to determine if your alcohol use is problematic. Check it out:


Some points to consider, from the DSM-V:

College and Alcohol Don’t Have to Go Together

Have you ever seen a movie about life on a college campus?

Are there any that don’t portray those years as one long, alcohol-filled party?

Sure, movies don’t necessarily reflect reality.  But the truth remains that there is a lot of alcohol consumed on college campuses.  According to the National Institutes of Health, 4 out of 5 college students drink alcohol and about half admit to binge-drinking.  The statistics don’t stop there.  Check these out:


  • Death: 1,825 college students between the ages of 18 and 24 die each year from alcohol-related unintentional injuries.

  • Assault: More than 690,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking.

  • Sexual Abuse: More than 97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape.

  • Academic Problems: About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall.

Clearly alcohol consumption on college campuses is a big deal.  But, universities are doing something about it.  The University of Colorado (my alma mater!) recently announced a sober living option for students in recovery who wish to live with other students abstaining from alcohol and drugs.  Check it out:

University of Colorado Collegiate Recovery Center

University of Colorado Collegiate Recovery Center

When I did a quick search for other universities and colleges in my area, I found that almost all offered some sort of substance abuse treatment program; typically through their counseling center.  If you or someone you know is a college student and struggling with substance use – it’s important to know there are options – and those options appear to be growing.

For more information about how much alcohol is too much, read more.

National Institutes of Health



Grieving Cory Monteith and Coming Clean About Addiction

It has taken me the 13 days since Cory Monteith’s death to write this post.  And I am still not sure what to say.

Regular Dr. Stephanie readers know that I am a Gleek. I have often written about the show’s messages about mental health and diversity. More than anything I simply love the characters and the music.

So, like many others around the world I was heartbroken to hear about Cory Monteith’s death of what turns out was a mixture of heroine and alcohol.

What can I say, and what can we learn from this extremely sad event?

  • Life is short
  • The death of a friend, a lover, a co-worker and even a TV idol can be tremendously painful
  • Substance abuse can happen to anyone, any family and in any circle of friends

Perhaps it is this last bit that can be the most shocking: anyone – no matter how rich, popular, talented, loved or good looking – can fall prey to substance abuse and addiction.  Addiction knows no bounds, and it is one heck of a liar; making it tough for even the closest of friends to spot its presence. Most of us know that sheer force of will can’t stop an addict from using, but we do know that support of friends and family can help make the path to sobriety a bit less arduous.

If you have a friend or family member who you believe is struggling with addiction, or has come to you for help check out the resources below:

RIP Cory Monteith.





Do I Drink Too Much?

After reading this post on CNN’s health blog, The Chart, I felt like it was time to write a post about alcohol use.  Alcohol is all around us – print ads, part of TV shows (Mad Men, anyone?), movies.  Not only that, but booze is part of most social events, and liquor stores are on every corner.  It can be easy to look past problematic alcohol consumption and dub it “normal” or “fun.”  And as The Chart’s article points out, it can be easy for even medical professionals to overlook folks with problematic drinking behavior. Screen shot 2013-01-17 at 8.12.04 PM

The CDC lists alcohol consumption as the third-leading cause of preventable death in the United States. A couple of other startling notes by the CDC:

  • On average, for each death due to alcohol, an individual’s life is cut short by 30 years.
  • 79,000 deaths per year are tied to the misuse of alcohol
  • Excessive alcohol use costs the United States about $185 billion each year in health care and criminal justice expenses, as well as lost productivity.

So, how do we know if we are drinking too much?  What makes someone an alcoholic?

The official criteria for alcohol abuse (in the DSM-IV) include things like:

  • Trouble fulfilling your obligations (ignoring kids, missing work deadlines, not showing up for/cancelling appointments or dates)
  • Using alcohol in situations that are hazardous (driving, operating machines)
  • Trouble getting along with others (fighting with partner/kids/parents about drinking too much)
  • Legal problems related to drinking too much (DUI’s, etc)

The National Institute on Alcohol Abuse and Alcoholism describes heavy or risky drinking as more than 14 drinks a week for men and more than seven a week for women. When it comes to daily consumption, five or more drinks for men and four or more for women is considered excessive.

Do you think you might have an issue with alcohol? Ready to do something about it? Try SAMHSA’s treatment service locator.  Alcoholics Anonymous is another good option.  You may also want to look at your insurance company’s list of behavioral health providers.  Churches, employee assistance programs, and community centers may also have resources to help.  Effective, low-cost and/or free treatment is available in most areas of the country.  For more information about support and treatment for issues involving alcohol, click here.

