By now, most people are familiar with the prescription drug Xanax to some extent or another. It has been one of the most popular anti-anxiety medications for many years now, and it has also garnered some infamy throughout our current culture through music and media. Hip-hop artists, like Future in the mainstream or… wait for it… Lil Xan in the underground, have promoted the use of the prescription drug for recreational purposes. Even television shows have made seemingly flippant comments about using the now-notorious medication to take the edge off.
Xanny bars are commonly characterized today as chill-pills, just like amphetamines were promoted in the 60s as “uppers” for the guy or gal on the go. The same can be said about other name brand benzodiazepine medications, such as:
But do people really understand how hard Xanax hits the brain and hurts the body?
Xanax on the Brain and Body
To get caught up to speed, Xanax is a brand name for alprazolam. This is one medication included in a group of drugs known as benzodiazepines, or benzos. Benzodiazepines are typically prescribed for anxiety.
Like all drugs taken orally, it’s absorbed into the body through the stomach. The drug passes through the mucous membrane and enters the liver. Finally, in the bloodstream, it makes its way to the brain. Now for those who don’t know, the blood-brain barrier is a membrane that filters out dangerous substances. It is built in to protect us. However, drugs like benzodiazepines are able to pass through this barrier. That is how they are meant to work.
Benzodiazepines work on parts of the brain known as GABA-A receptors. GABA-A receptors are responsible for producing sedative effects. They are naturally switched on by chemicals used to carry messages around the brain. Those chemicals are called neurotransmitters.
GABA-A receptors are switched on by the GABA neurotransmitter. This is a chemical that creates a calming effect.
Benzodiazepines are agonists, meaning they amplify the GABA-A receptors’ effects. They attach themselves to the GABA-A receptors and increasing the effectiveness of the GABA neurotransmitter. Taking Xanax activates that GABA-A receptor and kicks it into overdrive.
Now none of this is inherently wrong. In fact, doctors typically prescribe Xanax to treat anxiety, which can be caused by an imbalance of chemicals in the brain. In those cases, the effects created by Xanax in the brain actually correct an imbalance. Dr. Cathy Montgomery, reader in psychopharmacology at Liverpool John Moores University, says:
“If somebody’s experiencing high levels of anxiety, they have an increase in chemicals like adrenaline, which would normally make you feel more alert and awake, and a deficiency in GABA. High levels of adrenaline and low levels of GABA have a double impact of increased excitation in the brain, which people experience as anxiety. When they take Xanax, they won’t necessarily get the same type of heavy sedative effect.”
So in essence, Xanax does have a job to do. The issue is, so many people found out what a thorough job it does and decided it could be taken advantage of. Use of Xanax without the imbalance in the brain to cause that heavy sedative effect is what recreational users are looking for. Actually, using Xanax for recreation creates a self-inflicted imbalance in the brain. This creates a lot of issues because the body will try to preserve the balance, which only sets things up to get worse in the long run. Montgomery states:
“Whatever you take, your brain will try to regulate it. It may release adrenaline to try and combat this,”
So while your brain might fight back by releasing adrenaline, you won’t feel it until the effects of the drug wear off. The body takes several days to completely release the drug, even if noticeable effects will wear off after a few hours. The drug first detaches itself from the GABA-A receptors in your brain. Liver enzymes break it down, and eventually, the body gets rid of it.
How It Hurts
The issues can start to take shape once the drug detaches from your brain’s receptors. Like we said before, the effects will start to wear off, and the brain will still be trying to maintain its equilibrium. That self-inflicted imbalance we talked about then suddenly becomes a devastating crash. A sudden increase in brain activity finally breaks through the fog when the Xanax is gone, which can cause feelings of anxiety, agitation, insomnia, even terror.
Xanax use can actually create a cycle of dependency very quickly because while they may not have experienced anxiety before taking the drug, they have created it through the imbalance in the brain that may cause them to seek more of the drug. Before you know it, you are self-medicating to treat these symptoms, which are actually withdrawals created by the drug.
For those who use this medication for sedative effects, another issue presents itself. Benzodiazepines are supposed to be prescribed for a short time. To feel the same effects, people find they have to use larger and larger doses. And taking large doses for sustained periods of time can actually cause the body to stockpile significant withdrawal symptoms. These withdrawals aren’t just painful, they are extremely dangerous.
