Leslie Glass's Blog, page 354
June 26, 2018
Marijuana Addiction Is Real But Many Users Don’t Realize That
For Quintin Pohl and other teenagers before him, smoking pot was a rite of passage. It was a diversion from the loneliness he felt at home when his parents were splitting up and a salve for middle-school angst. It was his entire social life in seventh and eighth grades, he said, when social life is everything.
Even though nearly all his friends were using marijuana and seeming to enjoy it, Pohl said, at some point his marijuana use took a turn he never saw coming: He became addicted.
Many people are unaware of marijuana addiction. But in the public health and medical communities, it is a well-defined disorder that includes physical withdrawal symptoms, cravings and psychological dependence. Many say it is on the rise, perhaps because of the increasing potency of genetically engineered plants and the use of concentrated products, or because more users are partaking multiple times a day.
“There should be no controversy about the existence of marijuana addiction,” said David Smith, a physician who has been treating addiction since he opened a free clinic in San Francisco’s drug-drenched Haight-Ashbury neighborhood in the 1960s. “We see it every day. The controversy should be why it appears to be affecting more people.”
Although estimates of the number of people who use marijuana vary, the federal government and the marijuana industry tend to agree that total marijuana use has remained relatively constant over the past decade. Increased use in the past three years has been slight, despite increased commercial availability in states that have legalized it.
The percentage of people who become addicted to marijuana — estimated at about 9 percent of all users, and about 17 percent of those who start in adolescence — also has been stable. Some studies report that even higher proportions of marijuana users develop a dependence, which means they experience withdrawal symptoms when they stop using the drug.
Yet here in Northern California, some addiction treatment practitioners say they’re seeing a surge in demand for help, particularly among adolescents.
Marijuana’s estimated rate of addiction is lower than that of cocaine and alcohol (15 percent) and heroin (24 percent). Unlike with opioids and stimulants, marijuana dependence tends to develop slowly: Months or years may pass before symptoms begin to affect a dependent user’s life.
There are no known reports of anyone dying of a marijuana overdose or of the drug’s common withdrawal symptoms: chills, sweats, cravings, insomnia, loss of appetite, nausea, anxiety and irritability.
According to Nora Volkow, director of the National Institute on Drug Abuse, an estimated 2.7 million Americans meet the diagnostic criteria for marijuana dependence, second only to alcohol dependence.
Smith, a visiting physician at Muir Wood Adolescent and Family Services, a treatment center for boys where Pohl eventually got help, speculates that the potency of today’s pot is causing a higher prevalence of problematic marijuana use.
“Back in the day when kids were sitting around smoking a joint, the THC levels found in marijuana averaged from 2 to 4 percent,” Smith said. “That’s what most parents think is going on today. And that’s why society thinks marijuana is harmless.”
But selective breeding has resulted in an average potency of 20 percent THC, the primary psychoactive compound in marijuana. Some strains exceed 30 percent.
Marijuana concentrates and extracts, much more commonly used in the past five years, have THC levels that range from 40 percent to more than 80 percent, according to marijuana industry promotional information and Drug Enforcement Administration reports.
Susan Weiss, who directs research on the health effects of marijuana at the National Institute on Drug Abuse, told a group of addiction doctors at the annual meeting of the American Society of Addiction Medicine in April that the federal government is trying to get the message out that marijuana can be addictive.
“But believe it or not,” she told the group, “we’re having a hard time convincing people that addiction exists.”
The National Cannabis Industry Association’s chief spokesman, Morgan Fox, said he’s not surprised the federal government is having a hard time convincing the public that marijuana can be addictive.
“It’s their own fault,” he said of the government. “When people find out they’ve been lied to by the federal government about the relative harms of marijuana for decades, they are much less likely to believe anything they have to say going forward, even if that information is accurate.”
Fox said his organization has no disagreement with the finding that about 9 percent of people who use marijuana become addicted, and his organization urges its members to make that clear in their marketing information. But he disagrees that more-potent forms of marijuana may be causing an increase in addiction. “It just means people need to consume less to achieve the desired effect,” he said.
So far, no scientific studies have shown that stronger pot increases the likelihood of addiction, and large swaths of the general public continue to question the existence of marijuana addiction. But for Quintin Pohl, addiction was real.
Quintin’s Story
Pohl said his marijuana addiction took years to develop. His mother, Kimberly Thomas, said that once she realized her son was using marijuana frequently, “it was like a roller coaster chugging uphill, chugging, chugging, chugging. You know something is happening,” she said, “and then just within a couple of days, you reach the peak and zoom downhill. It was awful, awful.”
Scott Sowle, executive director of the Muir Wood rehabilitation center, said he gets the same call from parents nearly every day.
“They call and say, ‘My 16-year-old son was doing really well in school. He was interested in sports and involved in extracurricular activities. But suddenly, he’s just not the same kid anymore.’ ”
Pohl recalled that he drank a little, off and on, but that marijuana was his constant obsession. After middle school, he got involved in rowing for a couple of years and took a break from his group of marijuana friends. But after he decided competitive rowing wasn’t for him, Pohl said he started smoking pot again, this time with new friends who smoked all the time.
