Sleep and Substance Use

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Sleep and Substance Use

11 September, 2020Articles, News

“Sleep is the single most effective thing we can do to reset our brain and body health each day — Mother Nature’s best effort yet at contra-death.”

― Matthew Walker, author of “Why We Sleep: Unlocking the Power of Sleep and Dreams”.

Why is Sufficient Sleep Necessary to our Functioning :

Sleep is a physiological necessity, so much so, that we spend nearly one third of our lives sleeping. Getting sufficient, quality sleep, is as important to our survival as food and water. Research has shown that chronic lack of sleep, or poor quality sleep, increases the risk of health problems including high blood pressure, cardiovascular disease, insulin resistance, Type 2 diabetes, obesity, depression and other mental health disorders. Poor sleep quality reduces productivity and increases irritability. Without sufficient sleep you are unable to form or maintain the pathways in your brain which are responsible for learning and the creation of new memories, thus making it harder to concentrate and respond to situations effectively. Lethargy, dullness of mind, forgetfulness, feelings of not being able to cope, or even grumpiness are all signs of insufficient, poor quality sleep.

Substance Use and Sleep :

Sleep and substance use is frequently bidirectional in nature- substance use causes problems with sleep and sleeping; but insomnia and insufficient sleep may also be a factor in substance use and addiction. Different substances affect sleep in different ways, for example, alcohol increases slow wave sleep and suppresses rapid eye movement (REM) sleep. During periods of acute withdrawal, sleep latency (the time taken to fall asleep) is increased and the total time spent asleep is decreased. Similarly, opiates, despite being sedatives, interrupt sleep by increasing wakefulness and decreasing total sleep time, slow wave sleep, and REM sleep. Furthermore, opioids and opiates are known to affect the brain mechanism that controls breathing. This can potentially create sleep apnoea events where individuals experience pauses in their breathing, resulting in snoring or gasping, a dry mouth and even a headache in the morning. In terms of cannabis, chronic users develop a tolerance towards its’ sleep-enhancing effects. During withdrawal and periods of abstinence from cannabis, unusual dreams and poor sleep quality is common. This poor quality sleep together with insomnia has been shown to be predictive of a relapse amongst users of cannabis, with over 40 % of participants in one study reporting prolonged periods of insomnia and 10 % of those who relapsed, cited insomnia as a factor in their relapse. Insomnia experienced during withdrawal from substances, frequently fuels craving.

Sleep as a Predictive Factor in Relapse :

Poor quality sleep is a predictive factor in relapse. Studies have shown that sleep disturbances are reported by individuals for some drugs, long after they have quit taking them and after other withdrawal symptoms have subsided. For example, disruptions in REM sleep can sometimes persist for 1 to 3 years amongst alcoholics who have achieved sobriety. The REM stage of sleep is believed to be associated with mood regulation and the consolidation of memories. Disturbed sleep appears to be a significant predictor of relapse in alcoholics even after controlling other factors, such as depression. Further, because sleep is important in memory consolidation, sleep dysfunction may interfere with the learning of new associations and skills needed for successful recovery from alcoholism.

Although this is a relatively new area of study and much of the research that has been done in this field has been done on small groups, there can be no doubt that in order to successfully recover from addiction, we need to be mindful of practising good sleep hygiene.

Practising Good Sleep Hygiene :

Here are some tips that may assist you in practising good sleep hygiene.

Get sufficient exposure to daylight : light, especially sunlight, is one of the key drivers of circadian rhythms (internal processes that regulates the sleep-wake cycle, repeating roughly every 24 hours) that can encourage quality sleep.
Avoid caffeine and nicotine and other chemicals that interfere with sleep.
Exercise early : exercise stimulates the body to secrete the stress hormone cortisol, which causes the brain to become alert, so although exercise can help you fall asleep faster and sleep more soundly, it needs to be done at the correct time. Ideally, exercising should be completed at least three hours before your intended bed time. It is best to exercise earlier in the day.
Unplug from electronics: maintain a 30-60 minute pre-bed time that is free of all devices such as mobile phones, tablets, laptops and televisions. Not only do these devices cause our brains to be stimulated, they also generate blue light that may decrease melatonin (the hormone associated with sleep produced by the pineal gland. It helps you fall asleep by calming the body before bed ).
Follow a consistent routine at bedtime: follow the same steps each night, including things like putting on your pyjamas and brushing your teeth. Your brain picks up on the little cues that are telling it – it is time for sleep.
Budget 30 minutes for winding down prior to sleep: use calming aids such as soft music, light stretching, reading, meditation or prayer. Try not to make falling asleep your goal, instead focus on relaxation. Meditation, mindfulness, breathing exercises and other relaxation techniques may put you in the correct mindset for bed.
Don’t Toss and Turn: try to maintain a healthy mental connection between being in bed and actually being asleep. If after 20 minutes you haven’t managed to fall asleep, get up and stretch, read, or do something else calming in low light before attempting to fall asleep again.
Don’t Dine Late: Eating dinner late, especially if it’s a big, heavy, or spicy meal, can mean you’re still digesting when it’s time for bed. If you need to snack before bedtime, the snack should be a light one.

