Sober living

Alcohol and other waste products must be removed from the body by the kidneys. Pain in the kidneys may indicate more significant health problems. If you do choose to drink alcohol, limit your intake to no more than one to two drinks per day.

What are the signs of kidney damage from alcohol?

Depending on the extent of dehydration, a healthcare professional may give youintravenous (IV) fluids as the most efficient means of helping you rehydrate. I have stabbing pain in my right flank and lower abdomen with mild discomfort after urination. For overall kidney and liver health, take an essential amino acid supplement daily. BetterHelp offers affordable mental health care via phone, video, or live-chat. Sometimes, UPJ will improve independently or be treated with a minimally invasive procedure. However, more research is needed into the link between alcohol use and kidney injury.

I can’t urinate after drinking alcohol

A little alcohol—one or two drinks now and then—usually has no serious effects. The NKF also notes that excessive drinking can cause acute kidney injury (AKI) — a sudden decrease in kidney function that usually resolves with time but may be lasting in some cases. If you have kidney cancer, it’s best to talk with your doctor about moderate drinking.

How kidneys recover from alcohol damage

He is a leading biohacking expert and an experienced physiotherapist. Regular exercise strengthens the muscles that support my spine, improving posture and flexibility. I practice low-impact activities like swimming or yoga to reduce strain on my back. To manage stress, which can tense the muscles and exacerbate back pain, I use techniques like mindfulness or deep-breathing exercises.

• Treatment for chronic kidney disease includes dialysis and even a kidney transplant.
• When you drink alcohol, your kidneys play a vital role in filtering harmful substances from your blood.
• And medications for high blood pressure can be affected by alcohol.
• Patients with this conditions will experience significant amounts of back pain not only due to the damaged nerves but also do the nutritional status of the patient.

Alcohol can cause changes in the function of the kidneys and make them less able to filter your blood. In addition to filtering blood, your kidneys do many other important jobs. One of these jobs is keeping the right amount of water in your body. Causes range from kidney stones and infections to liver disease, often intensified by excessive alcohol intake. The discomfort may be mild or severe and manifest on one or both sides of the body.You may also experience kidney pain immediately after drinking alcohol or after you have stopped drinking.

People with alcohol-induced CKD will require treatment for AUD as well as CKD. Individuals who are concerned about their drinking habits can also consult a doctor for guidance on professional help and support. Kidney pain symptoms include lower back pain, fever, chills, and more.

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• Addiction Resource does not favor or support any specific recovery center, nor do we claim to ensure the quality, validity, or effectiveness of any particular treatment center.
• The kidneys are responsible for filtering blood to remove waste products, cellular debris, metabolic byproducts and extra water, which becomes urine.
• It could affect one or both sides of the body and be minor or severe.
• The symptoms and severity of a UTI may get worse after drinking alcohol.

Consume a lot of water and get in touch with your doctor right away if you suspect kidney infection. In order to ease discomfort, you can apply heat or take medication. Regular heavy drinking can eventually cause CKD, which can lead to kidney failure. There’s no cure for CKD, but treatment can help relieve symptoms and keep it from getting worse. Alcohol is also known to dehydrate the body, which can affect the regular function of the kidneys. People who drink too much are also more likely to have high blood pressure.

• Even without binge drinking, regularly drinking too much too often can also damage the kidneys.
• When acute kidney injury occurs, treatment can be given in the form of dialysis until kidney function returns to normal.
• Proper hydration is critical; it helps to maintain the health of spinal tissues and discs.
• According to the NKF, one potential symptom of AKI is flank pain, which is pain in the side of the back, between the ribs and hips.
• Are you ready to feel empowered and discover life beyond alcohol?

Tight chest pain after drinking alcohol, healthy male

The kidneys are about the size of our fists and are located below the rib cage on either side of our spines. Kidney pain may be experienced as back pain, but if there is kidney damage resulting from how does alcohol affect the kidneys alcohol use, other symptoms may occur. We review the symptoms of kidney damage and kidney failure further along in this article, but first let’s discuss how alcohol interacts with the kidneys.

If your doctor confirms kidney infection, you will be required to take antibiotics. If your kidney infections are recurring or turn severe, you may need hospitalization or surgery. To treat liver disease, you may be advised to stop drinking alcohol, lose weight, and follow a nutritional diet. One important method of treating kidney pain is making lifestyle changes that can promote kidney health and alleviate kidney problems.

However, severe or recurring kidney infections may need surgery or hospitalization. Alcohol can dehydrate your system and impair your kidney’s ability to function. Threats to proper kidney function lead to severe medical issues and negatively impact other body parts. Reducing alcohol intake can lessen the risk of alcohol-related kidney disease. It is important to see a doctor for any and all kidney pain, whether it is related to alcohol consumption or not. A person may feel intense back pain or pain in their genitals or stomach as the body attempts to pass the stone.

It is about admitting powerlessness in the face of addiction. If you want what we have to offer, and are willing to make the effort to get it, then you are ready to take certain steps. For those who wish to participate, meetings will conclude with another reading of the Serenity Prayer along with ‘Just For Today’ and the third step prayer. NA and AA groups are peer-based models designed to help people share support, advice, experiences, and hope. The idea is that as you have benefitted from someone else’s help, you should pay it forward by helping others. Without people’s contributions, these mutual support groups will cease to exist.

How Effective is Narcotics Anonymous (NA) for Drug Addiction?

Support people and loved ones who are not in recovery themselves are typically welcome to attend open meetings. NA meetings include people of every demographic and at various recovery levels, from many years to just a few days of sobriety. Click here for a list of virtual meetings, shown in the time zone from which you’re searching. Most of us realized that in our addiction we were slowly committing suicide, but addiction is such a cunning enemy of life that we had lost the power to do anything about it. Many of us ended up in jail, or sought help through medicine, religion, and psychiatry. Our disease always resurfaced or continued to progress until, in desperation, we sought help from each other in Narcotics Anonymous.

Narcotics Anonymous Meeting Finder

We feel that our approach to the disease of addiction is completely realistic, for the therapeutic value of one addict helping another is without parallel. We feel that our way is practical, for one addict can best understand and help another addict. These can you overdose on kratom meeting formats can be broken down even further, in the way that some of the discussions are conducted. All NA meetings have some element of discussion, the amount of which can vary. Some have a looser, open-sharing format where anyone can speak.

