The Prevalence of Substance Misuse and Addiction in Sports

Jessica Joiner, LCSW, LAC, has over a decade of experience working with those suffering from addiction, complex trauma, and co-occurring disorders. She uses her experience along with the extensive skills gained to address the many issues that arise for athletes.

In her workshop hosted by Harmony Foundation, Joiner discussed the prevalence of substance misuse among athletes, various ways of identifying “red flags,” and evidence-based interventions that can be helpful in combating the misuse of drugs and alcohol.

As Joiner explained, there are three main reasons athletes misuse substances: pain resulting from injuries, stress from incessant pressure to win, and the desire to enhance performance artificially. Over the years and decades, these reasons have stayed the same but the drugs involved are now more sophisticated than ever, with more options.

The statistics paint a grim picture. Substance misuse is prevalent in high school: approximately 19 percent of males and 14 percent of females binge drink in high school. 21 percent of teens use marijuana and up to 6.6 percent have used performance-enhancing drugs (PEDs).

It gets worse in college where 42 percent of students admit to binge drinking, 28 percent use cannabis, and around 11,000 NCAA athletes admit to taking PEDs. There is a strong correlation between concussions and alcohol use. “Having a concussion is actually predictive for alcohol use,” said Joiner. “If a high school student is entering college with a history of concussion, and we know about the correlation, we could put some measure in place to intervene before things get out of control. We don’t want them to get overwhelmed by the pressure of performing and the grades required to continue.” It’s much better to support them on the front end before things get out of hand.

Should players get drafted into the National Football League, the pain from injuries, the pressure to win, and the temptation to use PEDs get even worse. In the NFL, 51 percent of players use opioids and 71 percent of those athletes admit to misusing them. Many of the pills are not prescribed by medical doctors: 68 percent say they got them from other sources.

It takes only a few days to get addicted to opioids, Joiner warned, and professional athletes have easy access. Professional athletes tend to play through the pain and then “fix it” with opioids and other substances after the game, putting themselves at risk for greater injury and addiction.

Joiner then went over the possible consequences of such risky behavior, which include the impact on performance, health, relationships, and career—and in the worst-case scenario, death.

While substances were initially taken to enhance or maintain performance, escalating use will eventually compromise performance and wreak havoc with the athlete’s health. As is the case for all people with substance use disorder, addiction has “a definite negative impact on relationships.” If there is no intervention and treatment, players may end up with legal problems, a league suspension, or just get kicked off their team.

There are many examples of athletes falling into this trap. Former Boston Celtic Chris Herren struggled with substance misuse for much of his NBA career. While playing for the Celtics, Herren started to use opioid painkillers. In December 2007, he was charged with possession of heroin in Rhode Island and in the following June, Herren overdosed on heroin in Fall River, Massachusetts. According to the attending paramedics, he was clinically dead for 30 seconds.

Abby Wambach—widely considered the best female soccer player ever—was arrested for driving under the influence in 2016. Following the incident, Wambach published an autobiography revealing that she had misused prescription drugs and alcohol for many years.

After going into recovery, Herren started raising awareness of drug addiction and has now spoken to over one million students, athletes, and community members, promoting frank discussions about substance use disorder and wellness.

In the webinar, Joiner, too, stressed the importance of prevention and early intervention to attack this problem. Prevention should include educating everybody involved to raise awareness of mental health issues that often drive substance misuse, so parents, teachers, and coaches learn to recognize red flags. “From the outside, it often looks like they have everything”, explained Joiner. That’s why depression and anxiety disorders are often overlooked. Testing, screening and other interventions should be used in a supportive, not punitive way.

“We should stop just being reactive and be more proactive,” Joiner said. Coaches and trainers of athletes should not wait for a crisis to unfold and athletic programs should provide adequate mental health services for players (and other students). Treatment should not be perceived as punishment for bad behavior but as a concerted effort to heal psychological problems. “We need effective collaboration between therapists, doctors, school departments, and the community that facilitates integrated care,” Joiner said. Currently, too many people fall through the cracks because many athletic departments don’t provide nearly enough mental health professionals. Ultimately, a culture shift is required: our society’s approach to athletic injuries and mental illness needs to change significantly and we need more trauma-informed and stigma-free care—and not only for athletes.

