How to Talk to Someone About Their Substance Use Disorder

Even in the face of its seriousness, suicidal ideation often goes undiscussed because of the stigma that can surround it. But, as we're talking more and more openly about mental health, it's essential that we approach the subject of suicidal thoughts with as much empathy, openness, and support as possible. If you find yourself grappling with these thoughts, or if you're trying to understand and support someone you care about who is, this guide is for you.  Suicide prevention support If you're thinking about acting on suicidal thoughts, reach out for help immediately.  Call 911 if you’re having a mental health emergency. Text HOME to 741-741 if you're emotionally distressed and need immediate support. Call 988 for the National Suicide Prevention Hotline. What is suicidal ideation? Suicidal ideation transcends mere fleeting thoughts about death; it's a whole range of thinking that might start with not wanting to wake up and can go all the way to planning how to end one's life. Often accompanied by a sense of hopelessness, these intrusive thoughts can be potentially dangerous. Despite the severity, feeling this way doesn't have to be permanent. Instead, these thoughts can be a signal that indicates deeper psychological distress and emotional pain that need to be addressed.  The prevalence of intrusive thoughts  While it can feel isolating to experience, this mental health condition affects many. Every year, millions of people report these thoughts to medical professionals. Between 2015 and 2019, the CDC found that an estimated annual average of 10.6 million U.S. adults had thoughts of suicide in the past year, which accounted for about 4.3% of the adult population. Intrusive thoughts don't discriminate — depression can affect individuals of any age, gender, education level, socioeconomic status, or background. Suicidal ideation is part of a broader mental health landscape; it’s not a ‘character flaw.’  What causes suicidal thoughts? The causes of suicidal ideation are as varied as the individuals who experience it. They often stem from life circumstances, mental health disorders, or personal resilience levels. Common underlying conditions can include:  Major depressive disorder Bipolar disorder Post-traumatic stress disorder (PTSD) Social isolation Chronic pain Substance use disorder Understanding the warning signs of suicidal ideation in others For friends and family, recognizing the warning signs for suicide is paramount for timely intervention. The signals can look similar to the signs of depression and anxiety, but are typically more severe. Look for these behaviors: Withdrawal from social circles  Giving away possessions Sudden calmness after a period of depression Statements of feeling hopeless or having no purpose  Remember: Not everyone exhibits clear ‘red flags,’ and a person at risk might go to great lengths to hide their pain. How is suicidal ideation diagnosed? Identifying suicidal ideation typically occurs during a supportive conversation with a mental health expert. These caring professionals will talk with a patient, sometimes using questionnaires, to better understand their feelings and the severity of the thoughts they're facing.  They will also look for any underlying mental health conditions or life experiences that may be contributing to or exacerbating the intrusive thoughts. The recognition of suicidal ideation is less about certainty and more about concern. The presence of suicidal ideation often prompts an immediate need for intervention, regardless of other diagnoses. It's about recognizing that these feelings are a call for help and responding with the urgent care and support needed. What to do if you are experiencing suicidal ideation When you’re experiencing suicidal ideation, seeking help and taking action are crucial. Getting urgent help Seek help immediately if you're thinking about acting on suicidal thoughts. The 988 Lifeline provides 24/7, free, confidential support and crisis resources. Your options also include calling 911 or going to the nearest emergency room. No matter what course of urgent help is seen as the best fit at the moment, you will want to seek the support of a mental health professional as soon as possible. That also can be your first step when experiencing distress. Steps to take when it isn’t an emergency If you’re not in immediate danger, these are the first steps you could take toward getting the judgment-free help you deserve. 1. Make an appointment with a mental health professional Professional intervention is crucial in managing the risk of suicide or self harm. A mental health professional will provide a safe space to explore the thoughts and feelings you are experiencing. They can guide you to understanding the factors and strategies to manage your mental well-being effectively. 2. Identify and remove triggers Start by identifying the triggers that lead to these intrusive thoughts. They might be certain places, people, or events that consistently lead to distress. It might not necessarily mean avoiding them permanently, but it can allow for a safer environment while you address this mental health condition. 