Energy Drinks and Recovery: A Dangerous Mix by Scott Hambleton, MD

Scott Hambleton, MD

Energy drinks are designed and advertised to increase performance of the user, both mentally and physically by combining caffeine, carbohydrates, vitamins and various herbal supplements to provide a stimulant effect greater than the effect of caffeine alone.

Caution is warranted for anyone who chooses to drink an energy beverage, even healthy adults without a history of a substance use disorder. Red Bull is banned in Norway, Uruguay and Denmark, as the result of an 18 year old athlete who died hours after drinking four cans prior to an event in 2000. Although the FDA limits the caffeine content in soft drink food products to 71mg per 12 ounce can, energy drinks are designated as dietary supplements, and are not limited in their caffeine content.

Coca-Cola Classic contains 34mg per 12 ounces, Starbucks coffee contains 160mg per 8 ounce cup, and some energy drinks contain in excess of 500mg per can! Over-the-counter caffeine-containing products require warning labels and caffeine content, yet energy drinks do not. Other stimulants such as ginseng, yerba mate, kola nut, green tea extract, bitter orange and guarana are often added to energy drinks to enhance the effects of caffeine.

Pharmacologic tolerance and withdrawal develop quickly. Caffeine intoxication (DSM-IV R code 305.90) is an acute overdose of caffeine, usually occurring with doses in excess of about 300 milligrams in a new user, with no tolerance. In children and adolescents who are not habitual caffeine users, vulnerability to caffeine intoxication may be markedly increased. Signs and symptoms include facial flushing, restlessness, anxiety and irritability. Less common, but potential manifestations include cardiac arrhythmias, rhabdomyolysis, seizures, mania, psychomotor agitation, psychosis and death! Other caffeine-induced psychiatric disorders include caffeine-induced anxiety disorder, caffeine-induced sleep disorder and caffeine-related disorder not otherwise specified.

Everyone can agree that recovery is a precious gift worth guarding at any cost. Unfortunately, addiction is a chronic disease that has a tendency toward relapse, and recovery from a relapse is not always possible. Death is a very real consequence of relapse! Just as a diabetic needs to be cautious about their intake of sugar, the recovering alcoholic and addict must be cautious about the use of mood-altering drugs, including prescribed and over-the-counter preparations. Anything that has the potential to increase cravings is dangerous!

Caffeine is a psychoactive stimulant drug and excessive use can trigger cocaine and methamphetamine cravings. Restlessness, irritability and discontentedness (RIDS) are caused by excessive caffeine intake and caffeine withdrawal. RIDS are a great reason to relapse with drug and alcohol use! The best bet is to play it safe and avoid the use of any energy drinks.

Scott Hambleton is medical director of the Pine Grove Women’s Center, a gender-responsive residential treatment program offering three separate programs for women coping with eating disorders, women coping with chemical dependency, and women coping with both. This unique and distinct setting allows the ability of the multi-faceted and multi-disciplinary treatment team to triage treatment components based on the patient's individual and unfolding needs.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

The Women's Center: Sanctuary, Refuge, Shelter, Safety

The Pine Grove Women's Center is a gender-responsive residential treatment program offering three separate programs for women coping with eating disorders, women coping with chemical dependency, and women coping with both. This unique and distinct setting allows the ability of the multi-faceted and multi-disciplinary treatment team to triage treatment components based on the patient's individual and unfolding needs.

Work is done on the behavioral, cognitive, and affective level. Patients are supported in dealing with behavior, thoughts, and feelings. The program also integrates several theoretical perspectives including medical, psychiatric, socio-cultural, feminist, and 12-step.

Visit www.pinegrovetreatment.com or call 1-888-574-HOPE (4673) for more information.

Pine Grove Behavioral Health and Addiction Services in Hattiesburg, Mississippi is known as one of the nation’s most comprehensive treatment campuses. For over twenty five years Pine Grove has offered a continuum of services ranging from outpatient to inpatient and residential treatment for adults, children and adolescents suffering from psychiatric and addictive diseases. Specialized services include the treatment of addictions, eating disorders, and professionals struggling with interpersonal difficulties. The Pine Grove Mission is to be a leader in healing and changing lives by providing the highest quality behavioral health services.

