“Legal drugs” and the risks to recovery

Even though a substance is legal, it can still have some of the addictive qualities that illegal drugs are notorious for. If a person is in recovery they may be tempted to try supplements or stimulants that have less of the harmful attributes but still provide some euphoric effects. These products may be readily available for the general public, but can also promote new addictive behaviors.

From Kratom to kombucha, here are some of the most popular ‘legal drugs’ of 2021 and their potential risks to people in recovery:

Kratom

Often touted as a “wonder herb,” Kratom comes from a tree in Southeast Asia known as the Mitragyna speciosa. This plant is used as a stimulant and a natural painkiller in both medicinal and recreational purposes. Kratom can be ingested in pill, capsule or extract form. People also directly chew the leaves, smoke, or brew powered leaves as a tea.

In the dietary supplement world, there are many conflicting reports about the nature of Kratom. It may lessen pain temporarily, but the intensity of Kratom gives way to a gray area as far as health, safety, and addictive qualities

Legally speaking, there are many dietary supplements that are overlooked by the FDA, but that doesn’t mean the government isn’t aware of Kratom. Currently, the DEA seeks to classify Kratom as a Schedule 1 controlled substance. This should give you a clue as its dangerousness. Schedule 1 controlled substances include heroin, cocaine and PCP. Six US states have banned sales of Kratom, and there are reports of Kratom being linked to several deaths.

As of 2021, Kratom is still sold legally in most of the US and online. Many forms of Kratom will have “Not for Human Consumption” warning labels across the packaging, which should be warning enough. With the dangerous and addictive qualities, it is highly discouraged to take Kratom as it can be dangerous and is highly likely to negatively impact people in recovery. 

Kombucha

Kombucha is marketed as a healthy, lightly fermented drink that helps with inflammation and digestion issues. Kombucha has 0.5% alcohol in it, which is the highest amount that can be in a beverage before it must be sold as alcohol. Due to the fermentation however, it is not foolproof. There have been a few accounts of famous kombucha brands that have gone way over the legal limit while being sold at grocery stores.

That being said, it is virtually impossible to get drunk off of kombucha and there is no research that suggests that you can be physically addicted. There is, however, a large amount of natural sugar and caffeine, so many report getting more of a “sugar buzz” versus an alcoholic one, and some may experience other mild side effects.

If you drink kombucha as a sober person, it’s important to not treat this beverage as a replacement for alcohol. There are reports of people who start to “crave” kombucha after drinking it regularly, and this can be a dangerous path for someone who has a history of addiction. If consuming kombucha, which can have a slight alcohol taste, creates any cravings or otherwise causes problems for a person in recovery, it should be avoided.

CBD

Cannabidiol or CBD, has emerged as one of the most popular alternative anxiety and pain relief supplements today. A product of the same Cannabis plant that is commonly used for “getting high,” CBD is now being sold beyond pot dispensaries and is considered by some to be a legitimate treatment for pain management, depression relief or even epilepsy. Though it’s technically providing users a much milder counterpart to THC (the psychoactive compound in the hemp plant) CBD has yet to be fully regulated by the FDA. There are a wide variety of products on the market that do not give accurate dosages or quality of CBD you’re looking for. There are even cases of CBD oil actually having THC present in it.

As far as its risks to average people, to date, there are also no proven physical addictive qualities. According to the World Health Organization, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD.”

So, while there is no official evidence to suggest that CBD will have an impact on recovery, any mood or mind altering substance can be risky for a person in recovery. Studies are being conducted as to whether CBD is safe for use and it is advised you consult with a medical professional about how or if CBD products would be beneficial to you before use.

Salvia

This native plant from Mexico is originally used in spiritual practices but now is used recreationally for hallucinogenic effects similar to LSD. Saliva is currently a Schedule 1 controlled substance and is banned in 29 states around the U.S. This means it may or may not be legal depending on which state you live in.

