Sleep and Substance Use
Following a trauma event, such as a mass violence event, sleep can often get worse. You may find it difficult to fall asleep or stay asleep. Sometimes survivors think that alcohol, or other substances, will help them to sleep better. However, these substances actually make sleep worse due to how they are processed in your body. Avoid using alcohol and other substances, outside of medications prescribed by your doctor, to help you get better sleep. Instead, use the coping tips outline in this section, and if you feel like you still need help with your sleep, visit the Get Help/Resources section to find a therapist. For more information about getting a good night’s sleep, visit the Sleep Well section of this site.
Alcohol Use
How do I know what level is harmful? Understanding whether your alcohol use is outside of standard recommendations can be helpful when trying to understand the relationship between drinking and symptoms following a traumatic event. Here are the recommendations from the National Institutes of Health:
- For women, high-risk drinking involves consuming more than 3 drinks on any day or more than 7 drinks per week
- For men, high-risk drinking involves consuming more than 4 drinks on any day or more than 14 drinks per week
Tobacco Use
How do I know what level is harmful? Increased tobacco use following a stressful event is common; however, it is not recommended. No level of tobacco use is considered healthy or safe. If you have started smoking again, or increased your smoking, in the wake of mass violence, try not to be hard on yourself. Instead, focus your energy towards getting smoke-free now. Although tobacco use may feel like it is making you less anxious or less down, this is not the case. Tobacco use has actually been shown to worsen anxiety and depression symptoms. No matter your age, quitting smoking can have a big impact on your physical and mental health. If you are interested in learning more about quitting, or reducing, tobacco use, visit smokefree.gov for more information and tools to help you quit.
Substance Use
How do I know what level is harmful? Substance use can include using illegal, prescription, and over-the-counter medications. Given that this term applies to a broad group of substances, understanding the “harmful” or “normal” level can be difficult. Here are some questions to take into consideration to better understand your pattern of use:
- Is this substance or drug illegal? Any amount of illegal substance use is considered problematic.
- Am I taking a prescription medicine that is not mine?
- Am I taking a prescription medicine more frequently or in higher doses than prescribed by my doctor?
- Am I taking an over-the-counter medication more frequently or in higher doses than suggested?
- Have I noticed changes in the reason why I am using this substance since the mass violence event occurred?
- Am I noticing problems associated with my level of substance use (e.g., sleeping difficulties, unable to complete work or home activities, family complaints)?
Coping Ideas Instead of Alcohol, Tobacco, and Substances
If you are interested in cutting down your use of alcohol or other substances, it can be helpful to think of additional ways to manage difficult emotions. Below are some examples of ways to cope with negative emotions that other mass violence survivors have found helpful.
- Remind yourself why you are cutting down or stopping
- Talk to someone you trust
- Wait 15 minutes and “ride out” the urge to drink, smoke, or use a substance—often our desire to use decreases after waiting 15 minutes or so
- Distract yourself—go for a walk, watch a funny show, play with your pet
- Exercise—the endorphins and energy release from exercise can help curb your craving
- Visit the Trauma Reactions and Grief Reactions sections to learn more about managing negative emotions associated with mass violence
In addition to finding other ways to manage difficult emotions, many survivors find it helpful to think of “tempting situations” and temporarily avoid these situations while they are trying to cut down. Here are some examples of “tempting situations” to avoid if you are trying to cut down on alcohol or other substances.
-
Do not keep alcohol, tobacco, or substances in the home
-
Bars, Breweries
-
Social events where others are drinking, smoking, or using substances
-
Situations/places that you used to drink, smoke, or use other substances
One of the best ways to successfully cut down or quit alcohol and other substances is to have a plan in place. Take some time to think of coping strategies to manage difficult emotions, such as talking to someone you trust or “riding out” the urge. Also take some time to think of situations that you may temporarily want to avoid while trying to cut down on alcohol or substance use, such as certain social events. Remember, avoiding these “tempting situations” can be temporary. Once your negative emotions or urges to use substances becomes more manageable, you may be able to gradually resume some of these activities.” Try the “Coping Plan Activity” below to make a personalized plan of your own!
On the left side is a list of common situations and feelings that may make you want to use alcohol, tobacco, or other substances. On the right side there are strategies that you can use to cope with these cues. Using drag and drop, match a substance use cue with a coping strategy that you think would work for you.
Situations/Feelings
Upsetting Memory or Reminder
Negative Emotions (e.g., Sadness, Stress, Guilt, Shame)
Celebrations and Holidays
Negative Life Event
Spending Time with Friends and/or Family
Coping Strategies
Distract yourself (e.g., go for walk, watch funny show, play with pet)
Exercise, practice relaxation or mindfulness
Attend therapy or AA/NA meeting
Avoid “risky” situations (e.g., bar, certain social events)
Enlist the help of others
Remind yourself of the reasons you are cutting down or stopping
Remember, there are a variety of potential substance use cues and coping strategies outside of these examples. This activity is not designed to replace professional help, but rather give you an opportunity to think through different strategies that may be helpful for you.
Use the Coping Plan Worksheet to help guide you through creating a plan of your own! You can download and print this worksheet, or feel free to use it as a guide to make your own worksheet.
Cutting down or quitting alcohol and other substances can be difficult to do alone. Trained therapists and coaches are available to help you through this journey! See below for links to a variety of different resources available through this website and the National Institutes of Health.
Link to NIAAA Support/Resources
Link to NIDA Support/Resources
Link to Smokefree.gov
Link to SAMHSA