Connections between Sleep and Substance Use Disorders

From the Monthly Blog of Dr. Nora Volkow,
Executive Director, National Institute on Drug Abuse

Original Date March 9, 2020

nida-banner-science-of-abuse-and-addiction

Most common mental disorders, from depression and anxiety to PTSD, are associated with disturbed sleep, and substance use disorders are no exception. The relationship may be complex and bidirectional: Substance use causes sleep problems; but insomnia and insufficient sleep may also be a factor raising the risk of drug use and addiction. Recognizing the importance of this once-overlooked factor, addiction researchers are paying increased attention to sleep and sleep disturbances, and even thinking about ways to target sleep disruption in substance use disorder treatment and prevention.

We now know that most kinds of substance use acutely disrupt sleep-regulatory systems in the brain, affecting the time it takes to fall asleep (latency), duration of sleep, and sleep quality. People who use drugs also experience insomnia during withdrawal, which fuels drug cravings and can be a major factor leading to relapse. Additionally, because of the central role of sleep in consolidating new memories, poor quality sleep may make it harder to learn new coping and self-regulation skills necessary for recovery.

The neurobiological mechanisms linking many forms of drug use and sleep disturbances are increasingly well understood. Dopamine is a neurochemical crucial for understanding the relationship between substance use disorders and sleep, for example. Drugs’ direct or indirect stimulation of dopamine reward pathways accounts for their addictive properties; but dopamine also modulates alertness and is implicated in the sleep-wake cycle. Dopaminergic drugs are used to treat disorders of alertness and arousal such as narcolepsy. Cocaine and amphetamine-like drugs (such as methamphetamine) are among the most potent dopamine-increasing drugs, and their repeated misuse can lead to severe sleep deprivation. Sleep deprivation in turn downregulates dopamine receptors, which makes people more impulsive and vulnerable to drug taking.

In addition to their effects on dopamine, drugs also affect sleep through their main pharmacological targets. For instance, marijuana interacts with the body’s endocannabinoid system by binding to cannabinoid receptors; this system is involved in regulating the sleep-wake cycle (among many other roles). Trouble sleeping is a very common symptom of marijuana withdrawal, reported by over 40 percent of those trying to quit the drug; and sleep difficulty is reported as the most distressing symptom. (Nightmares and strange dreams are also reported.) One in ten individuals who relapsed to cannabis use cited sleep difficulty as the reason.

Opioid drugs such as heroin interact with the body’s endogenous opioid system by binding to mu-opioid receptors; this system also plays a role in regulating sleep. Morpheus, the Greek god of sleep and dreams, gave his name to morphia or morphine, the medicinal derivative of opium. Natural and synthetic opioid drugs can produce profound sleepiness, but they also can disrupt sleep by increasing transitions between different stages of sleep (known as disruptions in sleep architecture), and people undergoing withdrawal can experience terrible insomnia. Opioids in brainstem regions also control respiration, and when they are taken at high doses they can dangerously inhibit breathing during sleep.

Addiction and sleep problems are intertwined in other, unexpected and complex ways. In a particularly fascinating finding published in Science Translational Medicine in 2018, a team of UCLA researchers studying the role of the wakefulness-regulating neuropeptide orexin in narcolepsy were examining human postmortem brain samples and found a brain with significantly more orexin-producing cells; this individual, they then learned, had been addicted to heroin. This serendipitous discovery led the team to analyze a larger sample of brain hypothalamic tissue from individuals with heroin addiction; these individuals had 54 percent more orexin-producing cells in their brains than non-heroin users. Administering morphine produced similar effects in rodents.

Further research on the overlaps between the brain circuits and signaling systems responsible for reward and those regulating sleep may help us understand individual differences in susceptibility to addiction and sleep disorders. I believe that the future of addiction treatment lies in approaches that are more personalized and multidimensional, and this includes using combinations of medications and other interventions that target specific symptoms of the disorder. It could prove very useful to target an individual’s sleep problems as one of the dimensions of treatment. For example, NIDA is currently funding research to test the efficacy of suvorexant, an FDA-approved insomnia medication that acts as an antagonist at orexin receptors, in people with opioid use disorder.