The 12 Steps of Narcotics Anonymous

Twelve-step programs such as Narcotics Anonymous can be helpful, but you should start by talking to your doctor about your first steps. If you are preparing to quit, medications are also available that can help you detox and manage your symptoms of withdrawal. 12-step programs observe 12 principles to help you stay clean from whatever addiction you’re dealing with. Narcotics Anonymous, often referred to as NA, is a 12-step program where people with drug addictions can find support in recovery. It is a group where people recovering from drug addiction can help each other pursue healthy choices. The NA literature describes it as a program “for addicts who wish to pursue and maintain a drug-free lifestyle.”

Narcotics Anonymous (NA) is a nonprofit program for recovering and active drug users. Members attend weekly (anonymous) meetings to help one another maintain sobriety. This step focuses on acknowledging how to identify an alcoholic the harm caused by an individual’s addiction. In doing so, people can then feel more motivated to stick to their recovery in order to improve or restore their relationships with others.

Measuring success regarding specific data is challenging because NA members are anonymous. Additionally, most research focuses on a specific time frame. This means an NA member might be sober during data collection, but relapse occurs weeks, months, or years later. Your NA group might operate similarly in structure, but it will differ from meetings in other cities, states, and worldwide.

This can be difficult, but if you’ve found yourself feeling isolated lately, steps eight and nine can help you improve your relationships and rejoin your community. NA believes in an abstinence model of recovery, which means being completely drug free. But if you’re addicted to opioids, you may be taking buprenorphine maintenance therapy (BMT). The group’s official position is that the only criteria for membership is a desire to stop using drugs. If you want to continue with the program, NA recommends that new members go to a meeting every day for at least 90 days. You may be nervous at your first meeting, and it may take some time for you to feel like you can stay with the program and your recovery.

1. There are various types of discussion formats in Narcotics Anonymous meetings.
2. We seemed to be incapable of facing life on its own terms.
3. Anyone may join us, regardless of age, race, sexual identity, creed, religion, or lack of religion.
4. But if you’re addicted to opioids, you may be taking buprenorphine maintenance therapy (BMT).

If you are considering undertaking the 12 steps of NA, you’re not alone. According to a 2020 study, approximately 45% of Americans who have recovered from substance addiction have used 12-step programs to do so. Like AA, NA is a free, community-based resource that anyone can access.

There is one thing more than anything else that will defeat us in our recovery; this is an attitude of indifference or intolerance toward spiritual principles. Three of these that are indispensable https://sober-house.org/marijuana-statistics-in-the-us-cannabis-use-abuse/ are honesty, open-mindedness, and willingness. We suffered from a disease from which there is no known cure. It can, however, be arrested at some point, and recovery is then possible.

As you confront your past, you may find yourself feeling guilty or ashamed of your actions. This step helps you build the willingness to change your behavior. We made a decision to turn our will and our lives over to the care of God as we understood God.

You’ll also get key tags when you reach 60 days, 90 days, 6 months, 9 months, 1 year, 18 months, and then yearly from that point on. The group’s facilitator will ask at the beginning of the meeting if there are any new members in attendance. This is your chance to raise your hand and introduce yourself. There will be people at the meeting who are also new to the program. You may gain new members every week, and some may not show up at all. The 12 steps of NA are a guide you can use to help you in your recovery.

We did many people great harm, but most of all we harmed ourselves. Through our inability to accept personal responsibilities we were actually creating our own problems. We seemed to be incapable of facing life on its own terms. Narcotics Anonymous is closely modeled after its predecessor and as such, NA meetings are centered around confidentiality and non-judgemental support. The literature that’s read, the types of discussions held, and even who’s allowed to attend the meeting, are all variables that can affect the format of the meeting.

Becoming more aware of your alcohol triggers and reasons for drinking can help you plan ways to help manage the urge to drink. Maybe you don’t think you depend on alcohol exactly, but you still wonder whether you might be drinking too much. Within 5 minutes, you’ll receive an email with these details – free of charge.

• Direct tapering is not recommended for liquor drinkers as it is challenging to measure amounts and can result in binge drinking.
• If you plan to taper, you must create a schedule that is right for you.
• Ria Health offers access to many of these tools, including prescription medications, recovery coaching, and online support groups—all through a HIPAA-compliant smartphone app.
• Satisfying hobbies can distract you from wanting to drink, but they also help you relax — something everyone needs to do.

How to safely taper off your alcohol consumption

• Essentially, when an individual drinks, the brain amplifies certain activities to counterbalance the depressive effect alcohol has on it.
• If your health, wellness, and even life may be at risk, quitting alcohol should only be attempted with the help of a medical professional.
• This way, the process of breaking free from alcohol dependency becomes safer and more achievable.
• It is of the utmost importance that anyone considering tapering off alcohol first consult with a medical professional to determine their treatment needs.
• It is important to only attempt a taper while under a doctor’s care.

Gradual reduction strategies include slowly decreasing the amount of alcohol consumed over time and extending the time between drinks. Both methods allow the body to adjust gradually and reduce overall alcohol intake. These strategies should be implemented according to an individual’s specific needs and drinking habits, under the guidance of a healthcare professional or addiction specialist.

How Long Does it Take to Detox from Alcohol at Home?

When attempting to wean off alcohol, it’s important to be aware of the potential withdrawal symptoms that may arise. These symptoms can range from mild to severe and can vary depending on several factors, including the duration and intensity of alcohol use. Understanding the symptoms and timeline of alcohol withdrawal is crucial for a safe and successful recovery process. Individuals with undiagnosed alcohol use disorder may struggle more when trying to cut back and may be better suited to medical detox rather than tapering.

Identifying a Standard Drink

Finding a different, more healthy way to unload stress may go a long way in helping someone succeed in cutting back on their alcohol use. Weaning off alcohol gives your body chemistry a chance to adjust, reducing the shock to your system. It also lets you start working new habits and routines into your day to replace drinking, starting the transition. Rather than beginning your sober life drained and dazed from a week of feeling ill, you can already be getting on your feet. When you quit through tapering, you drink a little less each day until you’re able to have no alcohol at all. It can lower the severity of symptoms, and it can make you more likely to meet your goals.

