Tag: stigma

  • State Of Mental Health In America "Still Quite Bleak," Report Says

    State Of Mental Health In America "Still Quite Bleak," Report Says

    New data shows “alarming increases in adult suicidal thoughts and major depression in youth.”

    Talking about mental health is becoming less taboo, but is this making a real difference? 

    According to a new report that offers a snapshot of mental health in the United States, overall the picture is “still quite bleak.”

    The annual State of Mental Health report, compiled by Mental Health America (MHA), saw encouraging trends since the release of the first report. These include slight decreases in the number of American adults who have mental health concerns (18.19% to 18.07%) or substance use problems (8.76% to 7.93%).

    However, according to president and CEO of MHA Paul Gionfriddo, the data shows “alarming increases in adult suicidal thoughts and major depression in youth.”

    An estimated 9.8 million adults experience suicidal thoughts—an increase of 200,000 people since 2017. And more than 2 million young people were diagnosed with severe major depression, according to the report.

    Overall, more than 24 million Americans living with mental health issues go untreated.

    “Despite mental health being something that more and more people are talking about—far too many people are still suffering. People are simply not receiving the treatment they need to live healthy and productive lives—and too many don’t see a way out,” said Gionfriddo in a press release.

    The MHA report ranked all 50 states and Washington, D.C. based on rates of mental health issues and access to treatment. Minnesota came out on top at #1, with Nevada ranked #51. States ranked higher were deemed to have lower prevalence of mental health issues and better access to treatment, while states ranked lower were deemed to have more mental health issues with less access to care.

    The report also studied the long-term impact of childhood trauma, and determined that youth affected by trauma are more likely to have problems at school such as missing school, being removed from classrooms, and struggling with schoolwork.

    Thus MHA “strongly supports” integrating mental health services in schools. Early intervention and education can prevent the development of more severe mental health problems and help kids deal with trauma.

    This year, New York became the first state to require mental health education across all grades. Virginia enacted a similar rule this year, requiring mental health education to be taught in the 9th and 10th grades.

    “When young people learn about mental health and that it is an important aspect of overall health and well-being, the likelihood increases they will be able to effectively recognize signs and symptoms in themselves and others will know where to turn for help—and it will decrease the stigma that attaches to help-seeking,” said NY’s Education Commissioner MaryEllen Elia.

    View the original article at thefix.com

  • How Parents Can Support Teens’ Mental Health

    How Parents Can Support Teens’ Mental Health

    Parents play a key role in connecting teens with mental health treatment and helping them learn to live with their diagnosis.

    The parents of teenagers used to fret about whether their kids were sleeping too much or “just saying no” to drugs, but today’s parents are more in tune with the mental health needs of their children, recognizing that many mental illnesses start during adolescence. 

    More than 17 million American teenagers have a mental, behavioral or emotional disorder, according to USA Today, and many times parents are key in connecting these individuals with treatment and helping them learn to live with their diagnosis.

    With suicide being the second-leading cause of death among people ages 10-34 in the U.S., talking about mental health with young people could very well save a life. 

    Still, many parents aren’t sure what the warning signs of mental illness are, especially since teenagers are general apt to be moody and withdrawn. Parents should look for sudden changes in behavior—a quick drop in school performance, a change in sleeping or eating habits, or physical pains such as stomach issues. All of these can be signs of mental illness in teens. 

    Myths and stigma about mental illness can hinder access to treatment, so it’s important to remember that mental illnesses are biological conditions, not caused by bad parenting, personal weakness or character flaws. Just like physical illnesses require expert care, so do mental illnesses.

    It’s important that parents consult with professionals such as counselors and primary care physicians to get teens the help they need. Most mental illnesses that emerge during the teenage years will become lifelong conditions. Although this is scary, connecting with the best treatment as soon as possible will help teens learn to cope with their illnesses. 

    Even when parents are able to identify that their child has a mental or emotional issue confronting them, it can be hard to talk about. However, talking is key. Ask your child how he or she is doing. If they’re not receptive to conversation, just try again later rather than pushing the issue. 

    If you suspect that something is wrong but your child insists that he or she is fine, turn to other adults in their life, like coaches, teachers or school counselors. Ask if they’ve noticed changes or behaviors that they find concerning.

    Although a medical professional may not be able to give you information about your teenager due to patient confidentiality, they are always able to listen to your concerns. 

    Finally, connecting with teenagers is important for controlling and preventing mental illness. Take walks together outside or play sports. Eat dinner together. These activities allow you to connect with your teen without the pressure of a sit-down conversation. 

    View the original article at thefix.com

  • Lack Of Mental Health Resources A Global Issue

    Lack Of Mental Health Resources A Global Issue

    “All countries can be thought of as developing countries in the context of mental health,” says a new global mental health report.

    A lack of resources for those dealing with mental health issues is a major problem around the world, a new report has found. 

    The report by the Lancet Commission on Global Mental Health, which took three years to compile, was released last week at a London summit. 

    The report, which is 45 pages long, details the state of mental health treatment around the world. According to the authors—28 mental health researchers, clinicians and advocates from five continents—there are “pitifully small” levels of financial support from governments and assistance groups when it comes to mental health research and care. 

    Low-income communities, according to NPR, are being hit particularly hard. The report states that in developing countries, only one in 27 people with depression receive the necessary treatment. And in countries with more money, the care isn’t necessarily better. In fact, the report states that “all countries can be thought of as developing countries in the context of mental health.”

    The financial aspect, according to the report, is the main problem. The Lancet Commission states that funding availability is “alarmingly low” when compared to what was spent on other diseases in 2013 in comparison to mental illness.

    For example, for every year of healthy life lost to mental illness, the report found that global health donors had provided $0.85. But for HIV/AIDS, they had provided $144 for every year, and $48 for TB and malaria.

    According to psychiatrist Julian Eaton, part of the reason for the lack of funding has to do with cultural differences. 

    “In the academic world there has been an ongoing sometimes quite angry debate about whether it’s appropriate to export Western ideas about mental ill health to other countries,” Eaton told NPR.

    The stigma surrounding mental health issues also plays a role. Janice Cooper, who runs the Carter Center’s mental health center in Liberia, tells NPR that stigma is a problem in developing and developed countries. 

    “There’s ignorance, there’s the perception of contagion, there’s the notion that in some quarters this is not important,” she said. 

    According to NPR, the Commission recruited 15 youth leaders from around the world to spread messages about mental health on social media and get younger generations discussing it.

    Twenty-five-year-old Grace Gatera of Rwanda is one of the 15. She says the conflict in the country resulted in PTSD for her, as well as two suicide attempts. She tells NPR that the government doesn’t make mental health a priority. 