The causal relationship between impaired sleep and drug misuse/addiction can also go in the other direction. People who suffer insomnia may be at increased risk for substance use, because sufferers may self-medicate their sleep problems using alcohol or other drugs such as benzodiazepines that they may perceive as relaxing. Or, they may use stimulant drugs to compensate for daytime fatigue caused by lost sleep. Impaired sleep may also increase risk of drug use through other avenues, for instance by impairing cognition. Consequently, sleep disorders and other barriers to getting sufficient sleep are important factors to target in prevention.

Early school start times, for instance, have been the focus of considerable debate in recent years, as teenagers may be particularly vulnerable to the many health and behavioral effects of short sleep duration. Fewer hours of sleep correlate with increased risk of substance use and other behavior problems in teens. In this age group, tobacco, alcohol, and marijuana use are all associated with poorer sleep health, including lower sleep duration, again with possible bidirectionality of causation.

Longitudinal research is needed to better clarify the complex causal links between sleep, brain development, and mental health outcomes including substance use. The Adolescent Brain and Cognitive Development (ABCD) study is examining these relationships in a large cohort of children who were recruited at age 9-10. This longitudinal study, now in its third year, is already beginning to produce valuable findings. A team of Chinese researchers using ABCD data recently published in Molecular Psychiatry their finding that kids with depressive problems had shorter sleep duration 1 year later, as well as lower volume of brain areas associated with cognitive functions like memory. We will learn much more as the ABCD study progresses.

Despite all we are learning, more research is needed on the relationship(s) between drug use, addiction, and sleep, in adults as well as young people. NIDA is currently funding several projects to study various substance use disorders and sleep, as well as the neurobiology of reward and its relation to circadian rhythms. It is an area with great potential to prevent substance use as well as to treat one of the most debilitating side effects associated with substance use disorders.

Find Help Near You

The following website can help you find substance abuse or other mental health services in your area: www.samhsa.gov/find-treatment. If you are in an emergency situation, people at this toll-free, 24-hour hotline can help you get through this difficult time: 1-800-273-TALK. Or click on: www.suicidepreventionlifeline.org.

You can also find help through Narcotics Anonymous at 844-335-2408.

Let’s Go to Theology Class: Perspectives on the Crusades

The following summary is from my most recent class in pursuit of my master’s degree in theology at Colorado Christian University.

The Crusades became a new hot topic around the turn of the 21st century (March 2000), with Pope John Paul II and each succeeding pope making apology for them. Beginning with the horror of 9/11 both presidents and terrorists have referenced the Crusades, for various reasons. What is your opinion of the Crusades?

Sunday Times (London) called The God Delusion (2008) entertaining, wildly informative, a splendidly written polemic. “We are elegantly cajoled, cleverly harangued into shedding ourselves of this superstitious nonsense that has bedeviled us since our first visit to Sunday school.” Dawkins: “Imagine, with John Lennon, a world with no religion. Imagine no suicide bombers, no 9/11, no 7/7 1, no Crusades, no witch-hunts…” 2 Reddit posted many anti-religion quotes over the years since 9/11: Science flies you to the moon, religion flies you into buildings.

Christianity is saddled with guilt regarding the Crusades, defending against the accusation that they were unprovoked attacks fueled by religious intolerance. In AD 636, Muslims captured Jerusalem, Alexandria, Egypt, and Spain. Gonzalez says Christians, faced with the safety and order of the state, developed the Just War theory.3 Riley-Smith says Augustine was “at his most positive when writing about the right intention required of those who authorized and took part in violence,” adding, “only use as much force as necessary.”4 Just cause, legitimate authority, and right intention should be followed in Christian violence. The Crusades were to be reactive only and not wars of conversion. Muslims have a not-so-just policy of holy war (jihad), a solemn duty of every Muslim. The Bible forbids blanket use of military might or forcing unbelievers to convert or be killed. When Muhammad died (632), caliphs who succeeded him prosecuted a series of wars whose aim was conquest. These invasions had an egregious impact on the ancient centers of Christianity. Gonzalez states, “Islam presented itself as a constant threat to be held back only by armed force, with the result that Christianity became radically militarized.”5 Expansion of Islam eventually threatened Western Europe. Unwavering violent takeovers by Islamic forces had to be defended against. Charles Martel (France) stopped Muslims from invading Europe at the Battle of Tours (732).