Challenges to Weaning Off Alcohol

This article discusses some of the common withdrawal symptoms and what helps with alcohol withdrawal. It also covers some of the different treatment options that are available. https://ecosoberhouse.com/ If you need help figuring out how to taper off alcohol, or want to find alcohol detox services near you, our treatment specialists at Vertava Health can help.

Insurance May Cover The Cost of Alcohol Detox

Some symptoms of alcohol withdrawal, especially Delirium Tremens (DT) and seizures can be fatal, and hundreds of Americans die every year as a result. If you experience how to taper off alcohol severe withdrawal symptoms while tapering off alcohol, adjust your plan. The goal of tapering is to make the withdrawal process safer and more bearable.

Mild to Severe Withdrawal Symptoms

Tapering or Weaning Off Alcohol

In the Miró study, alcohol drinkers also had been receiving pharmacologic treatments such as beta-adrenergic blocking agents that reduce blood pressure and also may have antioxidant effects. Other researchers have used genetic approaches (i.e., transgenic animals) to prevent ethanol-induced oxidative stress. One approach included overexpression of proteins such as insulin-like growth factor (IGF-1), which stimulates growth and cell proliferation and has antiapoptotic effects (see Zhang et al. 2014). In contrast to control mice, the IGF-1–expressing animals exhibited no evidence of changes in expression of antioxidant enzymes (i.e., superoxide dismutase-1) or any decreases in contractile function after 16 weeks of ethanol consumption.

Staying Healthy

Many researchers have found that alcohol intake increases HDL cholesterol (HDL-c) levels, HDL (“good cholesterol”) particle concentration, apolipoprotein A-I, and HDL-c subfractions (Gardner et al. 2000; Muth et al. 2010; Vu et al. 2016). Findings have been equivocal for other lipids, such as low-density lipoprotein cholesterol (LDL-c) (the estimated amount of cholesterol within LDL particles, or “bad cholesterol”) and triglyceride levels (Rimm et al. 1999; Volcik et al. 2008; Waskiewicz and Sygnowska 2013). High triglyceride levels in the blood stream have been linked to atherosclerosis and, by extension, increased risk of CHD and stroke.

How Much Alcohol Is Too Much?

犀利士
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” width=”256px” alt=”Does Alcohol Affect The Cardiovascular”/>

Increased autophagy as a possible mechanism underlying the adverse myocardial effects of ethanol is intriguing. This is especially true in light of the relationship between a sensor of stress (mTOR) and nutrient deprivation and how essential autophagy is to cell survival. As noted above, chronic alcohol exposure leads to a decrease in mTOR activity, which corresponds to increased markers of autophagy (Lang and Korzick 2014). The autophagy pathway also is rapidly upregulated during ATP depletion, mitochondrial dysfunction, and oxidative stress.

The effects of alcohol on health are various and heterogeneous and vary depending on the dose and pattern of consumption [1,2] (Figure 1). Heavy use of alcohol is one of the leading global risk factors for poor health outcomes, having a direct impact on a variety of diseases. It has been described that up to 19% of alcohol-attributable deaths were due to cardiovascular diseases (CVD) in 2016, after cancer and liver disease [1].

I want to get healthier

When a rupture occurs, platelets coming in contact with collagen and other exposed subendothelial compounds become activated and operate in conjunction with other clotting (i.e., coagulation) factors to form a blood clot and seal off damage. Researchers have found evidence of mitochondrial dysfunction or impaired bioenergetics related to alcohol consumption. Dysfunctional mitochondria are less efficient, can become a source of ROS, and are more likely to initiate apoptosis (Marzetti et al. 2013). Some people should avoid even that much and not drink at all if they have certain heart rhythm abnormalities or have heart failure. But it may be worthwhile learning about what counts as binge drinking and whether or not you may be drinking too much and don’t even know it. And if you have a history of high blood pressure, it’s best to avoid alcohol completely or drink only occasionally, and in moderation.

However, the negative associations between alcohol consumption and CV outcomes in these countries also may relate to pervasive patterns of binge drinking (Leon et al. 2009). Several studies and meta-analyses have been conducted to determine the relationship between alcohol consumption and the risk of developing heart failure in healthy subjects, as well as in those with a history of MI or CHD. Studies also have examined the “safety” of alcoholic beverage consumption in subjects with heart failure. Results from another meta-analysis of 12 cohort studies found a similar dose–response relationship between alcohol consumption and HTN for males.

Because of space limitations, not all of the excellent scientific work on alcohol and the cardiovascular system could be assessed in this review. If you or a loved one is struggling whippets balloons with alcohol misuse and/or you’re concerned about the possible effects alcohol can have on cardiovascular health, help is available. American Addiction Centers offers multiple treatment centers throughout the U.S., providing everything from alcohol detox and inpatient treatment to outpatient care, telehealth treatment, and aftercare. Additionally, some people  may experience arrhythmias such as AFib during alcohol withdrawal as the body adjusts to the absence of the substance.12 Thus, it’s important to seek professional help to detox from alcohol and to monitor for heart safety during alcohol withdrawal. Hypertension (aka high blood pressure) is a serious medical condition characterized by persistent elevations in blood pressure. The pressure that’s measured when the heart contracts to pump blood is systolic blood pressure, which is the top number in a blood-pressure reading.

Changes in mitochondrial function have been reported from a number of animal studies in different species, under various alcohol consumption paradigms (ethanol in water or liquid diet), and after variable durations of chronic ethanol consumption (6 weeks to 6 months). Through the process of oxidative phosphorylation, the mitochondria generate ~90 percent of cellular ATP. Common findings in alcohol studies from the 1970s and early 1980s included decreases in mitochondrial indices that reflected mitochondrial state III respiration, or ADP-stimulated respiration (Pachinger et al. 1973; Segel et al. 1981; Williams and Li 1977).

