Helpful Information and Resources

I have designed this page to help those that don't know where to get started and those who want more information. I am posting links that I think may be helpful. I do not have any affiliation with these organizations, nor do they endorse me in any way but I, and my clients often use these organizations and information as a resource.

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General Substance Use Information and Questions I get asked:

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"How do I know I have a problem with X?" I like to use a simple set of criteria from Dr. Steven Melemsis: 1) Do you sometimes do more of X than you intend to and 2) do you continue to do so despite negative consequences? I also like to look at what is it doing for me vrs what is it doing to me and can I continue to do X and live the kind of life I want to lead? I like these questions because they allow for the whole spectrum of substance use issues and other behaviors to be included and it can empower people to make choices and plug in tools to help themselves. When asking yourself these questions it is really important that you be honest with yourself. It is estimated that people who abuse substances tend to underestimate how much they are drinking by 30%. Try tracking yourself for a period of time to get a clear sense of what is happening. People with binge eating also underestimate how many calories they are eating by 30% which is interesting. 

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"I can identify a lot with the addiction criteria with my binging and/or overeating. Does that mean I have a food/eating addiction?" The term food addiction does not appear in the DSM-5 (the mental health bible) but binge eating disorder does. There is a lot of overlap between the symptoms and behaviors of a substance use disorder and binge/overeating eating but there are also some differences. There also appears to be a subset of people who the addiction criteria fits really well for and a subset where it doesn't. I have included the study below if you are interested. When my clients present wanting to work on their weight or binge eating we look at in the context of how they live their lives. Often times they have tried the diet and exercise regime and are able to do this for a little while but "fail". I have put "fail" in quotation marks because its not a failure. The concept of looking at weight is also controversial and confusing. I could write a whole other piece on just that. In my opinion the problem with just focusing on diet and exercise is that it doesn't look at the context in which the problems were created and how it continues to be maintained. You can eat all the kale you want but if you run on 3 hours of sleep every night, hate your boss and your stress management program consists of Netflix and isolating yourself the changes you want become unsustainable. If you want to make a change, you have to make it sustainable. Here is the study as promised: Food Addiction: Implications for the Diagnosis and Treatment of Overeating - PubMed (nih.gov)     

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"Can I learn to drink in a controlled way?" I get asked this one a lot. I am going to give a really unsatisfying answer. It depends. There are some people who "mature" out of having problematic substance use. It depends on a variety of different factors and I am going to include the research below. Those that seem to have the most difficulty are those with more severe substance use issues and those that use alcohol to cope. With my clients that want to reduce as an experiment, we usually try a controlled drinking plan for a length of time within the context of making other lifestyle changes. This is done with the understanding that it comes at the risk of continuing to experiencing negative consequences. Before you alter, or quit drinking, it is extremely important you talk to your physician as withdrawal can be life threatening. They can advise you on what it is safe for you to do. 

 “Maturing Out” of Binge and Problem Drinking | Alcohol Research: Current Reviews (nih.gov) 

Strategies for Cutting Down - Rethinking Drinking - NIAAA (nih.gov)

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"I just want to stop/reduce X. Why do we have to look at this other stuff?" Stopping or reducing substance use is just a small part of treating an addiction issue. Lots of people can stop for a short period of time, its the staying stopped that's the problem. This is why we look at how you live your life. If you just quit drinking but don't look at or change the issues that contribute to it, then it is likely that you will relapse or continue to be sober and miserable. Getting some sort of help can also teach you how to deal with all the other issues you may have been sweeping under the rug for years that all of a sudden pop up once you quit. 

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"I quit drinking/drug use, why do I still feel terrible?" This is often an unwelcome surprise. It takes awhile for the pleasure centers in your brain to come back online after you quit. This is why it is difficult to enjoy things when you are drinking and once you quit. Good news, its not permanent. Your thinking, emotions and sleep may be affected as well. This is another reason we look at how you live your life. All of those lifestyle changes help this process to recovery.   

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This section is going to continue to evolve so stay tuned: 

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Websites: 

Fundamentals of Addiction | CAMH

Canada’s Guidance on Alcohol and Health | Canadian Centre on Substance Use and Addiction (ccsa.ca) This contains the updated drinking recommendations. 

Substance Use and Concurrent Disorders | The Royal The Royal has programs and a rapid access to addiction medicine program. It can be a great resource for those who need medical support with alcohol. 

National Center for Biotechnology Information (nih.gov) and 

NIDA.NIH.GOV | National Institute on Drug Abuse (NIDA)

These website contain tons of research. If you have a question about addiction someone has likely done the research and published it here. 

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"I hate A.A. but I need meetings" - I may have heard this once or twice. 

All People, All Pathways™ - CAPSA 

SMART Recovery

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