    “It’ll be like let’s deal with this crisis and deal with the crisis that comes after that and maybe when we get time we’ll talk about mental health,” she said. 

    Eaton says that despite the report’s findings, she and other commissioners were excited to receive the support for the summit from some international and British government organizations in addition to some private ones. They were also encouraged when royals Prince William and Kate Middleton, Duchess of Cambridge, attended the summit. 

    “But people are yet to sign the checks,” Eaton said.

    View the original article at thefix.com

  • Lady Gaga & WHO Director Pen Essay For World Mental Health Day

    Lady Gaga & WHO Director Pen Essay For World Mental Health Day

    The duo call for additional treatment funding and the need for governments to better prioritize mental wellness in the essay.

    Mental health issues are universal—and costly without proper treatment—so why is mental illness still a taboo subject?

    That question is raised by Lady Gaga and Tedros Adhanom, director-general of the World Health Organization, in a new essay published in the Guardian on the eve of World Mental Health Day (Oct. 10): “800,000 people kill themselves every year. What can we do?”

    This annual statistic translates to “more than the population of Washington, D.C., Oslo or Cape Town,” they write. “Sometimes they are famous names such as Anthony Bourdain or Kate Spade that make headlines, but they are all sons or daughters, friends or colleagues, valued members of families and communities.”

    Globally, suicide is the second-leading cause of death among 15- to 29-year-olds, yet mental health receives less than 1% of global aid, they write.

    This lack of funding translates to a higher cost overall—mental health issues cost $2.5 trillion a year globally, which will keep rising if they continue to be excluded from the conversation.

    “Stigma, fear and lack of understanding compound the suffering of those affected and prevent the bold action that is so desperately needed and so long overdue,” they write.

    Gaga (born Stefani Germanotta) and Adhanom urge governments to invest in mental health services, saying it will not only help individuals but benefit state coffers as well.

    “Research shows there is a fourfold return on investment for every dollar spent on treating depression and anxiety, the most common mental health conditions, making spending on the issue a great investment for both political leaders and employers, in addition to generating savings in the health sector,” they write.”

    Individuals have a part to play too, by supporting one another and urging lawmakers to make mental health a priority. “We can all help to build communities that understand, respect and prioritize mental wellness,” they write.

    The essay cites local efforts that are moving the momentum in a positive direction, such as the ThriveNYC initiative in New York City.

    Germanotta—who previously revealed that she lives with PTSD—spearheads the Born This Way Foundation, established in 2012, with her mother Cynthia Germanotta. The foundation focuses on young people with the goal of creating a “kinder and braver world.”

    View the original article at thefix.com

  • There Was Light A Mile Deep: Interview with Poet William Brewer

    There Was Light A Mile Deep: Interview with Poet William Brewer

    Someone contacted me when the book came out, who had very recently lost a parent to heroin. She said to me, and I’ve held on to this, “The poems gave me a feeling that I had a place to go.”

    The West Virginian landscape exists as one of the great splendors of North America, but beneath the canopies of spruce and maple and folded inside the canyons smolders a public health crisis whose effect has verged on apocalyptic for some communities, both spiritually and literally. Peddled by big pharma, opioids found special traction, furthering the hardships inherited from a history of economic injustice. Like new gears spinning a rusted machine.

    These conditions have sown a very human consequence, which looks out from the porch of William Brewer’s debut book of poems, I Know Your Kind, with lines like: “[I] have placed my lips against the shadow / of his mouth, screamed air into his chest, / watched it rise like an empire then fall.”

    Born and raised in West Virginia, the poet left Appalachia to pursue higher education, but his craft was drawn back towards the hills of his youth, rendering the anguish and ghosts that multiplied rapidly there in the mid-aughts when the state ranked as having the highest overdose rate in the country (it still does).

    With delirious imagery, Brewer uses natural subjects such as flies and logging to express deep emotions, at the same time accessing the past in order to help explain the unbelievable present. His poems have been published in The New Yorker, The Nation, American Poetry Review, and his chapbook Oxyana was selected by the Poetry Society of America for their 30 and Under chapbook fellowship.

    Then, last year Ada Limon selected I Know Your Kind as a winner of the National Poetry Series. A practice in empathy, the book illustrates not only the spirit of a place struggling to stand, but a cross-section of the epidemic timeline on a local level when the national media was just starting to grasp what was happening. Before the big policy responses. Despite all the graves already in the ground.

    Interviewed by The Fix, Brewer hikes into these “terrible truths” and cracks open the question of what drives someone to give themself to an artificial comfort, underlining that rural living can marginalize culturally and politically.

    Estimates place the number of people recovering in the United States around 25 million, and close to the same amount experiencing active substance use disorder. More than ever, there is a need for a strong literature to reflect this population, how we lived and how we want to live. I Know Your Kind stimulates our thinking about the prismatic possibilities of a modern addiction poetry.

    Note: This is sometimes a sad conversation, about suffering caused by substance use disorder. Seek out another interview if you’re unbraced.

    The Fix: Your book opens with the poem “Oxyana, West Virginia,” which establishes the setting of I Know Your Kind as a place where both splendor and suffering co-occur. Can you talk more about the relationship between the people and the land?

    William Brewer: Oceana is a small town in southern West Virginia, a blast site of the opioid epidemic. The nickname Oxyana refers to Oxycontin, the drug that took over. This poem takes the notion of a single place and applies it to multiple regions of the state to create a condensed fictional stage, to build out a landscape. Throughout the book, when I talk about one place, I’m talking about the whole state, because the problem is everywhere. The whole state is a kind of Oxyana.

    Now, with the idea of splendor and suffering, I think the word you used was co-occur—that’s absolutely right in West Virginia. It’s an immensely beautiful state, but it’s a state of contrasts. The ancient hills are beautiful, but that ancientness meant coal, which meant prosperity, but only for a very few until the mid-20th century. Coal, for much of its history, has meant a very hard way of living that has benefited very few. So the thing that gave West Virginia its prosperity is also the thing that has caused most of its destruction environmentally, economically, and to the physical well-being of its citizens.

    Now that the coal industry has died away, people are left in drained away communities, isolated from the outside world by the mountains and rivers, which also prevent jobs like manufacturing from coming in. The landscape becomes a beautiful prison.

    You often manipulate the symbol of light, twisting away from classic associations, or at least complicating them. For example, in “Overdose Psalm,” a tree is cut down and the line goes “Snow committing its slow occupancy, / filling the column like words, the light / saying in so few of them, like all terrible / truths, something here did not survive.” Besides being very very sad, it’s so resonant. How does light function in your book?