This is when your heart-pumping function gets weaker and your heart gets larger due to changes from heavy alcohol use over a long period of time. Due to the limitations of typical epidemiological studies, other types of study design, such as Mendelian randomization studies using an instrumental variable approach, sought to answer questions about the causality of the lower risk of low-level alcohol drinkers. However, the use of such an approach [45,46], which depends on several assumptions that are not easily met in a complex relationship, such as between alcohol consumption patterns and CVD risk, is highly debated [47,48,49,50]. An important aspect of the alcohol-hypertension association—and a fertile area for future studies—concerns alcohol’s interactions with antihypertensive medications such as propranolol and clonidine. Alcohol enhances the elimination of propranolol and opposes five rules of recovery the effect of clonidine, resulting in a decrease in the blood pressure-lowering properties of these medications. Also, because chronic alcohol consumption decreases the concentration of magnesium ions in the blood, the use of medications that increase kidney excretion of electrolytes and water (i.e., diuretics) to control blood pressure may be contraindicated, because their use can exacerbate magnesium loss.

The cardiovascular health effects of alcohol have classically been described as having a J-shaped curve, in which low-to-moderate consumers present less risk than lifetime abstainers, and heavy drinkers show the highest risk [5,19,20,22,23,24,25]. Alcohol intake benefits not only healthy individuals, but also patients with established CVD [3,5]. This review will focus on the association between cardiovascular risk factors (i.e., hypertension, diabetes mellitus type 2, and dyslipidemia) and alcohol consumption and its underlying mechanisms of damage, with review of the literature from the last 10 years.

There also is desensitization of the mitochondrial permeability transition pore, which can mitigate ischemia–reperfusion injury (Walker et al. 2013). In addition, alcohol may attenuate ischemia–reperfusion injury by activating protein kinase C epsilon (PKCɛ) (Walker et al. 2013). Activation of PKCɛ may protect the myocardium against ischemia–reperfusion injury by stimulating the opening of mitochondrial ATP-sensitive potassium channels. This in turn prevents the opening of the mitochondrial permeability transition pore (Walker et al. 2013).

1. Although highly individualized and dose dependent, alcohol use also can increase bleeding time (i.e., taking longer to develop a clot)(Salem and Laposata 2005).
2. Similarly, the observed increase in the activity of the enzyme LCAT may not play an important role in the alcohol-induced HDL increase (Nishiwaki et al. 1994).
3. Some investigators have suggested that drinking wine may offer more protection against CV disease because it contains polyphenols, such as resveratrol and flavonoids, which are micronutrients with antioxidant activity (Tangney and Rasmussen 2013).
4. For example, dogs fed alcohol for 1 year and rats fed alcohol for 8 months showed significant decreases in left ventricular function (Capasso et al. 1991).
5. Alcohol use was protective against CHD for subjects in most countries, except for people of South Asian ethnicity living in South Asia (India, Bangladesh, Nepal, Pakistan, and Sri Lanka).

Moderate drinking cannot be achieved by simply averaging the number of drinks consumed, however. For example, consuming seven drinks on a Saturday night will not have the same effects as consuming one drink each day of the week. Alcohol-induced damage to the cardiovascular system may result from either excessive prenatal alcohol exposure or from excessive alcohol use later in life. This article, however, focuses on four specific cardiovascular consequences (i.e., cardiomyopathy, cardiac arrhythmia, hypertension, and stroke) that result from heavy drinking later in life. Clinical studies have shown, however, that every 1-percent reduction in plasma cholesterol levels decreases the risk for CAD by 2 percent.

Alcohol’s Link to Coronary Artery Disease, Heart Attack, and Stroke

Holiday heart syndrome can happen if you don’t typically how long does molly stay in your hair drink alcohol, but then have a few at a holiday party or if you binge drink. This can cause you to develop an irregular heartbeat, called atrial fibrillation, which can increase your risk of stroke, heart attack and heart failure. BP, blood pressure; HDL-c, high-density lipoprotein cholesterol; HTA, hypertension; TG, triglycerides; T2D, type 2 diabetes. They do not pass readily through cell membranes, and they are major components of very-low-density lipoproteins (VLDLs), which are converted in the blood to LDLs. High levels of triglycerides in the blood have therefore been linked to atherosclerosis, heart disease, and stroke.

This makes creating and maintaining mutually beneficial relationships especially difficult for people with love addiction. The connection between addiction and mental health issues is a crucial factor in understanding the capacity for love in a relationship. Addiction can lead to heightened levels of anxiety and depression in the individual with the addiction, and feelings of powerlessness and being overwhelmed in the other partner.

When to get support

• For someone who isn’t an addict, this will never make any sense.
• While striving to meet their partner’s needs with a sense of desperation, the partner who exhibits codependent behaviors often depends on their loved one to the extent that it can feel like a love addiction.
• While clear communication may feel uncomfortable or vulnerable initially, regular practice can turn this into an easier pursuit, all in service of fostering healthy love and relationships.
• It can be tough for loved ones, especially parents and significant others, not to take addiction personally.
• Therapies such as Cognitive Behavioral Therapy can help bring awareness to the love addict as they become mindful of their thoughts.

But when these ideas are taken to an extreme, it can be unhealthy for both of you. It might feel like a compulsion to prioritize your partner — or an addiction to love. Love addiction (also loving an addict known as affective dependence, affective addiction, and emotional dependence) is a condition that causes a person to develop an unhealthy and obsessive fixation with a love interest.

Group therapy

But I think there are some reasons to suggest an affinity between love addicts and sex addicts. When an issue arises in a relationship, it mustn’t be swept under the rug but should be addressed immediately. If someone is struggling, it’s important to be honest with their partner so they can understand what is going on. If someone is disappointed or feeling let down or unloved or unseen, expressing how one feels to one’s partner is essential to keeping a relationship healthy.

What Is Love Addiction and Can You Have Withdrawals From a Person?

A 2018 review and case study echoed the link between love and dopamine. However, the authors noted that the cravings and longing tend to mellow over time into a more stable, lasting love. When people say they “have an addiction,” they’re often talking about an extreme fondness for something. Sure, you might really love snowboarding, listening to podcasts, or watching cat videos. It’s difficult to help are those who actually develop committed relationships with two or more people at the same time. They really believe that the only problem they have is deciding who would be the best choice.

