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.
America’s addiction crisis is now so pandemic that it features on one of the most popular TV programs for children. As was revealed in a recent episode, one of the Muppet characters on “Sesame Street” is struggling with a big, “grown-up” problem. Show producer Sesame Workshop created a series of videos in which young Karli talks to her friends about her mom’s struggle with addiction. Karli came to “Sesame Street” in May to stay with a foster family because her mother was “having a hard time.” Continue reading “Addiction Reaches Sesame Street”
By Michael Rass
Sink or swim are the metaphorical options for people with addiction. Andrea Carr, Michael Arnold, and Scott Leeper teamed up for a personal guide to recovery in Drowning in Addiction, sharing their first-hand experience with substance use disorder (SUD) and its devastating impact on families. Continue reading “Drowning in Addiction: A Personal Guide to Recovery”
By Michael Rass
About forty percent of Americans make New Year’s resolutions around this time. They typically resolve to live healthier in the new year or improve their lifestyle in other ways. Popular resolutions include staying fit and healthy, losing weight, enjoying life to the fullest, getting organized, and traveling more.
The good intentions listed above all share the same problem: they are rather vague. That is probably why most people give up on their resolutions by February. Most resolutions are not kept. As Nielsen.com notes, “43 percent of Americans say they plan to lose weight by making healthier food choices, but 76 percent said they did not follow a weight loss or diet program in 2014.”
So, if you have a substance use disorder, should you put recovery on the list? Should fighting a serious disease like addiction be a New Year’s resolution?
Don’t Set Yourself Up for Failure
Yes and no. It’s not a bad idea to have goals for the new year, but they should be SMART—specific, measurable, agreed, realistic and time based. In other words, your resolution should not be “drink less” or “cut back on smoking marijuana,” because those intentions have no time frame and cannot be measured effectively.
Goals are important to achieving recovery but ideally they are objectives agreed with a therapist or sponsor as part of a treatment program. They should not be the vague declarations of intent that New Year’s resolutions tend to be.
Goal-Setting Can Make You Heal Faster
When done right, setting specific goals can be surprisingly effective. In his 2012 book, The Power of Habit, author Charles Duhigg describes a Scottish study that examined the power of goal setting for patients recovering from knee or hip surgery. Mobilization and exercise are very important for these patients but the pain can be so extreme that many skip rehab sessions and refuse to get on their feet. Participants in the study had to set weekly goals, writing down exactly what they were going to do. Patients in a control group did not have to set any goals.
“It seems absurd to think that giving people a few pieces of blank paper might make a difference in how they recover from surgery,” writes Duhigg. “But when the researcher visited the patients three months later, she found a striking difference between the two groups.The patients who had written plans in their booklets had started walking almost twice as fast as the ones who had not. They had started getting in and out of their chairs, unassisted, almost three times as fast.”
Goal-setting is an important tool in addiction treatment as well. The right goals formulated in small achievable steps combined with appropriate therapy can improve clients’ chances of a successful recovery, but they should not just settle for a generic “I want to be sober.” They should formulate specific steps on how to achieve sobriety on a day-to-day basis.
For many people with addiction, pledges like “I will never use drugs again” often seem frighteningly daunting in early recovery. It is mentally easier for them to commit to the much more modest “I will not use today” and have that same goal every day. One patient in the Scottish study had the goal always to take a second step and not sit back down after the excruciatingly painful first step when getting up. Presumably, that was more effective for him than “keep walking.”
New Year’s resolutions like “enjoying life to the fullest” fail because they are too global. You wouldn’t even know at what point you have achieved it.
No Need to Wait
New Year’s resolutions also involve the risk of delay. Drugs and alcohol can kill you, often sooner than later, and waiting for New Year’s Day to come along to get better can be dangerous.
If you are battling a severe substance use disorder, your recovery should start as soon as possible.
Don’t resolve to quit drinking or using drugs next year and then go on a binge before New Year’s Eve. There is absolutely no need to wait until New Year before enjoying sobriety. The time to quit is right now. Get help before it is too late. Your life depends on it.
Addiction is not a crime! It isn’t a moral failing or a lack of constitution. Addiction is a disease of the mind that requires treatment and a program of maintenance, if recovery is to be possible. For decades, the United States government’s solution to addiction was locking up “offenders” and essentially throwing away the key. Even if a non-violent drug offender was released, the likelihood of recidivism was staggering.
Handcuffs and cell bars do not treat addiction, they only serve to put a scientifically accepted mental illness on the back burner; the disorder simmers until the day of release, at which time it comes forward and is brought to a rolling boil. Without the tools and resources necessary to remain abstinent, the vast majority will find themselves behind bars again. It is a vicious cycle that has been the status quo for too long.
Over the last decade, lawmakers have slowly come to terms with the fact that they can no longer treat addiction, and those who suffer from the disease, the way they have in the past; fear of punishment does little to detract addicts from continuing to use. Politicians from both sides of the aisle have begun to push for changes with regard to mandatory minimum sentences, rules that take sentencing out of the hands of judges. Right now, as these words are written, thousands of people are sitting behind bars for anywhere from 20 years to life – the result of nonviolent drug offenses.
Fortunately, we may be able to learn from the mistakes of our past, doing away with draconian mandatory minimum sentences and releasing those who are serving unjust terms for the crime of addiction. President Obama has done a lot in his tenure to undo some of our mistakes, granting clemency to hundreds of nonviolent drug offenders. In fact, the President has commuted the sentences of 248 prisoners thus far, more prisoners than the last six presidents put together, The New York Time reports. On Wednesday, the President commuted 61 sentences, more than one third of which were serving life sentences.