The Body Battle: Finding Harmony with Self and Food

The Body Battle is a three-day workshop designed for males and females ages 18 and older who suffer from disordered eating and are trapped in the cycle of body hate and low selfesteem. This didactic and experiential workshop is specifically for those who are struggling with repeated self-destructive attempts to manage their relationship with themselves and food. Participants will acquire information and participate in expressive therapy modalities which will lay a foundation to begin to accept oneself on the road to recovery.

The Workshop is desgined to help:

- Understand the many faces of disordered eating
- Learn how family of origin dynamics are re-enacted
- Face messages of internalized shame
- Learn about boundaries in relationships
- Discover self through safe release of emotions
- Identify how loss/grief/trauma has impacted your life
- Recognize harsh internal messages
- Learn to love yourself and live with compassion

Visit www.pinegrovetreatment.com or call 1-888-574-HOPE (4673) for more information.

Pine Grove Behavioral Health and Addiction Services in Hattiesburg, Mississippi is known as one of the nation’s most comprehensive treatment campuses. For over twenty five years Pine Grove has offered a continuum of services ranging from outpatient to inpatient and residential treatment for adults, children and adolescents suffering from psychiatric and addictive diseases. Specialized services include the treatment of addictions, eating disorders, and professionals struggling with interpersonal difficulties. The Pine Grove Mission is to be a leader in healing and changing lives by providing the highest quality behavioral health services.

Eating Disorders: How Much Snooze Can You Afford to Lose?

Ralph E. Carson, PhD, RD

The journey of recovery from an eating disorder is long and complicated. There are numerous treatment models that address this devastating health problem, but it has only recently come to light the importance of sleep in expediting the recovery process and its role in relapse prevention. With over 60% of the population reporting episodes of insomnia, those struggling with addictions report a much higher incidence. Sleep is the time the brain heals. Therefore, not only is it important that one gets enough sleep, but the quality of that sleep is a key to long-term recovery.

The Pine Grove Women's Center is a residential treatment program for women coping with eating disorders, women coping with chemical dependency, and women coping with both. This unique setting allows the ability of the treatment team to triage treatment components based on the patient's individual and unfolding needs.

Work is done on the behavioral, cognitive, and affective level. Patients are supported in dealing with behavior, thoughts, and feelings. The program also integrates several theoretical perspectives including medical, psychiatric, socio-cultural, feminist, and 12-step.

Ralph Carson, R.D. B.S., B.H.S., Ph.D., is a nationally recognized clinical nutritionist and exercise physiologist. Dr. Carson is a frequently requested speaker on a variety of nutritional topics for medical groups, pharmaceutical companies, universities, athletic training camps and corporations. He has a successful clinical practice as well as being a faculty member of the University of Alabama at Huntsville for over 20 years. Dr. Carson is also a nutritional advisor to numerous university athletic departments including the University of Tennessee National Basketball Champion Lady Volunteers. Dr. Carson received his B.S. from Duke University, his B.H.S. in pathology (Cum Laude) from Duke University Medical School, and his Ph.D. in nutrition (Phi Kappa Phi) from Auburn University. Dr. Carson currently manages Oprah Winfrey’s web page on eating disorders and is the consultant for Pine Grove’s eating disorder program, The Women’s Center.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

Exercise as an Adjunct to Recovery

Ralph E. Carson, PhD, RD

Exercise has long been touted as a means of reducing stress, maintaining healthy weight and supplying energy. Most addicts do not experience this benefit because they are looking for immediate results and do not have a grasp of how exercise improves mood, enhances metabolism and reduces depression. Repetitive and monotous activities stimulate nerve cell growth and promote restorative sleep that enhances recovery and initiates revitalization.

We are inundated daily with government guidelines, medical recommendations and frightening statistics that implore us to exercise. Resolutions are made to lose weight, lower blood pressure and improve our mood. Health club memberships, expensive home equipment and exercise videos are purchased in hopes we will be inspired to get fit. The ultimate dream is to achieve these goals quickly and painlessly. Yet, we know only too well, the only place where success appears before work is in the dictionary.

By understanding some fundamental physiology combined with motivational principles, we can make the prize worth the price and make exercise a productive tool in the treatment of addictive patients.

