The following information is provided to help persons make decisions regarding their substance use. Please remember that this information should not be taken in place of talking to your doctor, pastor, therapist, etc.

Substance use disorder treatment at Lighthouse Counseling

Mandated/court ordered Treatment

FAQs about substance use:

          Do I have to stop?

          What is addiction?

          What is moderate/social/reasonable use? 

          How do I stop using? 

          Alcohol

                    How much drinking is too much?

          Cannabis/Marijuana

                    What is Marijuana/Cannabis?            

                    Is marijuana addictive?

                    What is moderate/social/reasonable use of cannabis products?  

          Opiates

                    What are opiates?

                    Why are so many people dying of opiate overdose?

                    What are methadone and suboxone?

                    What can I do to prevent opioid overdose?

          Harm Reduction

                    What is Harm Reduction?

                    What are some Harm Reduction approaches?

Substance Use Disorder Treatment at Lighthouse

Lighthouse Counseling provides services that are individualized to the specific client. All clients receive a comprehensive evaluation (1-2 sessions usually), treatment recommendations are provided and then the client and clinician work together to create a plan for treatment.  

Lighthouse specializes in co-occurring treatment for people with mental health and substance abuse issues.  Our program utilizes evidence-based treatment approaches to maximize therapeutic progress for clients.  These approaches include Cognitive Behavioral Therapy, Motivational Interviewing and Enhancement, 12 Step Facilitation and Dialectical Behavior Therapy (DBT) among others.  Lighthouse prides itself on remaining up to date on advancements in the field of addiction to provide the best treatment to our clients as is possible. 

We offer both individual and group counseling.  Individual sessions are focused on any issue or mental health condition that impacts a person’s ability to remain abstinent.  Treatment groups are kept small with a maximum size of 10 people to provide individualized attention to clients.  Group sessions meet for an hour and a half and include random urine-based alcohol and drug testing to help support and encourage abstinence. 

Substance Abuse Treatment Group– This is a once-a-week group for individuals have developed issues in their life related to their substance use and have never had substance abuse treatment previously.  This group is considered a discovery group as clients are led through topics that encourage them to consider their substance use patterns and develop healthier coping strategies.  Clients attend this group for approximately four months. 

Mandated Treatment

Mandated treatment is counseling that is required by some referral source including Probation, DSS, the courts, employers, etc.  Lighthouse Counseling staff have extensive experience helping clients meet these requirements.  While “we work for you,” we also understand the treatment and documentation necessary to meet the referral sources requirements. We use a team approach, including referral sources in the treatment planning and monitoring processes to support the client’s goals in a timely manner. 


FAQs about substance use

Do I have to stop?

Any level of substance use can be harmful.  There are multiple approaches to addressing that harm including: harm reduction, abstinence, medication assisted therapy, individual and group therapy.

Harm reduction is working to reduce the harm of use rather than an exclusive focus on abstinence.  Examples include: not driving if you have had anything at all to drink, drinking only a certain number of days per week, etc. 

Abstinence may be better for you if you have tried to moderate your substance use and have been unable to do so.

Medication assisted therapy includes methadone, suboxone, naltrexone, acamprosate (Campral), Vivitrol shot, and Antabuse, just to name a few. These medications are generally used for those who are planning for abstinence.

Therapy can help you make decisions regarding your substance use.

 

What is addiction?

“Alcohol dependence”, “addiction”, and “alcoholism” are terms generally considered to mean the same thing. All of these refer to “LOSS OF CONTROL” which is the defining characteristic of addiction. More specifically, the following DSM 5 criteria are included in this definition.  If you meet some of the following criteria, you might be considered to have some level of a substance use disorder.

Tolerance

Withdrawal symptoms

Cravings

Repeated relationship problems

Repeated school/work/responsibility problems

Repeated use in hazardous situations

Failed attempts to stop or cut back

Use more than intended

Spending a great deal of time obtaining, using and recovering from substance use

Repeated physical/psychological problems caused or made worse by substance use

 

What is moderate/social/reasonable use?