And then the roller coaster plunged.
His grades plummeted. He stopped going home most of the time and was couch surfing for a while. Finally, he said, his mom called the police on him for stealing her car. “At that point, I was heartless, emotionless,” he said. “I was just kind of a blob taking up space. I was baked 24/7.”
Pohl’s mother said she saw that he was in trouble and demanded that he stay at home every moment he wasn’t in school. (Pohl’s father was living in San Francisco.)
“She told me to come back home. So I did,” Pohl said. “At the time, I wasn’t sure why she did that. I was still in that whole miserable phase, smoking at least an ounce of weed a week — two ounces on a good week.” (One ounce is enough to smoke four to eight joints every day for a week, depending on their size.)
Then early one morning before school, Pohl recalled, two private investigators his mother had hired appeared and took him to Muir Wood.
Pohl said he went through a week of pure misery at the rehab center: angry, in denial and suffering. “I couldn’t sleep for a week. I was cold, and then I was sweating. I hated everything,” he said. “And then the sun hit my face one morning, and it felt great. Things tasted good, smelled better, everything was just enhanced.”
During his six weeks there, Pohl took intensive classes with about 10 other boys and talked to his therapist frequently. His mother spent eight hours a week there, attending parent classes, sharing meals with her son and working with him and his therapist to address the underlying issues that had led him to self-medicate with marijuana.
Pohl says he hasn’t smoked marijuana since he left Muir Wood last July. For the rest of the summer and after school in the fall, he attended classes at a Muir Wood outpatient clinic in San Rafael.
Wearing black pants, a black sweatshirt and a pink skull cap on a cool but sunny day in late May, Pohl smiles broadly when he talks about his future. After his June graduation, he says, he plans to start working full time at the grocery store where he’s had a part-time job for the last year.
He’s thinks he can start smoking marijuana again some day — socially, when he’s an adult.
Vestal is a reporter for Stateline, an initiative of the Pew Charitable Trusts.
The post Marijuana Addiction Is Real But Many Users Don’t Realize That appeared first on Reach Out Recovery.
June 25, 2018
Why Drinking Too Much Causes Hangovers
From Bethany Cadman @ Medical News Today: A hangover is what some people experience the morning after an evening of heavy drinking. Symptoms typically include a headache, dehydration, tiredness, and nausea and vomiting.
The severity of a person’s hangover can depend on many factors, such as how much and what type of alcohol they drank, how much sleep they got, and whether they had any food or water.
Here, we look at nine ways drinking too much can cause and affect the severity of a hangover.
1. Drinking In Moderation
The best way to avoid a hangover is to drink alcohol in moderation or not at all. The more alcohol someone drinks, the more likely they are to have a severe hangover the next day.
How much is safe for an individual to drink will vary from person to person and depends on many factors, such as how much food they have eaten, how much water they have drunk, and how much sleep they have had.
However, according to the Centers for Disease Control and Prevention (CDC), the 2015–2020 U.S. Dietary Guidelines for Americans recommend that only adults of legal age should drink alcohol and they should only consume it in moderate amounts, consisting of:
up to one drink per day for women
up to two drinks per day for men
These guidelines consider a single drink to be
12 ounces (oz) of 5 percent alcohol by volume (ABV) beer
8oz of 7 percent ABV malt liquor
5 oz of a 12 percent ABV wine
1.5 oz of a 40 percent ABV distilled spirit or liquor
2. Drinking Water
Alcohol is a diuretic, which means it increases a person’s need to urinate and can cause some people to be at a higher risk of becoming dehydrated.
Drinking plenty of water alongside alcoholic beverages can help a person stay hydrated and reduce the symptoms of dehydration, such as thirst, fatigue, and headache.
3. Getting A Good Night’s Sleep
Drinking a lot of alcohol and going to bed early do not necessarily go hand in hand. However, getting plenty of sleep can help reduce the effects of a hangover the following day.
Alcohol can have a negative impact on both the quality and duration of sleep. By getting a good night’s sleep, a person can help their body to recover from the night before, so try lying in or going to bed early the next day.
4. Avoiding Congeners
Certain alcoholic beverages contain chemicals known as congeners. These chemicals are impurities and can contribute towards hangover symptoms.
Drinks high in congeners include:
whiskey, particularly bourbon
cognac
tequila
Drinks with low levels of congeners include:
vodka
rum
gin
In one study, the researchers found that congeners affected the severity of hangovers, with people feeling worse after drinking bourbon than with vodka.
5. Taking Supplements
Some experts think that some of the symptoms a person experiences when they have a hangover result from low-grade inflammation. Therefore, some people might benefit from taking supplements of herbs that have anti-inflammatory properties, such as red ginseng and prickly pear cactus.
6. Pacing Yourself
People who pace themselves when they are drinking alcohol and drink slowly are less likely to experience severe hangover symptoms the following day.
The average person can process one standard drink every hour. Drinking slowly also means that a person may drink less overall.