Harmony Fights Opioid Epidemic with HOPE

More than two-thirds of drug overdose deaths in the United States in 2017 involved opioids, according to the Centers for Disease Control and Prevention, escalating an epidemic the CDC says “continues to worsen and evolve.” From 2016 to 2017, opioid-related overdose deaths increased 12 percent overall, surging among all age groups 15 and older.

The CDC report’s recommendations for curbing opioid-related overdose deaths include “increasing naloxone availability, expanding access to medication-assisted treatment, enhancing public health and public safety partnerships, and maximizing the ability of health systems to link persons to treatment and harm-reduction services.”

Naloxone is a medication often used by first responders because it can rapidly reverse opioid overdose. It is an opioid antagonist—it binds to opioid receptors and can reverse and block the effects of other opioids. It can quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain relievers.

Medication-assisted treatment (MAT) is used to decrease opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission. Medications used for the treatment of opioid use disorder are buprenorphine (Suboxone, Subutex), methadone, and extended release naltrexone (Vivitrol). Some of these drugs are controversial in the recovery community because they are themselves opioids.

The National Institute on Drug Abuse, a US government research institute, clarifies that contrary to what some critics say, “methadone and buprenorphine DO NOT substitute one addiction for another. When someone is treated for an opioid addiction, the dosage of medication used does not get them high–it helps reduce opioid cravings and withdrawal. These medications restore balance to the brain circuits affected by addiction, allowing the patient’s brain to heal while working toward recovery.”

The use of these medications should always be combined with behavioral counseling with the ultimate aim of ceasing all substance misuse.

HOPE – Harmony’s Opioid Programming Experience

Harmony has provided all clients with medication-assisted treatment for many years. This combination of education, counseling, and the use of medication in early recovery is part of the Harmony philosophy. HOPE expands MAT to include medications that alter the physical response to opioids, reduce cravings, and give the patient time to heal from the psychological, social, and spiritual wounds of addiction.

“It’s important to remember that MAT is only a small part of the picture,” says Harmony’s medical director Christopher Reveley. “That is why we call it ‘medication-assisted’ treatment, because by itself it is not the treatment. Used alone it has a low probability of being successful.”

At Harmony, HOPE begins with thorough medical and psychological evaluations. Collaboration with the patient, members of the interdisciplinary team and, when appropriate, family and referral sources, determine the most effective treatment plan. All HOPE clients are invited to participate in weekly support groups led by a professional addiction counselor. These groups address the unique challenges of early opioid recovery, including uncomfortable physical and psychological symptoms, cravings, and strategies to avoid relapse. In this setting, clients support each other and are educated about the process of recovery.

Medication-assisted therapy may help stabilize the patient for these challenges in early recovery. “It gives people an opportunity to step out of the chaos of addiction and consider other ways of being,” says Dr. Reveley. “I never felt that buprenorphine was meant as a lifelong or even long-term solution.” Although there may be exceptions. It all depends on the individual needs of the patient. Reveley remembers a patient who had been on methadone for 46 years. “He tried to taper off a dozen times and relapsed to heroin use every single time. His family was initially very opposed to him being on methadone but eventually they told him ‘this is working, your life depends on it.’ So there are people on either end of the bell curve but in most cases buprenorphine is only a small but important part of the solution.”

Buprenorphine can be an important tool, especially in early recovery from opioid use disorder. The medication offers patients the opportunity to start living a “normal” life, far removed from the drug culture lifestyle they may have been immersed in while using heroin and other opioids. People are dying every day from opioid overdoses, especially in the age of the fentanyl scourge. Buprenorphine may provide the buffer that enables them to launch into sustained recovery. It is a buffer that can save people with addiction from a potentially lethal overdose.

Harmony has been treating addiction for 49 years and HOPE is now offered to all Harmony clients with opioid use disorders. The program involves enhanced medical, counseling, and case management services specifically tailored to meet these clients’ unique needs.