Xanax withdrawal symptoms include:
- Blurred vision
- Muscle aches
- Tension in the jaw and/or teeth pain
- Numbness in fingers
- Tingling in limbs
- Sensitivity to light and sound
- Alteration in sense of smell
- Loss of appetite
- Heart palpitations
- Impaired respiration
Stopping the use of these drugs abruptly has been known to cause seizures, and detoxing without medical assistance can even be lethal.
You don’t have to use Xanax for an extended period to experience withdrawals. Some people with prescriptions have even reported to feeling withdrawals between doses. Repeated use can lead to withdrawal symptoms in a very short amount of time. Another issue we find is that GABA-A receptors are concentrated in an area of the brain known as the hippocampus, which is important for memory and is believed to be the reason why these drugs can cause blackouts.
Xanax becomes even more dangerous when combined with other substances, such as alcohol or opioids. Not only can combining these drugs be harmful to the body, they can actually be life-threatening. Often overdoses involved benzodiazepines like Xanax occur when the drug is used along with other substances that have a compounding effect, such as alcohol or opioids. The drugs react to one another and cause more severe reactions in the brain and the body.
While anti-anxiety medications can be useful for those who suffer due to an imbalance in the brain, everyone should be aware of the risks associated with Xanax and similar substances. Dependence to this drug can be incredibly hazardous, and discontinuing use should always be done with the utmost caution and with medical assistance. No one should try to stop abruptly without consulting a medical professional, and for those who struggle with substance abuse, there is help.
If you or someone you love is struggling with substance abuse or addiction, please call Palm Partners Recovery Center toll-free now. You are not alone.
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Why are more kids than ever before overdosing on ADHD drugs in America?
Did you know that the number of U.S. children unnecessarily exposed to powerful medications meant to treat Attention Deficit Hyperactivity Disorder (ADHD) has gone through the roof over the past few years? In fact, over a 15-year period, unnecessary exposure to ADHD drugs has increased by more than 60% according to reports!
Study on ADHD Drug Exposure
Recently there was a report published by the American Academy of Pediatrics on ADHD drug exposure and reports to poison control centers indicate:
- In the year 2000, there were 7,018 calls to poison control centers related to an ADHD drug
- In 2014, there were 11,486 calls to poison control centers related to an ADHD drug
The study defines “exposure” to an ADHD drug as “unnecessary ingestions, inhalation or absorption” of ADHD medications. This includes when the exposure to the drug is both accidental and on purpose.
The study examined data from approximately 156,000 poison center calls made over the course of 15 years. Another disturbing aspect of the data they collected showed:
- 82% of the calls were “unintentional exposure”
- 18% were “intentional exposure”
When taking a closer look at the ADHD drug exposure statistics, the researchers focused in on four of the most common medications used to treat ADHD, including:
Ritalin was the ADHD drug with the highest number of exposures.
One of the lead authors of the study is Dr. Gary Smith. When discussing the conclusions made during the study, Smith states:
“What we found is that, overall, during that 15 years, there was about a 60% increase in the number of individuals exposed and calls reported to poison control centers regarding these medications.”
Smith also concludes that one of the more troublesome findings in the study is the severity of the exposures among the adolescents due to intentional exposure. So essentially, 18% of the calls coming into poison centers concerning an ADHD drug were due to kids taking the medications on purpose.
The study also compared these medications across three different age groups:
- 0-5 years
- 6-12 years
- 13-19 years
In the 0-5 year age group, they discovered that unintentional exposure was due to “exploratory behaviors”. However, with children 6-12 years old, exposure was due to:
- “Therapeutic errors”
- “Accidentally taking multiple pills”
Sadly, among the group 13-19 years old, more than 50% of exposures to an ADHD drug were intentional. Researchers note that many teenagers will use these stimulants because.
Even worse is, of all the poison center calls, around 10% resulted in a serious medical outcome. 10% may not seem like a lot, in regards to poisoning from medications any number is too many.
Ups and Downs
Smith did note that there were some ups and downs in the trends concerning ADHD and complications from the medications. For instance, the study notes:
- Between 2000 and 2011- ADHD drug exposures increased by 71%
- Between 2011 and 2014- ADHD drug exposures dropped by 6.2%
It is unclear why there was this decrease in ADHD drug exposure rates. However, some believe it may be due to the fact that warnings from the FDA about the adverse side-effects of ADHD medications could play a big part in it.