    In IKYK, I’m interested in exploring the power opiates have to mimic a kind of divine energy. They aren’t like psychedelics, which connect you to the feeling of a greater universe. Or amphetamines, which accelerate our reality. This is something simple: an optimism, a brightness, a luminosity, therefore light will function in the mind of the speaker as positivity, but for the reader the function is more sinister. Here, our feelings about beauty (which light is often in service of) become less straightforward than they seem.

    Writing has to look carefully at the way certain chemicals make people feel.

    We must recognize the ways substances make you feel fulfilled.

    Yes. And in the case of West Virginia, you have a largely poor, often isolated populace that is, in many respects, ignored by the rest of the country. When the outside world does engage with WV, it’s often through joke and insult. “Trash,” “Hillbilly,” “Did you marry your cousin?” “I’m surprised you wear shoes.” In her essay “The Fog Zone,” Leslie Jamison gets it right: “West Virginia is like a developing nation in the middle of America. It has so many resources and it has been screwed over again and again: locals used for labor; land used for riches; other people taking the profits.” With all that in mind, it’s suddenly a lot easier to understand how big unfulfillment can be as an idea, and how deep unfulfillment can function like a kind of pain. Through that pain comes the chemicals.

    What about the power dynamic between other parts of the U.S. and West Virginia? In your poem “Oxyana, West Virginia” you have those lines about river beds being wine glasses for the Roosevelts. It seems to me this dynamic could compound with the marginalization of the state, worsening the epidemic, distancing external aid.

    You’re absolutely right. That Jamison quote again. This is a place that gave everything to America during its rapid rise through the last century, and then when it was finished America turned its back on them. This was and continues to be a form of erasure. When people are told they don’t matter or feel like they don’t exist—that’s going to worsen a problem like the epidemic. The drug problem has been going on for over 10 years, but it’s only just now garnered attention. That’s in part because a lot of people—a lot—still don’t know WV is its own state. A few months back I was seated at a dinner beside an Ivy League graduate who kept referring to my home as Virginia, even after I corrected them multiple times.

    Yeah, that’s a completely different state.

    And when your country doesn’t know you exist, it’s like your suffering doesn’t exist. Then it’s like, who are they to tell you how you handle your suffering?

    All of this leads to the larger point, the key point about the book. IKYK is not about the opioid epidemic, and it’s not about WV, it’s about how these two subjects are bound together through a continuation of history. The history of WV is the history of massive industry making gargantuan profits off the lives of WV citizens. Timber, minerals, oil, coal, gas, and now: pharmaceuticals. They pumped 780 million pills into a state of 1.8 million people. By doing that, those companies, that industry, made a conscious choice: The lives of West Virginians aren’t as important to us as money; this is a population we can afford to kill.

    Leads me to think of “Daedalus in Oxyana.” There’s a line… “I gave my body to the mountain whole. For my body, the clinic gave out petals inked with curses.”

    I want to hear more of how you funneled real life places and people into this book. What was your research process like?

    The research was living and seeing the issue grow. The research arrived. But I don’t necessarily like that word, “research,” because it suggests I went looking for it. It’s more that the problem appeared. Things snowballed very quickly. Sometimes I didn’t realize it, other times I did. In conjunction, at one point someone came to my fiancée and me and told us they were a heroin addict and they were terrified. I got angry, thinking they got themselves into the mess and didn’t care about anyone else. Ten minutes later I realized this reaction was repulsive. I wrote the person off at their most vulnerable. A flip switched, and I realized this was something deeper I wanted to sit with and look at. That meeting between personal interrogation and social observation is how the book came to be.

    I like how the initial motivation for this book was a reaction to the stigma you had fallen into initially. You were like, “Wow, this is the way I think, so I’m going to do some work and examine it.”

    The disease of addiction has taken a toll on my family throughout my life and my parents’ lives, so I’ve seen how people come to reckon with it. I thought I had developed sophisticated responses, but in that moment those responses failed when presented with this new problem. I’d seen what alcoholism can do, and how as a culture we accept it as a problem. But we were turning away from opiate abuse and denying its reality, and I felt I needed to resist that turning away.

    I think it’s stunning for someone who hasn’t experienced addiction himself, how you put words to those unique feelings and moments. There’s a line from “Resolution,” “…I stood in the yard // and decided that sometimes / you have to tell yourself / you’re the first person // to look out over / the silent highway / at the abandoned billboard // lit up by the moon / and think it’s selling a new / and honest life.”

    There are details about the way of life that can accompany opioid use disorder, which echo the conversations I’ve had with people. “Leaving the Pain Clinic,” you write “…and though the door’s the same, / somehow the exit, like the worst wounds, is greater / than the entrance was. I throw it open for all to see / how daylight, so tall, has imagination. It has heart. It loves.” Like, how did these lines come to be in such striking detail?

    For me, the writing of a poem is an impulsive act. But there’s a lot of gestation and thinking that goes on behind the scenes, before I write—a lot of thinking. And there’s living that goes into them, too. When I was in college I had an accident that required some heavy surgery and a long rehab period. Opioids were a big part of that period, I was on them for a long time. The power of those drugs, what they could do, has remained vivid in my mind, and always will. That passage about daylight comes from that.

    In regard to the former passage: I’ve dealt with serious depression my whole life. Depression and substance abuse are often bedfellows. What depression can unleash in someone—hopelessness, dependency, fear, recklessness towards how we feel about our lives, suicidal impulses—can certainly be unleashed by substance use disorders, too, with the volume turned up to 11. To be clear, I do not mean in any way to suggest that depression and substance abuse are the same thing. Rather, what I mean to articulate is that I brought every bit of myself to every poem. This is not just a matter of aesthetics. It’s me doing my best to extend myself out, to say, “Dear Person X, the possibility that your pain may feel even remotely similar to my pain is why I’m trying to do my absolute best to recognize you in hopes that you may feel less alone, but even more importantly, so that you may feel loved. Loved.”

    I come from a spoken word community that preaches sticking to your own story. Personally, I think your book is an important addition to literature, both generally and in the addiction/recovery sub-genre. But throughout it you often speak through the persona of someone with substance disorder. I worry other poets will take this as license to do the same, without possessing the knowledge or respect you have for the subject. What are some potential hazards here?

    First, thank you for saying that. I appreciate it greatly and don’t take it lightly.