7. Measuring Your Drinks
It is crucial for a person to measure their drinks and be aware of how much they are drinking. When drinking at home, some people may pour themselves more substantial measures or be less aware of the volumes they are using. This can make it more difficult for an individual to keep track of their alcohol consumption.
8. Eating Before Drinking
Eating a good meal before drinking can reduce a person’s blood alcohol level. It is important for a person to eat a good meal before drinking.
Eating before or at the time of drinking can slow down the absorption of alcohol into the bloodstream.
Food can help keep a person’s blood alcohol concentration lower and may reduce the effects of a hangover.
9. A Good Breakfast
Having low blood sugar levels may make a hangover worse. Eating a good breakfast can help to maintain blood sugar levels as well as provide the body with the right combination of vitamins and minerals to function better.
Outlook
Drinking in moderation or not at all is the best way to avoid a hangover. However, it is essential to remember that excessive drinking, and even moderate drinking, can have an adverse impact on a person’s short-term or long-term health.
People who drink more than the recommended amount of alcohol are putting themselves at increased risk of:
heart disease
certain cancers
liver disease
nervous system damage, including brain damage and peripheral neuropathy
The risk of developing these conditions increases over time with the amount of alcohol a person drinks.
Content originally published by Medical News Today. Note: Content may be edited for style and length.
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Why We Give Up On Goals And How To Power Through
From Science Daily: So you’ve set a goal to eat healthier and you’ve mapped out a plan of attack. You’ll replace those chips with fruit for your late-night snack. You’ll switch to whole-grain bread. You’ll start buying fresh vegetables.
But then you walk into the grocery store, and the fresh vegetables you wanted to buy for your weekly meal plan are unavailable for the third week in a row. Cue the action crisis.
“Setbacks present real challenges in pursuing our goals,” said Richard Vann, assistant professor of marketing at Penn State Behrend. “When goals are blocked by obstacles, we often feel bad about ourselves and sometimes stop pursuing these goals.”
A series of setbacks like this can be defined as an “action crisis,” a time in goal pursuit when circumstances cause an individual to question whether or not a goal is still important.
For instance, if the goal is to lose weight, the action crisis may come when the dieter hits a plateau.
All too often, an action crisis may lead a person to reassess the cost-benefits of a goal and consider giving it up. New research from Vann provides a better understanding of how people respond to action crises.
Vann is the lead author of “When consumers struggle: Action crisis and its effects on problematic goal pursuit,” published early online in the journal Psychology & Marketing. Together with José Rosa, a John and Deborah Ganoe Faculty Fellow at Iowa State University, and Sean McCrea, an associate professor of psychology at the University of Wyoming, Vann conducted experiments to gain a clearer picture of the effects of action crises.
“We really wanted to understand what repeated setbacks and struggles look like,” Vann said. “The whole project was structured around the idea that this is a common shared experience, so we ran the experiments in different contexts.”
One component of the research looked at how people respond to action crises in three different goal situations: a goal to have a stronger patient-provider relationship, a goal to lose weight and a goal to be a more environmentally-conscious shopper.
The experiments, which were administered online through a series of questions, simulated situations in which action crises arose. In each instance, the data showed that the crisis led the person to concentrate on disengagement-focused thoughts rather than reaffirming the goal.
“We found the same pattern across all these areas,” Vann said. “These action crisis thoughts lead people to start devaluing their goal and ratchets up the difficulty of sticking to the goal. It leads people to draw back from their commitment.”
However, if a person (or their support network of family, friends, and professionals) were to know ahead of time that an action crisis may be imminent, he or she might be more likely to stick to the goal. That’s where Vann sees this research being most beneficial.
“If we’re going to be able to help people as they enter that period of repeated struggles or setbacks, we need to know what it looks like when they face an action crisis. That’s why I think this research can be so helpful,” Vann said. “We’re looking at this from a consumer standpoint, but there’s potential relevance in a number of other areas, including health behaviors, careers and personal relationships.”
The research is also very personal for Vann. Growing up, he witnessed his family members struggling with health goals while battling chronic illnesses.
“There was no easy way for them,” Vann said. “They already felt bad, and as they tried to get better, they would hit setbacks. These struggles take a toll; it affects everyone. As we learn more about what setbacks look like and how we respond to them, hopefully we can work to overcome the setbacks to either reach our goals or learn how to use these setbacks to select goals better suited to our situation.”
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F*ck It
From Psychology Today:
The seduction of defiance.
The expletive leaves our lips when we are about to do something we know we shouldn’t—eat a forbidden food, grab fruit from someone else’s tree, use a bus-only lane to bypass a line of traffic, put a purchase we can’t afford on a credit card, give in to a craving that spurs an alcohol binge. We know we are crossing a line. The essence of f*ck it is our awareness of the transgression. The root word trans is active, connoting a deliberate motion toward the choice.
The line we are crossing is there for a reason. One cookie or one drink may have led to binges in the past. If many passersby took an apple, the tree’s owner would be deprived of their rightful bounty. If the bus lane became occluded with single-occupant cheaters, a system intended for all would be subverted by a few. Building up credit card debt only leads to higher monthly payments and more suffering.