Another thing that stands out about this study is that we have also seen a steady increase in the rate of ADHD diagnosis. Case in point, according to new reports:
- 14% of all American children were diagnosed with ADHD in 2014
- Between 2005 and 2014 the number of ADHD diagnoses more than doubled
While it is important to note that these medications can be helpful for some, they can also be extremely dangerous. According to Dr. Benjamin Shain of NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine,
“Adverse effects of taking too much stimulant medication include fast heart rate, increased blood pressure, tremors, and agitation. Worse case scenarios include schizophrenic-like psychosis, heart attack, stroke, seizures and death,”
Shain adds that adverse effects are the same if you do or do not have ADHD, or if you take too much of the medication. So people who are prescribed an ADHD drug still run the risk of suffering through some of these side-effects.
Making Safer Choices
At the end of the day, it is all about making safer choices for yourself or your loved one. When it comes to treating attention-deficit hyperactivity disorder, there are other important elements. Various therapies can be helpful in creating a more comprehensive treatment plan, such as:
Ironically, these same therapies are also extremely helpful for those who may find themselves abusing these kinds of prescription medications. People suffering from substance use disorder can benefit greatly from these opportunities.
Because these ADHD drugs are stimulants, they also have a tendency to be abused. Either by those with a medical prescription who use too much of the drug or by those with no medical need who use them for the feelings of energy and focus they get. Again, in the case of prescription stimulant abuse, the beginning of a path to recovery means making safer choices. One of the best choices you can make is to seek professional and effective treatment options.
Palm Partners Recovery Center believes in providing innovative and personalized treatment options to anyone battling with substance abuse or addiction. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
Zuckerberg Testimony: Should Facebook Be Stopping Opioid Trafficking?
Author: Justin Mckibben
This past Tuesday and Wednesday, Facebook co-founder and CEO Mark Zuckerberg found himself sitting in front of a tough crowd on Capitol Hill for 2 days of questioning that covered various topics about the social media empire. The testimony covered how Facebook influences politics, handles user data, and what steps are being taken to prevent abuse of the massive tech companies international platform.
During the testimony of Mark Zuckerberg, the topic came up of drug trafficking, specifically opioid sales, through Facebook.
Is Social Media Enabling Illegal Activity?
The line of questioning concerning opioids came from David McKinley. McKinely is the Republican Representative from West Virginia. On day two of the testimony, Mark Zuckerberg was grilled about opioid dealers abusing the social media space in order to distribute their drugs. During the conversation, McKinley states,
“Your platform is still being used to circumvent the law, and allow people to buy highly addictive drugs without a prescription,”
The Congressman went on to ask,
“With all due respect, Facebook is actually enabling an illegal activity and, in so doing, you are hurting people. Would you agree with that statement?”
“Congressman, I think that there are a number of areas of content that we need to do a better job of policing on our service. Today the primary way that content regulation works here … is that people can share what they want on the service, and then if someone sees an issue they flag it to us, and then we will review it.”
During McKinley’s comments, he actually shows Zuckerberg with images on a screen that opioids and other prescription narcotics are still actively being sold via Facebook. Later in McKinely’s statements he adds,
“That was just from yesterday. It’s still up. So my question to you is- when are you going to take down these posts that are done by illegal digital pharmacies?”
“Congressman, when people report the posts, we will take them down and have people review them.”
When the congressman continued to press Zuckerberg on Facebook taking responsibility for the posts made on the platform concerning illegal drugs, Zuckerberg replied,
“Congressman, I agree that this is a terrible issue and respectfully, when there are tens-of-billions or a hundred-billion pieces of content shared every day… even 20,000 people reviewing it can’t look at everything. What we need to do is build more AI tools that can proactively find that content.”
- AI referring to artificial intelligence.
This is not the first time critics have called out tech companies for falling short on policing illicit drug sales through their platforms.
