Today we’re delighted to have a guest blog post by Constance Ray, the founder of Recovery Well, on getting back on track after substance abuse relapse.

Contance Ray started Recoverywell.org with the goal of creating a safe place for people to share how addiction has affected them, whether they are combating it themselves or watching someone they care about work to overcome it. The goal is to share stories of hope from survivors who know that the fight against addiction is one worth having, because no matter how it affects you, life can get better.

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Many people understand the battle against substance abuse; for millions of people, drugs and alcohol play a big role in relieving stress, anxiety, and the symptoms of depression, but unfortunately, substances only contribute to the problem–or exacerbate it. Because using drugs or alcohol to cope only numbs the issue and doesn’t get rid of it, many individuals find that after making the decision to live a sober lifestyle, they are unable to deal with their feelings in a healthy way, which leads to a relapse. This can in turn lead to guilt, shame, and even thoughts of suicide.

That’s why it’s so important to learn how to cope with stress, anxiety, and depression in ways that will make you feel strong and empowered. Having the support of your friends and/or family will go a long way, as will working to get your body healthy. This will allow you to see that even after a relapse, you have the power to turn things around for good.

Keep reading for some great tips on how to get healthy after suffering a relapse.

Seek professional help

One of the biggest keys to living a sober life is realizing that you can’t get there on your own. It’s imperative that you seek professional help so that you can address any physical or mental health issues that may be underlying. Starting at the root of the problem will help you find success much more easily when it comes to staying sober.

Forgive yourself

True recovery is impossible without the ability to forgive yourself for past mistakes. Understanding that all humans have inner struggles–and deal with them in different ways–will help you come to a place where you can love yourself, and therefore heal. Consider practicing yoga and/or meditation, which will incorporate mindfulness into your day. Learning to focus your mental energies on positive things rather than worry or stress will help immensely when it comes to your recovery.

Come up with a plan

It’s important to have a plan in place when it comes to your sobriety. Creating a step-by-step plan–as well as a routine to get there–will help you stay on track and find daily motivation for sobriety. For instance, you might set some small goals, such as working out every day or eating healthfully, and create a routine to make that happen. Having a plan in place will allow you to feel in control, which is important to many individuals in recovery.

Take up a hobby

Having a hobby can be hugely beneficial to those in recovery. Not only is it good for your mental health, it can help you get active, stay social, and will provide structure to your day. For many people who have battled substance abuse, the ability to know what comes next is important. Think about your interests and look online for activities that you’ll enjoy. Gardening, playing a sport, making art, and rock climbing are all great ideas. For more on how staying active can help your recovery, click here.

Stay connected

It’s common for individuals in recovery to have trouble staying social, especially after suffering a relapse. There may be feelings of guilt or shame involved, or you may be worried that your friends and loved ones are judging you. But having a connection with other people can be a big help for your sobriety, and it will give you a circle of support when things get tough. Make an effort to stay connected to your loved ones, even if it’s only through text messages.

Story update:  The Canadian government’s alcohol  and  cancer warning label experiment has been halted due to pressure from the alcohol industry who threatened legal action for defamation and trademark infringement.

Many drinkers are unaware that alcohol causes a number of cancers including breast and bowel cancer. In order to raise awareness of this the Yukon government, in collaboration with researchers, has introduced labels on alcoholic drinks warning that alcohol causes cancer. The labels also provide recommendations on safe alcohol consumption for men and women as well as advising that people should plan to have two or more non-drinking days a week.

This new initiative was a challenge to implement as Yukon is a small jurisdiction and couldn’t influence drinks manufacturers to change their labelling. Therefore the Yukon Liquor Corporation and Public Health Ontario researcher, Erin Hobin, affixed the labels to thousands of bottles themselves.

These labels are a world’s first. No other country warns drinkers, through labelling on drinks, that alcohol causes breast or bowel cancer; South Korea highlights the link between alcohol and liver cancer and the US only warns of the dangers of drunk driving and risks of drinking while pregnant.

Researcher Erin Hobbs explained the reasoning behind the labelling:

“Alcohol is such a big part of our culture in Canada. We’re inundated with alcohol marketing that shows us how much fun alcohol is. It’s part of most of our celebrations … (But) consumers have a right to know the health risks if they do choose to drink alcohol. If they do choose to drink, they can do so in a safer manner.”

Alcohol is not just linked to breast and bowel cancer, but has also been linked to cancers of the mouth, upper throat, food pipe, voice box and liver.  The number one cancer impacted by alcohol is breast cancer.

The International Agency for Research on Cancer  has classified alcohol as a type 1 carcinogen, which means there is the highest level of evidence to suggest that it does cause cancer.

It is hoped that governments will follow Yukon’s example as awareness of the link between alcohol and cancer is very low and people need to have this information so they can make an informed decision about their drinking habits, and hopefully protect their health.

Friday 17^th November was the second annual Caribbean Alcohol Reduction Day. This year’s theme was: Drink Less, Reduce Cancer and to mark the day the Healthy Caribbean Coalition, in collaboration with PAHO, CARPHA and CARICOM, hosted a webinar on Alcohol and Cancer in the Caribbean.  This was a very informative and interesting webinar which featured three speakers:

• Dr Kevin Shield – Alcohol Consumption and Cancer in the Caribbean
• Dr Maristela Monteiro – Alcohol Policies in the Caribbean
• Dr Rohan Maharaj – Alcohol use among the elderly in the Eastern Caribbean: Associations with NCDs and psycho-social issues

Alcohol Consumption and Cancer in the Caribbean

The first presentation was delivered by Dr Kevin Shield. He started by providing some background into cancer in the Caribbean explaining that the latest data, from 2012, shows that in the Caribbean about 21,000 new cancer cases are diagnosed every year and just over 13,000 deaths per year in the region are due to cancer.  When we look at the number of cancers in the Caribbean caused by alcohol, it is estimated to be 650 cancer cases per year or put another way 3.1% of all cancers diagnosed in the Caribbean are due to alcohol consumption. Looking at the number of cancer deaths in the Caribbean due to alcohol, 2.9% of all cancer deaths are due to alcohol consumption or 387 deaths per year.