Teen Depression and Glee

Photo by: Glee on Fox

Yippee! Yahoo! Hooray! Glee is back for Season 3! And now that I have done my “research” for this post by watching the episode several times, I am ready to write something about the season premiere.

While I enjoyed the song selection, the number featuring Blaine, and the look of the purple pianos in last week’s episode, what really got me was the transformation of Quinn’s character.  It’s not just that I have a fondness for pink hair (I really do!), but I was both relieved and energized to see the writers doing something different with her character.  In case you don’t remember, Quinn has been through a lot in 2 years: she got pregnant, was kicked out of her house, gave her baby up for adoption, and had her heart broken by longtime boyfriend, Finn.  It was also revealed that she had a childhood history of weight problems and had plastic surgery as a youngster.  Finally, in this episode Quinn is appearing to deal with these events as many of us would: with psychological and emotional turmoil.

We have yet to learn if Quinn is actually depressed (dying one’s hair isn’t necessarily a sign of depression), but here are some things we can look out for as the season progresses to help us know for sure.  These are also good warning signs for the real teens in your life:

Change in interests.  Kids that used to love glee club, soccer, or chess may no longer be interested/find pleasure in these things.  It’s normal for kids’ interests to change over time, it’s concerning when the change is drastic and sudden.

Isolation.  Is your child spending more and more time alone in their room?  Is he turning down invitations from friends, or have the invitations stopped altogether? It’s time to step in.

Poor confidence.  Unfortunately, adolescence does a number on most kids’ confidence levels.  However, if your child seems to be suffering from particularly low self esteem, such that it makes it tough for them to do things (socialize, complete school work, try new things), it might be a warning sign.

Substance use. Many of us equate experimentation with alcohol and tobacco with the teen years.  However, if your child is using substances regularly (like once a week), it could be a sign that they are struggling with their mood and looking for ways to cope.

Changes in eating or sleeping.  Eating and sleeping too much or too little can be a warning sign that something has changed in your child’s psychological health.  Sleeping late one morning isn’t a big deal, not being able to get out of bed for 2 or 3 days is.

Irritability.  None of us are pleasant all the time, and it is a teen’s job to question adults’ decisions and figure out boundaries.  However, if your teen has recently become unusually irritable or angry, lashes out verbally or physically, or is unable to enjoy people and activities she used to because of the irritability, this could be a warning sign of depression.

Thoughts of harm.  If your teen even hints at a thought of wanting to harm themselves, or if you find any blogs/posts/tweets/updates suggesting a desire to die, stop living, or “end things” it is time to take action immediately.  It is better to be safe in these situations, so if you suspect your child is having suicidal thoughts of any kind, take them to the emergency room right away.


Alcohol: How Much is Too Much?

Alcohol is everywhere.  People compare drinking stories, advertisements for liquor are all over TV, and bars abound in almost every town (there is even one next door to my office!).  With the prevalence of alcohol and alcohol-related activities in our society, it can be hard to know when one’s alcohol use has gone from fun and recreational to dangerous and addictive.  Here are some warning signs that one’s alcohol use has crossed over into unhealthy territory:

“Whoa. I didn’t mean to have that much.”  People with alcohol problems may find themselves drinking more than they intended on a regular basis.  What starts out as a trip to the bar with the plan to have “just one,” turns into a whole night’s worth of drinking.  This might happen with greater and greater frequency.

“I’m going to quit tomorrow.  Just like I did last week.”  People with an addiction or dependence on alcohol may make deals with themselves, (“I’m going to quite tomorrow”) that they then find hard to keep.  A desire to stop drinking paired with several unsuccessful attempts to do so is a sign of problemed use.

“I just need to grab something across town.”  People who have problems with alcohol will often spend quite a bit of time obtaining it.  For example, they might have a circuit of liquor stores in which they buy the booze.  They may also be adept at telling stories about why they were late to the birthday party (the traffic was terrible, there was an accident, I had to run in to work) rather than admitting they stopped at the bar beforehand.

“I used to love to play tennis.”  Alcoholism is a time consuming pursuit and doesn’t leave much time for other hobbies.  People with drinking problems will often give up previously fun activities in order to spend time drinking.

“I know it’s causing problems, but I just can’t give it up.”  People who use alcohol in unhealthy ways often recognize the detrimental effects of their drinking.  It may be causing them physical, emotional, or psychological harm, but even that knowledge doesn’t help them put the bottle down.

For more information on alcoholism, check out the APA Help Center.

For more information on alcohol treatment, go to Alcoholics Anonymous.