3. Reach out to a close friend or loved one  You’ll need a strong support system. You may be nervous about opening up, but doing so with a trusted, supportive connection can be a critical step in alleviating the burden, finding relief, and embarking on recovery. 4. Call a suicide hotline If you don’t feel comfortable talking to someone close to you at the time, a suicide hotline can be an invaluable mental health resource. Specialists on these hotlines are trained to support and assist those in crisis.  Managing suicidal ideation is a process; there will be ups and downs. The most crucial thing is to keep moving forward and continue seeking help from mental health resources. Treatment options for suicidal ideation There is no one-size-fits-all approach to treating suicidal ideation. Treatment will vary based on the individual’s needs but may include psychotherapy, medication, or a combination of the two. Hospitalization or intensive outpatient programs may be necessary for those at immediate risk of self-harm.  Additionally, new approaches to reducing suicidal ideation are continually being explored and implemented, often creating expanded access to care.  Treatment goals Regardless of the course of treatment, the focus will be on achieving several key goals. Address the underlying factors contributing to the intrusive thoughts.  Build coping strategies for preventing suicide. Create a support network for the individual.  Individuals will be actively involved in their treatment plan, working collaboratively with their care team. The path to recovery Recovery from suicidal thoughts comes with its own challenges, but many individuals who have once experienced these thoughts have gone on to live fulfilling lives. Recovery often involves finding the right treatment, building a solid support system, and learning healthy coping mechanisms. We know that each person's road to recovery is unique, but it’s important to avoid projecting set timelines or expectations. Celebrating the small victories can make a world of difference. Whether it’s practicing a new coping skill or continuing to seek help, these concrete steps signify resilience and strength. Remember: Patience and consistency in support are key if you’re standing by someone in recovery.  The myth and reality of suicidal thoughts and creativity There is a common misconception that suicidal ideation is a byproduct of creativity. While individuals with artistic inclinations might be predisposed to deeper emotional experiences, it’s crucial not to romanticize or normalize the suffering that comes with suicidal thoughts. The art lies in expressing your emotions in a healthy manner that supports your well-being rather than harming it. Art, writing, and other creative outlets can be a powerful force in recovery. However, these outlets should be harnessed under the guidance of a mental health professional so their benefits can enhance structured therapy and/or medication like anti-depressants or mood stabilizers. The role of community in suicide prevention Support can take many forms, from suicide prevention organizations and support groups to simply being there for someone in need. By building a community that is educated on the warning signs of suicide and the steps to take to support someone in crisis, we can provide a safety net for those who are in need.  Engaging in open, honest conversations about mental health and suicide removes the stigma that often surrounds these topics. Creating a safe space to talk makes it easier for people to seek help and for those around them to provide support. If you or someone you know is struggling with suicidal thoughts, please know that there is hope and help available. Reach out to a mental health professional, call the national suicide prevention hotline at 988, or talk to someone you trust.  Remind yourself: You are not alone — there are people who care and want to help.  Working to stop suicidal thoughts Cerebral is continuing to make strides in improving clinical quality and safety for those experiencing suicidal ideation. With systems in place to connect you to care quickly in crisis situations, not only can unnecessary emergency room visits and hospitalizations be avoided, but meaningful improvements in symptoms can be made in a short period. Of the patients who come to Cerebral considering suicide, half of the individuals stopped having thoughts of suicide within an average of 6 months of treatment. This highlights the powerful impact of seeking support and the real possibility of regaining a sense of hope and purpose. Critical resources 988 Suicide & Crisis Lifeline offers free and confidential support via phone, text, or chat. Crisis Text Line allows one to text with a trained crisis counselor for free by texting TALK to 741-741. Veterans Crisis Line enables veterans to get help via text by sending one to 838255. Vets4Warriors provides free, 24/7 peer support for veterans via phone at 855-838-8255 or by email. The Trevor Project offers immediate crisis support for LGBTQ+ youth via phone at 1-866-488-7386 or by texting START to 678-678. Image by rawpixel.com on Freepik.