The first Crusade (AD 1095-1102) was to liberate Jerusalem from Muslim domination. Muslims marched toward global domination, seizing land. They demanded conversion or death. Jihad is a religious duty built upon universalism inherent in the Muslim mission. Aggression is a matter of Islamic theology. It has been implied that Islam is a religion of peace. However, the word Islam means “submit.” We cannot dismiss the Crusades entirely as defensive. Riley-Smith says the Crusades were not only fought in the Levant and the eastern Mediterranean region, but also along the Baltic shoreline, in North Africa, the Iberian Peninsula, Poland, Hungary, the Balkan, and parts of Western Europe, proclaimed not only against Muslims but also pagans, Balts, Lithuanians, shamanist Mongols, Orthodox Russians and Greeks, and Catholics. Riley-Smith says, “The crusading movement generated holy leagues, which were alliances of front-line powers, bolstered by crusade privileges, and military orders, the members of which sometimes operated out of their own order-states.”6

Regardless, many believe Muslims should wage jihad as a protest to the Crusades.  Osama bin Laden announced a fatwa against America because Saudi Arabia used American troops to fight against Saddam Hussein. He was infuriated by the presence of U.S. troops throughout the “holy lands” since the 1980s. Yet Madden denies any correlation between the Crusades and increased terrorism today. As with any religion, biaes, prejudices, selfish interests, and dogmatic defections abound. It is impossible to claim unequivocally that a religion or political body adheres 100% to applicable theology or law. It is unfortunate that the Crusades are often seen as a black mark against Christianity. Todays liberal thinkers and pacifists trade heavily on their opposition to war (of any type) as unjust, stating a “God of peace” cannot also be a “God of war.” Today’s evangelists and apologists must address this issue responsibly with gentleness and reverence.


July 7, 2005 London Bombings.

Richard Dawkins, The God Delusion (New York: Mariner Books, 2008), 23.

Justo Gonzalez, The Story of Christianity (New York: HarperOne, 2010), 293.

Jonathan Riley-Smith, The Crusades, Christianity, and Islam (New York: Columbia University Press, 2008), 12-13.

5 Gonzalez, 293.

6 Riley-Smith, 9.

Let’s Go to Theology Class: Constantine and the Church

The following summary is from my most recent class in pursuit of my master’s degree in theology at Colorado Christian University.

Engage the perennial question: Was Constantine good or bad for the church of Jesus Christ? In making your case, note (and cite from Gonzalez, and other sources, if you would like) the ways in which Constantine affected the church’s doctrine and practice. Answer these questions as parts of your overarching answer:

  • Which effects were good, and which were bad?
  • What have been the long-term results—good and bad— of those effective changes?

Just when I thought I was already having enough fun studying theology, we were given another fascinating assignment. Beginning with the conversion of Constantine, Christianity began to move from persecution to dominance. In AD 392, the emperor Theodosius I outlawed pagan worship—Christianity effectively became the “official” religion of the Roman Empire. Constantine said, “The eternal, holy and unfathomable goodness of God does not allow us to wander in darkness, but shows us the way of salvation… This I have seen in others as well as myself” (in Gonzalez, 2010, 131). At first blush, this statement rings like a true profession of faith in the One True God, but is it? We’re asked to consider whether Constantine was good or bad for Christianity. In part, this must include consideration of whether the above statement equates to public profession of faith in Jesus as the Christ. It is interesting to note that Constantine did not refer to Christ as the only god. Accordingly, the veritas of Constantine’s confession has been the subject of many discussions. Some believed it was merely a shrewd political maneuver. Constantine referred to the Christian God as “the greatest god,” the summa deus (Stephenson, 2009,169), yet he adorned the city with pagan statues from around the empire. Ravi Zacharias (2007, 10) said some scholars believe Constantine wanted to assert control over his “chosen religion” to the benefit of his empire and so insisted on the convening of a group of men to determine the content of the Bible (Council of Nicaea, AD 325). However, this was not the purpose of the Council.