Dr Shield  stated that in the Caribbean, on average, an adult consumes 1.2 alcoholic drinks per day, but there is a difference amongst countries with some countries drinking less and other drinking significantly more.

Dr Shield explained the  link between cancer and drinking stating that numerous studies have been conducted that have determined how drinking causes cancer. Data suggests that alcohol causes cancer in the following ways:

• By our bodies converting alcohol into a cancer-causing chemical (i.e. a chemical that can damage our DNA)
• By affecting our hormone levels and various pathways in the body

Through research links have been found between alcohol and cancers of the mouth, upper throat, food pipe, voice box, breast, bowel and liver.  The number one cancer impacted by alcohol is breast cancer.

Based on all of these factors the  International Agency for Research on Cancer  has classified alcohol as a type 1 carcinogen, which means there is the highest level of evidence to suggest that it does cause cancer. So drinking is a major problem.

The question then is: how can we prevent the cancers that are caused by alcohol? The solution is to reduce alcohol consumption and Dr Shield stated that there are three cost effective and feasible approaches that can be taken:

• Restrictions on access
• Banning advertising
• Increasing excise taxes

This presentation ended on a fairly positive note highlighting that many Caribbean countries have not fully introduced these three measures which means that there is potential to make a huge difference in tackling alcohol and cancer in the Caribbean.

Alcohol Policies in the Caribbean

We then heard from Dr Maristela Monteiro who gave an overview of alcohol policies in the Caribbean. She started by explaining that as part of the voluntary global non-communicable diseases target for 2025 there is a goal to reduce harmful use of alcohol by 10%.  WHO and PAHO, in consultation with a number of organisations, developed a global strategy to reduce harmful use of alcohol and they provided recommendations on 10 policy areas and countries are to try to implement as many as possible. They describe particular recommendations as “best buys” especially for low to middle income countries and these were the three areas mentioned by the previous speaker (restrict access to alcohol, enforce bans on advertising and raise taxes on alcohol).

Dr Monterio then went through each of these three policy areas giving an assessment of how successful Caribbean countries have been with their implementation. She started first with whether countries have a national alcohol policy in place.  Out of the 14 Caribbean countries that they looked at only three had some form of national policy.

Dr Monterio then looked at policies to restrict access to alcohol:

• Licensing: most Caribbean countries have a licensing system, 12 out of the 14 countries. Licensing systems restrict access by imposing rules and penalties to those who wish to sell alcohol such as not selling to minors, the license also has a fee and this may limit the number of businesses who choose to sell alcohol.
• Restrictions on hours, locations and days of sale of alcohol: only three Caribbean countries were fully compliant in this area.
• Minimum drinking age: most Caribbean countries have a minimum drinking age, only three don’t.  The majority of countries in the Caribbean with a minimum drinking age have set this at 18, some have set this at 16.  It was felt that 18 was a relatively low age restriction and this could be increased to 21 to have more of an impact.

Dr Monteiro then discussed taxation. She stated that in the Caribbean most countries have some taxation of alcohol, but these taxes were introduced many years ago and have not been adjusted for inflation. This means that taxation is not having the impact that it should as taxes are fairly low and are not acting as a deterrent.

Finally Dr Monteiro discussed restrictions on advertising and explained that this was the least developed area of policy in the Caribbean.  She explained that this is a major problem as 20% of students are exposed to alcohol advertising daily and research has shown that this is associated with an increase in alcohol consumption. She explained how persuasive these advertising campaigns are and some of the tactics used to encourage people to drink –  companies focus on alcohol as an antioxidant, that consuming alcohol causes weight loss and improves your mood (this communicates the message that alcohol is healthy)  and equating drinking alcohol to business success.

Action needs to be taken to address advertising as research as shown that youths are more exposed to advertising than adults so there is a concerted effort by the alcohol industry to reach young people and make them life-long drinkers.

Alcohol Use and the Elderly

Finally we heard from Dr Rohan Maharaj who summarised a very interesting piece of research carried out across four Caribbean countries on alcohol use and the elderly.  The research consisted of participants from Puerto Rico, Barbados, the US Virgin Islands and Trinidad. The data was collected from April 2013 to May 2015 and they determined whether people were ever-drinkers, current drinkers, problem drinkers or heavy drinkers and related this to various psycho-social and health issues.  Their main conclusions were:

• Generally there was wide use of alcohol across all participants
• 5-6% of participants were involved in potentially harmful alcohol use
• Males were more likely to be problem or heavy drinkers
• There was an association between alcohol use and stage 1 hypertension
• There was an association between alcohol use in ever-drinkers and cancer
• A higher proportion of those with lower educational achievement admitted to alcohol use
• Those who were employed were more likely to be drinkers (thought to be because they had more disposable income)
• Those who reported earlier initiation of sexual activity reported heavy drinking
• Those who had issues with domestic violence (current or past) had reports of problem drinking
• Heavy and problem drinkers tended to be lower educated males, living in Trinidad, married, physically active and employed with high rates of hypertension and being diabetic.

Dr Maharaj and his team will be doing a follow up study with participants in the next 2 to 3 years and this will give them the opportunity to further explore the link between alcohol use, cancer and other non-communicable diseases.

Conclusion

This was a very informative webinar  and it’s so important that we get some of this information out to the public as we know that many people are not aware of the link between cancer and alcohol consumption.

For more information you can listen to a recording of the webinar here