The Harmony care team works closely with clients who choose to include buprenorphine in their treatment strategy. This will typically involve full participation in HOPE and a recommendation for participation in Harmony’s Transitional Care Program (TCP), an intensive, 90 day intensive outpatient program coupled with monitored sober living and medication management by Harmony providers. When clinically indicated or to accommodate client preference, Harmony’s case managers may refer clients to other programs with similar services.

If you or someone you know is struggling with opioid use disorder and needs help, call Harmony at 970-432-8075 and one of our admissions specialists can discuss next steps.

A Vaccine for Heroin?

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The American prescription opioid epidemic has affected millions of Americans and their loved ones. Efforts to curb painkiller abuse had the unintended effect of leading to a scourge of heroin use – as the drug is often times cheaper, stronger and easier to acquire in the wake of prescription opioid crackdowns. Heroin abuse has become a major public health concern in both urban and rural America, due to the rise in both addiction and overdose death rates. While there is help available in the forms of treatment and 12-Step recovery, relapse rates are particularly high among opioid addicts.

Scientists continue to develop new methods intended to give addicts the best shot at successful recovery, and believe it or not, in the near future there may be a vaccine available that will prevent people from getting high if they use. Research was published last month that dealt with developing a vaccine that would prevent people from getting high if they use the powerful opioid narcotic fentanyl – an analgesic that is 80 to 100 times more potent than morphine, and 50 times stronger than heroin.

What’s more, clandestine laboratories are manufacturing fentanyl which is then being mixed with heroin to make it more potent. Heroin users are often unaware of the presence of fentanyl, an ignorance that can prove fatal. Admixtures of heroin fentanyl can severely depress respiratory function, which can result in death.

Working with mice, researchers were able to inject the animals with booster shots that would train their immune systems to attack the fentanyl molecules in the bloodstream before the drug crossed the blood-brain barrier resulting in euphoria or potential overdose, The Daily Beast reports. Additionally, when the researchers injected the mice with lethal doses of fentanyl, the mice survived.

“The idea that [the researchers] can make an effective vaccine is very cool. It’s a good accomplishment,” says Phil Skolnick, director of the Division of Pharmacotherapies and Medical Consequences of Drug Abuse at the National Institute on Drug Abuse (NIDA), who was not involved in the study. “You have to trick the body, and it requires a fair amount of trickery.”

If the human clinical trials are successful, it could eventually lead to the development of a heroin vaccine. The vaccines would be specific to particular drug molecules. If people in recovery from heroin addiction are vaccinated, it could significantly deter relapse because the user would know that they will not experience the desired euphoric affect.

Until such time, the best opportunity of successful recovery rests on effective, evidence-based addiction treatment programs. If you are battling with prescription opioid and/or heroin addiction, please contact Harmony Foundation to begin the journey of recovery.

New FDA Commissioner Supports Abuse-Deterrent Opioids

abuse-deterrent-opioids

It does not matter how someone uses prescription opioids, they can be dangerous and potentially lead to a deadly overdose. However, it could easily be argued that the greatest risk is associated with intravenous (IV) use; opioid addicts will crush their pills, mix the powder with water and inject. In order to combat the use of opioid narcotics in unintended ways, pressure was put on pharmaceutical companies to develop formulations of their painkillers that are harder to abuse – known as abuse-deterrent opioids.

Critics of such efforts argue that harder-to-abuse painkillers are merely a band-aid, and have little effect on the opioid epidemic. While the new formulations are more difficult to use, addicts often find their way around tamper resistors and/or turn heroin as a cheaper, stronger alternative. Nevertheless, such arguments can easily be countered with ‘anything is better than nothing.’

The U.S. Food and Drug Administration (FDA) has a new commissioner who has vowed to support abuse-deterrent opioid efforts, the Associated Press reports. Dr. Robert Califf told a panel of FDA advisers that he is pledging to do “everything possible under our authority to prevent abuse, save lives and treat dependence.”

The new commissioner’s declaration is just one facet of an interagency effort to end the American opioid epidemic. However, Califf made clear that the FDA alone cannot resolve the current crisis, according to the article. Since 2010, Califf’s agency has approved five abuse-deterrent opioids, and there is reportedly another 20 such drugs in development. FDA Commissioner Califf plans to work with outside advisers and he has a comprehensive plan for addressing the prescription opioid scourge, which claims as many as 44 lives per day.