Gonzalez believes it is important to determine the impact Constantine’s conversion and rule had on the Church. He states, “The truth is probably that Constantine was a sincere believer in the power of Christ” (139). He failed to place himself under the instruction of church leaders, yet he felt authorized to intervene in ecclesiastical matters. Gonzalez said Constantine considered himself “bishop of bishops” (138). Christian leaders thought that although inclined to become a believer, Constantine was not “one of the faithful” (139). Constantine was a sincere man, but he held a meager grasp of the Christian faith. For example, he thought the Christian God and the god “Unconquered Sun” were compatible. In his mind, there was room for serving other gods. He frequently took part in numerous pagan ceremonies without a thought that he was betraying the Christian God. Regardless of whether his conversion was genuine, Constantine’s beliefs and practices had a definite impact on Christianity.

Bad Effects

Paganism was still considered the “official” religion of the empire. As head of the empire, Constantine took the title of Supreme Pontiff or High Priest of that belief system. Gonzalez notes, “[A]lmost to his dying day, Constantine continued functioning as the High Priest of paganism” (141). His influence caused a drop in catechism prior to baptism. Because the ancient gods were still a part of everyday life, Constantine’s desire to “serve two masters” perpetuated pagan worship in the empire. Gonzalez states despite having done much to the detriment of paganism, Constantine “became one of the pagan gods… the Eastern church considers him a saint, thus resulting in a saint who is also a pagan god” (141). Spiritual ambiguity caused persistent violence against pagans by Christians, resulting in their rejection of Christianity. Power and prestige among church leaders caused increased arrogance and corruption in the church. Gonzalez notes that Lucius “bought” his position as bishop of Alexandria—a practice eventually known as simony. Moreover, as bishops were permitted increasing judicial powers, bribery became an issue. Perhaps this was a secular foreshadowing of priests selling “indulgences” for sins in the Catholic Church.

The laity began to see conversion as less critical or dramatic. Syncretism and superstition were on the increase as a result of merging Christianity and paganism. Many believers were buried with both Christian and pagan artifacts and symbols. Constantine’s conversion led to imperial impact on Christian worship. Incense, which was initially used to venerate emperors, began to be used in Christian services. We can see the influence of this today in Catholic, Episcopal, United Methodist, Orthodox Christian, and some Lutheran services. Ministers started wearing fancy or luxurious garments when officiating, and the church started calling ministers “priests” as in paganism. Kneeling seems to have originated with bowing before the emperor.

Ancient artifacts and bodies of martyrs were dug up, relocated, or venerated—perhaps a form of idolatry? As church membership grew exponentially, limitation on time and space led to many “new converts” not being baptized. Additionally, pre-baptismal instruction was shortened or eliminated. This is something the early church would have deemed unacceptable. Churches, worship services, and other aspects grew complex in contrast to a simpler and humbler time. An “official theology” developed, likely as a means for paying homage to Constantine for outlawing persecution of the faithful. Many believed Constantine was “chosen” by God to facilitate the merging of church and empire. This was something Christ vehemently discouraged (No doubt the congregations became inundated with “so-called” Christians. Gonzalez notes an exodus from “the imperial church” which many believed had become sinful and apostate.

Good Effects

The conversion of Constantine had several positive effects on the Christian church. Prior to this, Christians lived under the unpredictable threat of persecution. Stephenson notes that Constantine may not have been a Christian at this point (AD 312), but he began showing sympathy and concern for its followers (169). Accordingly, he forbade persecution of the Christian faith. Constantine also wanted to end factionalism within the community of Christian believers (Stephenson, 169). Under Constantine, Lactantius wrote an early apologetic titled On the Deaths of the Persecutors wherein he stated that monotheism was Rome’s “original religion, and the idea of many gods was introduced in error.” Monotheism was said to be superior to polytheism, and Christianity was expressed as the only means through which wisdom was attainable (Stephenson, 170). It is interesting to note the likely origin for celebrating the birth of Jesus on December 25. Sol Invictus (the personification of the Sun) was worshiped as the “greatest god” that was acceptable to all (177). Initially, December 25 was the “Day of the Sun.” According to Stephenson, on December 25, 323 Constantine declared the date as the dies natalis of Christ and exempted all Christians from having to participate in the veneration of Sol (178).