Used in liquid or plant form, it can give users a short-lived high that lasts 30 minutes to over two hours, depending on how it’s ingested. There are no accounts of where Salvia is fatally addictive, however too much usage shows that you can build a tolerance and require more and more of a dosage as time goes on. This shows a chemical use disorder and dependency. There are also many accounts of symptoms like irritability and anxiety when users stop using salvia.

Due to the hallucinogenic properties, salvia is not recommended for anyone seeking to maintain sobriety. 

Caffeine

Perhaps the least dangerous but most widely available is caffeine. Caffeine gives you energy, and while that is true, caffeine can also make you dependent on it. Caffeine use is not classified as a true addiction, yet it is considered a stimulant. 

What’s the difference? Caffeine produces a small rise in dopamine but not large enough that it unbalances the reward circuit in the brain that classifies it as a true addiction. Though we may see people say they are “addicted” to coffee, it is not scientifically accurate. With addictions, there’s an element of compulsive behavior that involves the user believing that they will not engage in destructive behavior without it. 

This means, generally, caffeine is okay to have in moderate amounts for most people, even folks in recovery. 

Nicotine

Likely one of the most popular “legal drugs,” nicotine is a powerfully addictive substance. In many smokers lifetimes, there have been multiple attempts at quitting smoking. According to a 2015 survey put on by the FDA, 55% of adult smokers had attempted to quit in the past year, but only 7% were successful in quitting for 6-12 months.

There are medications that help as a nicotine replacement therapy, but the surge of endorphins in the reward circuit of the brain gives instant elation and it spurs the repeated cycle of nicotine use. Over time, studies show that repeated exposure can permanently alter the brain circuits and trigger self-control issues. 

However, withdrawal symptoms are not as severe compared to other illegal substances. Nicotine users experience mild to moderate cravings, depression, mood swings, and issues with sleep and appetite. Unlike other “legal drugs” smoking may not have any immediate dangers, but it contributes to a wide variety of health issues when sustained over time. 

For a person in recovery, while smoking is certainly not a “healthy choice.” it isn’t likely to have a negative impact on sobriety.


We hope this brief exploration of the “legal drugs” out there today was useful as you or a loved one considers what is best for maintaining sobriety. Please be sure to consider talking to a doctor or mental health professional as you decide what supplements and substances are safe and helpful for you.

Green Hill’s Transitional Living and Community Outpatient programs offer a hands-on community of support, ready to help with the recovery process. With a knowledgeable clinical staff that specializes in young men’s recovery and other mental health issues, our team is dedicated to working through any questions and concerns you or your family may have, and to be a long-term support system for those who need it.

Want to learn more about recovery options in Raleigh or elsewhere in North Carolina? Give us a call at (984) 204-1106 and we’ll help you find the right resources.

How toxic masculinity is linked to excessive drinking

Easily misinterpreted, we see the term “toxic masculinity” being thrown around the news cycle as a way to address cultural issues facing men today. At first glance, toxic masculinity isn’t clearly defined. The boundary between common social interactions and negative misconduct is often blurred. However, toxic masculinity is connected to aggression, violence, and sexual prowess, describing a deeply rooted ideal of how a man “should” be. 

Understanding the signs of toxic behavior early on can provide great insight into breaking apart this dangerous brand of masculinity. 

Excessive Drinking

Toxic masculinity extends beyond obvious aggressive behavior seen in the headlines. There are direct correlations between toxic masculinity, addiction, and dangerous behaviors involving substances like alcohol. Excessive drinking happens especially with college-aged men due to the societal pressures put on them. With drinking challenges and pressures to perform in crowds of their peers, it can quickly lead to normalizing binge drinking during their college experience and well into adulthood.

In a survey conducted in the research article “Man-ing” up and Getting Drunk: The Role of Masculine Norms, Alcohol Intoxication and Alcohol-Related Problems among College Men,” 68% of male college students equated consuming dangerous amounts of alcohol without an adverse physical reaction as part of “masculine” behavior.

