Addiction and Self-Harm

Addiction and Self-Harm

The UK has the highest self-harm rate of any country in Europe, according to the Mental Health Foundation. An estimated 400 in every 100,000 adults is said to be struggling with self-injury disorder or compulsion. The Mental Health Foundation estimates that a third of “self-harmers” have drug and alcohol issues.

One of our experts explains, “self harm and addiction is a dangerous combination. Many addicts and alcoholics struggle with depression and low self-esteem. Self-harming behaviours further reinforce feelings of shame and self-loathing. Many addicts who self-harm are at a loss to explain why they do it – causing them to fall into a deeper spiral of hopelessness.”


What is Self-Harm?

Self-harm is an intentionally injurious act with a vague feeling of “wanting to punish” oneself. Common behaviours include:

  • Cutting or burning the skin – often with knives, razor blades and cigarettes or lighters
  • Punching or hitting oneself, banging ones head against a wall
  • Poisoning oneself with medications, toxic chemicals or household cleaning agents
  • Misusing alcohol and drugs
  • Starving and bingeing – whether episodically or as part of anorexia/bulimia

Most people struggling with self-harm will be secretive about their behaviour. The combination of shame and fear of being discovered means that many sufferers hide their injuries and are often reluctant to discuss their difficulties. Some might admit that they have self-harmed “once or twice” but, just as with conversations about drug or alcohol use, the sufferer will minimise the problem.


What Causes Self-Harm?

The reasons why someone self-harms are varied and complicated. It is generally thought that self-harm, like addiction, is a way of coping with overwhelming feelings. Sufferers typically come from families where feelings are not expressed or talked about.  It is also thought that most self-harmers will have an underlying depression and occasionally, a personality disorder, such as borderline personality disorder.

External factors which are thought to contribute to self-harming, include:

  • Problems at school or work, such as being bullied, or feeling overwhelmed with work or study.
  • Difficult relationships with friends and family, or the break-up of an intimate relationship
  • Trauma – especially physical or sexual abuse, being attacked or suffering a bereavement
  • Struggling with sexual or gender identity or cultural expectations, such as an arranged marriage or conforming to a hetero-normalcy

There are many other factors but what we do know is that self-harm is extremely dangerous. If an individual is using drugs and alcohol, the risk of serious or lethal injury greatly increases and the condition develops into dual diagnosis.


What to do if a friend or family member struggles with self-harm and addiction?

It can be extremely difficult to talk to a loved one who is self-harming and using drugs and alcohol. It is important to approach the sufferer with gentleness and compassion, even if their behaviour makes us angry or afraid. Family members might want to talk to a GP or experienced mental health professional first.

Sometimes the best intervention is simply to express worry and offer support and help. Help might take the form of simply listening, but it could be the offer to help the sufferer find a form of treatment.

If there is a drug and alcohol problem or an eating disorder alongside self-harming, it is vital to seek specialist treatment. The sufferer may need inpatient treatment to withdraw from alcohol or drugs and stabilise any eating disorders. Often an experienced psychotherapist or counsellor can offer the right sort of support on an outpatient basis, to enable a physical recovery.

It might be necessary for a GP or psychiatrist to prescribe a course of antidepressants or mood-stabilising medication, if there is a history of depression or mood disorder.

Whatever the immediate treatment, it is important that sufferers address the underlying reasons for their behaviour(s). Support groups such as 12-step recovery groups can help anyone struggling to maintain sobriety or abstinence. There are a number of self-help groups specifically for people struggling with self-harming behaviours.  GPs and mental health professionals should be able to signpost anyone to groups.

However, most people with a history of self harm and addiction need a more in-depth form of treatment such as psychotherapy and counselling.  Psychotherapy helps sufferers look at the issues underlying the self-harming and addictive behaviours.  An experienced addictions and self-harm expert will also support the sufferer with strategies to better manage difficult feelings and to avoid acting out.


Recovering from Addiction and Self-Harm

Recovering from self-harming behaviours, and recovery from addiction, can be a long process.  Physical recovery must come first, with a sufferer maintaining his or her abstinence from alcohol and drugs, as well as being able to tolerate periods of stress and anxiety without resorting to self-harm.

Psychotherapy and counselling will help sufferers identify their “triggers” – situations or emotional states where someone would act out and harm themselves.  This can be a complicated process, as there may be stressors in everyday life, but often there is a cluster of unresolved feelings and traumas from the past, which exacerbate the urge to self-harm.  An experienced therapist will help identify and better understand feelings and situations which trigger the urge to self-harm.

Psychotherapy can help sufferers find better ways of managing strong and distressing feelings.  Often the process of talking in the therapeutic environment helps process and contain difficult feeling states.  Some therapist offer specialist techniques, such as “DBT” or Dialectic Behavioural Therapy.  DBT was devised in the 1980s and is designed to help people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states.  Sometimes, sufferers will be encouraged to practice a Mindfulness technique or Yoga – all of which have proven benefits for emotional regulation.