I want it. I need it. I deserve it. What we tell ourselves is the same, whether we are tossing aside a personal or a societal restriction. An in-the-moment burst of wanting prompts us to summon justifications. One cookie won’t matter. There’s plenty of apples on this tree. I’ll only be in the bus lane for a minute. I’ve been wanting this camera for a long time. One lousy glass of wine won’t make a difference. Then, if we give in and cross the line, there is a distinct thrill and relief in breaking free of restraint.
Self-control is tiring; it takes continual effort to keep denying ourselves what we want right now. There’s so much waiting involved, especially in being strategic financially. The rewards for harnessing our impulses are in the future, cerebral and somewhat theoretical. Meanwhile, we see other people doing the f*ck itmaneuver and have to fight off feeling foolish. Being sensible feels dull, even on the way to a good life that is likely to be full of rewards for prudence.
To cheat or not to cheat? To succumb to immediate desire or contribute to the common good? Urgency, being late for an appointment, can feel much more compelling than holding to the abstract idea of a bus lane. Sure, the wellbeing of the many should take precedence over the claims of the few. We may recognize that anything supporting the good of all benefits everyone, ultimately. But that empty stretch of road calls to us, and resisting the selfish impulse is tough. I am late. F*ck it.
Moral violations are, by definition, selfish and short-sighted; adherence to principles that improve life for all are generous and future-oriented. I’m staying in this clogged lane—it’s the right thing to do. Virtue can feel good as we join with others to rise above our individualistic and grasping nature. Long ago, we learned about this trade-off in kindergarten, along with the rules on sharing, turn-taking, and putting things back where you found them. Everyone knows that a free-for-all, each person grabbing for themselves, makes a big mess on both a personal and a societal level. It is a better life for everyone when we inspire each other with the fairness and optimism of being able to count on each person doing their part.
This is where the personal and societal levels come together. To oppose the force of f*ck it, we have to remain alert for those sneaky thoughts we whisper to ourselves when we get frustrated, impatient, and envious. Bitterness and resentment, especially, feed the impetus to seize what we want just because we want it, right now, instead of pausing and pondering if this is really the right time or the right way and if this is good for ourselves and others. The first moment we notice such thoughts we have to refuse them. This capacity grows as we get older, so long as we maintain our determination to master this awareness and turn it into a reflex.
Giving up on a diet, taking liberties with another’s property, violating a traffic law, piling up unresolvable debt, and relapsing with drugs and alcohol each begin with the seduction of defiance. We throw off restraint in exchange for later pain, trying artfully at the time to avoid reckoning with the consequences. The more we push back against these impulses at their inception, the better we get at resisting their power over us. If other people have disappointed us in the past, we find that we can choose to enact our own trustworthy conduct and thus increase the likelihood of receiving the same from others. We can hold onto the kind of life we are enhancing with intention, visualizing it vividly and believing in it ardently.
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June 24, 2018
I’m An Addiction Treatment Consumer Advocate
What is an addiction treatment consumer advocate? You may well ask. As a family in long term recovery, we’ve spent over thirty years receiving various forms of addiction and mental health treatment. We’re one of the lucky families who have explored many forms of treatment from 12 Step programs, to social workers, recovery and lifestyles coaches, psychologists, psychiatrists, sober homes, and rehabs. We know what works, and what doesn’t work. We kept at our recovery efforts during challenging and frightening times. Nobody told us that it takes two to five years to restore brain function after years of substance use. As we were not informed about treatment needs back then, consumers know little more today.
Addiction Treatment Consumers Need Information
Fifteen years ago, no organization, state or government website, could provide the information about the kinds of help we would need and where to get it. Fifteen years later, despite millions of deaths, no State, Government, Pharma-funded, Psychology, Psychiatric, or Wall Street-funded rehab site provides the simple information platform that people must have to effectively cope with their disease. Every little group has its recovery resource portal. Some of them are unscrupulous referral sites, some of them are Wall Street Funded, some of them mean well, but none of them provide the full range of information and services families need. Have you seen a site that tells you how long it takes to heal? Let’s get honest about how much and many kinds of treatment we need.
Addiction Treatment Consumers Need Advocates Now
For a decade, I have watched academics, professional associations and organizations of every type, task forces to address the opioid crisis, and a myriad of addiction researchers and professional spend literally billions of dollars on conferences and marketing, advertising, and legislation that does not serve the consumer. The conferences are for the professionals and the marketers and the academics. Many addiction experts call for more research. Lawmakers call for legislation that has nothing to do with people getting help now or prevention. Wall Street is purchasing more and more referral sites and rehabs hoping to get a greater share of $40 billion rehab business.
Who is sharing all the useful information from all these conferences with the consumer and the families affected? ROR aggregates all the research, but no one makes a real job of providing consumer information.
Consumer Advocacy
I have also seen many recovery advocacy organizations refuse to work together or help each other, and in fact undermine each other. It’s sad that each nonprofit wants to be the one and only Recovery Organization. Self interest, whether for profit, or nonprofit isn’t working well for anyone. I personally don’t give a fig for research when literally hundreds of people are dying every day. I don’t believe it’s enough to refer people to outdated government and crowded State websites that do not serve desperate consumers. Government websites are not designed to be useful tools for consumers, and they are not useful tools for consumers. I don’t think that nonprofit organizations that refuse to cooperate with each other end up serving the public.