    While you come from a spoken word community, my literary life is rooted in fiction. The literary texts we had in my house were Herman Melville, Mary Shelley, Jane Austen, Nathaniel Hawthorne. They sat on a single shelf at the top of the stairs. I can still see them. Likewise, at school, literature = fiction. I read maybe two poems in high school, so my life in books began, and in many ways persists, through fiction, and so because of that, the root of my literary practice has always been—to use Roth’s (for better or worse) definition of fiction writing—“the crafting of consciousness,” with the understanding that this requires immense care, thought, patience, and humility. Do as much work as you can to get it right, and then do more. IKYK is very much a book that attempts to synthesize this quality of fiction, in addition to its immense capacity for world building and social examination, with poetry’s sense of deeply distilled emotional and psychological textures, its power to challenge language, and its unique ability to find unexpected connections. 

    As for other poets taking my work as license, I’m not sure what to say about that. It would seem to me that the potential for bad poetry, and bad poems about this subject, was there long before any of my poems came into the world. At the same time, for as long as that potential for faulty work has existed, there’s been a concurrent tradition of very valuable work being done in persona, poems by Bidart and Ai being just two gleaming examples (not to mention what has been done in fiction). So, maybe we could reframe the thinking in more positive terms, i.e. maybe this book can stand as an example of what persona can do? What the poem can do?

    What eats at me is how there aren’t a lot of poets writing about their personal experiences with substance recovery, at the level where they’re prominent within the poetry industry or community. Are these poets dead from overdoses? Did their time go towards using instead of writing? Or maybe they’re not writing openly because of stigma? Can you speak on the importance of us all lifting up and listening closer to people who have personal experience with these issues?

    I’m not sure about this, though it’s a wise question, one of huge importance. I don’t know of a clear answer. But it seems like the work you do in your day to day is connected to this and is very valuable. That’s something to be optimistic about. People have reached out and told me how they have brought my poems or the book into spaces like meetings, support groups, halfway houses, and that has been very humbling to hear. Just getting poems into spaces where maybe they’ve never been before—maybe that’s part of how we turn it around? As for the importance of lifting people up and listening closely—it is the most important thing. At the same time, the responsibility to write about this problem, which is now a national problem, shouldn’t rest solely on those suffering, should it?

    What do you hope your book accomplishes?

    Someone contacted me when the book came out, who had very recently lost a parent to heroin. She said to me, and I’ve held on to this, “The poems gave me a feeling that I had a place to go.” This was the greatest response I could have received. I hope that on a larger level, the book can extend the realities of the epidemic in WV to people who maybe had no idea what was going on, or didn’t believe it, or didn’t think it mattered—i.e. didn’t think the lives of West Virginians mattered.

    To graft onto that statement, I think the book is educational for people who don’t understand West Virginia, and how the opioid epidemic has taken root so deeply in this specific place.

    I surely hope so. That’s one of the book’s largest aims.

    I also want to add, while it’s a needed pursuit to write a place for pain to feel seen, it’s also necessary to create sites for recovering peoples to draw strength, hope, and triumph. What are some lines in your book that are doing this work?

    I think strength is an impulse that runs through much of the book—books about WV are inherently about strength. I think “Resolution” is a poem that leans toward a sense of hope or even triumph, even if it may be the first of a few failed attempts toward a larger triumph. Overall, though, I don’t think hope or triumph are large elements in the book, again this is because it’s a book about a specific situation in a specific place, and when I was writing it and editing it, things didn’t seem very hopeful or triumphant. I turned my book in to my editor in the fall of 2016. At that time, it felt like a situation that no one much cared about. The New Yorker hadn’t yet run its large profile about the state, the Charleston Gazette-Mail hadn’t yet run its now Pulitzer Prize-winning expose that gained national attention, Netflix’s Heroin(e) hadn’t yet been released, etc. etc. That said, I agree wholeheartedly that these sites and books are necessary, and I’m confident that they are coming, especially as our relationship to this epidemic, and our ability to help those afflicted by it, changes. So, while some of those elements may not be as present in my book, I don’t believe every book can or should do everything. Moreover, this subject, and its impact on our country, is vast. Perhaps, when it’s all said and done—if it’s ever all said and done—this book will be seen as one part of the larger record and discussion.

    Last question. What’s next for you? Anything that involves substance use disorder?

    I’m working on a novel that looks at the larger social, political, and economic networks that can be at play in making something like the opioid epidemic thrive in a place like West Virginia. I’m also working on a second book of poems about paranoia, suicide, and the idea of inherited death. And let me say thank you for taking the time to talk to me, your generosity toward the work, and for everything you do.

    More poems by William Brewer:

    “In the New World,” Southern Indiana Poetry Review

    “Oxyana, WV: Exit Song,” Diode Poetry

    Other interviews in this series about poetry and addiction:

    Lineages of Addiction: Interview with torrin a. greathouse, a Trans Poet in Recovery

    Addiction and Queerness in Poet Sam Sax’s ‘madness’

    Kaveh Akbar Maps Unprecedented Experience in “Portrait of the Alcoholic”

    View the original article at thefix.com

  • Should You Breastfeed Your Baby If You're on Methadone?

    Should You Breastfeed Your Baby If You're on Methadone?

    My daughter was born with neonatal abstinence syndrome but I was not allowed to nurse or have her in the room with me; the hospital staff said the methadone in my breast milk could be dangerous. They were wrong.

    Earlier this summer several news outlets reported on the death of an 11-week-old infant in Philadelphia by what appeared to be a drug overdose. The mother, who has been charged with criminal homicide, blamed the drug exposure on her breast milk. Although an autopsy revealed that the infant’s drug exposure also included amphetamine and methamphetamine, many news outlets chose to focus on the fact that the mother was a methadone patient. The death of an infant by drug exposure is unquestionably terrible; unfortunately, misleading articles make what is already a tragedy even worse by insinuating or directly stating that the methadone content in the breast milk was involved in the infant’s death.

    Stigma around methadone use in the United States has a long shadow. Prescribed primarily to treat opioid use disorder (but also sometimes for pain management), methadone is a long acting opioid that builds in the patient’s bloodstream to create a stable, non-euphoric equilibrium when used correctly. It is a highly effective form of both addiction treatment and harm reduction, shown to reduce overdose deaths by 50% or more. Unlike short acting opioids like heroin or morphine, methadone prevents patients from experiencing the physical chaos of sedation and withdrawal, and can help re-balance neurochemical changes that take place during active addiction. For decades, methadone has been considered the gold standard of treatment for opioid use disorder, including during and after pregnancy.

    But in spite of the demonstrated benefits of methadone and its pharmacological differences from commonly misused opioids, it has, for many years, acquired a popular status as “legal heroin.” Social media is flooded with memes mocking methadone patients or complaining that they don’t deserve “free methadone” when other drugs cost money (in fact, methadone has a price tag like any other medication). Even other people in recovery or the throes of active addiction disparage methadone, sometimes referring to it as “liquid handcuffs” because of the stringent regulations requiring daily trips to a clinic during the first several months of treatment.

