Year Of Sobriety Research Articles

863 When sleep takes you to unwanted places?

Abstract Introduction Somnambulism is a parasomnia occurring in non-rapid eye movement sleep, and is characterized by ambulation as a disorder of arousal regulation. Sleep deprivation, alcohol abuse, fragmented sleep and certain medications can increase the risk of sleep walking. Report of case(s) Here we present a 35-year-old man with multiple triggers for sleep walking, resulting in recurrent parasomnia events over fifteen years. He had a history of bipolar disorder, post-traumatic stress disorder (PTSD), chronic insomnia, moderate untreated obstructive sleep apnea (OSA), anxiety with violent daytime behaviors, and prior alcohol abuse status post six years of sobriety. He was sent to our clinic due to increased frequency and severity of events, with nightly events for the last five years. Episodes were characterized by walking around the home, leaving the home, and driving on occasion. He reported at least one minor car accident as a result of sleep driving. He also reported an injury resulting from a fall in his home while sleep walking. Several security measures were implemented, including door gates, door alarms, and hiding car keys. His family slept in different bedrooms with locked doors for safety. The patient’s chronic insomnia improved with cognitive behavioral therapy, leading to an average sleep time of five hours per night with no reported hypersomnia or daytime fatigue. After his initial evaluation, he was referred for a mandibular advancement device for treatment of his OSA, due to prior poor compliance with positive airway pressure therapy related to his PTSD. Optimizing his OSA helped decrease arousals that might trigger sleep walking events. He also maintained close follow up with mental health for pharmacotherapy and psychological therapy. Treatment with clonazepam 0.25 mg at bedtime was initiated given the severity of his somnambulism. Conclusion The use of a benzodiazepine can reduce slow wave sleep duration by its effect on the inhibitory neurotransmitter gamma aminobutyric acid (GABA). Our patient had multiple risk factors for parasomnias, with severe, frequent episodes of sleepwalking leading to self-injury. His treatment involved both pharmacotherapy as well as optimization of underlying triggers. Support (if any):

Special Report: Hispanic Community and COVID-19—Addressing Health Inequalities Can No Longer Be Delayed

<i>Special Report:</i> Hispanic Community and COVID-19—Addressing Health Inequalities Can No Longer Be Delayed

A feasibility study exploring self-care and parenting for adults recovering from addictive substances

Little information is available on parental self-care while in recovery from addictive substances, and its relationship to parenting and recovery outcomes. We evaluated the feasibility of obtaining self-care and parenting outcomes for adults in long-term recovery from addictive substances, and explored potential contributing factors. Nineteen mothers and fathers who self-reported at least two years of sobriety participated in this study. Feasibility challenges included recruitment and scheduling interviews, given multiple work and personal demands on participants' schedules. Possible associations of self-care to parental efficacy (PE), parenting behaviors, resilience, and total recovery years were examined as indicators to parental functioning. The exploratory analyses showed a significant moderate correlation between PE and parenting behaviors (r = 0.45, p < 0.05) as well as total years in recovery and age (r = 0.43, p < 0.05); total years in recovery differed significantly when compared by race (χ2 (1) = 5.63; p = 0.018) and education (χ2 (1) = 3.94; p = 0.048). There was also a significant inverse relationship between total years in recovery and PE (r = −0.43, p < 0.05) and parental self-care (r = −0.59, p < 0.01). Recruiting parents (especially minorities) in long-term recovery was very challenging indicating that recruitment through community organizations was not feasible without a site champion. Preliminary findings showed statistically significant correlations among self-care, parental efficacy, age, and total years in recovery. As researchers and clinicians, it is necessary to determine the role and impact of self-care for future intervention development, however, recruitment strategies need to be modified to ensure sufficiently large study samples.