40 million Americans suffer from a substance use disorder according to the Substance Abuse and Mental Health Services Administration. Unfortunately, many are not receiving the care they need: 82% of Americans with opioid use disorder do not receive potentially life-saving treatment, and only 7% of adults with alcohol dependence are receiving treatment. The consequences of not receiving treatment are devastating - 75% of overdoses in 2021 were opioid-related and an estimated 99,000 people died from alcohol-related causes in 2020. Substance use disorders also impact the workplace. 75% of employers say their workplace is impacted by opioid misuse, but only 17% feel prepared to deal with the issue. Alcohol use disorder is linked to 232 million missed work days annually.  Substance use disorder is a growing problem that further exacerbates poor mental health, this is why Cerebral is getting involved. Cerebral offers high-quality care for multiple substance use disorders, including opioid use disorder and alcohol use disorder. Cerebral developed these programs in partnership with in-house and external psychiatrists specializing in addiction treatment, and in close collaboration with Cerebral’s CEO and Chief Medical Officer, Dr. David Mou.  Since substance use is highly comorbid with mental health conditions, such as anxiety and depression, Cerebral has ensured its care programs treat patients comprehensively for all conditions.   “As a high-quality mental health company, it’s critical for us to be able to treat substance use disorders in addition to mental health conditions so that our patients can access a comprehensive solution,” said Dr. David Mou, Cerebral CEO. Further details on Cerebral’s substance use disorder programs are below: Cerebral’s Opioid Use Disorder (OUD) Plan Cerebral’s Opioid Use Disorder plan is a Medication-Assisted Treatment (MAT) plan with regular care counseling. It is specifically tailored to treat those struggling with opioid dependence. In the MAT plan, patients will be treated for their opioid use with FDA-approved medication like Suboxone, if clinically appropriate. Patients will have a high degree of interaction with their dedicated care team, including an initial 60-minute evaluation, weekly meetings with a prescriber to start, all with the flexibility and convenience of telehealth. 90% of Cerebral’s Opioid Use Disorder members who have been enrolled for at least 3 weeks attended their weekly prescriber sessions on time. 100% of Opioid Use patients who were prescribed medication were able to get their prescriptions filled on time. This is imperative to preventing relapse.  Cerebral currently offers Medication-Assisted Treatment for opioid use in Colorado, Florida, and Washington, and has plans to continue the expansion of this program throughout 2022. Cerebral’s Alcohol Use Disorder (AUD) Plan Cerebral’s alcohol use disorder treatment program includes therapy and/or medication management. All members are connected with licensed clinicians to develop a personalized treatment program. These programs include regular appointments with the patient’s care team, as well as in-app messaging, self-guided CBT exercises, and prescription management. Cerebral takes particular care to tailor its treatment to the individual. Cerebral offers care for alcohol dependence in 36 states: Alabama, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, and Wisconsin, and will continue the expansion of this program throughout 2022. If you're in a state that offers Cerebral's OUD or AUD program, start a free assessment to get started.