    This stigma leaks into every aspect of patient care. For me, it prevented me from seeking treatment for years. I was terrified to get on methadone. Who would volunteer to be “handcuffed” by a treatment system? But when I learned I was pregnant, my doctors urged me to get on methadone. They said that attempting to withdraw from heroin would be dangerous for my developing baby, and continuing to use would be even riskier.

    I was reluctant, but I enrolled in a methadone maintenance program as my doctors advised. Because of that, I had a healthy, full-term pregnancy. But at the Florida-based hospital where my daughter was taken after a speedy, unplanned home birth, I was not allowed to breastfeed. My daughter suffered neonatal abstinence syndrome (NAS), a condition caused by opioid withdrawal that occurs in some babies whose mothers used methadone or other opioids while pregnant; she was dosed with morphine to wean her down from the methadone she received in utero, and the hospital staff told me that adding my methadone dose via breast milk could be dangerous. Because of that, my milk production dwindled, and my daughter—who stayed in the hospital over a month—never learned to properly latch. After she came home, she suffered colic, constipation, and sleep disturbances as we worked through various formulas trying to find one that was gentle on her stomach.

    But these negative ideas about methadone distribution in breast milk are flat out wrong. We know that methadone is a highly potent, long-acting opioid that is extremely dangerous if given to infants and children directly. No amount of methadone syrup should be administered to an infant or child by a parent or caregiver without physician approval. But studies have demonstrated that the amount of methadone that gets passed into breast milk is negligible, and will not harm an infant, even a newborn. A 2007 study of methadone-maintained mothers in addiction recovery found that methadone concentrations in breast milk remained minimal in the first four days postpartum, regardless of maternal dose, time of day after dosing, and type of breast milk being expressed. The daily amount of methadone ingestible by the infants did not rise above .09 mg per day. To help prevent even that slight fluctuation, John McCarthy, a practicing and teaching psychiatrist who has treated opioid-dependent pregnant and postpartum women for over 40 years, suggests splitting nursing mothers’ methadone doses in two—a measure that should have begun during pregnancy to help minimize the risk of NAS. “It’s not dangerous to nurse on a once a day dose, but it’s not the best way to give the medication. The baby should be given a smooth level of methadone.”

    Some people believe that breastfeeding an infant with NAS while on methadone will help decrease withdrawal symptoms by providing a minute amount of the same drug from which the infant is withdrawing. According to experts like Jana Burson, a doctor specializing in the treatment of opioid addiction, this belief is also false: “some mothers erroneously think their babies won’t withdraw if they breastfeed—that’s wrong. There’s not enough methadone in the breast milk to treat NAS.” Of course, breastfeeding a child who experiences NAS is beneficial, both because of the health benefits of breast milk, and because maternal contact is important for babies in distress. “Breastfeeding will help in the general sense that babies like to breastfeed and it’s calming, but not because babies are getting methadone in the breast milk.”

    Sandi C., a methadone-maintained mother based out of Massachusetts, breastfed her son for two and a half years, and plans on breastfeeding the baby she is currently expecting. Like me, Sandi was addicted to heroin when she learned she was pregnant. She began on buprenorphine, a partial-opioid agonist used similarly to methadone, and switched to methadone partway through her pregnancy. But her postnatal experience was different than mine.

    “I’m really fortunate that my area is really encouraging of breastfeeding,” says Sandi. “Actually, I wasn’t sure if I could breastfeed and [my doctor] said ‘definitely breastfeed, we encourage it.’” Like my daughter, Sandi’s son was diagnosed with NAS. But instead of being sent to the Neonatal Intensive Care Unit (NICU), her son was allowed to be in the hospital room with her, where Sandi could hold and breastfeed him as much as he needed. Her son was released after just two weeks, less than half the time my daughter spent in the NICU at our hospital in Florida. She continued to breastfeed at home until he was over two years old.

    “He never got sedated,” she recalls. “Everything was fine.”

    Just because methadone is safe for breastfeeding moms doesn’t mean the same is true for other drugs. If the Philadelphia baby’s death was in fact caused by what many outlets have called “drug-laced breast milk,” it would have been due to the amphetamines, not the methadone. Methamphetamine breast milk exposure has not been studied as extensively as methadone, but current recommendations are that lactating women should wait 48 hours after their last use of methamphetamine before resuming breastfeeding. Experts like Burson and McCarthy agree that mothers on methadone maintenance who are not using other substances can safely breastfeed. “All of the major medical groups recommend it,” Burson said, adding, “even on higher doses they all recommend that mothers on methadone breastfeed.”

    View the original article at thefix.com

  • Suboxone: A Tool for Recovery

    Suboxone: A Tool for Recovery

    With medication-assisted treatment (MAT), people with opioid addictions are given the chance to rebuild their lives—often from the ashes and debris of drug-induced destruction—without having to fight cravings and withdrawal.

    Suboxone is a prescription medication that treats opioid addiction. It contains buprenorphine and naloxone, active ingredients that are used to curb cravings and block the effects of opioids. Although a major player in addiction recovery today, and often referred to as the gold-standard of addiction care, many in the recovery community remain resistant and even wary, including a large portion of rehab facilities and many members of the 12-step community.

    How does Suboxone work? When an opioid like heroin hits your system, it causes a sense of euphoria, reduced levels of pain, and slowed breathing. The higher the dose, the more intense the effect. Buprenorphine and heroin are both considered opioids, but the way they bind with the opioid receptors in the brain differs. Heroin is a full agonist, meaning it activates the receptor completely and provides all of the desired effects. Buprenorphine is a long-acting partial agonist. While it still binds to the receptor, it is less activating than a full agonist, and there is a plateau level which means that additional doses will not create increased beneficial effects (although they may still cause increased adverse effects). In someone who has been addicted to opioids, buprenorphine will not cause feelings of euphoria—the sensation of being “high.” Naloxone is paired with the buprenorphine to discourage misuse; if Suboxone is injected, the presence of the naloxone may make the user extremely ill.

    Jail Physician and Addiction Specialist Dr. Jonathan Giftos, M.D. offers this analogy: “I describe opioid receptors as little ‘garages’ in the brain. Heroin (or any short-acting opioid) is like a car that parks in those garages. As the car pulls into the garage, the patient gets a positive opioid effect. As the car backs out of the garage, the patient experiences withdrawal symptoms. Buprenorphine works as a car that pulls into the same garage, providing a positive opioid effect—just enough to prevent withdrawal symptoms and reduce cravings, but unlike heroin, which backs out after a few hours causing withdrawal—buprenorphine pulls the parking brake and occupies garage for 24-36 hours. This causes the functional blockade of the opioid receptor, reducing illicit opioid use and risk of fatal overdose.”