In fact, about five out of six people who try a drug will not get hooked on it. So why does substance use become a problem for some people and not for others? There is no easy, single answer, but researchers believe it comes down to a combination of genetics, trauma from childhood, and other psychiatric problems, such as anxiety, depression, and bipolar disorder. By the time a person is addicted, their behaviors are conditioned, and the brain changes that have occurred make stopping seem like an impossibility. To help identify unhealthy patterns and distinguish between love addiction and healthy relationships, please view the navigational guide below.

What is love addiction?

“Are you an addict when you jump from relationship to relationship? Here are a few truths about this compulsion and what is most likely to happen if you have not processed and grown from your painful experiences. David Sack, M.D., is board certified in addiction psychiatry and addiction medicine and serves as CMO of Elements Behavioral Health and Promises Treatment Centers.

Recovery from addiction is a challenging and complex process that requires the support and understanding of both partners. Working together to navigate the recovery process and rebuild love in their relationship is crucial for long-term success. It’s complicated, and lust and love and addiction don’t always exclude one another. Endless analyzing doesn’t help or change our feelings, because we’re often driven by forces outside our conscious awareness. The love addict partner is unconsciously drawn toward a relationship in which there is intense romanticism (at first) but which cannot lead to a stable grown-up relationship. In the long run, the love addict will be subjected to disappointment, deception and episodes of abandonment by the person they love.

In relationships where addiction is present, it is common for codependency and enabling behaviors to develop. Codependency is a very demanding relationship, where one partner needs a lot of assistance and care from the other. This kind of relationship usually involves extreme physical or emotional dependency on the part of the addicted person. This dynamic can lead to the neglect of one’s own well-being, potentially resulting in depression, low self-esteem, health issues, and even the potential onset of a more serious mental illness. Sex releases oxytocin, the love chemical that makes us want to nest with our partner. As we get to know our lover, we may want to spend more or less time together, depending on what we learn.

You’re compelled to keep seeking that thing out, even when your need negatively affects you or your loved ones. By nature, we are all addicted to love—meaning we want it, seek it, and have a hard time not thinking about it. We need emotional bonds to survive and we instinctively seek connection, especially romantic connection. The key thing to remember is that in order for your loved one to deal with one issue, they must deal with the other. If pursuing or maintaining relationships is disrupting your happiness, health, or ability to complete day-to-day responsibilities, Saltz recommends reaching out to a mental health professional.

The latest article from Alcohol Research Current Reviews explores links between alcohol use and suicidal behavior. Research on associations of suicidal behavior, including suicide and suicide attempt, with alcohol use disorder (AUD) and acute use of alcohol (AUA) are discussed, with an emphasis on data from meta-analyses. Based on psychological autopsy investigations, results indicate that AUD is prevalent among individuals who die by suicide.

LinkOut – more resources

Safety planning is frequently included as an element in cognitive behavioral interventions for suicide prevention and can also be used as a brief standalone intervention, typically paired with a referral for mental health treatment. Early intervention after a suicide attempt is vital because the 3-month period after an initial attempt is when an individual is at the highest risk of additional suicidal behavior. Yet those who attempt suicide have been found to be very difficult to engage in treatment. These interventions can include outpatient or inpatient treatment depending upon the severity.

Cross-national studies indicate a linear relationship between suicide rates and per-capita alcohol consumption [19, 20], suggesting that alcohol may be a key factor in suicide. Indeed, rates of alcohol misuse have escalated over the last two decades [21, 22] in parallel with rising drinking on shrooms suicide rates [23, 24]. Since 2001, past-year prevalence of high-risk drinking has increased by 29.9%, and alcohol use disorder (AUD) by an alarming 49.4% [21]. Importantly, rising rates of alcohol misuse are accompanied by a 35% increase in alcohol-related suicide deaths [23]. Alcohol and opioid use are the two most common substances implicated in suicidal behavior [14•]. This review briefly surveys the literature on the overlap of these disorders, highlighting the complex and multidirectional relationships between them.

You can find lasting healing and recovery with resources far more relieving than alcohol or drugs.

Alcoholism: Quantity and Frequency of Alcohol Use

More specifically, agonism to the amygdala kappa receptors mediated anxiogenic-like behavior [269] whereas antagonism to kappa receptors in the amygdala [269, 270] and prefrontal cortex [271] produced anxiolytic effects. Relative to controls, patients with OUD treated with buprenorphine demonstrated reduced amygdala activation in response to negative stimuli [272]. In addition, buprenorphine causes decreased amygdala responses to heroin-related cues in heroin-dependent patients [273]. Co-use of alcohol and opioids can significantly increase the risk of death from overdoses due to respiratory depression [153], and in fact, many OUD-related deaths involve alcohol use [154]. There are a number of predisposing risk factors that contribute to both AUD and OUD, and some pharmacological treatments are indicated for both AUD and OUD (e.g., naltrexone). However, despite the high cooccurrence of AUD and OUD [155], research on the contribution of this comorbidity to suicide risk is lacking.

When struggling with suicidal thoughts and tendencies, it’s common to want to escape the pain you’re feeling inside. This is why many individuals often turn to risky behaviours, including using drugs and alcohol. Providing patients with resources is an opportunity that clinicians should use to empower patients to take initiative in maintaining and protecting their mental health. Patients are often unaware of the resources available to them and are more likely to use them if they know where to look.

Chronic opioid use, tolerance, and stress may mobilize the kappa receptors system [214, 215]. Animal studies suggest that an activated kappa receptor system is a key mediator of dysphoria-related symptoms and depressive-like behavior [215–220], both relevant to mood disorders and chronic drug use/dependence [221–228]. In humans, increased expression of kappa receptors has been found postmortem in the brains of suicide victims [229]. Moreover, kappa receptors availability in the amygdala-anterior cingulate-striatal circuitry were shown to mediate the phenotypic expression of dysphoria [230].

This asked the participant to choose on a 4-point scale their response to the question ‘If you are experiencing any emotional or behavioral problem, how difficult has this made it to do eco sober house your work at school, take care of things at home, or get along with people? Online of 40,335 students at four universities took place at the beginning of four academic years, 2015–2018. Of these, 2296 met criteria for an increased risk of suicidal behavior and completed 1- and/or 6-month follow-up evaluation(s).