Why is substance abuse and addiction so prevalent among the LGBTQ+ community? In a world in which diversity should be celebrated, the LGBTQ+ community can find themselves excluded. Approximately 20-30% of the LGBTQ+ community suffers from substance abuse , compared to roughly 9% of the general population as a whole. This can include but is not limited to  marijuana, opioids, smoking/vaping, amphetamines, heroin and alcohol. For LGBTQ+ youths of color, the increased risk is even higher. So the question stands - why are these individuals struggling so greatly and what can we do to help? Sexual minorities experience a range of challenges the rest of the population isn’t as often affected by. These challenges can  include but are not limited to: A negative stigma/discrimination based solely on their sexual orientation. Rejection by family and friends. Lack of support from the community as a whole. Discrimination at work through job loss or being passed up for promotions. Internalized homophobia and self-identifying with anti-gay stigmas. Hate crimes, threats and public humiliation. LGBTQ+ individuals might also be likelier to experience: Sexual abuse/assault. Sexual dysfunction. Compulsive sexual behavior. This can further spiral into mental health issues like: Unhealthy levels of stress. Self-harming and attempted suicide. Generalized anxiety disorder (GAD). Major depressive disorder. This can lend to LGTBQ+ individuals dealing with co-occurring mental or sexual disorders. Unfortunately, young transgender people have higher levels of depression, suicide, self-harm and eating disorders.  Oftentimes, individuals, including those in the LBGTQ+ community, might attempt to self-soothe in order to deal with negative circumstances by turning to drugs and alcohol. Sadly, he LGBTQ+ substance abuse statistics confirm it. For example, one study shows that transgender students are 2.5 times likelier to use cocaine or meth. In addition, they’retwice as likely to abuse prescription medications, like opioids and benzodiazepines. Lastly, for young adults who are in the sexual minorities, 12.4% have reported an alcohol use disorder, compared to 10.1% for the general population. So what can be done to help… LGBTQ+ substance abuse treatment Traditional therapeutic methods might not be the best approach for LGBTQ+ individuals. Substance abuse isn’t always the root of the problem—oftentimes it’s a byproduct. Counseling the LGBTQ+ community requires a specialized approach as  we must address all of the varying factors that are contributing to LGBTQ+ individuals’ struggling mental and physical health. This includes addressing social isolation, family issues and even violence, among other things.  Furthermore, sexual minorities might be afraid to seek help out of fear of rejection by a therapist;group therapy can be intimidating and clients are unsure  if they’re safe to truly let their guards down. Discrimination against LGBTQ+ people can happen anywhere unfortunately—even in a therapist’s office. With mental illness in the LGBTQ+ community more prevalent, receiving mental health counseling online can help to reduce occurrences of depression, anxiety and other disorders. Cerebral offers individual therapy, in a safe, online atmosphere to people across the nation battling mental illness. Talk therapy online gives a person the ability to achieve  healthier ways to cope and manage mental hurdles. Cerebral offers a variety of monthly subscriptions to fit our clients’ needs and goals. In addition, should a client and their therapist decide that medication is necessary, we deliver it right to their front door. Ways to support the LGBTQ+ community How can we all take part in building a more inclusive society? Here are just a few suggestions. If you see something, speak up! Is an LGBTQ+ coworker being treated unfairly? Report it to your manager. Make sure your coworker knows you are an ally. Think before speaking - if you think your joke or comment might offend someone; then do not say it.  Be inclusive. LGBTQ+ people often experience social isolation. Make a point of including everyone!!. Confront your own biases. Challenge yourself to stop making assumptions about people just because of their gender or sexuality. Start a dialogue with someone; learn about who they are and educate yourself at the same time. Additional addiction resources for LGBTQ+ Cerebral’s goal is to make therapy available, accessible and affordable. There are additional places one can turn to, on the internet, if they need support. If someone is in crisis and needs immediate help, Crisis Text Line connects crisis counselors with individuals in need. It’s free, 24/7 support that you can access right at your fingertips. Just text HOME to 741741 and you’ll be connected to a trained counselor. They’ll help take you from a “hot moment” to a “cool moment.” The Trevor Project offers a similar service. Counselors are available by online chat, call and text. They listen without judgment. The Trevor Project also offers an international community for people ages 13-24. Trans Lifeline is run by trans people, for trans people. They have hotlines for both trans people, as well as, family and friends. They offer full anonymity and confidentiality and calls are always secure. Thrive Lifeline is a community of trained crisis responders and suicide interveners. If you’re 18+, you can receive judgment-free, confidential text messaging. If you’re a relative or friend of an LGBTQ+ person, PFLAG can help. They provide an abundance of resources on how to be an ally. Countering the unique obstacles that LGBTQ+ people face starts right at home with family and friends. A more inclusive and accepting community means fewer sexual minorities suffering. Take the next step with Cerebral The stigma surrounding mental health treatment persists. But Cerebral aims to shine a light on emotional wellness. This Pride Month, and every month, our goal is to reach and guide as many LGBTQ+ individuals as possible. If you or someone you know is dealing with a substance abuse issue, or if your mental health is otherwise suffering, help is a few clicks away. Get started by taking our free emotional assessment so we can learn more about you. Someone from our team will reach out with the next steps.