Preventing relapse to substance use is mainly a matter of becoming aware of the triggers to relapse and either finding ways to avoid or cope with them. Triggers can be external, for example being in places where substances are being used. Stress of any kind (job stress, financial stress, arguments with important people) can also be an external trigger. Triggers can also be internal such as craving, depressed mood, anxiety, hunger or fatigue. The key is, whenever possible, to anticipate triggers ahead of time so they don’t come as a surprise and have a plan or coping strategy to deal with the triggers. Usually professional help can be helpful in gain awareness of triggers and developing plans to deal with triggers to relapse. There are also very good medications for alcohol, opioid and tobacco use disorders that effectively reduce craving and can help prevent relapse.

The symptoms of dementia vary between individuals and types of dementia. Some of the early signs include memory problems, problems with language, misplacing personal belongings, trouble with organizing and planning activities like physician appointments, mood changes, difficulties in performing familiar tasks or using everyday objects like a cellphone, being confused about time and place, and withdrawal from social activities like family gatherings.

Opioid type medications that have potential to lead to addiction are only one way, and probably not the best way, to help manage chronic pain. So the best plan is to try all the alternatives first.

Non-medication interventions such as graded exercise programs, physical therapy, mindfulness meditation, yoga, tai-chi and a form of psychotherapy called cognitive-behavioral therapy (CBT) all take some effort but often work very well. Acupuncture may benefit some people living with pain. Many medications that do not have addiction potential can also be helpful for chronic pain. These include anti-inflammatory medications like aspirin, ibuprofen or naproxen; antidepressants like nortriptyline or duoloxetine; or medications often used for seizures like gabapentin or pregabalin.

If you or someone you know does require opioid pain medications to help manage chronic pain, it is reassuring to know that the majority of people who take these medications for chronic pain do not become addicted to them, although anyone who takes these type of medications for more than a few weeks is likely to have some tolerance (less effect of the medication over time) and withdrawal symptoms if the medications are stopped abruptly.

Stress and burnout are common in caregivers for individuals with dementia, especially as the severity of dementia progresses and requires more investment in care by caregivers. Caregivers can be frustrated, depressed, and anxious about caring for their loved ones, which can take a toll on their physical and mental health. It is vital that caregiver burden and stress be addressed when assessing individuals with dementia. They should be provided with a break from caregiving for a few hours a day to take care of themselves and their needs. Family members can also take turns providing care for the individual with dementia.