Excessive or binge drinking paired with competitive environments creates the perfect storm for unsafe interactions. This includes risky sexual behavior, aggression, alcohol-related injuries or even death. 

Suppressing Emotions and Masculine Norms

Disordered drinking connects to another aspect of toxic masculinity: suppressing emotions. Suppressing emotions, forming a ‘hard’ appearance, or extreme self-reliance is often associated with stereotypical masculinity. For many, not being able to be vulnerable or asking for help leads to drinking as a coping mechanism to avoid or numb emotions. 

The “Man-ing Up” study continues with a list of other masculine norms,

  • Striving to win at all costs (winning)
  • Sexual prowess / Hypersexuality (being a playboy)
  • Controlling one’s emotions (emotional control)
  • Engaging in risk-taking behaviors (‘YOLO’ / risk-taking)
  • Inclination towards physical aggression (violence)
  • Asserting influence over situations (dominance)
  • Proclivity towards independence (self-reliance)

All of these defined and idealized traits can be magnified and abused with alcohol. 

Healthy Masculinity vs. Toxic Masculinity 

Untangling the overt nature of toxic masculinity ultimately means being vulnerable. For many stuck in the toxic masculinity cycle, the idea of asking for help seems unheard of. Usually toxic behavior is only addressed when there are academic challenges, dropping out of school all together, health scares from binge drinking, or destroyed relationships. 

When going through the beginning stages of recovery, opening up about the emotional toll that toxic masculinity has taken can be seen as weak. Discussing not only the triggers of drinking, but the underlying emotions surrounding it can be a real challenge. The first step to creating healthy masculinity is to start the conversation.

Here are some behaviors shown in healthy masculinity:

  • Being able to ask for help
  • Expressing a wide range of emotions beyond anger, especially sadness, fear, or tenderness
  • Creating healthy relationships through communication, support, and consent 
  • Being able to express self in nurturing or traditionally “feminine” roles
  • Calling out behavior in other men that are seen as toxic in their communities

Green Hill Recovery believes in building a strong emotional vocabulary. Substances are often used to avoid feelings all together, so communicating specific feelings is essential for growth. Recovery will break through the anger, the first emotion associated with toxic masculinity. 

Then comes the hard part: asking for direct help. Asking for help challenges the toxic belief of self sufficiency with direct community support. Having immersive sessions with a therapist or group therapy will put toxic hypersexuality in perspective by modeling open communication with partners, giving and receiving consent, and redefining healthy intimate relationships. 

At Green Hill, we use the resource 7 Pillars of Masculinity Exercise when working with clients to help facilitate discussions around what toxic masculinity looks like, and help explore alternative healthy concepts. 

One aspect that is very common for us to see in our clients is guys exploring the stereotypes of hypersexuality. We also explore how sex may in fact be another addiction, or at least is a substitute for substances, in early recovery. Tied to this, we sometimes see “flexing”, a form of bragging, in group interactions where some guys try to show off amongst peers.

In our programs, we have really pushed for modeling respectful and non-degrading communication about sex and partners as a key focus. This is because one reason flexing or jokes about sex can come up is because it is an easy way for a group of people who struggle with intimate/vulnerable conversations to deflect away from their real feelings.

What now?

Simply put, there isn’t a quick fix for dealing with toxic masculinity. It involves a in-depth look at actions that have caused harm to oneself and others. It then means getting involved in a community that supports healthy masculinity, vulnerability, and a deep committed willingness to change. While not easy, there is help available for those dealing with the effects of toxic masculinity.

At Green Hill Recovery, our Outpatient program offers a hands-on community of support, ready to work through any lingering issues that are associated with toxic masculinity. With a knowledgeable staff that specializes in young men’s recovery, our team is dedicated to working through understanding the nuances of both toxic and healthy masculinity, triggers associated with addiction, and the challenges that young men in society face today. 