He stated that the agency will add more cautionary warning labels to the opioid narcotics prescribed the most, the article reports. What’s more, the FDA will encourage the safe disposal of unused medications, which will prevent narcotics from ending up in the wrong hands.

“What we can do is work with prescribers, professional associations, patient advocates and state and local partners — essentially the entire country — to encourage safe use and disposal of opioid medications,” said Califf. 

If you or a loved one struggles with prescription opioid and/or heroin addiction, please contact Harmony Foundation. We have been helping people break the cycle of addiction for decades, teaching people about the resources needed for a living a life on the road of recovery.

Poll: Heroin Addiction Is A Serious Problem

One of the major concerns being voiced by voters is the prescription opioid epidemic, and the scourge that followed in its wake now being referred to as having reached epidemic proportions. With each day that passes with the nation continuing to struggle with how to curb the opioid crisis in America, more people are being affected – even if they themselves are not the ones addicted to opioid narcotics. In fact, a new poll shows that more than one-third of respondents know someone who has struggled with prescription opioid or heroin addiction, The Huffington Post reports. The findings come from an online poll conducted between January 20-22, and involved 1,000 completed interviews.

The new HuffPost/YouGov poll showed that nearly half of respondents (49 percent) view heroin use as a serious national problem, and 87 percent say that the heroin problem is at least a somewhat serious problem. Interestingly, when respondents were asked who should be held responsible for the heroin problem in America, almost the majority said an equal share of fault falls on:

  • Drug Users
  • Drug Dealers
  • Government
  • Law Enforcement

Who is to be held to account for the problem is somewhat irrelevant, what is important is how we, as a nation, plan to address the crisis. Greater access to addiction treatment services needs to be made available; many addicts who are in need of help often need to wait long periods of time to receive the help they so desperately require. What’s more, making clean needles and the life saving drug naloxone more readily available will not only stop the spread of infectious disease – it will save thousands of lives.

Fortunately, the President will ask congress for $1.1 billion dollars next week to fund addiction treatment services across the country, USA Today reports. Funding such programs is a clear sign that America no longer agrees with the idea that addiction can be swept under the rug through arrests, and subsequent jailing. Treatment is our best fight against addiction.

If you or a loved a one is suffering from opioid addiction, please contact Harmony Foundation. Harmony is one of the longest running, most successful, treatment programs in the world, our experienced addiction treatment team can help you begin the journey of recovery.

Raising Awareness About Addiction

The United States has been faced with a prescription opioid epidemic for a number of years, and just when everyone thought the problem might be getting better, a scourge of heroin abuse reared its ugly head. The use of heroin is at an all time high, and addicts are losing their lives every day.

The disease of addiction does not just affect alcoholics and addicts, it has an impact on the entire family. Years of abusing drugs and alcohol, accompanied by dishonest and deceitful behavior, takes its toll on the parents who have had to watch their loved one self destruct. The hope is that those battling addiction will seek help, and begin a journey down the road of recovery – living a productive life free from all mind altering substances.

Just as active addiction involves the family, so too does recovery. It is important that families take an active role in their loved one’s recovery process. Addicts and alcoholics who have the support of their family have a better chance at achieving long term recovery. Many parents who have been involved in the addiction/recovery process can also help the families whose loved ones are still active in their addiction, by raising awareness.

While the holiday season is a time for friends and families to come together and rejoice, it is also a time to reflect about the things for which we are grateful. For some people, the thing they are most grateful for is their recovery or that of their loved ones. With Christmas right around the corner, countless houses have covered their properties with lights and ornaments, to reflect the spirit of Christmas. One family has decided to use the opportunity to raise awareness about addiction and inform people that there is help available.

Every year, the Kurtz family of Bel Air, MD, puts on a spectacular Christmas light show at their home, but this year they’re using the spectacle to talk about addiction, ABC 2 reports. Jim and Helen Kurtz know all too well about addiction, their daughter Caroline is recovering from heroin addiction.

“We’ve been dealing with our daughter’s drug addiction for a few years now and we thought, we finally became brave enough to put it out there,” said Helen. “It’s a slow road, you know, it’s a road out of hell, but you can get out.”