There is no one cure or simple pathway to recovery for these complicated conditions.  However, it is important to find specialist help and Help 4 Addiction has a wealth of resources to guide you in the right direction.

Nick Conn / 7th December 2018/ Posted in: Expert Talk

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    Detoxification (detox) is the medical intervention required for someone who is physically dependent to drugs or alcohol. If required, medical detoxification would be the first step taken in residential rehab. Detox is used to prevent uncomfortable and dangerous (even fatal) withdrawals symptoms resulting in suddenly becoming abstinent from alcohol/certain drugs.

    The goal of a medical detox is to aid in the physical healing required following long term addiction and rid the body of all together of substance whilst providing a cushion for unpleasant symptoms of withdrawals. Detox is not considered the whole treatment for drug/alcohol addiction and it is always recommended that a comprehensive rehabilitation program is used along side to help maintain long term abstinence.

    Medication is often required for alcohol detox. If you are dependent on alcohol and experiencing withdrawal symptoms it is vitally important to seek medical advice prior to stopping. There is a long list of medications used when treating alcohol addiction and the exact medication given to an individual will depend on their needs/medical history. Some of these include;

    • Chlordiazepoxide (Librium)
    • Lorazepam (Ativan)
    • Diazapam (vailium)

    Librium and Valium are the most commonly used detox medication in the UK. All medication used to help with alcohol detox have been proven to help reduce the effects of withdrawal symptoms.

    There are also a number of drugs recombined by the NHS to help treat alcohol misuse. Some of these include:

    • Naltrexone
    • Disulfiram (Antabuse)
    • Nalmefene
    • Acamprosate (campral)

    Medication is always required for heroin detox. For someone suffering from heroin addiction, the thought of detoxification (detox) can be exceptionally daunting. Withdrawal symptoms from opiates, such as heroin, can be severe and include pain, vomiting, nausea and shaking.

    There are different ways that heroin detox can be carried out, most usually either ‘maintenance therapy’ or ‘full medical detox’.

    Attempting to switch from heroin to a heroin substitute, usually on a controlled prescription, is known as Maintenance therapy. Subsites used are most often methadone or buprenorphine.

    A full medical detox from heroin will always be carried out in a residential rehab setting and will allow the individual to switch form heroin to a substitute and slowly withdraw completing treatment free of all substances. Someone using a heroin substitute can choose to have a full medical detox at any time, however detoxing substances such a methadone can often add to the length of detox required. Drugs most commonly used to fully detox from heroin are, Subutex, Suboxone and Methadone. Much like alcohol, the exact drugs used will be dependent on the individuals needs/medical history.

    Once detoxed from heroin the risk of overdose is much higher following relapse due to tolerance following withdrawal.

    The length of treatment in a residential rehab depends on a number of elements. Some substances require longer periods of detox than others.

    Private paying patients will also often choose a length of stay that suites their therapeutic and financial needs. As a rule, a full treatment program in a rehab is considered to be 28 days (often referred to as a month), however, treatment is offered in several different ways and lengths starting at 7 days.

    Treating alcohol addiction will always require a minimum of 7-10 days, this would be considered the detoxification (detox) faze. The length required for treating drug addiction can vary drastically depending on the substance being used. Detox for Heroin addiction is generally around 14 days minimum, with more time required if substances such a methadone are being used. Treating prescription drug addiction can often take the longest. The time required for treating gambling addiction, eating disorders and sex addiction will be based on the individuals needs.

    Rehab programs can be as long as an individual requires but primary treatment is normally caped at 12 weeks, with the offering for further secondary and tertiary treatment thereafter.

    *based on average rehab stays, everyone will vary dependant on needs and medical requirement/history.

    There is no need for your employer to know that you are seeking help for trauma and addiction unless you choose to involve them with the process. All employers should have a policy that explains what you do if you cannot come to work due to illness – illness to include treating alcohol addiction/treating drug addiction.

    If your work absence extends over 7 days your employer is likely to require an official statement of fitness to work which would be obtained from your GP. This would need to supply evidence of your illness as well as any adjustments required for returning to work, fazed return or reduced hours, but does not need to specify in detail the reason why you have been absent.

    If you are absent from work for 7 days of less, for example entering rehab for a detoxification (detox) on a Saturday for 7-10 days taking a full week away from work, you can self-certify your illness by letting your employer work you will not be attending work for that period of time. Exactly how an individual would do this would be dependent on a specific companies’ policies on taking sick leave.