Want to learn more about recovery options in Raleigh or elsewhere in North Carolina? Give us a call at (984) 204-1106 and we’ll help you find the right resources.

Am I Too Young to Be Addicted? – A Look at Adolescent Substance Use Disorder

When you visualize someone suffering from addiction, what kind of person do you imagine? Many people’s image of addiction includes only the rock bottom consequences of the disease. While it’s true that homelessness, poor health, incarceration, and death can be the end result of years of substance abuse, in fact many, if not most, people dealing with addiction never reach those depths. 

The misguided notion that only “low bottom” cases require help often gets in the way of much needed recovery. We hope to dispel some misconceptions out there that may wrongly lead young people in active substance abuse to believe their problems are not “severe enough” to seek help. 

Misconceptions about addiction are especially common in adolescents and young adults who may have only been using drugs and alcohol for a few years. It can be difficult to recognize their use as an issue at this early stage. Hopefully, having a working understanding of addiction will help you recognize if you have an issue before you suffer the most severe consequences of this disease.

Is Addiction the Same as Substance Use Disorder?

There are professionals in the substance use treatment industry who prefer not to use the term “addiction” due to associated negative connotations. They instead prefer to use the clinical term Substance Use Disorder or SUD. We choose, at times, to use the word addiction as this term is what is most commonly used by the general public. We use the two terms interchangeably in this article. 

What is Substance Use Disorder?

The Substance Abuse and Mental Health Services Administration (SAMHSA) define a substance use disorder (SUD) as:

“Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home.”

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-V) outlines eleven symptoms of SUDs:

  1. Having a persistent wish to stop using the substance and/or continuously trying to reduce or control substance use
  2. Continuing to use the substance despite knowing that a physical or psychological health issue was likely caused or worsened by the substance
  3. Using the substance in larger amounts or over a long time period than originally intended
  4. Exhibiting withdrawal symptoms when not using the substance
  5. Spending a significant amount of time trying to obtain the substance, use it, or recover from using it
  6. Stopping or decreasing social, work-related, or recreational activities due to substance use
  7. Building up a tolerance, where a larger amount of the substance is needed to experience an effect
  8. Having a strong urge to use the substance
  9. Continuing to use even when it causes an inability to fulfill work, school, or home-related responsibilities
  10. Continuing to use the substance even when it causes interpersonal problems or makes them worse
  11. Continuing to use the substance even in situations that are risky or physically dangerous

Careful reflection of the above list reveals that a catastrophic collapse in health and social standing are not necessary for a person to have a problem. The more important factors to consider are your personal relationship with drugs and alcohol and the relative decline of your relationships, work, and overall lifestyle. Whether you have only been drinking or using for a few months or many years, you may be suffering from a SUD.

Does Age Have an Impact on Substance Use Disorder?

As we have seen, age is irrelevant as a criteria for diagnosis with a SUD, but what do the numbers say?  

According to SAMHSA, approximately 3.8% of adolescents aged 12-18 have suffered from a substance use disorder in the past year. This may not sound like a whole lot, but across the entire US, this amounts to almost 1 million adolescent sufferers every year.

In North Carolina, there are an estimated 25,000 adolescent substance abusers, and 3.45% of all 12-17 year old North Carolinians need but do not receive treatment. This is a substantial challenge to not only the sufferer, but their family and friends.

If you or a loved one is an adolescent and are concerned that they might be suffering from a SUD, here are some questions to consider:

1. Social Impact: 

  • Have I scaled back my life and changed my behavior to maximize opportunities for drinking and using? 
  • Have I failed to meet my relationship, work, or school obligations? 
  • Am I spending more and more of my time trying to obtain the substance? 
  • Am I hiding my use?

2.  Physical Impact: 

  • Has my tolerance increased? 
  • Do I still have control over the amount I use?
  • Do I experience withdrawals or cravings?

3. Mental Impact:

  • Do I continue to use despite wanting to stop? 
  • Do I continue to use despite knowing that it will have an adverse affect on my health and relationships?