What The Addiction Treatment Consumer Really Needs
Consumers need a platform that offers direct access to all the providers in their area along with profiles of those providers that spotlight the services and expertise they, along with consumer experience of care reviews. That’s what they need. As a mental health consumer, I want to know from people who have been there what the treatment was like. I know that families coping with addiction are as sick as the patients. I’ve been there. I know they say crazy things. I know they are angry, but I still want to know what they have to say. How else can I be informed Can I rely on the advertising marketing companies rehabs have hired to build their websites? Can I rely on the fake reviews from commercial “information” site? And how can judges refer without knowing the results of their previous referrals? How can patients know what outcomes they can expect if they have to rely on self-interested parties who refer them?
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Who is Best Qualified to Provide Recovery Support Services
At present, non-clinical RSS are being provided through and within a wide variety of organizational settings by people with diverse backgrounds in both paid and volunteer roles. While research to date suggests that such services can enhance recovery initiation and long-term recovery maintenance, no studies have addressed the three questions above or the broader issue of the kinds of evidence that should be considered in answering these questions.
I have repeatedly suggested that these questions should be answered by methodologically-rigorous research evaluating whether recovery outcomes differ by variations in delivery setting, attributes of those providing the services, and the medium (paid vs. volunteer) through which such services are provided. There are, however, considerations beyond such outcomes that ought to be considered and factored into decisions on the design and delivery of RSS.
As for organizational setting, I have heard such arguments as follows:
*RSS should be provided by addiction treatment organizations to assure a high level of integration between treatment and post-treatment continuing care.
*RSS should be provided by criminal justice and child welfare agencies to assure the balance between the goals of recovery support, public/child safety, and family reunification.
*RSS should be provided by hospitals and other primary care facilities to assure effective integration of recovery support and primary health care.
*RSS should be provided through public health authorities to assure the integration of prevention, harm reduction, treatment, recovery support, community-level infection control (e.g., HIV, Hep C), and wellness promotion.
*RSS should be provided by behavioral managed care organizations (or insurance companies) to assure coordination and integration of support across levels of care (and potentially multiple service providers) and the effective stewardship of limited financial resources.
*RSS should be provided by private professional recovery coaches who can coordinate support across multiple systems and across the long-term stages of recovery.
RSS are now being piloted through all of the above arrangements, but I think a strong argument can be made for providing RSS through and beyond all of the above settings under the auspices of authentic recovery community organizations (RCOs). Allocating financial resources to deliver RSS through these organizations and to the community at large has the added advantages of: 1) maintaining long-term personal and family recovery as the primary service mission, 2) drawing upon the experiential knowledge within communities of recovery to inform the provision of RSS, 3) contributing to the growth of local recovery space/landscapes (i.e. community recovery capital), 4) financially strengthening the infrastructure of local RCOs, and 5) proving greater peer support to the workers providing RSS.
Similarly, RSS are now being provided by people from diverse experiential and professional backgrounds. I think there are many RSS functions that can be effectively delivered across this diversity of backgrounds, but I think the delivery of these services by people in recovery who have been specifically training for this role offers a number of distinct advantages. Through the delivery of peer-based recovery support services, people in recovery can uniquely offer: 1) recovery hope and modeling (living proof of the reality of long-term recovery), 2) normative information drawn from personal/collective experience on the stages and styles of addiction recovery, and 3) knowledge of and navigation within local indigenous recovery support resources. Such hope, encouragement, and guidance is grounded in more than 200 years of history in which people in recovery (i.e., wounded healers, recovery carriers) have served as guides for other people seeking recovery from severe AOD problems (See Slaying the Dragon, 2014). It offers the further advantage of expanding helping opportunities for people in recovery—creating benefits for both helpee and helper through the helping process. (See discussion of Riesman’s Helper Principle). Some of these advantages are limited, however, when the knowledge of the RSS specialist is drawn from personal experience within only one recovery pathway—thus the importance of combing experiential knowledge with rigorous training and supervision.
If we accept the delivery of RSS through recovery community organizations and by people with lived experience of personal/family recovery from addiction, there still remains the question of whether those directly providing RSS should be in paid or volunteer roles. The most prevalent model of delivering RSS is presently through paid roles, with progressively increasing expectations of education, training, and certification—similar to the modern history of addiction counseling. Paying people in recovery to provide RSS has the advantages of expanding employment opportunities for persons in recovery, acknowledging the value and legitimacy of experiential knowledge and expertise, and potentially creating a more stable RSS workforce. That said, the professionalization and commercialization of the RSS role risks undermining the voluntary service ethic within the recovery community, potentially creating an unfortunate future in which people in recovery would expect financial compensation for all service work.