    Critics and skeptics of medication-assisted treatment (MAT) believe that using Suboxone is essentially replacing one narcotic with another. While buprenorphine is technically considered a narcotic substance with addictive properties, there are important differences between using an opioid like heroin or oxycontin and physician-prescribed Suboxone. Similarities between using heroin and Suboxone are that you have to take the drug every day or you will experience withdrawal and likely become very ill. Aside from the physical dependency, which is without a doubt a burden, Suboxone offers people in recovery the opportunity to live a “normal” life, far removed from the drug culture lifestyle they may have been immersed in while using heroin.

    People are dying every day from heroin overdoses, especially now in the nightmarish age of fentanyl. People in recovery from opioid addiction are living, free from the risk of overdosing, on Suboxone. Suboxone is a harm reduction option that while initially raised some eyebrows is gaining more traction, and considered an obvious choice for treatment by addiction medicine professionals. While someone using heroin is tasked daily with coming up with money for their drugs, avoiding run-ins with police or authorities, meeting dealers and often participating in other criminal activity, someone using physician-prescribed Suboxone is not breaking the law. They are able to function normally and go to school or get a job, and they are often participating in other forms of ongoing treatment simultaneously. People are given the chance to rebuild their lives—often from the ashes and debris of drug-induced destruction—without having to fight cravings and withdrawal.

    There is a common misconception about Suboxone, and medication-assisted treatment in general, that it is a miracle medication that cures addiction. Because of this idea, many people use Suboxone and are disappointed when they relapse, quickly concluding that MAT doesn’t work for them. When visiting the website for the medication, it reads directly underneath “Important Safety Information” — “SUBOXONE® (buprenorphine and naloxone) Sublingual Film (CIII) is a prescription medicine indicated for treatment of opioid dependence and should be used as part of a complete treatment plan to include counseling and psychosocial support.”

    So, as prescribed, Suboxone is intended to be only part of a treatment plan. It is but one tool in a toolbox with many other important tools such as counseling or therapy, 12-step meetings, building a support system, nurturing an aspect of your life that gives you purpose, and practicing self-care. It is medication-assisted treatment, emphasis on the assisted.

    With that being said, the type of additional treatment or self-care a person participates in should fit their own individual needs and comfort level and not be forced on them. Like a wise therapist once said, “Everybody has the right to self-determination.” Twelve-step meetings, although free and available to everyone, are not the ideal treatment for many people struggling with addiction. Therapy is expensive. People using Suboxone or other MAT shouldn’t be confined to predetermined treatment plans that have little to do with an individual’s needs and more to do with stigma-imposed restrictions.

    It’s unlikely that you’ll find a person claiming that simply taking Suboxone instead of heroin every day saved their life. It is not the mere replacement of one substance for another that is saving lives and treating even the most hopeless of people who have opioid use disorder; it is the relentless pursuit of a new way of life, a pursuit which includes rigorous introspection and a complete change of environment, peers, and daily life. Through the process of therapy, 12-step, using a recovery app, or whatever treatment suits you best, a person can face their demons, learn healthy coping mechanisms, and build confidence without the constant instability of cravings and withdrawal. Suboxone is giving people a chance that they just didn’t have before.

    So why is there such a stigma tied to the life-saving medication? Much of it comes from misinformation and is carried over from its predecessor—the stigma of addiction. It is hard for people who have a pre-existing disdain for addiction in general to swallow the idea that another “narcotic” medication may be the best form of treatment. In addition to addiction-naive civilians or “normies” as 12-steppers might call them, many members of the Narcotics Anonymous community are not completely sold on Suboxone’s curative potential either. Some members of the 12-step community are accepting of MAT, but you just don’t know what you’re going to get. You may walk into a meeting and have a group that is completely open and supportive of a decision to go through the steps while on Suboxone, or you may walk into a meeting of old-timers who are adamant that total abstinence is crucial to your success in the program.

    Another reason people are unconvinced is the length of time Suboxone users may or may not stay on the medication. Again, there is a stigma that shames people who use Suboxone long-term even though studies have shown long-term medication-assisted treatment is more successful than using it only as a detox aid. If Suboxone is helping a person live a productive life in a healthy environment, without the risk of overdose, that person should have the right to do so for however long they need without the scrutinizing gaze of others. While their critics are tsk-tsking away, they may be getting their law degree or buying their first home.

    Suboxone is a vastly misunderstood and complex medication that has the potential to not only save the lives of people with opioid addictions, but also allow them to recover and rebuild lives that were once believed to be beyond repair.

    View the original article at thefix.com

  • Americans Not As Aware Of Opioid Crisis In Their Own Backyards, Study Finds

    Americans Not As Aware Of Opioid Crisis In Their Own Backyards, Study Finds

    Americans are three times more likely to be informed about the opioid epidemic as a national problem rather than one in their own area.

    Despite the opioid epidemic dominating headlines, a new study has found that most Americans are not aware of the extent of the epidemic in their own areas of residence.

    The study, conducted by Laguna Treatment Hospital in Aliso Viejo, California, found that Americans are three times more likely to be informed about the opioid epidemic as a national problem rather than one in their own areas, The Guardian states

    The study found that a mere 13% of participants in the southern part of the country and 10% of those in the northeastern region felt that “drugs posed a crisis in their own communities.” But based on past data, states like West Virginia, Kentucky, Pennsylvania and Vermont have been among the states most affected by the crisis.

    Dr. Lawrence Tucker, medical director of Laguna, tells the Guardian that the results of the study were surprising due to the prevalence of the epidemic “despite regional differences.”

    “You can see those differences in not just the prescriptions of opioids but the amount of heroin that is available—China White, for example, is prevalent along the east coast as is fentanyl,” he stated. “There is oxycodone in the midwest and Black Tar heroin on the west coast.”

    Tucker played a large role in the recent study, called “Perceptions of Addiction.” The study surveyed 999 participants, 45% of which were male and 55% of which were female, from all parts of the country. The participants were between the ages of 18 and 76, and about 33% stated that they had dealt with substance use disorder at some point. 

    In 2014, a Pew Research study found that very few Americans had knowledge of the growing opioid epidemic. Tucker and others involved in the study wanted to find out if four years later, in light of the growing spotlight on the epidemic, the perceptions had changed. 