    Any time longer than 7 days it is likely an employer will require a note from the individuals GP certifying their sickness and a fit note on return. Most companies have a clearly outlined policy on sickness and receiving sick pay so the exact requirement can vary. A rehab will always be willing to advise on time off work.

    How much does rehab cost is a very frequently asked question. The cost of treatment can range from £1,000 per week upwards depending on the place, with luxury rehab being the most expensive.

    There are free options available on the NHS but the waitlist of those looking for free treatment is longer than that for privately paying patients. Some private health insurance policies will cover treatment in some rehabs around the country.

    Choosing the right rehab centre will often be based on priced but it is important to follow guidance on the most suitable treatment centre for an individual’s needs which our expert team of advisers are on hand to offer.

    There are certainly pro’s for both treatment near by and traveling for treatment with one of the most asked question being should I get rehab near me? There are rehabs all over the UK and around the world that all offer expert programs, let’s look at how to choose a rehab.

    Local treatment

    Being close to home gives certainly has benefits. Visitors are normally permitted in rehab following the first 7 days stay, therefore if an individual is in treatment for a length of time longer than that being local will make it easier for loved ones to visit.

    Most rehab centres will also provide a full aftercare plan for someone following treatment, this will include ongoing aftercare in the specific treatment centre. Living close by can make it easy to take full advantage of ongoing aftercare. There can also often be the option for ongoing care with an individual therapist, again being close by will allow that treatment to be carried out face to face.

    Some individuals wish to be local but are willing to look broader, for instance the greater city of residence (London, Manchester, Liverpool, etc)

    Treatment Away

    Getting treatment away from home can be very appealing to some. Being out of the local area makes it a lot harder to just walk out of treatment as resources locally are unknown. Some also take comfort in knowing that they are not near home and focus more on treatment.

    As the price for treatment can vary so much from one residential treatment centre to another, private paying patients often would rather travel to keep the cost down. Those using private health insurance may also have to travel to find a treatment centre covered in their policy.

    When opting for treatment away from home this can be anywhere in the UK and also abroad. Aftercare can still be carried out and very successful using tools such as The Online Rehab.

    There is no right or wrong when choosing where to go to residential rehab, but our expert advisors are always on hand to help provide information on all possible options.

    Whilst millions of people in the UK have taken recreational drugs (amphetamine, cannabis, cocaine, crack, crystal meth, GHB, heron, ketamine, methadone, and prescription drugs) and drank alcohol not all become ‘addicted’. Most recent reports show that 279,793 individuals were in contact with drug and alcohol misuse services in the last year with over half of that being from opiate addiction and a quarter for alcohol.

    There are several risk factors invoiced in addiction and those using drugs and alcohol socially, simply take the risk. These risks are as follows;

    Tolerance – basically, if a substance is used repeatedly an individual’s tolerance to it will build. This will result in more of the same substance being required to get the same effect. In the long run this can easily lead to addiction and physical dependencies.

    Environmental risks – these can include influences such a peer pressure and stress as well as physical or mental abuse of an individual (particularly as a child). Overall, those who live with frequent pressures and stress are more likely to reach for a substance to cope and are therefore at higher risk of becoming addicted.

    Drug type – it is very well known that certain drugs are simply more addictive than others. Using substances such as heroin increases the risk of becoming addicted for need to ‘chase’ a high as well as physical dependency.

    Drug administration – how a drug is administered can affect its addictive qualities. A drug injected rather than smoked or snorted will release a quicker and more intense high thus making it psychologically (and in many cases physically) more addictive.

    Biological factors – it is now widely reported that being an addict is not only psychological but also biological. This includes your genetic makeup, mental health, sex and age. It is also reported to be 8 times more likely for the child of an addict to become an addict themselves.

    Its believed that addiction is approximately half genetics and therefore some are 50% more likely to become addicted than others.

    How do you help a loved one trapped in addiction?

    The first step is to help and encourage the individual to become willing to accept help. They do not need to be shouting this off the rooftops, but they do need to be willing to go into treatment. There are ways to help someone become willing to get treatment for alcohol or treatment for drugs.

    Set boundaries – set boundaries and stick to them. Once you have laid them out follow through with whatever consequences you have set however hard it is.

    Stop finances – if you are financially supporting someone stopping these finances can be the quickest way for the addict needing to ask for help. With no money to acquire a substance an addict’s options become very limited.

    Intervention – getting together with other family members/friends/colleagues and staging an intervention is often very successful in the fist stage of acceptance and gaining an admission to residential rehab.

    You can’t make them quit, this can lead to dangerous withdrawal. Boundaries are very important in helping someone become willing to get help. Unfortunately you cannot do someone’s recovery for them and without self-motivation it is very hard to make it work.

    The next step is to call our highly trained advisers 0203 955 7700.

    There is a huge range of rehab options available and where to start can be completely over whelming so let us help.