In 2011, search-engine giant Google agreed to pay $500 million to the Department of Justice for showing prescription drug ads from Canadian online pharmacies to U.S. consumers. Only a week before Zuckerberg sat down to speak with Congress, the FDA Commissioner Scott Gottlieb had already called on social media platforms to root out and exterminate the online opioid trade. Gottlieb stated,
“We find offers to purchase opioids all over social media and the Internet, including Twitter, Facebook, Instagram, Reddit, Google, Yahoo, and Bing. But when it comes to opioids, we haven’t seen meaningful, voluntary actions.”
Some of the posts McKinely flagged to Facebook have already been taken down. However, McKinley still says that Facebook’s internal controls “don’t seem adequate” in regards to detecting and removing illegal drug posts.
Are Zuckerberg and Facebook Responsible?
The biggest theme- whether it came to Cambridge Analytica, censorship of political views, selling consumer data or illicit opioid marketing- was accountability.
The question throughout the testimony is- are Zuckerberg and Facebook responsible?
Some have argued that if Facebook intends to censor things like hate speech or political interference, then they should also be responsible for monitoring and shutting down any illegal activity happening on the website. Some people believe that if drug dealers are posting on social media, their posts should be automatically removed. That is a good goal. Others might even insist that Facebook should report these profiles to law enforcement to help investigate dealers and make more arrests.
But should Facebook be mandated and regulated to enforce these ideas? Moreover, should they be punished when people manage to cheat their system or slip through the cracks?
Many might argue Facebook should not be punished for the posts individuals make. One comparison might be that we do not prosecute cell-phone service providers when their products and services are used in illegal activity. And if we expect Facebook to thoroughly monitor all activity and report any suspicious behavior to the authorities, should cellular services be held to the same standard?
While private phone-calls are a far cry from public posts to the internet, what is the best way walk this line of privacy and security in the digital age?
Is it fair to say that Mark Zuckerberg is himself hurting people because his company is unable to police the hundreds of billions of posts made to their site every day? Or is it true that the company is slacking when it comes to addressing these issues promptly and effectively?
Social media is changing a lot of the way we communicate, and like any other advancement, it can be taken advantage of. One thing is certain; if we want to fight the opioid epidemic we have to put more research into prevention, and more focus and support into safe and effective treatment. Technology can impact drug use, but it can also connect people and help them get on the right path toward recovery. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
It hasn’t even been one week since I wrote about the Center for Disease Control and Prevention (CDC) reporting opioid overdoses increased by 30% in only one year, and already a new story from The Washington Post suggests that these numbers are actually being highly undercounted! So in reality, the increase could be skewed by the fact that the real rates of overdose deaths are tragically misrepresented.
This new study reveals that the government has actually been undercounting opioid overdose deaths by anywhere between 20% and 35%!
So how is this happening? How much worse is the overdose outbreak?
A Closer Look at Coroner Reports
The reason the study says this underreporting is happening is due to how the current numbers are actually determined. In order to estimate national trends in opioid overdose and opioid-related death, the federal Centers for Disease Control and Prevention amasses data from over 3,000 coroner’s offices across the US.
However, the issue is that coroners function independently, so their available resources vary from case to case. The same goes for their reporting practices.
Christopher Ruhm, a professor at the University of Virginia, took a closer look at tracking trends and found that a lot of coroners do not specify the drug when documenting a fatal overdose. Ruhma states that from 1999-2015, of all fatal overdoses 23.1% did not have a drug specified on the death certificate.
The CDC cannot control local coroners, so it is the states and counties responsibility to improve their overdose reporting practices. If we want a more accurate reading of how opioids are harming a community, there has to be efficient documentation.
Unfortunately, the political incentives are not very supportive of accurate reporting. Officials may be concerned that by spending money on better overdose recording, they will have paid for the chance to look like their opioid problem is actually getting worse. The incentive just isn’t there from a political stance. However, that isn’t a good enough reason to botch the records. Communities still deserve to have a comprehensive idea of the issues they are facing.
Tracking Overdose Death Trends
The inference of coroners not including the drug in the report is that there are a lot more overdoses that do not get included in the official figures released at the federal level. There could be thousands of more deaths from opioids that go unaccounted for. To take a shot at tracking trends, Ruhm studied the records of coroners who did record specific drugs for overdose deaths. Based on this tracking, he was able to attribute a “corrected count” of opioid overdoses. In his report, Ruhm states:
“Corrected rates were obtained by using information from death certificate reports where at least one drug category was specified to impute involvement for cases where none was specified.”