One option is to provide funding to RCOs for the recruitment, orientation, training, and ongoing supervision of RSS, while relying primarily upon trained volunteers to deliver such services. Only time will tell if this option is a viable and sustainable model for the delivery of high quality RSS. If not, great care will need to be taken to avoid the over-professionalization and over-commercialization of recovery support. Questions related to the design and delivery of RSS should be answered primarily through research on RSS-related recovery outcomes, but such research should also examine broader benefits and the potential for inadvertent harm rising from particular models of RSS.
William (“Bill”) White
Emeritus Senior Research Consultant at Chestnut Health System
Recovery Historian
Read all of Bill White’s Blog Posts on his website here www.williamwhitepapers.com
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June 23, 2018
Meet The Poster Book
Creating current, easily-digestible information about mental health and addiction recovery that looks good and gets the point across.
Over the years, ROR created a collection of posters for two specific reasons:
We love RECOVERY. Everyone here in our office has been affected by addiction and healed by recovery. We want to help others find the serenity we have.
We love ART. We’re creative types and we need an outlet.
As ROR works to create lines of original, up-to-date content for our readers, we felt it was time to offer these posters because so much of our audience works in the recovery world, or has reason to have these kinds of infographics nearby.
Go Big Or Go Home
All of the colorful posters are also available as 18″ by 24″ posters, perfect for everything from rehabs, to sober livings, to meeting houses, to any home where people feel recovery information should be close and clear.
Sadly, we’re living in a time where having a poster about Fentanyl facts and opioid overdoses have become a necessity.
So, check out the booklet here.
And, check out the posters here.
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A Landmark Study On The Origins Of Alcoholism
From The Atlantic:
For Markus Heilig, the years of dead ends were starting to grate.
A seasoned psychiatrist, joined the National Institutes of Health in 2004 with grand ambitions of finding new ways to treat addiction and alcoholism. “It was the age of the neuroscience revolution, and all this new tech gave us many ways of manipulating animal brains,” he recalls. By studying addictive behavior in laboratory rats and mice, he would pinpoint crucial genes, molecules, and brain regions that could be targeted to curtail the equivalent behaviors in people.
It wasn’t to be. The insights from rodent studies repeatedly proved to be irrelevant. Many researchers and pharmaceutical companies became disillusioned. “We cured alcoholism in every rat we ever tried,” says Heilig, who is now at Linköping University in Sweden. “And at the end of every paper, we wrote: This will lead to an exciting treatment. But everything we took from these animal models to the clinic failed. We needed to go back to the drawing board.”
Heilig doesn’t buy that mice and rats have nothing to teach us about addiction. It’s more that researchers have been studying them in the wrong way. Typically, they’ll let the animals self-administer drugs by pressing a lever, which they almost always learn to do. That should have been a red flag. When humans regularly drink alcohol, only 15 percent or so become dependent on the stuff. Why them and not the other 85 percent? That’s the crucial question, and you won’t answer it with an experiment in which every rodent becomes addicted.
Eric Augier, who recently joined Heilig’s team, tried a different approach—one pioneered in his former laboratory to study cocaine addiction. After training rats to self-administer alcohol, he offered them some sugary water, too. This better mimics real life, in which drugs exist simultaneously with other pleasurable substances. Given a choice between booze and nectar, most rats chose the latter. But not all of them: Of the 32 rats that Augier first tested, four ignored the sugar and kept on shooting themselves up with alcohol.
“Four rats is laughable,” says Heilig, referring to the study’s small size, “but 620 rats later, no one’s laughing.” Augier repeated the experiment with more rats of various breeds, and always got the same results. Consistently, 15 percent of them choose alcohol over sugar—the same number as the proportion of human drinkers who progress to alcoholism.
Those alcohol-preferring rats showed other hallmarks of human addiction, too. They spend more effort to get a sip of alcohol than their sugar-preferring peers, and they kept on drinking even when their booze supply was spiked with an intensely bitter chemical or paired with an electric shock. “That was striking to me, as a clinician,” says Heilig. “Embedded in the criteria for diagnosing alcoholism is that people continue to take drugs despite good knowledge of the fact that it will harm or kill them.”
Many lab studies treat animals as if they were identical, and any variation in their behavior is just unhelpful noise. But in Augier’s work, the variation is the important bit. It’s what points to the interesting underlying biology. “This is a really good study,” says Michael Taffe, a neuroscientist at the Scripps Research Institute who studies drug addiction. “Since only a minority of humans experience a transition to addiction, [an approach] such as this is most likely to identify the specific genetic variants that convey risk.”
That is exactly what the team did next. They compared the alcohol-preferring and sugar-preferring rats and looked for differences in the genes that were active in their brains. They focused on six regions that are thought to be involved in addiction, and found no differences in five. “But in the sixth, we did,” says Heilig. “And it made me smile because I started out doing my Ph.D. on the amygdala.”
The amygdala is an almond-shaped region that sits deep within the brain, and is heavily involved in processing emotions. When Augier looked at the amygdala of alcoholic rats, he found signs of unusually low activity in several genes, all of which are linked to a chemical called gaba.
Gaba is a molecular red light: Certain neurons make and release it to stop their neighbors from firing. Once that’s done, the gaba-making neurons use an enzyme called GAT3 to pump the molecule back into themselves, so they can reuse it. But in the amygdala of alcohol-preferring rats, the gene that makes GAT3 is much less active, and makes just half the usual levels of the pump. Gaba accumulates around the neighboring neurons, making them abnormally inactive.