A social drinker is someone who drinks in moderation, never uses in dangerous situations (like drinking and driving), has no problems stopping when they plan to do so, and there are no significant consequences from their use (legal charges, complaints by family members, failure to live up to responsibilities, etc.). Of note, discussing the notion of “social” use of other substances (i.e., marijuana, cocaine) theoretically follows the same logic.

How can I stop using substances?

If you want to stop using substances, you may find the following strategies helpful.

CAUTION: sudden cessation of substance use can cause withdrawal symptoms and some of these can be fatal.  It is recommended that you talk with your physician prior to stopping regular substance use.

1)         Find alternatives. If drinking/using has occupied a lot of your time, then fill free time by developing new, healthy activities, hobbies, and relationships, or renewing ones you’ve missed. If you have counted on using alcohol/substances to be more comfortable in social situations, manage your moods, or cope with your problems, then seek other, healthy ways to deal with those areas of your life

2)         Avoid “triggers”. What triggers your urge to drink/use? If certain people or places make you drink/use even when you don’t want to, try to avoid them. If certain activities, times of day, or feelings trigger the urge, plan something else to do instead of drinking/using. If drinking/using at home is a problem, keep little or no alcohol/drugs there.

3)         Plan to handle urges. When you cannot avoid a trigger or an urge hits, consider these options: remind yourself of your reasons for changing (it can help to carry them in writing or store them in an electronic message you can access easily); talk things through with someone you trust; get involved with a healthy, distracting activity, such as physical exercise or a hobby that doesn’t involve drinking/using; instead of fighting the feeling, accept it and ride it out without giving in, knowing that it will soon crest like a wave and wash away. Remember, cravings last, at most, 15 minutes as long as you don’t feed into them.

4)         Know your “no”. You’re likely to be offered a drink/drug at times when you don’t want one. Have a polite, convincing “no, thanks” ready. The faster you can say no to these offers, the less likely you are to give in. If you hesitate, it allows you time to think of excuses to go along.

5)         Social support – One potential challenge when people stop drinking/using is rebuilding a life without substance use. It may be important to: educate family and friends, develop new interests and social groups, find rewarding ways to spend your time that don’t involve substance use, ask for help from others,

6)         When asking for support from friends or family, be specific. This could include: not offering you alcohol/drugs, not using alcohol/drugs around you, giving words of support and withholding criticism, not asking you to take on new demands right now, going to a group like Al-Anon,

7)         Consider joining Alcoholics Anonymous, SMART Recovery, Celebrate Recovery or another mutual support group (see “Links”). Recovering people who attend groups regularly do better than those who do not. Groups can vary widely, so shop around for one that’s comfortable. You’ll get more out of it if you become actively involved by having a sponsor and reaching out to other members for assistance.

8)         Note that it is common for people with substance use problems to feel depressed or anxious. Mild symptoms may go away if you cut down or stop using. See a doctor or counselor if symptoms persist or get worse. If you’re having suicidal thoughts, call your health care provider, or go to the nearest emergency room right away. Effective treatment is available to help you through this difficult time.

Resources: support for quitting: Rethinking Drinking: http://rethinkingdrinking.niaaa.nih.gov.

Alcohol

How much drinking is too much?

High risk drinking for men is more than 4 standard drinks (1 beer, 1 shot, 1 standard glass of wine) in any one day or more than 14 in any one week. For women, the standard is more than 3 drinks on any day or more than 7 drinks per week.  Note that these are just guidelines and that your drinking might be problematic even if you are drinking at or below these levels. Source: http://rethinkingdrinking.niaaa.nih.gov.

Cannabis/Marijuana/THC

What exactly is Marijuana/Cannabis?

