Stress and substance use: Recognizing, understanding, and getting help

This is the eighth in a series of stories about how you can use the myStrength wellness portal and app to enhance your emotional well-being. In this installment, Ayzha Corbett, mySupport program manager and clinician, and Micah Saviet, mySupport MSW intern, address stress and substance abuse and the tools available to help JHU employees deal with them.

Everyone experiences stress, and the addition of a pandemic can magnify it. Stress during COVID-19 can manifest physically, emotionally, behaviorally, and even cognitively. Individual experiences of stress can vary widely and can show up as muscle tension, heart palpitations, headaches, irritability, impatience, feeling numb or negative, wanting to isolate or not be around others, difficulty concentrating, working too much, and more.

Individuals cope with stress and emotional distress in different ways. Some can be healthy or adaptive, others more unhealthy or maladaptive.

Maladaptive coping strategies are ways of dealing with stress that are detrimental to our physical or mental health. Examples include avoidance of the problem; excessive rumination or perseveration; and overeating, gambling, or using substances to numb emotions, among others.

Research tells us that there is a two-way relationship between stress and substance use: Increased stress, especially during COVID-19, can put individuals at risk for substance abuse, and individuals who are addicted to substances may be hypersensitive to stress.

When it comes to substance use, being aware of some guidelines and parameters may be helpful to prevent "use" from becoming "abuse" or an "addiction," especially during quarantine.

First, the National Institute on Alcohol Abuse and Alcoholism provides a guideline for what constitutes a "standard" drink, based on the amount of alcohol involved. For example, a "standard" drink is defined as one 12-ounce can of regular beer, eight or nine ounces of malt liquor, five ounces of table wine, or one-and-a-half ounces of distilled spirits.

The National Institutes of Health says that to stay within low-risk parameters, men should have no more than four drinks on any single day and no more than 14 drinks per week, and women should have no more than three drinks on any single day and no more than seven per week. Being aware of and following the guidelines can aid individuals who want to remain within the low-risk category or individuals who may be unsure of whether to be concerned about their drinking habits.

Differentiating between risky substance use and addiction is not always straightforward. The Center on Addiction defines "risky substance use" as the use of "tobacco, alcohol, or other drugs in ways that threaten the health and safety of the user, as well as others, but does not meet the clinical criteria for a substance problem."

Alcohol and marijuana are the top two most commonly abused drugs in the United States according to the Substance Abuse and Mental Health Services Administration and the National Survey on Drug Use and Alcohol, but there are many other substances that individuals can become addicted to. In addition, certain behaviors—including eating, internet usage, gaming, shopping, sex, gambling, and codependency—can become addictions. Be aware of these behaviors during quarantine and continued state-of-emergency orders.

If you are concerned about your substance use, engage in risky substance use, or have an addiction to substances, seeking help and support is now easier than ever.

Johns Hopkins employees and their family members can download the myStrength app, available from the Apple App Store or Google Play, with the access code JHU.

The myStrength app offers guided modules on focus areas including alcohol, drugs, and other substances during a crisis; nicotine recovery; and opioid recovery. These modules include components on understanding your use during a crisis, exploring patterns of use, mindfulness skills, gauging your motivation to change, setting goals, and more. The modules can be used on your own time and from the privacy of your own home.

For additional support, Johns Hopkins mySupport is available to assist employees and their family members with a wide range of issues, including any concerns or questions you may have regarding use of substances. You can contact mySupport at 443-997-7000.

It is important to remember that no concern is too small or too big to pursue help; you don't need to have an addiction. If you are hesitant or unsure about whether the myStrength app or mySupport is right for you, you are encouraged to reach out.