There are many elements to how Ruhm came up with her corrections, and I encourage everyone to read the full analysis, which is published by the Society for the Study of Addiction (SSA). The report makes some pretty intense claims about what overdose deaths opioids should account for. For example in 1999 the CDC figures show:
Yet, Ruhm’s corrected count shows 1999 saw:
- 10,232 overall opioid deaths
- 3,421 synthetic opioid deaths
In 2015, the CDC figures say:
- 33,091 overall opioid deaths
- 19,884 synthetic opioid deaths
But Ruhms count pushes that up to:
- 39,999 overall opioid deaths
- 23,857 synthetic opioid deaths
Finally, when we look at the 2016 CDC figure, it said 42,249 opioid overdose deaths nationwide. But the corrected count figure puts 2016 at 49,562 opioid overdose deaths nationwide
What we can take away from Ruhm’s research is simply that the severity of the opioid crisis is being underestimated. From 1999-2015, Ruhm’s corrected counts for overdose deaths were 21% to 35% higher for all opioids. With corrected counts involving heroin and synthetic opioids were 20% to 30% higher.
So when we look at these stats, even if we leave some room for calculation errors, it is still a troubling thought. Since 2009, the leading cause of injury-related death in America has been drug overdoses. For years now, opioids have been public enemy number one concerning drug policy. Everything from prescription painkillers to synthetics being shipped halfway across the world has contributed to this crisis. If all we know about the true devastation of this epidemic is merely our best guess that still doesn’t take it all in, now is truly the time to urge officials and community leaders to take significant steps toward real, lifesaving solutions.
One of the most important resources that we need to take advantage of is providing safe and effective treatment to those who are struggling. Palm Partners Recovery Center has offered innovative and holistic treatment options for over two decades. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
As someone who struggles with anxiety, I can understand the desire to find something that can help protect yourself from haunting feelings of dread that cripple your peace of mind. Anxiety is a complicated condition that can creep in from the most unexpected places, and people experience it in many different ways. While some may think it’s based in fear or weakness, the reality is far more complex. Those people may say all you need to overcome anxiety is a more grounded and positive outlook. But the truth for most people with an anxiety disorder is that battling anxiety goes a lot deeper than promoting optimism. Especially when your condition convinces you that all levity is just you lying to yourself. Sometimes, you need a little outside help, and anti-anxiety drugs can be very useful when a physician and an individual decide on the right route to take.
However, anti-anxiety medications can also be dangerous. These anti-anxiety drugs may not be in the spotlight the way opioids are, they are commonly abused, extremely addictive and can be just as lethal.
With recent reports showing a rise in deaths associated with anti-anxiety medications, some experts are saying there is a hidden epidemic being overshadowed by the opioid crisis.
Anti-Anxiety Drugs Underestimated
It is true that opioids are doing massive damage all across the country, but that doesn’t mean the death rates due to anti-anxiety drugs should be ignored. While focusing on prescription opioids, heroin and synthetic opioids is important, we should also keep in mind the other dangerous medications out there.
The usual suspects are benzodiazepines, which include drugs like:
While these anti-anxiety drugs may be useful in helping some people, they still carry their risks, which can be devastating and even lethal.
According to the director of the Scripps Mercy Hospital emergency department Dr. Roneet Lev, benzodiazepines are responsible for more drug deaths in San Diego County than people may expect. She says,
“That comes from people who come into our trauma center from car accidents because they’re on benzodiazepines, people who come in because they’re falling down because that affects their balance and coordination on benzodiazepines,”
“We’ve seen terrible withdrawals, when they’re used to having it, with seizures, that end up in the ICU.”
And it isn’t just people who are buying these drugs off the street. Concerning drug-related deaths by legal prescriptions, benzodiazepines are not as far behind opioids as people may think. Dr. Lev adds that while oxycodone is the number one prescribed drug associated with death, hydrocodone is second, and benzodiazepine is in third place.
But San Diego County is definitely not the only area experiencing a surge in benzodiazepine-related deaths. According to the National Institute on Drug Abuse (NIDA), deaths involving these anti-anxiety drugs have more than quadrupled between 2002 and 2015.
Something that does make these medications even more treacherous is when they are mixed with opioids.