“Most of them are low-level drug offenders whose sentences would have been shorter if they were convicted under today’s laws,” President Obama said on his Facebook page. “I believe America is a nation of second chances, and with hard work, responsibility, and better choices, people can change their lives and contribute to our society.”
Our understanding of addiction has come a long way in a relatively short period of time; how the disease is viewed and treated are perfect examples of the progress we have made. Not too long ago, society’s answer to addiction was to dismiss those who used drugs and alcohol to the point of despair as having a shortage of willpower and perpetually hedonistic. The government’s response was to arrest and jail people who sold or abused mind altering substances, essentially branding millions of Americans as social pariahs for something that they were unable to control.
After decades of draconian drug policies, U.S. jails and prison populations exponentially grew, costing taxpayers billions of dollars each year. What’s more, when offenders with substance use disorders were released, more often than not they would be re-incarcerated for similar offenses.
Advances in medicine and our understanding of the brain has given scientists the ability to see that addiction is not a voluntary lack of self-determination and personal responsibility, but rather a disease of the brain; and, like any disease, for one to recover they require intensive treatment. Today, in most states people with substance use disorders are given the option of treatment in lieu of jail, and for those who are willing to do the work – recovery is possible.
Treating addiction as a mental illness is still a hard pill for many people to swallow, the reasons for this vary. One reason for this is that neurobiology is difficult to understand, another may be that the idea that using drugs and alcohol is a voluntary decision. The list goes on, but treating addiction as a mental illness has allowed experts to develop more effective treatments and sound prevention methods.
A review of available research conducted by the director of the National Institute on Drug Abuse (NIDA), Nora Volkow and colleagues, about addiction as a brain disease was published in the New England Journal of Medicine (NEJM). The goal was to enlighten those who question the brain disease model of addiction. The review of research produced a clear outline supporting the model, and we encourage you to read it in full. Dan L. Longo, M.D. writes:
“Advances in neurobiology have begun to clarify the mechanisms underlying the profound disruptions in decision-making ability and emotional balance displayed by persons with drug addiction. These advances also provide insight into the ways in which fundamental biologic processes, when disrupted, can alter voluntary behavioral control, not just in drug addiction but also in other, related disorders of self-regulation, such as obesity and pathologic gambling and video-gaming — the so-called behavioral addictions.”
For many people, alcohol and cigarettes often go hand in hand. Some people who do not regularly smoke cigarettes will concede to doing so when they are drinking. The correlation between alcohol and nicotine may be more important than you think when it comes to addiction recovery.
Recovering from any addictive substance is challenging, anything one can do to make the experience less trying is recommended. Those in recovery usually give up cigarettes last, but it turns out that alcoholics who quit smoking when they stop drinking may find a greater chance at success.
New research suggests that smokers with a history of alcohol abuse are at an increased risk of relapse three years later if they continue smoking, Science Daily reports. The study was conducted by researchers at Columbia University’s Mailman School of Public Health and the City University of New York.
The findings come from a sample of 34,653 adults with a past alcohol use disorder. The researchers found, when compared to nonsmokers, daily smokers and nondaily smokers had about double the odds of relapsing to alcohol, according to the article.
Across the country, many substance use disorder treatment facilities do not require patients to give up cigarettes. Although, most will encourage smoking cessation, offering access to a number of current therapies. Some treatment centers believe that quitting drinking and smoking at the same time is too difficult. While that mindset may have some merit, in the long run quitting both at the same time may be more fruitful.
“Quitting smoking will improve anyone’s health,” says Goodwin, an associate professor in the Department of Epidemiology at the Mailman School of Public Health. “But our study shows that giving up cigarettes is even more important for adults in recovery from alcohol since it will help them stay sober.”
The findings held even when factoring in:
- Illicit Drug Use
- Nicotine Dependence
The findings appear in the journal Alcoholism: Clinical and Experimental Research. __________________________________________________________________________________
If you are or a loved one is struggling with alcohol, please 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.
Recovery is a cause for celebration, whether you are 24hrs sober or 24 years; abstaining from drugs and alcohol is a huge accomplishment. Substance use disorders plague the lives of millions of people, leaving wreckage in its wake; the brave individuals who have made the decision to free themselves of the bondage of addiction are worthy of commendation, working towards repairing the damage of their past and practicing a set of principles to ensure a healthy future. September is National Recovery Month, now in its 26th year the National Recovery Month is a time to honor the millions of people who have worked a program of recovery for nearly a century.
Throughout the month, SAMHSA sponsored events are being held to celebrate the countless men and women who are working a program of recovery, and everyone who works in the field of addiction or mental health – helping people live a life free from the insidious effects of drugs, alcohol and mental illness. People who have found recovery and those who work in the field, remind the general public that addiction is a disease not a moral failing. It is an illness that requires treatment, not incarceration.
The nation has long been in the grips of an opioid epidemic. While terrible, the scourge of opioid abuse has touched people from every class, race and demographic; reinforcing the fact that anyone can be caught in the grips of addiction. Ridding the world of the stigma of addiction will drive more addicts toward the rooms of recovery, and fewer people to the morgue. Dismantling the stigma of addiction is one of the main goals of the National Recovery Month. According to SAMHSA:
“Recovery Month promotes the societal benefits of prevention, treatment, and recovery for mental and substance use disorders, celebrates people in recovery, lauds the contributions of treatment and service providers, and promotes the message that recovery in all its forms is possible. Recovery Month spreads the positive message that behavioral health is essential to overall health, that prevention works, treatment is effective and people can and do recover.”
President Obama has Proclaimed September:
If you are or a loved one is struggling with addiction, please 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.