Ralph Carson, R.D. B.S., B.H.S., Ph.D., is a nationally recognized clinical nutritionist and exercise physiologist. Dr. Carson is a frequently requested speaker on a variety of nutritional topics for medical groups, pharmaceutical companies, universities, athletic training camps and corporations. He has a successful clinical practice as well as being a faculty member of the University of Alabama at Huntsville for over 20 years. Dr. Carson is also a nutritional advisor to numerous university athletic departments including the University of Tennessee National Basketball Champion Lady Volunteers. Dr. Carson received his B.S. from Duke University, his B.H.S. in pathology (Cum Laude) from Duke University Medical School, and his Ph.D. in nutrition (Phi Kappa Phi) from Auburn University. Dr. Carson currently manages Oprah Winfrey’s web page on eating disorders and is the consultant for Pine Grove’s eating disorder program, The Women’s Center.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

Treating Addictions and Eating Disorders Together

All of the disorders of eating (compulsive overeating, compulsive under eating or anorexia, binging and purging) have much in common with addiction. Brain imaging shows problems for both in the mesolimbic structures deep inside the brain, family histories of eating disordered patients frequently reveal addictions somewhere, and many of the psychological elements of denial, craving, tolerance, and relapse are the same. Experienced addiction therapists say that many, if not most, women with addictions also show disordered eating at some point. Are there differences? Of course, but it’s in the common elements that our strength can be found. Each woman, indeed, each human being on this earth, is unique, yet we all share certain challenges and issues. Unity and diversity are not mutually exclusive, and who would argue that we need all the help we can get in dealing with illnesses as troublesome as these?

Besides the issues related to diagnosis, many women with addictions and eating disorders are depressed or have other untreated medical problems, many have been psychologically, sexually, or physically abused and traumatized, and many are anxious and unempowered, with no idea how to go about changing these things. At Pine Grove Women’s Center, we know that your time here is just the beginning of a lifelong journey of recovery. However, we also know that if we don’t help you set up some signposts now, you will be at risk for losing your way in the future.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

The Disease Model

Once upon a time, all mental disorders, including eating disorders, gambling addiction, drug and alcohol addiction and sexual addiction (along with everything else in the compulsive spectrum) were thought of as wickedness, weakness, or both. Now we use what is called “the disease model” to talk about these things because (thank goodness) we know a lot more than we used to about them. We know that all addictions are compulsions and vice versa, which gives rise to the saying, popular in all the best recovery circles, “An addiction is an addiction is an addiction.”

From the standpoint of recovery, the specific substance or activity is less important than the recognition of the fact that someone who is suffering with this terrible problem feels driven, absolutely compelled to do, ingest, or focus on something that hurts her in body, mind, and spirit, wrecks her relationships, and keeps her from wholeness and wellness in life. As a well regarded researcher in the field, Dr. Doug Talbott, says, “The compulsion IS the disease.”

The scientific evidence for this position is mounting in all areas of research—clinical work with patients, family history studies, newer brain imaging techniques, and psychological research into what is called “addiction interaction.” The compulsion really is the disease. As one woman put it to me once, “I overeat and throw up just like my dad used to drink. It’s so out of control and I can’t make anybody see I need help just like he did.”

The difficulty in the medical sciences often lies in translating research evidence into clinical practice. Someone has to lead the way, and we all tend to resist change. At Pine Grove Women’s Center, however, we are committed to bringing you the most up to date, comprehensive care possible, using what has worked in the past to set a framework for making full use of the advances in the here and now.

Visit http://www.pinegrovetreatment.com/ or call 1-888-574-HOPE (4673) for more information.

Warning Signs of Eating Disorders

Over 30 million Americans have some type of eating disorder and while each problem is unique, eating disorders do have warning signals.

Here are some signs that might indicate a problem in you or someone you love:

- Fear of being unable to stop eating once you start
- Abusing drug or alcohol before “binge eating”
- Intentional vomiting after meals
- Constant low-calorie or crash dieting
- Compulsive exercise with strict “exercise rules”
- Using body weight and being thin to measure self-worth
- Thinking or talking constantly about food
- Refusing to discuss food at all
- Using food to hide anger, loneliness, or feelings of rejection

If you are concerned about your eating behaviors or attitudes, or even a friend or family members, consider professional help.

The Pine Grove Women’s Center is a residential program in Hattiesburg MS devoted to the treatment of addictions and eating disorders in women. Our mission is to be a leader in healing and changing lives by providing the highest quality behavioral health services.

Visit www.pinegrovetreatment.com or call 1-888-574-HOPE (4673) for more information.