Helping Older Adults With the Ageless Challenge of Substance Abuse

Helping Older Adults With the Ageless Challenge of Substance Abuse

Elders Need Thorough Screening for Alcohol Abuse

Elders Need Thorough Screening for Alcohol Abuse

Life in the Fast Lane: Stacy Hollins and the Hollywood Headache

Stacy Hollins, president of Warner Bros. Television, had a big problem with Kevin Tanner, creator and show runner of the hit comedy program It's a Man's World. After nearly six years of sobriety following two DUI arrests, a divorce, and a suicide attempt, Tanner had relapsed, and Hollins was worried about both Tanner's welfare and the future of a show that was a huge money-maker for her studio. When Hollins had suggested that It's a Man's World could go on production hiatus while Tanner entered a rehabilitation facility, Tanner's agent had stated that his client would rather end the program for good—stopping one of Warner Bros. most successful and valuable sources of income—than face the embarrassment of having his creation suspended or run by someone else. Should Hollins simply fire Tanner, allow the show to remain in production with Tanner unchecked for two more months, or should she insist—despite the chance of losing It's a Man's World—that Tanner get help immediately? This case fosters quality discussions in leadership, organizational behavior, or business ethics courses that deal with sensitive personnel issues. Excerpt UVA-E-0386 Rev. Oct. 9, 2013 LIFE IN THE FAST LANE: STACY HOLLINS AND THE HOLLYWOOD HEADACHE The atmosphere was buoyant on the set of the NBC sitcom It's a Man's World, which had just finished taping its 116th episode (17th of a 24-episode order for 2011 to 2012, the show's sixth season). The production staff was gathered on the historic Stage 5 at the Warner Bros. Studio lot in Burbank, California, for its traditional postshow party, complete with chocolate fondue fountain, DJ, and full bar. After a week of 18-hour workdays, last-minute changes from the network and studio, and the standard pressures of staging a comedy show in front of a live studio audience, the staff deserved a respite. It's a Man's World, a comedy about three men raising one of the men's teenage son, was an extremely well-received show, having spent five straight seasons in the Nielsen top 20, having averaged more than 15million viewers per episode, and having won several Primetime Emmy Awards. (See Exhibits 1 and 2.) But Stacy Hollins, president of Warner Bros. Television—the studio backing the show—knew all was not well with the show. As she stood listening to the NBC executives rave about how funny the shoot had been, her thoughts shifted to Kevin Tanner, the program's volatile creator and show runner. After six years of sobriety, Tanner had recently relapsed, and his personal life was spiraling out of control. His previous three months had been littered with increasingly disturbing incidents: hospitalizations for alcohol-related injuries, drug-fueled romps with strippers, and his car having been found mysteriously abandoned on the 101 freeway. . . .

Exploring the role of sport in the development of substance addiction

PurposePotential benefits of participation in sport are widely known. However, sport participation has also been associated with risks, including consumption of alcohol and drugs and such risks may be enhanced among certain populations. The purpose of this study was to examine the possible links between participation in sport and the subsequent development of substance addiction. MethodRealistic Evaluation guided the study, with data collection occurring through semi-structured interviews. Interviews were conducted on a university campus or at a residential treatment center. The study included a total of 21 participants: 7 people who had between 3 and 29 years of sobriety, 13 people in a residential addiction treatment program, and 1 counselor. ResultsParticipants were grouped according to their sport backgrounds as 1) limited sport backgrounds, 2) recreational sports, 3) competitive athletes or 4) competitive athletes whose sport was terminated. Five main contexts were identified: 1) Familial History, Stability, and Illness, 2) Perceived Acceptability of Alcohol, 3) School and Social Atmosphere, 4) Sport Culture, Demands, and Expectations, and 5) Termination of Sport Involvement. The three main mechanisms were identified as: 1) Psychological Characteristics, 2) Coping Strategies, and 3) Availability of Substances. ConclusionsThe prevalence of substance abuse in sports settings might be under-represented in extant literature. The prevalence of substance abuse in sport contexts poses heightened risk of addiction for individuals who are already vulnerable for other reasons such as the presence of predisposing behaviors, psychological characteristics, or circumstances.

Glad You’re Here

“Glad You’re Here” is the story of a recovering alcoholic with seven years of sobriety who is involved in an accident that triggers a relapse. The story portrays Kathleen’s abiding friendship with the idiosyncratic Mae, while gradually revealing the details of both the accident and Kathleen’s history as a high-functioning drunk.

Long-Term Suboxone Maintenance Therapy for Opioid Use Disorder: 2 Case Reports

The medical profession is divided in its approach to treating patients with addiction issues, particularly in regards to the treatment of opioid use disorder with Suboxone (buprenorphine/naloxone). Here we present two cases of patients who have achieved over 11 years of sobriety with long-term Suboxone maintenance therapy. Their stories help to demonstrate that Suboxone is a viable long-term treatment option for severe opioid addiction. While life-long Suboxone use can lead to physical dependence on the drug, this is far from simply replacing one addiction with another. Some providers may feel that physical dependence on a medication does not represent appropriate or adequate treatment of opioid use disorder; however, when compared with the grave potential consequences of severe opioid use disorder, the potential benefits of achieving sobriety with Suboxone maintenance far outweigh the risks.

Gender effects on zolpidem efficacy and safety

Gender effects on zolpidem efficacy and safety

Early mortality after entering a methadone treatment program in Badalona, Spain

Early mortality after entering a methadone treatment program in Badalona, Spain

Widespread effects of alcohol on white matter microstructure.