If you are a recovering addict or alcoholic and you are experiencing persistent problems with sleep, do not ignore them. Keep a sleep journal, speak to your sponsor or counsellor and seek assistance in improving your quality of sleep.

RESOURCES :

Sleep Hygiene :

https://www.sleepfoundation.org/articles/sleep-hygiene

Differential Effects of Addictive Drugs on Sleep and Sleep Stages :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6688758/

Sleep Disorders in Substance Abusers- How Common Are They? :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766287/

Connections between Sleep and Substance Use Disorders :

https://www.drugabuse.gov/about-nida/noras-blog/2020/03/connections-between-sleep-substance-use-disorders

Drugs, sleep, and the addicted brain :

https://www.nature.com/articles/s41386-019-0465-x

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The encouragement, love and support from the team at Crossroads allowed me to eventually see that I was worth something - that my life could be turned around and that I could accomplish the things that had long been a forgotten dream.
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On the last day of my stint at Crossroads I could only express gratitude towards all who works there. A wise councillor once commented on my question when one is ready for rehab by explaining that when one is ready for rehab, rehab is ready for you.
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Foetal Alcohol Syndrome – The Dangers

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Home / Posts tagged "alcohol" (Page 3)

Foetal Alcohol Syndrome – The Dangers

12 August, 2020Articles, News

The consumption of alcohol, though legal, is not without its risks. Prolonged and frequent drinking can have serious consequences for the heart, liver and brain. During pregnancy a whole new set of possible consequences arise for the child. They can take the form of spontaneous abortion, premature labour, stillbirth and a range of disorders known as foetal alcohol spectrum disorders. Foetal alcohol spectrum disorders cover a wide range of birth defects related to alcohol consumption during pregnancy, this article will explore the one of the most common ones, Foetal Alcohol Syndrome (FAS).

What causes it

Foetal Alcohol Syndrome is caused directly by drinking during pregnancy. When alcohol is consumed it passes through the placenta and is processed by the internal organs of the foetus as well as the internal organs of the mother. The organs of the baby, the liver especially, are still busy developing, therefore the foetus cannot process alcohol the same way an adult can. This is particularly damaging to the rapidly developing cells of the brain, though other organs can also be affected.

There is no “safe” time to drink during pregnancy. It is even recommended that people attempting to get pregnant, avoid alcohol because it can even be damaging to the foetus before a pregnancy is detected. There is also no safe amount to drink. Even as little as one unit of alcohol can be enough to have a severe impact on the neurological development of a child.

During pregnancy, mother and child share a circulatory system. All the chemicals processed in the mother’s body pass to the child through the placenta, thus when drinking, the alcohol ends up in the child’s blood stream. There is no was to ensure that the alcohol is only processed by one and not the other. Due to the brain developing so rapidly during pregnancy, it is the organ most susceptible, though other organs are also affected.

Implications

FAS is a lifelong developmental disability. There is no cure or way to reverse the damaging effects that alcohol has on the brain. A person with Foetal Alcohol Syndrome will have it until the day they die.

Children with FAS have distinct facial features, other signs and symptoms are grouped into 2 categories, developmental and behavioural.