Alcohol Misuse and Suicide Risk

There are many FDA-approved medications for treatment of depression [112] and primary among them are selective serotonin reuptake inhibitors (SSRIs). As yet, however, there are no FDA-approved medications specifically indicated for suicidal ideation, urges, or behavior [113]. A few fetal alcohol syndrome face celebrities pharmacotherapies have been approved for the treatment of alcohol misuse [114, 115]. They include disulfiram, which produces aversive symptoms following alcohol intake; acamprosate, thought to mitigate withdrawal-related symptoms; and naltrexone, a nonselective opiate receptor antagonist that reduces alcohol cravings. These drugs primarily operate by targeting reinforcement mechanisms involved in alcohol misuse; however, extended-release naltrexone has also shown some benefits in reducing attendant anxiety and depressive symptoms [116]. Safety planning is a brief intervention to help individuals survive suicidal crises by having them develop a set of steps to reduce the likelihood of engaging in suicidal behavior.

1. Indeed, one study found a significant negative relationship between frequency of alcohol use and the likelihood of seriously considering suicide (Kisch et al., 2005).
2. Indeed, a history of childhood abuse significantly increase the risk for suicidal behavior in individuals OUD [144, 149, 157].
3. The brevity of the principal measures of depressive symptoms and of alcohol use patterns precludes more detailed analysis, but this was necessary to maximize participation and sample retention.
4. Social and environmental disadvantages, such as lack of family support, unemployment, and homelessness [144, 156–158] are highly prevalent among persons with OUD, as well as suicidal individuals.
5. There is a multitude of factors to be considered when examining the correlation between substance abuse and suicide as independent variables with an anecdotally strong interdependent relationship.

The below review therefore primarily concerns research on the cooccurrence of OUD and suicidality, without specifically accounting for comorbidity with other substances. The initial screening for depressive symptoms consisted of the PHQ-2 (Kroenke et al., 2003), which assessed three depressive symptoms in the preceding 2 weeks, each scored 0–3. Students who had positive screens for high risk went on to rate the remaining PHQ-9 items (Kroenke et al., 2001). For the following analyses, a PHQ-8 scale was used to quantify depressive symptoms because the ninth item quantifies suicidal ideation. High-risk individuals also completed a 10th PHQ item (Kroenke et al., 2001) that rates functional impairment.

Results

People with problematic alcohol use are also a vulnerable population and we owe them a special duty of care; that should also inform public policies. If it means saving a loved one, warning labels on beer cans seem like a pretty low price to pay. If you (or someone you care about) have thoughts of self-harm or are thinking of taking action to hurt yourself, you should know that help is available and that you’re not alone. There is always a place to turn, no matter how dire or hopeless your situation may seem in the moment.

Suicidality and Alcohol Use as Predictors of Future Suicidal Behavior in College Students

Extended-release naltrexone hydrochloride (XR-NTX) is a nonselective opioid receptor antagonist that has been also widely used for treatment of OUD and AUD, among other indications. Some studies report an improvement in depressive symptoms in patients with OUD after 4 weeks of adherence to naltrexone treatment [242, 246]. Some evidence points to the specific role of kappa opioid receptors in mediating negative affective states in OUD. The euphoric effects of most abused opioids (e.g., heroin, oxycodone, and morphine) are due to their mu receptors agonism [213].

Although the relationship between alcohol and behavioral aggression is complex (Cavell & Malcolm, 2007), meta-analyses consistently suggest that alcohol increases aggression (Bushman & Cooper, 1990; Hull & Bond, 1986; Ito, Miller, & Pollock, 1996). In stark comparison, probability of marital aggression among those low on alcohol dependence was not influenced by hostility (.01 probability). Others have documented the relationship between alcohol consumption and violence toward intimate partners (e.g., Lisco, Parrott, & Tharp, 2012) and sexual minorities (e.g., Parrott, Peterson, & Bakeman, 2011). Anger, either additively or in interaction with alcohol, was related to increases in negative anger- and alcohol-consequences (Leibsohn et al., 1994).

Increased likelihood of expressing anger while intoxicated

When alcohol enters the equation, its impact on our neurobiology becomes essential to understand. To curb alcohol-fueled rage, it helps to know how you respond to drinking. Those expectations can also arise from what we’ve learned about alcohol from family members and peers. If you had a parent who was frequently enraged while drunk, you may expect that response in yourself when drinking and therefore exhibit it. Additionally, more than three-quarters of study participants with the gene had mood disorders, personality disorders, and mood swings (10). Studies have shown that serotonin levels may begin decreasing within 30 minutes of that first drink (4).

• Initial support for alcohol-adapted anger management treatment suggests that clinicians and researchers may have an additional intervention to address anger-alcohol associations.
• When someone has both a mental health and substance use disorder, they are considered co-occurring disorders.
• The best decision you can make is often the most difficult because it may involve putting your life, your family and your career on hold.
• Moreover, alcohol also affects the information-processing pathways present among the brain cells.

Co-treatment Approaches: Alcohol Recovery and Anger Management

• Alcohol consumption reduces negative emotional states, including anger, and is negatively reinforcing via tension reduction (Sher & Levenson, 1982).
• To work properly, it has many special chemical-like substances known as neurotransmitters.
• This approach has been identified as a promising strategy to prevent sexual violence [43] and intimate partner violence [44].
• Meditation can help clients to relax physical tension, become more self-aware, and work toward creating a healthy mind-body balance.
• An example would be if you were to get cut off by another driver on a busy or chaotic highway.

There’s a difference in safety between someone who is expressing anger verbally and one who has become physically aggressive. Extreme happiness, or euphoria, is another common experience during drinking. As a positive, https://ecosoberhouse.com/ unalarming emotion and one that others are used to seeing, however, happiness isn’t on the radar as much as anger. It helps people understand events and thought processes that lead to depression and substance misuse.