    “The survey’s verbiage attempted to achieve admittance of, versus just awareness of, addiction across the United States,” Taylor Bloom, the survey’s project manager, told the Guardian. “We would ask questions using the word ‘perceive’ instead of ‘aware.’ For example: ‘Do you perceive an addiction crisis in your community?’”

    According to the Guardian, Bloom and other researchers did discover some improvements when compared to the 2014 study.

    “We saw increased awareness among Hispanic and African American demographics,” said Bloom. “But then we saw that Americans are 79% less likely to perceive an addiction crisis in their communities today as they were four years ago… which is kind of crazy.”

    According to Tucker, race plays a large part in awareness.

    “Some races, particularly white young adults, are being hit harder than others,” he told the Guardian. “Which is why the neighborhoods that are affected the most are certainly aware of the epidemic, because they have lost loved ones and friends. But the communities that aren’t really aware of the opioid epidemic is because it’s just not affecting them as much due to the racial makeup of their neighborhoods.”

    View the original article at thefix.com

  • Relapsing While Famous: Demi Lovato, Stigma, and Compassion

    Relapsing While Famous: Demi Lovato, Stigma, and Compassion

    “We would typically not blame a patient with a chronic medical condition for their problem; nor imbue the patient with shame over their offending organ—why do we seem to do this with addiction?”

    The news that Demi Lovato was hospitalized of a suspected drug overdose has sent her celebrity friends and fans into overdrive; they are full of praise and well wishes for the singer.

    The support offered has been a beautiful response to witness, and this outpouring of encouragement is the exact caring that Lovato needs right now.

    This overwhelmingly positive response is a very different reaction than we normally associate with people falling off the wagon. Our society has painted the ordinary (non-celebrity) person with an addiction—whether it be to drugs, alcohol, sex or some other negatively perceived behavior—who loses their sobriety as a monster, as someone who cannot fix themselves, as a loser, as an undisciplined and unhealable soul.

    How many Internet memes have been generated that show the unforgiving and unflattering face of addiction? How many ill-conceived jokes about addicts relapsing have you heard? How often do you see mockery of those who have lost their fight? Or a sense of them being not strong enough to withstand the urges we all face?

    But the reality is that relapses are oftentimes part of the process, even for those who have spoken about their recovery. Just because someone has stood up and celebrated their recovery does not mean they will never possibly have a setback.

    Demi Lovato has been open about sharing her struggles through addiction, eating disorders and bipolar disorder. In her music (her song “Sober” details her ongoing struggle with sobriety), her interviews and social media accounts, Lovato has never shied away from speaking her truth. She is proud to be a mental health advocate and has spoken about how she knows her music has helped other young women struggling with some of the same issues that she has.

    Lovato’s openness in sharing her fight and the help her art has provided for others is all the more remarkable considering she was on the Disney Channel when she first entered rehab. There were many pressures and expectations upon her young shoulders and no one would have blamed her for wanting to keep that part of her life private.

    But admitting that the struggle continues after a setback can be the hardest part. Often, as a culture, we are not gung ho on offering people second chances, and especially not third or fourth chances.

    What’s that famous saying? Hurt me once, shame on you. Hurt me twice, shame on me.

    As a society, we can be unforgiving when it comes to people relapsing, but we seem to be much more sympathetic and forgiving with celebrities who struggle with addiction than we are with our ordinary peers.

    There is an unwritten social contract that we follow with celebrities that allows them to loom larger in our minds than normal, everyday people. We see them as larger than life while at the same time feeling intimately connected to them, as though they are family. We feel we know them.

    And we do know them when they share their personal demons with us. We recognize our own struggles and feel buoyed up by their example of openness and honesty.

    Could Lovato’s suspected relapse be an opening for a new understanding of the addiction cycle and conversation about the role of relapse in recovery? Perhaps her experience can shine a light on why no one deserves to be stigmatized for their illness.

    Of course, this goes for all mental health conditions, whether the diagnosis is addiction, bipolar disorder, depression, schizophrenia or others. Historically, our culture has stigmatized people with mental illness so that they feel embarrassed or that they need to hide their condition. It is only in recent decades that more individuals have been brave enough to come forward and speak about their struggles.

    Lovato’s overdose can serve as an example and a beacon to help people understand that addiction and other mental health issues are illnesses which aren’t always cured on the first, second or even third try.

    The fact that wealthy celebrities, who often have the best treatments and practitioners at their fingertips, still suffer relapses shows us how devastating mental health conditions can be. How can we expect our neighbors—who have those same diagnoses but may be struggling to make ends meet—to fare any better than our most celebrated and privileged?

    Many individuals prefer to suffer in silence rather than seek help because of this prejudice. They would rather live with often debilitating diseases rather than expose themselves to the potential stigma that comes with admitting they need help.

    What can we do to help alleviate the suffering of those around us?

    We can read and learn more about addiction and how difficult the road is to recovery and we can work to understand that the road is not always without bends and turns and sometimes brief exits.

    “Research has consistently shown addiction to be a chronic/relapsing disease, where multiple treatment episodes are often necessary, and that recovery may be a cumulative and progressive (non-linear) process,” says Dr. David Greenfield, Assistant Clinical Professor of Psychiatry at University of Connecticut Medical School and a specialist in addiction medicine. “We would typically not blame a patient with a chronic medical condition for their problem; nor imbue the patient with shame over their offending organ—why do we seem to do this with addiction?”

    We can have compassion for those who struggle and sometimes fall in their recovery, which will help alleviate their feelings of shame. For those closest to us, we can be supportive without enabling them or being codependent. The celebrity outpouring of love and caring through social media is an example of how compassion can be expressed through this modern tool.

    But Lovato’s friends are not the only ones sharing the love; her fans are sending messages of support, too.

    How Demi Lovato speaks to the public about her reported relapse can have real consequences for the greater conversation society needs to have. Hopefully, she will use her celebrity status to continue the dialogue with her fans about addiction; at the same time, she may express a need for privacy and time for reflection.

    The real opportunity for change will occur around the water coolers at work or on our social media feeds. When we can openly discuss mental health conditions—not as signs of weak moral character or evidence of being less than or incapable—but as true illnesses which require assistance from all corners—financial, family and friends, and sociocultural—we will then be truly supporting not only the celebrities amongst us, but our neighbors and ourselves as well.

    View the original article at thefix.com

  • Mommy Doesn't Need Wine: The Stigma of Being a Sober Mother

    Mommy Doesn't Need Wine: The Stigma of Being a Sober Mother

    “I’ve always wanted to film the real ‘after party’ when the mom is passed out with her little kid in the background, or she gets into her car and drives drunk. It happens all the time.”