Developmental symptoms are a result of the brain structure not developing as it should. Therefore, a host of symptoms can occur. These include but are not limited to:

Intellectual disability
Learning Disorders
Delayed development
Poor coordination and balance
Poor memory
Difficulty problem-solving and reasoning
Difficulty paying attention, general jitteriness and anxiety – which may include a diagnosis of ADHD
Poor judgement and difficulty making connections between choices and consequences
Rapidly changing moods

The second category for symptoms are social and behavioural issues. These are a result of development symptoms in the first category. These are the only symptoms that can be worked with and adjusted for throughout life. They may be lessened or addressed through adjusted schooling, therapy, life skills and coping skills training. It is however important to note that the success of these strategies is dependent on how severe the brain development issues are, not just the quality of the therapy received. Signs include, but are not limited to:

Struggling in school and in traditional working environments
Poor impulse control
Poor social skills and difficulty making friends and forming social connections
Hyper focus, and difficulty adjusting to a different task or a different way of doing a familiar task.
Difficulty in planning and working towards a non-immediate goal
Poor concept of time and poor time management
General behavioural issues, such as destructiveness, aggression and hostility
Trouble communicating effectively, (may even present as mute)

South African Stats

Foetal Alcohol Syndrome is the third highest cause of congenital mental retardation and the most common form of preventable mental disability. South Africa has the highest incidence of Foetal Alcohol Syndrome in the world. This varies from area to area with certain parts of the Western Cape having an incidence of 12.9%. This number is alarmingly high when compared with The European Union where incidences of the full range of alcohol spectrum disorders are between 1% and 5% depending on region.

Foetal Alcohol Syndrome is an entirely preventable form of mental disability. Should you or a loved be pregnant, or trying to get pregnant, and are struggling saying no to alcohol despite the possible negative consequences, this may be indicative of alcoholism. Contact Crossroads for a free assessment to determine if intervention is needed.

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Conversations the Crossroads Alcohol Ban

Conversations @ The Crossroads. The Alcohol Ban.

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Home / Posts tagged "alcohol" (Page 3)

In episode 2, Taku Mhonyera, Head of Treatment at Crossroads, Johannesburg, discusses the ban on alcohol and the implications thereof for alcoholics and the medical community, with Dr. Tich.

The link between alcohol and levels of violence in South Africa has been greatly debated since the 1^st of June when the ban on the sale of alcohol was lifted.

Alcohol addiction is widespread due to its easy accessibility and social acceptance. If compulsive and uncontrolled alcohol consumption, binge drinking, blackouts and reckless behaviour under the influence dominate your life, you may be an alcoholic. If you or anyone close to you needs help with an addiction to sex, gambling, substances, alcohol or food, please contact us for a free assessment.

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Is Alcohol Fueling South Africa’s GBV crisis?

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Home / Posts tagged "alcohol" (Page 3)

Is Alcohol Fueling South Africa’s GBV crisis?

18 June, 2020Articles, News

The link between alcohol and levels of violence in South Africa has been greatly debated since the 1^st of June, when the ban on the sale of alcohol was lifted. Our society experiences massive levels of gender based violence and subsequent to the lifting of restriction of alcohol sale, 21 women have been murdered in domestic violence incidents.

The question thus arises; “Are we able to demonstrate a link between alcohol use and gender based violence? “

In the President’s speech last night, he is quoted as saying, “In particular, we need to examine the effect of alcohol abuse not only on levels of violence, but also on road accidents and reckless behaviour. Several international and domestic studies show clear linkages between alcohol abuse and gender-based violence.”

Unsurprisingly, 85% of the victims of gender based violence are female, according to the United States Bureau of Justice Statistics. Women experience intimate partner violence at a 5-8 times higher rate than men and most of the partner abuse takes place in the home.

Domestic violence as a legal term includes different forms of abuse :

Physical acts, such as hitting, punching, slapping or pulling of hair;
Sexual abuse including rape, marital rape, treating a partner in a sexually abusive and demeaning way, and molestation,
Emotional abuse for example intentional and malicious attacks on a partner’s self-worth, and,
Psychological abuse including controlling the partner, blackmail, threatening harm to children, violence toward pets, and intimidation.

Violence against an intimate partner can also include stalking, social isolation (for example, not letting an intimate partner leave the house), and depriving them of resources and necessities.

Various studies have identified substance abuse as a factor in 40-60% of incidents of domestic violence, either in precipitating the abuse or exacerbating it. A study by the WHO shows that alcohol use increases both the occurrence and severity of the violence against an intimate partner. More than 20% of male perpetrators of intimate partner violence (IPV) had used alcohol or drugs immediately before the most recent incidents of violence. The Sonke Gender Justice Project conducted research into the relationship between alcohol abuse gender-based violence (GBV) in 2016. According to their studies, women with male partners who “come home drunk frequently” are 4 to 7 times more likely to suffer violence than those whose partners drink infrequently. Perpetrators of gender based violence are 5 times more likely than non-perpetrators to consume alcohol . Male-to-female aggression is 11 times more likely to occur on days when perpetrators have consumed alcohol. The Sonke Project have has also documented links between alcohol abuse and the transmission of HIV, where – problem drinkers had a 2.0 fold higher prevalence of HIV then non-problem drinkers.