  • Dried leaves, flowers, stems, and seeds from the plants Cannabis Sativa (most commonly used form) and Cannabis Indica (main source of hashish). These plants have been found to contain more than 420 different chemicals in a single plant of which the mind-altering cannabinoid delta-9-tetrahydrocannabinol or THC is found. Known as: grass, weed, nugget, bud, trees, herb, and flower.
  • Sinsemilla (High Potency THC) known as: Sens, Skunk, Weed, Ganja, and Mary Jane
  • Hashish/Hashish Oil (High Potency THC) known as: Gash, Butane Hash, Hash Oil, Wax, Dabs, Dabbing, BHO, Amber, Shatter.
  • Delta 8- THC is a psychoactive substance found in the Cannabis Sativa Plant which is typically manufactured from hemp-derived cannabidiol (CBD). These products are sold online and at Tobacco Shops and have not yet been evaluated by the FDA. The FDA has received adverse event reports involving this product and the National Poison Control Center received 661 exposure reports between Jan 2018 and July 2021 many of which were children who required hospitalization. Delta 8 has psychoactive effects similar to Marijuana. Delta 8 THC also uses a host of other chemicals in the creation of the concentrations that are marketed.

Is marijuana/cannabis addictive?

Yes, cannabis products/marijuana use can become addictive as defined by the addiction criteria above. Specifically, it is possible to have tolerance, withdrawal and cravings; use that causes problems; and loss of control.

What is moderate/social/reasonable use of marijuana?

No one knows the answer to this question. We propose using the same criteria for cannabis products as for alcohol. Proposed moderate marijuana use guidelines might include:

  • A moderate marijuana user considers occasional marijuana to be a small, though enjoyable, part of life and has hobbies, interests, and other ways to relax and enjoy life that do not involve marijuana
  • Doesn’t use marijuana if it has caused problems for you in the past like paranoia, anxiety, breathing problems.
  • Doesn’t use and then drive, or use in any situation that might be hazardous
  • Doesn’t use daily
  • Is cautious about use of edibles and concentrates. When consumed as an edible, the THC in marijuana requires up to 90-minutes to take effect and it is easy to overdose.
  • Doesn’t “need” marijuana to cope, relax, or sleep.
  • Moderate users use marijuana mostly to have a mild effect, not generally “to get stoned” and certainly not “wake and bake”.
 

 

 

Opiates

What are opiates?

Opiates are a class of central nervous system depressants that have an effect of relieving pain and causing sedation.  Opiates include illicit drugs like heroin and opium as well as prescription medication like hydrocodone (Vicodin), oxycodone (Percocet), Tylenol III w/ codeine, Vicodin, Opana, Dilaudid, and many others.

Fentanyl – is a synthetic opioid drug approved by the Food and Drug Administration for use as an analgesic (pain relief) and anesthetic.

Carfentanil (potency approximately 10,000 times that of morphine and 100 times fentanyl).

Why are so many people dying of opiate overdose?

Taking too much of any opiate can cause overdose and death. However, tolerance developed over time can create difficulties in determining how much is too much. Further problems include fentanyl laced heroin, using after a period of abstinence and/or using opioids with alcohol, benzodiazepines or other sedatives.

What are methadone and suboxone?

Studies show that people with opioid use disorder who follow detoxification with complete abstinence are very likely to relapse or return to using the drug. While relapse is a normal step on the path to recovery, it can also be life threatening, raising the risk for a fatal overdose. Thus, an important way to support recovery from heroin or prescription opioid use disorder is to maintain abstinence from those drugs. Someone in recovery can also use medications that reduce the negative effects of withdrawal and cravings without producing the euphoria that the original drug of abuse caused.

Methadone and Suboxone (Buprenorphine and Naloxone) work to eliminate withdrawal symptoms and relieves drug cravings.

What can I do to prevent opioid overdose?

          Save 1 Life: Carry Narcan

          Dispose of unused medications

          Lock up medications

Harm Reduction

What is Harm Reduction?

            Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.

 

What are examples of Harm Reduction approaches?

  • Condoms
  • Designated drivers
  • Don’t Use Alone Hotline
  • Drug checking – Fentanyl test strips, Xylazine test strips
  • Gastric bypass
  • Gun “Buy Back”
  • Methadone/Suboxone
  • Needle exchange and syringe cleaning kits
  • Nicotine gum/patches
  • PrEP – Pre-Exposure Prophylaxis
  • Safe injection sites
  • Seat belts
  • Sex Education
  • Vaping instead of cigarette smoking