The Kurtz’s daughter is now doing well, living in a sober living home, according to the article. Caroline’s recovery appears to be the family’s Christmas miracle. She will be joining her family on Christmas Day.

“The one thing we always said was that it could not happen to us,” Jim said. “And that’s the one takeaway you need to be aware of, it can happen to you, addiction can happen to anyone, it’s not choosy about who it happens to.”

 

Motivational Interviewing Combats Opioid Abuse

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It is safe to say that prescription opioid addiction, like any substance with the potential for addiction, does not discriminate. The nation has seen opioids take the lives of thousands of people for over a decade, yet patients continue to be prescribed the drugs at unprecedented levels. Part of the problem is that pain needs to be managed, and the drugs that work best happen to be highly addictive. If misused, opioids like oxycodone or hydrocodone can be life threatening.

Unlike the typical stereotypes that often accompany heroin addiction, prescription opioid addicts are often: professionals, mothers, students, productive members of society. Addiction typically stems from an injury that required the use of painkillers. While most people can use a prescription opioid until the pain goes away, there is a large number people who become dependent on such drugs and what was once a method of pain management can quickly become an addiction.

Faced with a prescription opioid addiction epidemic, federal agencies and lawmakers have made it more difficult for prescription opioids to be acquired and abused. In turn, people dependent on the drugs have been forced to look to the street, many of which opt for heroin as a cheaper and stronger opioid.

The American Society of Addiction Medicine (ASAM) reports that prescription opioids:

  • Are abused by 1.9 million Americans.
  • Cause nearly two deaths every hour from overdose or respiratory depression.
  • Almost 75 percent of opioid addiction patients switch to heroin.

The nation’s opioid epidemic happens to coincide with the “Baby Boomers” meeting old age or on the cusp. Naturally, the generation is requiring more frequent medical attention, many of which require pain management. It is believed that more than half of patients being treated for chronic pain misuse their medication at some time, ScienceDaily reports. Fortunately, new research suggests that motivational interviewing (MI), a form of behavioral counseling developed to treat alcohol abuse, may be effective in fighting prescription opioid abuse among aging adults.

“Older adults are at high risk for complications resulting from prescription opioid misuse,” says Chang, PhD, RN, associate professor and interim associate dean for research and scholarship in the University of Buffalo School of Nursing. “As the baby boomer generation ages and more patients are prescribed opioids, abuse is likely to become an even greater problem.”

MI promotes a patient’s desire to change behaviors that may be problematic by:

  • Expressing empathy for what they are going through.
  • Using non-confrontational dialogue
  • Creating a divergence between actual and desired behavior.

Patients 50 years of age and older who had chronic pain and were rated at risk for opioid misuse were examined by researchers, according to the article. The participants underwent MI for one month with counselors, and later received a one month follow-up test. Participants reported an increase in confidence, self-efficacy and motivation to change behavior, and a decline in depression, anxiety and the intensity of chronic pain.

“The Effect of Motivational Interviewing on Prescription Opioid Adherence Among Older Adults With Chronic Pain,” was published in a recent issue of Perspectives in Psychiatric Care.

Public Schools Screen for Substance Abuse

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A number of states across the country have seen a dramatic rise in overdose deaths related to prescription opioids or heroin. Naturally, as the affected states work to combat this crisis there is a lot of concern about teenage substance abuse. In Massachusetts, a state which saw more than 1,000 overdose deaths last year, child advocates are calling for substance abuse screening in public schools, WBUR reports. Screenings could help school nurses identify the students who may be in need of help before a problem gets even more out of hand.

School nurses already screen for hearing and vision problems, why not add substance abuse screening to the list? Currently, eight schools in MA have already started screening, with seven more districts expected to follow this fall, according to the article.

“Similar to the way they do hearing and eye tests, all with the goal that this is a normal process where kids are brought into their nursing offices and given a screening,” said Mary McGeown, president and CEO of the Massachusetts Society for the Prevention of Cruelty to Children.

Identifying a problem early on could potentially save the lives of teens who might look to opioids for their next high. Many teens are unaware just how addictive and life threatening these types of drugs can be.