Alcohol recovery and anger management co-treatments

If an intoxicated person becomes upset because the bartender refuses to serve them, help from a friend might calm them down. If no one can defuse the tension, they may become an aggressor, escalating the situation to a violent one. Seeking help is essential, but remember, managing anger and alcoholic rage syndrome recovering from alcoholism requires effort. Anger often leads to excessive drinking, which can then amplify anger issues. Without breaking this cycle, it can damage both you and those around you. Addressing both anger and drinking is crucial, with professional help highly recommended.

Alcohol use disorder

Some people may become more angry or aggressive when they drink, in part because of alcohol’s effects on brain chemistry. One of the most common misconceptions about seeking treatment for anger issues or alcohol use is that you’ll need to leave your family, your work, or your friends. If that’s something you feel you’re unable to do, we can support you with other methods of treatment. The ultimate goal is to help them get into a treatment program that addresses their substance abuse and the way it causes them to behave. But this is often easier said than done, and mean drunks can turn violent when provoked — meaning that if you share a living space with one, your safety should be your main priority. It was initially reported that women are less likely to engage in binge drinking patterns than men (Bobrova et al., 2010).

Low Regard for Consequences

As mentioned above, alcohol can damage the brain cells and their chemicals; alcohol can lead to aggression, uncontrolled anger, offensive behavior, and violent activities. Moreover, alcohol can also cause dysregulation in the body’s stress pathways, resulting in increased anxiety, stress, psychosis, and suicidal tendencies. Navigating the complexities of addiction often involves confronting a myriad of emotions, and one of the most potent among them is anger. The intersection between anger and addiction is a multifaceted and deeply impactful aspect of recovery journeys. As individuals grapple with the challenges of substance dependency, anger can surface as a powerful force, influencing behaviors, relationships, and overall well-being. Understanding the connection between anger and addiction is not only essential for those directly affected but also for their loved ones and healthcare professionals providing support.

Alcohol-related treatment material comprised approximately 54.6% of the AAF condition and 30.4% of the AM condition. One aspect of the research the author has conducted with the support of NIAAA, and which is the topic of this article, has focused on identifying the physiological and neural effects, as well as the subjective and cognitive effects, of binge and chronic alcohol use. This research also has explored the factors that influence these effects and investigated whether these effects can be reversed or normalized to allow for recovery from any of the long-term changes that occur with binge and chronic alcohol misuse. But in real life, a person who loses control of their emotions when they drink is anything but entertaining.

“Although alcohol primarily contains carbs, it’s metabolized and stored as fat so it doesn’t help with refueling or rebuilding muscle,” says Santiago. One study found that men and women who drank weekly were more apt to be classified as physically fit than those who didn’t drink. Researchers theorize that the physically fit may be more likely to drink because many like to celebrate their athletic wins (or soften their losses) with an alcoholic beverage. They also note the emergence of “drunkorexia,” in which some people—particularly women—engage in more exercise to offset the extra calories drinking provides.

Drinking beer every night can alter your sex hormones

We can thank our livers for taking the brunt of it, as they’re responsible for breaking down and metabolizing toxins. But once alcohol enters our bloodstream through the stomach, it also touches nearly every other organ and system, explains registered dietitian and ACSM exercise physiologist Jim White. Most of our members (90%) have tried cutting back, beers after work however, few experienced any long-term success in changing their relationship with alcohol. These numbers show us that it is HARD to break the routine once we have developed a dependence on alcohol to unwind at the end of the day. We believe in the age-old idea of balance and moderation—and we believe in celebrating your victories, small and large.

• A reverse French 75 with .5oz gin and 2oz sparkling wine is one of my go-to’s, or a nice amaro or liqueur with a fresh tonic or flavored soda.
• This is because alcohol is a diuretic, meaning it reduces the amount of water a person’s kidneys can reabsorb back into the bloodstream, causing them to urinate more frequently.
• Food and drink products are responsible for seven of the 10 highest increases since last year.
• This article discusses what happens to a person’s body after drinking alcohol, and the risks of drinking and exercising.
• This does not imply that alcohol consumption has any benefits following a workout, though,” says Wylie.

Drastically Dropping Calories Has No Effect On Performance

People can avoid the downsides of drinking alcohol before working out in several ways, or not drinking it before working out. A person’s body temperature rises as they begin to exercise, and they begin to sweat. The combined sweating and alcohol’s diuretic effect makes dehydration worse if a person works out after drinking. These effects can negatively impact a person’s performance during exercise or competitions.

Top Reads in Health Education

• We frequently see our beers enjoyed as a weeknight meal pairing, on adventures, day drinking, post-workout refreshments, sporting events, and any other occasion where you want a refreshing beer and a clear head.
• The best part about this cocktail is that it is low in calories, making it a guilt-free indulgence.
• Then you’re at risk of issues including higher water loss, reduced muscle gains, less than optimal training, and potentially an increase in body fat.
• Dehydration will only make it harder for you to recover from your training session, leading to a longer recovery time and fewer fitness gains.
• Drinking isn’t for everyone, and socializing, well, that’s not necessarily for everyone either.

Beer may have a slight edge over liquor when it comes to choosing your post-exercise beverage, but be sure to double fist with water, too, so your body can fully rehydrate. Therefore, drinking alcohol after your workout isn’t ideal. For the best results — especially when it comes to muscle growth — avoid alcohol and refuel with plenty of protein and carbs. “The biggest concern when it comes to drinking alcohol after exercise is dehydration. Alcohol is a diuretic, meaning it encourages your body to release more fluids,” she explains. “The first priority following a workout should be to replenish electrolytes, rehydrate with water, and fuel correctly with a nutritious meal or snack consisting of both carbohydrates and protein.

Don’t:Drive

• In fact, the chances of a September cut have risen slightly – with market forecasts up from 36% yesterday to 45% today.
• Even then, the employee’s ability to be aware of the rules regarding the consumption of alcohol at work is relevant.
• American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information.
• “Mixed with alcohol, these drugs can be sedating.” This can be especially problematic if your workout zaps you of energy.
• Moderate alcohol consumption reduces the rate of muscle protein synthesis (MPS) following strenuous exercise (3).

The risk of relapse when someone leaves addiction treatment is particularly concerning. One study into people being treated for heroin addiction showed a considerable risk of death from overdose in the month following treatment. This indicates the need for greater health education of drug users and the implementation of relapse and overdose death prevention programs.