    When I made the decision to quit drinking, one morning in June 2017 when my relentless hangover was surpassed only by my anxiety and self-loathing, I didn’t think about how sobriety would affect my role as a parent beyond the obvious positives: less time nursing a glass of wine and more time to engage with my kids; a clearer morning mind during the pre-school madness; more patience, less irritability. More money.

    What I didn’t consider was my exclusion from the Mommy Needs Wine club. Although exclusion isn’t the right word – it was my choice to leave. I just hadn’t realized how significant a part of my life it was until I canceled my subscription.

    When I first became a mother in 2007, I quickly realized there was an unwritten rule, one that was never mentioned in the parenting manuals: being a mother is hard, and wine (or gin, or vodka, or whatever your particular poison is) makes it easier.

    At that point, I didn’t yet have a Facebook account, and Instagram wasn’t even a thing. Today’s pervasive social media culture gives the Mommy Needs Wine club even more power. It recruits mothers from their Facebook and Instagram feeds, via memes that declare: “The most expensive part of having kids is all the wine you have to drink” and “I can’t wait for the day when I can drink with my kids instead of because of them.” We’re encouraged to buy baby onesies emblazoned with “I’m the reason Mommy drinks” and prints saying “Motherhood. Powered by love. Fueled by coffee. Sustained by wine” (to put in a pretty frame and display on your wall, lest anyone should forget how crucial booze is to parenting).

    “The media makes a ton of money marketing alcohol to moms, playing on the difficulties of being a mom and offering alcohol as the only solution to stress,” said Rosemary O’Connor, certified life and addiction coach and author of The Sober Mom’s Guide to Recovery. “I’ve always wanted to film the real ‘after party’ when the mom is passed out with her little kid in the background, or she gets into her car and drives drunk. It happens all the time, yet it seems so harmless because wine is so much a part of our culture.”

    It’s so much a part of our culture that the Moms Who Need Wine Facebook page is liked by over 726,000 people; that the memes and baby onesies and wall prints are promoted by thousands of likes, shares and crying-with-laughter-face emojis; that even celebrity moms are in the club. Kelly Clarkson said in a January 2018 interview, “[Kids] are challenging. Wine is necessary.” And millions of mothers around the world raised a glass.

    The truth is, this alcohol-dependent culture—if you don’t drink you’re boring, judgmental, not to be trusted (Winston Churchill and his quote “Never trust a man who doesn’t drink” have a lot to answer for)—and the ensuing stigma around sobriety are far from harmless. Between 2006 and 2014, alcohol-related emergency room visits soared among women, according to a study published in January 2018 in the journal Alcoholism: Clinical and Experimental Research. A study published in the International Journal of Drug Policy in May 2015 found that a significant number of mothers said drinking helped them “assert their identity” as something other than that expected of a woman in early midlife. Mothers with young children told researchers the “transformative effects” of “excessive drinking” let them to revert, for a short time, to their younger, more stress-free selves.

    When I started to share my sobriety with friends and family, I received varying reactions. Many people were supportive, some stopped inviting me to parties, and the vast majority were surprised. Not just surprised that I—always the first to suggest a glass of prosecco, always the last to leave a party—was the person who had publicly declared my commitment to sobriety, but surprised that I could even contemplate being a parent without booze. How was I going to get through a challenging day with my kids without the promise of a few glasses of wine to take the edge off? How was I going to reward myself for surviving another week of homework, messy bedrooms, mini rebellions and Xbox arguments if I wasn’t going to do it with wine?

    Back then, I had no answers to those questions. I was simply concentrating on getting through one sober day at a time. That was enough of a reward. What I needed was support and encouragement, not interrogation.

    And then there was the pity. It came in various forms, from the “Oh, you must be so bored?” on one of my first sober nights out, complete with sympathetic head tilt (for the record, I wasn’t bored until I was asked that question) to the barefaced “I feel sorry for you!” at my first sober wedding. The pity was worse than the perplexity and the cross-examination, because it came with a “but.” But this is your choice. But you’re not an alcoholic, are you? (Because alcoholics have to be homeless, jobless, friendless losers.) But you won’t die if you have a drink, will you? But you could just have one, right? People didn’t feel sorry for me the way you feel sorry for someone with a broken leg. Their faux-pity made me feel guilty. It made me question my decision, not because I didn’t think it was the right decision, but because it was a decision that excluded me from so much. I didn’t fit into the drinking culture the other parents in my social circle celebrated and depended on, so where the hell did I fit in?

    O’Connor had a similar experience when she stopped drinking. “People who I thought were my ‘best friends’ stopped calling and inviting me to parties,” she said. “When I was newly sober, the feelings of not being included was one of the most difficult realities to face. Being newly sober, going through a divorce, and having people abandoning me was so painful. I found out who my real friends were and they are still my friends today.”

    Now, with over a year of sobriety under my belt, I feel differently. I’m proud of my decision and the strength it’s taken to get to this point, to stay sober at parties and weddings and nights out when everyone else is getting drunk, and, sometimes, to stay home and miss those occasions because protecting my sobriety is more important than worrying about what anyone else thinks. I’ve also realized that in most cases, how people react to my sobriety has actually nothing to do with me, and everything to do with their own issues with alcohol.

    O’Connor agrees. “I realized that when I was drinking I never wanted to hang out with non-drinkers because it made me self-conscious about my own drinking,” she said.

    It’s difficult to talk about alcohol dependency with a group of friends who’re all knocking back wine while you’re working your way through the mocktail menu. But it’s a conversation that needs to be had. How many mothers are functioning alcoholics or have alcohol dependency issues, but don’t know this because our culture tells them—repeatedly—that drinking is the answer?

    I’m no prohibitionist. (I say that so often I should have it tattooed on a prominent body part.) But I do believe that we need to question the media messages we receive about alcohol. If not for ourselves, then for our kids.

    “Parents of young children need to be aware that when they place themselves on the slippery slope to alcohol use disorder by frequently exceeding recommended drinking limits, they place their young children on that slope, too,” warned George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism. “We know that young children learn from watching what their parents do and not just from what they say. The children of parents who are heavy drinkers are more likely to become heavy drinkers themselves and develop an alcohol use disorder than the children of moderate drinkers or abstainers.”

    I see my kids benefiting from my sobriety—in countless little ways, every single day. A lengthy bedtime story because I’m not counting the minutes down to wine o’clock. A relaxed morning before school because I’m not hungover, sleep-deprived and snappy. A healthier model for how to administer self-care. A lesson on how to question cultural norms and why, sometimes, taking the road less traveled is the most rewarding journey of all.

    View the original article at thefix.com