Evidence suggests that chronic misuse of alcohol may preferentially affect the integrity of frontal white matter (WM) tracts, which can impact executive functions important to achieve and maintain abstinence. Global and regional WM microstructure was assessed using diffusion magnetic resonance measures of fractional anisotropy (FA) for 31 abstinent alcoholics (ALC) with an average of 25years of abuse and approximately 5years of sobriety and 20 nonalcoholic control (NC) participants. Data processing was conducted with FreeSurfer and FSL processing streams. Voxelwise processing of the FA data was carried out using tract-based spatial statistics. Clusters of significance were created to provide a quantitative summary of highly significant regions within the voxelwise analysis. Widespread, bilateral reductions in FA were observed in ALC as compared to NC participants in multiple frontal, temporal, parietal, and cerebellar WM tracts. FA in the left inferior frontal gyrus was associated with drinking severity. This study found widespread reductions in WM integrity in a group of ALC compared to NC participants, with most pronounced effects in frontal and superior tracts. Decreased FA throughout the frontostriatal circuits that mediate inhibitory control may result in impulsive behavior and inability to maintain sobriety.

Long-Term Sobriety Strategies for Men With Co-occurring Disorders

Objective: Roughly half of people with severe mental disorders also experience a co-occurring substance use disorder, and recovery from both is a critical objective for health care services. While understanding of abstinence initiation has grown, the strategies people with co-occurring disorders use to maintain sobriety are largely unknown. This article reports strategies for relapse prevention as described by men with co-occurring disorders who achieved one or more years of sobriety. Methods: We analyzed semi-structured interviews conducted with a sample of 12 men with co-occurring psychosis and substance use disorder who achieved and maintained sobriety for at least one year, supplemented with demographic and diagnostic clinical record data. These men were participating in residential or outpatient treatment at a private, nonprofit integrated treatment clinic. Results: The 12 men were primarily Caucasian (91.7%) and unmarried (100%), and their ages ranged from 23 to 42 years. The two most common psychiatric disorders were schizoaffective disorder (n = 4, 33.3%) and bipolar disorder (n = 4, 33.3%), while the two most commonly misused substances were alcohol and cannabis. Qualitative analyses showed that participants maintained sobriety for at least one year by building a supportive community, engaging in productive activities, and carefully monitoring their own attitudes toward substances, mental health, and responsibility. Alcoholics Anonymous might act as a catalyst for building skills. Conclusions: People with co-occurring disorders who achieve sobriety use a variety of self-management strategies to prevent relapse—seeking support, activities, and a healthy mindset. The findings suggest a relapse prevention model that focuses on social networks, role functioning, and self-monitoring and conceptualizes self-care as critical to extending periods of wellness.

Alcohol-Related Injuries and Alcohol Control Policy in Lithuania: Effect of the Year of Sobriety, 2008

To evaluate the changes in mortality and the years of potential life lost (YPLL) due to alcohol-related injuries, as well as the impact of alcohol-related injuries on life expectancy during the period of the implementation of comprehensive alcohol control policy in Lithuania. Data on deaths from injuries (ICD-10 codes V01-Y98) of the able-bodied population (aged 15-64 years) during 2006-2009 were obtained from the Lithuanian Department of Statistics. Age-standardized rates of alcohol-related mortality and YPLL per 100, 000 population due to injuries and the impact of alcohol-related injuries on life expectancy were calculated. The results of forensic autopsies were the basis for the alcohol-attributable fraction. The age-standardized YPLL/100,000 of the able-bodied population due to alcohol-related injuries was 2285.6 (4067.5 for males and 573.6 for females) in 2009. In 2009, YPLL/100,000 due to alcohol-related injuries declined by 16.3%, while due to alcohol-related traffic accidents by 51.2% when compared with 2006. However, YPLL/100, 000 due to alcohol-related suicides increased among males. A 15 to 64-year-old decedent lost an average of 21.2 years of life due to alcohol-related injuries (21.6 years on average per male and 19.1 per female). The impact of alcohol-related injuries on life expectancy decreased from 1.14 years (1.86 for males and 0.34 for females) in 2006 to 0.97 years (1.62 for males and 0.26 for females) in 2009. The positive changes in YPLL due to alcohol-related injuries and the impact of alcohol-related injuries on life expectancy indicate successful implementation of evidence-based alcohol control measures.