The consequences of this are unclear, but Heilig thinks that all this extra gabahampers the rats’ ability to deal with fear and stress. They are naturally more anxious, which might explain their vulnerability to alcohol. He predicts it will take another five years of work to fully close this loop. But for now, his team have definitely shown that GAT3—the gaba-recycling pump—is important. They took rats that prefer sugar and deliberately reduced the levels of GAT3 in their amygdala. This simple procedure was enough to convert those resilient rodents into addiction-prone, alcohol-preferring 15-percenters.
At this point, the team submitted their result to a journal, which agreed to publish them. Good news—but after Heilig’s long history with rat-shaped dead-ends, he wanted to do one more experiment. “Curing alcoholism in rats is not important,” he says. “What’s important is what this looks like in humans with alcohol addiction.”
As it happens, it looks much the same. Heilig’s colleagues examined postmortem tissue samples from people who had donated their brains to research, some of whom had alcohol addiction. As in the rats, they found nothing unusual in five of six brain regions. But in the amygdala, they found low levels of GAT3.
Others scientists have found connections between alcoholism, the amygdala, and gaba-related genes. But by identifying rats that are particularly vulnerable to alcoholism, Heilig’s team has begun fleshing out the details behind these somewhat hazy links. “It is a very significant study that will impact the alcohol research field deeply,” says Jun Wang from Texas A&M University. “Identifying GAT3 is not that important because alcoholism is controlled by multiple genes, but [the team’s new approach] will help to find those genes. It’s a wonderful method for modeling human alcoholism.”
There are other signs that what Heilig found is relevant to humans as well as rats. A decade ago, a French cardiologist named Olivier Ameisen claimed to have cured his own alcoholism by taking a drug called baclofen. “That was met with skepticism, and there was no basic science to support his claims,” says Heilig. But there is now: Baclofen stops neurons from releasing gaba. If individuals with alcoholism aren’t good at recycling this chemical, it might be possible to compensate by producing less of it in the first place.
But baclofen is controversial. It has been tested in several clinical trials, to mixed results. Two recent studies, which analyzed the results from these trials, concluded that the drug’s ability to treat alcoholism is only “slightly above placebo effects” and its growing use is “premature.” It can be harmful, too. People quickly build up a tolerance to it, which prompts them to seek higher doses. They can experience severe side effects, and France has seen more than 100 cases of people inadvertently poisoning themselves with baclofen. “It’s a terrible drug,” Heilig says.
Other drugs like benzodiazepines also exert their effects through gaba, but like baclofen, they’re easily abused themselves. “They’re a good alternative for alcoholism in the short term but they’re not safe in the long term,” says Lara Ray from UCLA.
But Heilig’s study suggests that other chemicals, which could influence gabalevels in more subtle ways, might help people to control their addictions. Several such substances are in development, and Heilig’s team can see if they change the choices of their alcohol-preferring rats.
“It’s just such an impressive breakthrough for the field of alcoholism, with real potential for therapies,” Ray adds.
The post A Landmark Study On The Origins Of Alcoholism appeared first on Reach Out Recovery.
Demi Lovato Reveals She Relapsed In New Song “Sober”
From The Fix:
“To the ones who never left me we’ve been down this road before, I’m so sorry, I’m not sober anymore,” the pop star sings in her new song.
Pop star Demi Lovato is forthright about not only about the positive side of her recovery, but also her struggles along the way. The singer-songwriter’s new single “Sober” is a candid confession about a recent relapse after six years of sobriety.
“I don’t know why I do it every time/ It’s only when I’m lonely/ Sometimes I just wanna cave/ And I don’t wanna fight,” she sings. “Mama I’m so sorry I’m not sober anymore/ And daddy please forgive me for the drinks spilled on the floor/ To the ones who never left me we’ve been down this road before/ I’m so sorry, I’m not sober anymore.”
Lovato goes on to apologize to fans, as well as herself: “I’m sorry that I’m here again/ I promise I’ll get help/ It wasn’t my intention/ I’m sorry to myself.”
Lovato is a champion of mental health and recovery support. She herself celebrated six years of sobriety back in March, marking the occasion on social media—“Just officially turned 6 years sober. So grateful for another year of joy, health and happiness. It IS possible”—as she does every March.
She even brings “therapy sessions” to fans before her concerts. “We have speakers from all over and we’re also helping out with different charities from around the country, so it’ll be incredible and a very moving and inspiring experience,” she said.
The goal of the mobile therapy sessions is to shed the stigma of struggling with mental health or asking for help.
“Shame’s just such a lousy feeling,” she said. “There’s nothing positive that comes out of shame.”
Last October, while accepting the Spirit of Sobriety award at a fundraising event hosted by the Brent Shapiro Foundation, the pop star described the consistent work that goes into her recovery.
“Every day is a battle. You just have to take it one day at a time, some days are easier than others and some days you forget about drinking and using, but for me, I work on my physical health, which is important, but my mental health as well,” she said.