Constantine used imperial edicts to establish privileges for churches and their leadership. For example, churches were allowed tax exempt status for properties and their ministers. Further, members and others were permitted the legal right to pass property on to the church. We see this practice in operation today, allowing some denominations to amass a vast amount of assets. According to Church and State, the Roman Catholic Church is likely the wealthiest non-business entity in the world, with assets ranging from $10 billion to $15 billion and an operation budget of approximately $170 billion in the United States alone (Network for Church Monitoring, 2020). Of course, whenever accumulation of wealth become more important than seeking God’s kingdom and storing up treasures in heaven, such developments can be detrimental for Christianity

IN CONCLUSION, clearly Constantine’s conversion to Christianity is in question. First, although he made a public profession of faith, he did not undergo water baptism until on his deathbed in 337. Moreover, many of his attitudes and actions seemed to belie true dedication to Christ. He continued to participate in pagan ceremonies at times and functioned as its high priest. Constantine’s serving two masters caused the prolonging of pagan worship. Negative effects included ongoing violence against pagans by Christians, ecclesiastical and judicial corruption, early practices that mimic the selling of indulgences by the Catholic Church, syncretism, a lack of catechism teachings before water baptism, and at least a temporary diluting of Christianity. Constantine did, however, outlaw persecution of Christians, helped to cause a slow increase in observing monotheism over polytheism, and establishment of December 25 as Christmas Day.

I am impressed by the impact of Christian ecclesiastical history on grasping the many nuances of the Christian faith.

References

Church and State (London, England: Network for Church Monitoring), 2020.

Gonzalez, J.L., The Story of Christianity, Vol. 2: The Early Church to the Dawn of the Reformation (New York, NY: HarperOne), 2010.

Stephenson, P. Constantine: Roman Emperor, Christian Victor (New York, NY: The Overlook Press), 2010.

Zacharias, R., Beyond Opinion: Living the Faith we Defend (Nashville, TN: Thomas Nelson), 2007.

Let’s Go to Theology Class: What Difference Does it Make?

The following summary is from my most recent class in pursuit of my master’s degree in theology at Colorado Christian University.

What difference do heaven, the second coming of Christ, and Hell make to you right this very moment? The emphasis, as it was for Paul in 2 Thessalonians, is on “right now.” Be honest, appropriately personal, and conversant with course sources – including Scripture – in formulating your post.

Reflecting on the above query, I immediately think of the purpose of Paul’s second epistle to the Thessalonians. Interestingly, Paul had visited this church only a few months prior, only to learn of lingering questions among the new believers. More troublesome, some new Christians were deliberately misleading others. Paul wrote in First Thessalonians, “…remembering before our God and Father your work of faith and labor of love and steadfastness of hope in our Lord Jesus Christ” (1:3).

Paul noted also that new converts were initially led by the Holy Spirit, which provided them with the “gospel truth” that should have remained undeniable.  Paul said, “…when you received the word of God which you heard from us, you accepted it not as the word of men but as what it really is, the word of God, which is at work in you believers” (2:13). Paul heard of the good news from Timothy of the faith and love of these new believers. This made his distress and affliction worth enduring. Paul was most pleased, and he encouraged these new believers to “do just as you are doing” (4:1). Of course, he was speaking here of those who had remained faithful to the gospel.