Women in abusive relationships often report that their abusive partner coerced them into engaging in alcohol and drug consumption, although, even where women do not commonly engage in harmful alcohol use, men’s drinking is a risk factor. For example, a four-country study from Asia-Pacific, found if a woman’s partner drank alcohol regularly, they were more likely to experience intimate partner violence.

A study aimed at understanding the drivers of intimate partner violence (IPV), perpetrated by men and experienced by women, shows that there are multiple scenarios in which alcohol abuse leads to increases in intimate partner violence. “Consuming harmful levels of alcohol can lead to more frequent quarrelling about finances and household responsibilities, as money and time are spent drinking. For couples who often drink together, there may be alcohol-related diminishment of cognitive functioning, increasing the likelihood of arguments in relationships becoming violent. Qualitative research in one IPV prevention trial in South Africa, Stepping Stones and Creating Futures, found that one way women sought to reduce their IPV risk was not arguing with their male partner if he, or she herself, were drunk. While not transforming gender relationships, this was an important harm reduction strategy that emphasized how alcohol, quarrelling and IPV are interlinked”.

On the 1^st of June, videos went viral of queues of people waiting to get into outlets to buy alcohol. Although less than a third of adult South Africans drink alcohol, almost six out of 10 drinkers engage in binge drinking, according to a 2018 World Health Organisation report. The same study ranks South Africa as the 6^th heaviest drinkers in the world. South Africans who consume alcohol, drink the equivalent of 5.4 standard drinks per day. There can be little doubt that South Africans have a problematic relationship with alcohol.

Although this article has focused on violence against women, it should not be forgotten that violence fuelled by drug and alcohol consumption also takes place in same-sex relationships. Lesbian, gay, bisexual, and transgendered individuals have higher rates of substance abuse than the general population, often due to the prejudice that many of them face in their lives, and this may manifest in violence carried out within their domestic unions.

As President Cyril Ramaphosa said, “We need to draw the lessons from this lockdown and decide how we can protect our society from the abuse of alcohol. Certainly, we need to provide greater support to people with drinking problems, including through rehabilitation and treatment…..Of course, it is not alcohol that rapes or kills a woman or a child. Rather, it is the actions of violent men. But if alcohol intoxication is contributing to these crimes, then it must be addressed with urgency”

Alcohol addiction is widespread due to its easy accessibility and social acceptance. If compulsive and uncontrolled alcohol consumption, binge drinking, blackouts and reckless behaviour under the influence dominate your life, you may be an alcoholic. If you or a loved one needs help with addiction or alcoholism, contact us for a consultation.

Resources :

https://www.tandfonline.com/doi/full/10.1080/16549716.2020.1739845

https://apps.who.int/iris/bitstream/handle/10665/274603/9789241565639-eng.pdf?ua=1

https://www.sanews.gov.za/south-africa/murder-spike-noted-level-3

https://www.who.int/violence_injury_prevention/violence/world_report/factsheets/ft_intimate.pdf

http://www.dirco.gov.za/docs/speeches/2020/cram0617.pdf

https://genderjustice.org.za/article/alcohol-abuse-linked-gender-based-violence-increased-alcohol-prices-not-liquor-amendment-bill/

https://bhekisisa.org/opinion/2020-06-11-why-did-south-africa-ban-alcohol-during-lockdown-covid19-coronavirus-evidence/

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Stories of Recovery

The encouragement, love and support from the team at Crossroads allowed me to eventually see that I was worth something - that my life could be turned around and that I could accomplish the things that had long been a forgotten dream.
Oliver VG
Read more
On the last day of my stint at Crossroads I could only express gratitude towards all who works there. A wise councillor once commented on my question when one is ready for rehab by explaining that when one is ready for rehab, rehab is ready for you.
Johan B
Read more
I was lost and my soul was broken until I ended up at Crossroads and was introduced to the Twelve Steps. With the help of their excellent staff and amazing support I have recently been clean for 18 months, I could not have done it without them!
Carla S
Read more
"Just for today I am more than three years in recovery. I have Cross Roads to thank for this wonderful gift. Cross Roads helped me to set a firm foundation in my recovery on which I can continue to build."
Angelique J
Read more