If you or a loved one answered yes to all or some of the above questions, you/they may be suffering from a substance use disorder. So what now?

What Can I Do About Substance Use Disorder?

Being a teen or young person with a substance use disorder can cause you to feel hopeless, alone, and ashamed. It can be hard to see a way to build or rebuild your life and have hope for a happy future, either with or without your drug of choice. Happily though, there is a way out. 

For many this involves clinical treatment in programs specializing in adolescent SUDs, outpatient programs, and participation in recovery fellowships. These steps can help stabilize life, recover physically, and build a social network of other young people on a similar path.

One of the programs out there that specializes in dealing with adolescents is Stonewater Adolescent Recovery Center. We spoke with them recently about how young people who work with them often experience recovery from addiction issues.  

Young people often express that they have been using substances to cope with the discomfort of feelings, that prior to treatment, they couldn’t identify and were overwhelmed by,” notes Heather Thomas, a Clinical Therapist at Stonewater. “After treatment, they feel a sense of empowerment to manage those emotions that they once found overwhelming. The sense of relief that accompanies this powerful change in emotional awareness and management is life-changing.

Another important consideration that Elizabeth Fikes, one of the Founders at Stonewater, made clear is how important it is for families looking at treatment programs for an adolescent to seek out programs that focus not only on the substance use, but dig into why an adolescent began using in the first place.

In our work with emerging adults, we’ve found that young people’s lives do get better over time in recovery, but the journey is almost never linear. Embracing that your journey is unique to you is important, and know that there are people who’ve walked a similar path as you and are ready to guide you along. The most critical thing to remember is that there is help available. 

No matter how young you are, it is never too early to recover. 

Are you or a loved one looking for help with substance use in North Carolina? Give us a call at 984-204-1106 and we’ll gladly help you find the right resources.

Green Hill Throws Support Behind North Carolina’s Largest Addiction Professionals Network

Combatting the substance use disorder epidemic through community partnerships. 

8/10/2020, Raleigh, NC – Green Hill has become Addiction Professionals of North Carolina’s (APNC) newest organizational member. APNC is North Carolina’s leading professional development organization in the substance use disorder prevention, treatment, and recovery field. As a member organization, Green Hill supports APNC’s mission of empowering professionals focused on prevention, harm reduction, treatment, and recovery through providing education, training, and networking opportunities throughout the state. 

Tripp Johnson, CEO of Green Hill, is proud to be joining APNC. “This is a tough, often thankless, line of work. Professionals in the addiction field are often overwhelmed, under resourced, and siloed. We joined APNC because we believe that community partnerships,  training, and education are paramount if we want to combat the growing epidemic of mental health and substance use disorders.”

APNC represents the interests of over 16,000 addiction professionals throughout North Carolina by providing advocacy, training, and networking opportunities. Green Hill believes that in supporting APNC, it can help in the following ways. 

  • Support a thriving community of professionals through education and training. 
  • Advocate for legislative change to support individuals battling addiction. 
  • Encourage innovation and collaboration in the field. 
  • Increase access, quality, and affordability of prevention, treatment, and recovery resources. 

Green Hill and APNC are dedicated to bettering the lives of North Carolinians struggling with substance use disorders. Stay tuned for an announcement about APNC’s upcoming fall conference where Green Hill’s CEO, Tripp Johnson, will be presenting. 

About Green Hill: Green Hill is a nationally recognized treatment provider for young adults grappling with substance use and other co-occurring mental health disorders. Green Hill prepares clients for success beyond their days in treatment through sophisticated addiction, mental health, and executive functioning treatment; intentional community integration, experiential, and wellness offerings; and individualized academic, career, and personal growth curriculum. At its core, Green Hill empowers individuals to live with profound purpose.

About APNC: Addiction Professionals of North Carolina (APNC) empowers our prevention, harm reduction, treatment and recovery professionals to thrive in an evolving continuum of care.

To learn more about APNC, click here.