It is fitting, then, that Paul also informed the new converts in Thessalonica to not pay attention to the murmurings of sudden travail and destruction at the second coming of Christ. He said, “For you are all sons of light and sons of the day; we are not of the night or of darkness” (5:5). Paul provided some key guidelines for the last days: give thanks in all circumstances; avoid quenching the Holy Spirit; do not denigrate prophesy; abstain from evil; hold fast to that which is good. Moreover, Paul reminded the Thessalonians in his second epistle (as he first told them) the day of the Lord will not come until the unleashing of a great rebellion and the coming of the son of perdition, who will seek to be worshiped; he will take his seat in the temple of God, proclaiming himself to be God. Paul told them to warn even their greatest enemy of the coming of the son of perdition. Kind of reminds me of the platitude, “I wouldn’t wish this on my worst enemy.”

For me, much of what Paul warned the church about in his two letters to the church at Thessalonica is prevalent today. My “right now” has to do with the responsibility of us believers to not merely sit idle and wait for Christ, nor to close our eyes to travail and destruction and hide in our “ivory tower.” Many of today’s challenges to Christianity come from the halls of academia—in our high schools and our universities. Christianity is no longer the predominant religious influence over academia or culture it once was. The proliferation of secularism, scientism, naturalism, and moral relativism (I find most isms to be bad news) has blinded non-believers with a catch-all “just do good and you’ll be fine” vibe for life on earth. Theism (especially Christianity) is attacked as a backward, elitist belief in a fairytale invisible “God.” Atheists and agnostics shout from the rooftops that there is no absolute (ontological) truth. It is difficult today to discuss religion in the public forum as it has been relegated to a private, personal belief that should be kept to one’s self. I consider this the first wave of unbelief.

The second wave relates to an attack on our Christian sons and daughters who enter post-secondary education only to have their beliefs eviscerated. Militant atheism is determined to outlaw all discussion of religion in public, including in our high schools and universities. These “last things” (the eschatology of Christianity) carry an intense importance. Right now, we are facing a tall order: explaining what is meant by heaven, hell, and the second coming of Christ. Government officials and university professors and deans continually tie our hands and tape our mouths shut. Tertullian wrote, “And so we are also ridiculed because we proclaim that God is going to judge the world. Yet even the poets and philosophers place a judgment seat in the underworld.” [1]

Grudem says we should eagerly welcome Christ’s return. Because we long for this wonderous event as believers without knowing when it will occur, many have the tendency to procrastinate relative to sharing the gospel. But modernity has dulled our “spiritual senses” about the final days. It has served to distract us from the paramount importance of Christ’s great commission. Most believers agree on one major fact: Christ is coming back for His bride. Some even possess knowledge about what the final days will be like. Still, many Christians today remain silent. Grudem asks, “Could Christ come back at any time?” [2] Scripture says, “Watch therefore, for you do not know on what day your Lord is coming… be ready; for the Son of man is coming at an hour you do not expect” (Matt. 24:42, 44b). We do know first the gospel must be preached to all nations (Mark 13:10). Jesus said we’d be hated for His name’s sake; regardless, we are commanded to go forth and preach the gospel no matter the obstacles or personal costs.

I believe the Church must speak unequivocally, honestly, and emphatically about the reality of heaven, hell, and the trials and hardships of the great tribulation during the final days. There are times when I feel overwhelmingly guilty for squandering decades of my life fulfilling the pleasures of the flesh while walking in near-complete apostasy despite what I knew to be true. Through my outrageous behavior while in active addiction, I brought shame to my family and detracted many from becoming a Christian. Today, my “right now” entails studying the doctrines of Christian theology and becoming comfortable with the absolute truth of gospel (indeed, I must present a “living” theology), then stepping into this fallen world and sharing Christ, defending to anyone who asks me what is the hope that is in me concerning Jesus Christ and Him crucified (see 1 Pet. 3:15).

Our eschatology, as Grudem notes, provides a great motive for evangelism. Grudem writes, “In fact, Peter indicates that the delay of the Lord’s return is due to the fact that God ‘is forbearing toward you, not wishing that any should perish, but that all should reach repentance’ (2 Peter 3:9).” [3] As Christians, we believe hell is a real place, reserved for eternal conscious punishment of those who have refused to repent and believe in Christ Jesus. As noted in the parable of Lazarus and the certain rich man, there are no second chances for believing the gospel; nor can the departed unbeliever warn his family about what is to come for those who reject Christ. There is only the right now.