Widespread and sustained cognitive deficits in alcoholism: a meta‐analysis

The cognitive repercussions of alcohol dependence are well documented. However, the literature remains somewhat ambiguous with respect to which distinct cognitive functions are more susceptible to impairment in alcoholism and to how duration of abstinence affects cognitive recovery. Some theories claim alcohol negatively affects specific cognitive functions, while others assert that deficits are more diffuse in nature. This is the first meta-analysis to examine cognition in alcohol abuse/dependence and the duration of abstinence necessary to achieve cognitive recovery. A literature search yielded 62 studies that assessed cognitive dysfunction among alcoholics. Effect size estimates were calculated using the Comprehensive Meta-Analysis V2, for the following 12 cognitive domains: intelligence quotient, verbal fluency/language, speed of processing, working memory, attention, problem solving/executive functions, inhibition/impulsivity, verbal learning, verbal memory, visual learning, visual memory and visuospatial abilities. Within these 12 domains, three effect size estimates were calculated based on abstinence duration. The three groups were partitioned into short- (< 1 month), intermediate- (2 to 12 months) and long- (> 1 year) term abstinence. Findings revealed moderate impairment across 11 cognitive domains during short-term abstinence, with moderate impairment across 10 domains during intermediate term abstinence. Small effect size estimates were found for long-term abstinence. These results suggest significant impairment across multiple cognitive functions remains stable during the first year of abstinence from alcohol. Generally, dysfunction abates by 1 year of sobriety. These findings support the diffuse brain hypothesis and suggest that cognitive dysfunction may linger for up to an average of 1 year post-detoxification from alcohol.

Gender and Extroversion as Moderators of the Association Between Alcoholics Anonymous and Sobriety

Although women make up one third of Alcoholics Anonymous (AA) membership, research on gender and AA has been limited. Findings in the literature are mixed, with few empirical investigations of factors that may moderate any gender differences found. AA is highly interpersonal, and research has found that women are more extroverted than men. The current study explores the impact of AA on sobriety, gender differences in the relationship between AA and sobriety, and whether extroversion can inform our understanding of gender differences. A sample of 276 alcohol-dependent adults (180 men, 96 women) was recruited from four sites and followed prospectively for 2.5-3 years. Participants completed the Timeline Followback interview. AA membership was assessed by an item from the Alcoholics Anonymous Involvement scale. Multiple logistic regression analyses were conducted to determine whether gender, extroversion, AA membership, and their interaction would predict sobriety status at follow-up. AA membership significantly increased the odds of achieving a year of sobriety, and this relationship was stronger for women than men (odds ratio [OR] = 4.42, 95% CI [1.14, 17.18]). There were no main or interactive effects of extroversion on sobriety. A A was founded by men, and early in its history it was exclusively attended by men. Some have criticized AA for women because of its emphasis on "powerlessness." Despite its historical beginnings and such debate, this study joins others in finding evidence that women fare better in AA than do men. In this sample, extroversion did not moderate the association between gender and sobriety. Further research is needed on gender differences in AA and its explanatory factors.

2008—LITHUANIA'S YEAR OF SOBRIETY: ALCOHOL CONTROL BECOMES A PRIORITY OF HEALTH POLICY

2008—LITHUANIA'S YEAR OF SOBRIETY: ALCOHOL CONTROL BECOMES A PRIORITY OF HEALTH POLICY

Helping Others and Long-term Sobriety: Who Should I Help to Stay Sober?

Examination of the change strategies associated with successful long-term sobriety remains an understudied area in addiction research. The following study recruited individuals with long-term sobriety (range 16–25 years continuous abstinence). Subjects (n = 11) were surveyed on demographic information, problem history, Alcoholics Anonymous (AA) affiliation, and helping behaviors within several life domains over the course of sobriety. General helping behaviors increased from lower levels in the month prior to getting sober, to moderate levels at 1 year of sobriety, but did not continue to increase with additional years of sobriety. Levels of general help to others at home, work, and 12-step programs were similar at varying lengths of sobriety. Whereas overall levels of general help given to others were similar across settings, helping other alcoholics, as opposed to helping others at home or work, was rated as contributing the most to staying sober. Across time, alcoholics increased participation in helping behaviors specific to 12-step programs. The utility of helping others as a behavioral strategy to maintain successful addictive behavioral change is discussed.

Adding Consumer-Providers to Intensive Case Management: Does It Improve Outcome?

Adding Consumer-Providers to Intensive Case Management: Does It Improve Outcome?

Pragmatic Help Seeking: How Sexual and Gender Minority Groups Access Mental Health Care in a Rural State

This qualitative study examined how lesbian, gay, bisexual, and transgender (LGBT) people in rural areas of the poor and multiethnic state of New Mexico access secular (professional and lay) and sacred (indigenous and Christian) mental health care resources. In-depth, semistructured interviews were used to document the help-seeking processes of 38 rural LGBT people. Obtaining assistance was complicated by the ideal of self-reliance and the view of mental illness as a sign of weakness. Financial considerations and a lack of and community-based LGBT social networks also exerted substantial influence on help seeking. Many LGBT people would strategically remain silent about their sexuality or gender status and rely on their family ties to access the range of secular and sacred resources that are most commonly available in medically underserved rural communities. Although persons from sexual and gender minority groups often experience positive outcomes as a result of help seeking, some LGBT people remain vulnerable to anti-LGBT sentiments that persist within secular and sacred sectors of rural health care systems.