Stress Management

Many people use drugs to mask underlying problems in their lives -- problems that are still there once they have become drug-free. One common trigger for relapse is having inadequate skills for managing stress and anxiety.

In therapy and in working with supportive others, addicts can learn these skills. They include:

-- Dealing with uncomfortable feelings and situations when they occur, instead of letting stress build up. Often, this can be as simple as acknowledging them: "I'm unhappy that I have to work late, and I feel tired."

-- Taking pleasure in everyday life. This can include planning good meals, time for exercise, and time for hobbies or activities the person finds relaxing and renewing.

-- Attitude of Gratitude

-- Identifying support people with whom you can talk out stressful situations.

-- Planning your responses to high-stress situations (such as being offered a drink or a hit of a drug).

-- Recognizing and planning responses to stressful feelings (loneliness, anger, boredom).

Behavioral Therapy for Cocaine Use

Cognitive-behavioral therapy is a common aspect of treatment for cocaine use. It is popular both because clinical trials have found it effective, and because it is relatively short-term and thus less expensive.

Rather than try to untangle the cocaine user's childhood or past issues, the cognitive-behavioral therapist focuses on the user's current situation, with a goal of reinforcing abstinence and teaching the patient skills such as:

-- Recognizing situations that are likely to lead to using cocaine

-- Avoiding those situations

-- Coping with current life stresses without depending on cocaine

Therapist and patient then work together on practicing skills such as planning for emergencies, managing cravings, refusing drugs, and understanding past episodes of drug use.

Cocaine and Alcohol

Cocaine tends to speed up the user's nervous system, while alcohol tends to slow it down. Some users combine the two in the hopes of moderating the effects of one with the other. Instead, they're creating a deadly combination.

When people mix cocaine and alcohol, the two substances combine in the liver to form cocaethylene, which intensifies cocaine's euphoric effects (including delusions of grandeur). This combination is thought to increase the risk of heart failure and cardiac arrest, and many drug-related deaths occur among people using this combination.

Scientists from the National Institute on Drug Abuse studied the combination and found that people who used both cocaine and alcohol showed poorer performance on intelligence tests and more impaired decision-making skills than users of either substance alone.

Abuse Prevention

Early attempts to prevent steroid abuse concentrated on drug testing and on educating students about the drugs’ adverse effects.

A more sophisticated approach has shown promise for preventing steroid abuse among players on high school sports teams. In the ATLAS program, developed for male football players, coaches and team leaders discuss the potential effects of anabolic steroids and other illicit drugs on immediate sports performance, and they teach how to refuse offers of drugs. They also discuss how strength training and proper nutrition can help adolescents build their bodies without the use of steroids. Later, special trainers teach the players proper weightlifting techniques.

A program designed for adolescent girls on sports teams, patterned after the program designed for boys, is currently being tested.

If You Need Help Now

If you are having a medical emergency because of drug use, or if you are in danger because of violent people associated with drug use, call 911. Police and ambulance crews are trained to handle drug problems.

If you are facing arrest, remember that your own cooperative attitude will be a factor in the way you are treated. You should give police your name, address, date of birth, and phone number. Beyond that, you do not have to answer any question and you are entitled to a lawyer.

If you are thinking of killing yourself, call a suicide hotline, where a trained volunteer can help you deal with your crisis. Two national suicide hotline numbers are 1-800-SUICIDE (1-800-784-2433) and 1-800-273-TALK (1-800-273-8255). There may also be local numbers where you can be referred to resources for help in your area.

If you are craving alcohol or a drug and want to stay abstinent, call your sponsor or a sober friend, practice diversions to get you through the next minute (try 10 push-ups or a quick walk), and make a plan to get to a 12-step meeting as soon as possible. You may also find it helpful to visit an online meeting.

Behavioral Therapy for Marijuana Users

Research into marijuana addiction therapy has been somewhat lacking, in part because for many years experts did not believe the drug was physically addictive.

One recent study focused on men in their 30s who had been regularly using marijuana for at least 10 years. The study found similar benefits from a 14-session group therapy treatment with a cognitive-behavioral focus, and just two sessions of individual therapy. About 30 percent of the users in both groups were able to maintain abstinence over the following year.

A current area of research involves establishing a system of rewards which patients can earn through continued abstinence, as verified by urine testing.

Programs aimed specifically at teens often include an element of family therapy to establish a family system that supports the young patient's continued abstinence.