Mixing Meds Causing More Deaths
As if opioids or anti-anxiety drugs weren’t hazardous enough on their own, the fact that many people mix these two medications makes them even more deadly. The San Diego County Medical Examiner has concluded that 83% of benzodiazepine-related deaths also involved opioids. Nathan Painter is an associate professor in pharmacy at UC San Diego. He explains how the chemicals interact with the body, and how mixing them only amplifies these effects.
“The benzodiazepines themselves can cause respiratory depression, or your breathing slow down, and so can opioids. So when you combine them, especially in the case of not using them on a regular basis, or being new to the benzo or the opioid, if you give too much, or combine it with other things like alcohol or other medications, then it can cause that breathing to slow down, or even stop.”
What could make this even worse? Well, many of the people mixing these medications may have just been following instructions as prescribed by their doctor. Painter notes that sometimes the prescribing physicians aren’t necessarily aware of all the drugs that someone is taking, and may not be as conservative or as slow in starting the medicines as they could be. So some people may be unknowingly consuming dangerous amounts of these drugs.
Sadly, there are areas of our current culture that put people at elevated risk of death by anti-anxiety drugs.
One of the more vulnerable populations is our veterans. In fact, the Veterans Association Healthcare System has to deal with the issue of mixing medications in particular, as many veterans end up using both benzodiazepines and opioids. Dr. James Michelsen is a physician at the VA. According to Michelsen,
“Anxiety related to their combat time, problems with sleep, post-traumatic stress disorder. And traditionally these conditions benzodiazepines have been used to treat. Additionally, many of our veterans came back with physical wounds, as well.”
This becomes a serious issue when there is a lack of communication between networks of doctors, which can happen if a veteran visits a non-VA doctor and receives a prescription.
It’s not just veterans and hospitals that have problems with benzodiazepines. In fact, benzodiazepines are some of the most prescribed medications in the United States. But it has gone beyond that and even made it into pop culture.
Drugs have always been part of the music industry. History shows us how hallucinogens like LSD influenced rock like the Beetles, and how cocaine coexisted with disco, or how heroin lingered along with jazz and blues over the years. It’s still hard to find a country song that doesn’t glorify good ol’ boys with whiskey and beer. Now, pill-popping in hip-hop and pop music is so mainstream it can be unsettling.
Along with that spotlight came greater influence. Some musicians try to paint that pretty picture with abusing anti-anxiety medications, but these drugs have taken the lives of some of the great artists of a generation. In the last several years alone we lost:
There are even others like Chris Cornell, who’s wife believed that the anti-anxiety medication he was taking is partly to blame for his suicide. Even with all the death caused by these drugs, some still glamourize prescription drug abuse in our culture. Not to mention the issue of mental health and substance use disorders already growing across the country.
Fighting Anxiety and Addiction
Personally, the risks involved with anti-anxiety drugs is troubling because a lot of my anxiety is rooted in health. It manifests at times in the side-effects of even the most mundane of medicines. Some days I can’t take an Aspirin without a secret part of me wondering if my kidneys will shut-down (which is ironic considering the years I spent polluting my body with hard drugs and excessive drinking). So while everything is going fine on the outside, my inner dialog is trying to measure and analyze every muscle movement or twitch as an indication of a terminal illness.
In reality, anti-anxiety drugs can be the difference between an everyday struggle to endure the rush of nameless terror and a window into serenity and stability. For people who can take advantage of the opportunity, it can be life-changing.
However, these drugs are nothing to take lightly, and plenty of people develop severe addictions to these drugs. Anti-anxiety medications can be fatal. Some might think they are an easy way to get a rush, they can be just as lethal as opioids. Just because they are not painkillers doesn’t mean we should underestimate their capacity to do harm.
Fighting anxiety is extremely important for people with anxiety disorder. But we have to remember the risks that come with these drugs and find a way to stay safe. This is especially true for those of us in recovery from addiction. Dual diagnosis treatment is a way to create comprehensive and holistic recovery that addresses both anxiety and addiction simultaneously in order to help people overcome their anxiety in the healthiest way possible.
If you or someone you love is struggling with anxiety, or any mental health disorder, please seek help. If you struggle with substance use disorder, drugs or alcohol is not the answer. There is real help out there. Please call toll-free now.
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