“In about 10 percent of the cases there is brief counseling, that the individual reports that they have used alcohol or have used marijuana,” said McGeown.

“In a very, very small percentage of those 10 percent, really 1 or 2 percent, there’s a referral to treatment,” she added. “And it’s at that point that a parent would be called.” Lawmakers are meeting today to discuss a bill that would take the program statewide.

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If you are currently struggling with opioids and are need of help, please do not hesitate to contact Harmony Foundation to begin the journey of recovery. Harmony is a state-of-the-art, affordable, residential addiction treatment program located in the Rocky Mountains.

Pharmacy Shopping Linked to Overdose

Many in the field of addiction are familiar with the term “doctor shopping,” the act of going to multiple doctors to obtain the multiple prescriptions of the same medication – such as OxyContin ® (oxycodone), a highly addictive opioid narcotic. While prescription drug monitoring programs have made it more difficult for addicts to engage in doctor shopping, it is still possible for people to engage in what’s called “pharmacy shopping” – using multiple pharmacies at the same time in order to obtain more medication than a patient needs.

A new study suggests that patients who engage in pharmacy shopping are at an increased risk of opioid overdose deaths, HealthDay reports. The researchers found that patients who used four pharmacies within 90 days had the highest risk of overdosing.

The records of more than 90,000 Medicaid recipients aged 18 to 64, who were long-term users of narcotic painkillers, were analyzed by researchers. The Medicaid patients involved in the research had used three or more narcotic prescriptions for 90 days from 2008 to 2010, according to the article.

The researchers point out that that there are legitimate reasons for using more than one pharmacy, such as:

  • Relocating
  • Traveling
  • Changes in Insurance Coverage

In many states, in order to deter prescription drug abuse, Medicaid programs track the number of pharmacies a patient visits, the article reports. When a patient’s pharmacy records are not tracked, it is possible to fill multiple prescriptions for the same drug. The overlapping of opioid prescriptions was associated with higher overdose rates.

The study authors note that it has not been determined how many pharmacies or how much time should occur between prescriptions, for a patient to be considered a pharmacy shopper.

The study is published in The Journal of Pain.
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If you are currently struggling with opioid addiction, such as prescription drugs or heroin, and are in need of help, please do not hesitate to contact Harmony Foundation to begin the journey of recovery. Harmony is a state-of-the-art, affordable, residential addiction treatment program located in the Rocky Mountains.

Addiction and recovery news provided by Harmony Foundation.

Prescription Drug Overdose Deaths Rise in 26 States

In a number of states, especially the ones hardest hit by prescription opioid abuse, drastic measure have been taken to curb the problem. While such efforts have shown promise, such as prescription drug monitoring programs and greater access to naloxone, many states are still seeing a rise in overdose deaths. New research suggests that the number of drug overdose deaths rose in 26 states between 2009 and 2013, Reuters reports. Only six states saw a decrease in overdose deaths during the same time period.

The study was conducted by the nonprofit group Trust for America’s Health and the Robert Wood Johnson Foundation. Their findings indicated that an estimated 44,000 Americans died from drug overdoses in 2013, a figure which is more than double the number found in 1999. Drug overdoses were responsible for more deaths in 36 states than motor vehicle-related deaths, according to the article.

In 2013, almost 52 percent of overdose deaths were related to prescription drugs. The two types of prescription drugs that were linked to the majority of overdoses were opioid painkillers and benzodiazepine anti-anxiety medications, such as OxyContin ® (oxycodone) and Xanax ® (alprazolam). The study found that more than 16,000 deaths were related to opioids and almost 7,000 were tied to benzodiazepines and sleep medications.

The report clearly shows the need for more access and training to the life saving overdose reversal drug naloxone, sold under the brand name Narcan ®. There are 34 states and D.C. which have laws in place to expand access to, and use of, naloxone, according to the study. 

Prescription Drug Abuse Treatment 

If you are currently struggling with prescription drugs, and are need of help, please do not hesitate to contact Harmony Foundation to begin the journey of recovery. Harmony is a state-of-the-art, affordable, residential addiction treatment program located in the Rocky Mountains.
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Addiction and recovery news provided by Harmony Foundation