[1] Tertulian, “On Hell and Heaven,” in the Evangelical Dictionary of Theology (Chichester, West Sussex, UK: Wiley Blackwell, 2017), 534.

[2] Wayne Grudem, Systematic Theology (Grand Rapids, MI: Zondervan, 1994), 1095.

[3]Grudem, 1148.

Children Suffer in Families of Addicted Parents or Siblings

Kids of Addicted Parents

One group that doesn’t get the robust advocacy it needs is young children experiencing the impact of addiction in their family. Kids can be profoundly impacted by a parent’s or sibling’s addiction, and they grow up at greater risk of developing addiction themselves. And yet, insurance doesn’t cover care and prevention efforts for such children or the family, and children and families generally get scant mention in policy plans like the 2020 National Drug Control Strategy or relevant federal budgets (see here and here). That’s why advocates like our Jerry Moe and Sis Wenger, the CEO of the National Association for Children of Addiction, say children are the first hurt and the last helped.

National Children of Addiction Week just wrapped up, and we spent the week advocating for “kiddos,” as some of our Children’s Program counselors like to say. Jerry spoke in Ohio and did interviews with media from nearby West Virginia, two states hit hard by the addiction crisis. Lindsey Chadwick and our Children’s Program in Colorado hosted an art show featuring the drawings and paintings of young children growing up in families affected by addiction, and discussed it on a Denver TV station. And, Jerry fielded online, anonymous questions in real-time during a Reddit AMA (Ask Me Anything) hosted by NPR. That Q&A lives on—please help advocate for children by sharing it with others who may have questions about how to support kids affected by addiction in their family. Jerry will continue to answer questions over the next couple of weeks.

Find Help Near You

The following can help you find substance abuse or other mental health services in your area: www.samhsa.gov/find-treatment. If you are in an emergency situation, people at this toll-free, 24-hour hotline can help you get through this difficult time: 1-800-273-TALK. Or click on: www.suicidepreventionlifeline.org. Also, a step by step guide on what to do to help yourself, a friend or a family member on our Treatment page.

 

Narcotics Anonymous National Hotline: 1(877) 276-6883
Alcoholics Anonymous Website: https://www.aa.org
You can also visit https://www.allaboutcounseling.com/crisis_hotlines.htm

Colors Other Than Gray

A glimpse inside, riding the
tide of my emotions, until a
wave knocks me down near
the side of a stone jetty.
The lifeguard blows her whistle
and signals that I’m in danger;
I’m at risk;
too near injury to be left alone.

It’s sunny today, with
blue skies.
Background music of baritone
teens imitating the Ramones,
down the shore, just a quarter mile
from Barnegat Light.

I might, for the first time
in a long time,
be seeing life again as
it’s meant to be seen.
Feeling the warmth of our
giant solar orb on my face,
and catching glimpses of pretty young girls
in bikinis, clad in
colors other than gray.

© 2017 Steven Barto

Up Here

I originally published this original poem under the title “The Roof,” but decided it was not about a rooftop experience; rather, it is about allowing yourself to rise above the craziness for a few moments and see what’s really going on. I welcome any feedback, especially if it sparks a dialog about the current atmosphere in our beloved country.

Up here
on the roof,
I am tall,
taller than all,
at the apex:
not of height,
nor of stature;

just here
at the edge
where anything
is possible:
creativity,
destruction,
enlightenment,
apostasy;
whatever I choose
begins up here
at the edge
of heaven and hell

where God waits,
and angels watch;
where birds soar
without awareness
of my struggle,
or my questions,
or my potential,
good or bad;

below, a community
ekes out its
existence,
parading
up and down
the streets
and avenues,
with no inkling
of what comes
next;

life in
pieces, its
very blood spilled
on the macadam
of tomorrow
by the handguns
of a thousand
angry, disenfranchised men,

rudderless,
willing to take
everyone
with them
into the
crevasse where
not even light
can escape.

©2017 Steven Barto