Insurance plans do not cover most sober living homes because they do not provide treatment services. Additionally, you may find an organization that offers grants or scholarships for people facing financial, medical or emotional hardships in life and use that money to pay for sober living. This option may not be ideal, but seeking out a loan can be helpful if you move forward on your path to sobriety. Recovery Residences (RRs) are organized into four categories, or “levels,” by the NARR. The levels describe the intensiveness of the program and the level of care provided. Most sober living homes do not offer formal addiction treatment but utilize programs in the broader community.

Researched, fact-checked and transparent articles and guides that offer addiction and mental health insight from experts and treatment professionals. Thanks sober house to the city’s relationship with the Blue Cross Blue Shield of Massachusetts Foundation, they expanded treatment access for substance abuse patients. We’re not including Delray Beach on the list because that’s where we’re located. The truth is that Delray Beach offers a large number of affordable sober living housing with more than 1,200 beds in the city.

Rehab vs. Sober Living Houses

It can provide opportunities for individuals in recovery to build new relationships, reconnect with loved ones, and build a support system. Organizations that offer a feeling of community and connection, like Alcoholics Anonymous and Narcotics Anonymous, can help people in recovery remain inspired and dedicated to their sobriety. Without social support, recovery from addiction can be a lonely and difficult process, lacking the emotional and practical assistance that is necessary https://yourhealthmagazine.net/article/addiction/sober-houses-rules-that-you-should-follow/ for success. The norms and guidelines in sober living facilities encourage structure and routine, which can be helpful in the development of positive routines and habits.

Since sober living houses (SLHs) are minimally regulated, there will be high variability between programs. For people in rehabilitation, sober living facilities frequently provide ongoing support and tools like assistance in work placement, counseling, and 12-step meetings. The cost of sober living homes can vary based on factors such as location, living arrangements, and program amenities. Sober living homes may charge weekly or monthly fees that cover room and board. Other financial considerations, such as transportation expenses and meals, may apply.

• Sober living houses in California provide options for residential recovery programs, substance abuse treatment, intensive outpatient programs, and recovery services through the best sober living homes.
• However, these homes provide a supportive place to transition from an addictive lifestyle to one of sobriety and responsibility.
• Sober living houses are also called sober residences, recovery houses, and recovery residences, among other names.
• Since then, homes operating under the Oxford House model have spread across the country – as of 2012, there were 1,500 homes.

How long can you stay in a sober living house?

Most of these homes are privately owned, although some group homes are owned by businesses and may even be owned by charity organizations. Sober living housing is usually located in quiet areas to help ensure a peaceful environment for individuals in early recovery. Oxford House is a network of drug-free, self-supporting houses or apartment buildings. It was founded in 1975 as the next step in substance use recovery, focusing on sober community living as a way to prevent relapse. Recovery.com combines independent research with expert guidance on addiction and mental health treatment. Our mission is to help everyone find the best path to recovery through the most comprehensive, helpful network of treatment providers worldwide.

Transcend Recovery Community New York

We created this guide to support you in finding treatment that meets your needs. At Lighthouse Recovery Institute, we believe addiction treatment never ends. State penal code statutes guide sober living, promoting support group attendance, family therapy, and household chores in everyday life. Greenleaf’s sober living facilities provide a foundation for a sober lifestyle. His two sober living facilities are in Frisco, Texas, just a few miles north of Dallas/Fort Worth.

Bishop House – Gambit Recovery

A vibrant city is an excellent place for young people to enjoy sober living to its fullest. The town has plenty of halfway houses to choose from and a tremendous sober club scene that expands. Throughout the county, many drug-free communities with the San Diego Second Chance program create a unique set of opportunities for those in recovery. Not too far away, you’ll also find plenty of sober communities across Orange County.

Many high schools could also benefit from a sober person willing to mentor students or give a speech. While it might not be a city known for being a tourist hotspot, Yakima makes political, economic, and social efforts to fight addiction and promote sobriety. The city’s drug-free community coalition brought the numbers of drug abuse in the town by half in five years alone. The 12 step model is a great recovery tool to help foster deep and beneficial peer relationships.

Sober living places are all about giving you the support and accountability you need while giving you room to breathe and grow. It’s about having a support network right where you live, people who ‘get it’ and are rooting for you. Most Level 3 houses are overseen by paid staff, rather than self-governing like Level 1 and 2 homes. As a result, the cost of Level 3 homes often includes the expense of paying counselors and administrative staff, in addition to the shared expenses of living in the home.

Find the Right Sober Living Environment for You

Sober living is a lifestyle change that encourages abstinence from drugs and alcohol. It is a residential setting that provides a safe and supportive atmosphere for people who are in their recovery journey from addiction. Sober living homes offer a structured living environment with rules and regulations designed to promote sobriety and recovery. All sober living homes have a zero-tolerance policy regarding the use of drugs or alcohol. Usually, residents have recently completed inpatient or intensive outpatient treatment for substance use addiction. Sometimes, sober living houses also act as a stand-alone approach for substance misuse problems, meaning that someone will go straight there without first attending a residential treatment center.

In addition, residents may be expected to participate in random drug testing to ensure compliance with the house’s program. Living in a halfway house is generally cheaper than living in a residential rehab because the staff provides fewer services. Some sober living facilities provide substance-free transitional housing for only men or only women, meaning men live with men and women live with women. Our research team evaluated the 467 best treatment centers for sober living in North America.

Since the sober living home industry has been undergoing many changes, many people may not be aware of the options, and it can be difficult to find a quality sober living home if you don’t know where to look. We created this guide to explain the options for sober living homes, and to help you decide if they are right for you. Additionally, we will provide resources to help locate a certified recovery residence near you. You can also ask your rehab program about recommendations for reputable homes. In some cases, they will help you transition to a sober living environment straight from treatment. The houses are owned and operated by organizations or individuals that create general guidelines and regulations within the homes.

Get the latest news from Sober Centers of America, including updates made to our rehab directory. Prices vary depending on location, living arrangements, and program offerings. Typically, the cost is about the same as living in a modest apartment or home. Since 2013, our expert team has built comprehensive resources you can trust to find the right treatment for you.