Her recovery relies on a multi-faceted approach, like anyone else’s. “I see a therapist twice a week. I make sure I stay on my medications. I go to AA meetings. I do what I can physically in the gym. I make it a priority,” she said.
Rapper Iggy Azalea—who once credited Demi with inspiring her to be more open about receiving therapy at a time when she was “mentally exhausted”—tweeted her support for the “Sorry Not Sorry” singer.
“All of us who love you only want to see you happy and healthy,” she wrote. “I’m proud of you for having the guts to reveal your truth to the world again… I pray you’ll choose recovery again.”
The post Demi Lovato Reveals She Relapsed In New Song “Sober” appeared first on Reach Out Recovery.
Is it Difficult To Quit Marijuana?
Marijuana is one of the most casually used drugs today. Repeated use can lead to physical and psychological dependence, which means your body and brain crave marijuana to be able to function normally. But what’s the difference between the two?
PHYSICAL DEPENDENCE is natural and expected outcome of regular use of a psychoactive drug like marijuana. It occurs in all individuals who use marijuana daily…but the time it takes to become drug dependent varies by individual.. Those who are physically dependent can become drug-free through a gradual decrease in dosage or by quitting marijuana cold turkey.
PSYCHOLOGICAL DEPENDENCE (a.k.a. ADDICTION) can be accompanied or precipitated by physical dependence, but not always. The main difference between physical dependence and psychological dependence are a mental obsession. Those who have become addicted to marijuana will experience an uncontrollable need (cravings) to feel the pleasurable and euphoric rush from another dose. This craving can lead to obsessive-compulsive drug seeking and drug use behavior and an inability to quit smoking weed, even if you want to, even if you are aware of the harm it’s causing.
How Addictive Is Marijuana?
The jury is still out on this one.
According to the Controlled Substance Act (CSA) marijuana is still a Schedule I drug. Federally, law enforcement officials view marijuana as having a high potential for abuse/addiction and no medical purpose. However, more and more states are challenging this view. According to Business Insider magazine, in 2018, over half of all U.S. states have legalized the use medical marijuana for therapeutic purposes. The medical use of marijuana is certainly under the microscope.
Still, scientific research supports the view that marijuana is an addictive drug due to the following facts:
Neuroscientific demonstrations have proved that marijuana affects the reward center in the brain in an exact same manner as all other addictive substances.
Animal studies where marijuana was given twice a day for one week showed an occurrence of addictive symptoms.
Clinical reports of humans reveal a similar pattern of withdrawal symptoms as in animal studies during the first weeks of abstinence.
The bottom line is that marijuana is a psychoactive drug. It affects the mind. When you use marijuana daily for a period of time, you become physically dependent on the THC found in marijuana. Take away the THC, and withdrawal symptoms occur.
Still, withdrawal alone does not characterize addiction. The cravings and obsessive thought patterns around use, followed by uncontrolled consumption are the hallmark signs of an addiction. Add to this continued use dspite negative consequences to home, health, or social life…and you’ve got a budding addiction on your hands.
Why Quitting Is Difficult?
Marijuana does not cause strong physical dependence when used for a short period, but when abused over a longer period it might cause tolerance (need for increasing doses to be able to reach the initial high). High-dose or long-term smokers can experience more severe withdrawal symptoms, making total cessation difficult. Furthermore, the need to use weed to fill an emotional gap can keep people from a life of abstinence.
Quitting can also be difficult if other people around you continue to use. For example, when surrounded by smokers while trying to give up, you’ll find yourself strongly influenced by them to smoke also. This is why experts advise major life changes when you want to quit for good.
Dangers
Marijuana is considered a fairly benign drug, although main dangers of use as reported by the NHTSA include the real threat of drugged driving incidents. Still, there haven’t been any consistent records of severe dangers during quitting. However, the following methods of discontinuation are not recommended due to the high chances of relapse that can lead you back to using again.
1. Relapse.
The main risk of quitting marijuana is starting back again. This is called “relapse”. Excessive cravings can make tapering a prolonged and unpleasant experience for you. In fact, if you find that can’t stop, then you can use cold-turkey as an alternative method. Be aware that going cold turkey can increase the severity of mood disorders and sleeping problems. See the list of side effects below for more.
2. Stopping marijuana without medical supervision.
Marijuana alters the brain chemistry and when used for a longer period causes physical and psychological changes. Doctors at detox clinics/ treatment centers can monitor your state and manage withdrawal symptoms to ensure that the process is safe…especially if co-occuring mental health disorders like depression or anxiety are just below the surface.
Side Effects
If you’ve been using marijuana for a longer period of time, physical dependence can cause you difficulties during quitting because of withdrawal symptoms. While many people report experiencing few or no withdrawal symptoms at all, others report extreme mood swings, dysphoria, and sleeping problems.
A list of common marijuana withdrawal symptoms includes:
Anxiety
Cravings
Depression
Distorted sense of time
Headache
Increased aggression
Loss of appetite
Paranoia
Sleep disturbances
The Safest Way To Quit
If you feel unable to stop using marijuana on your own it’s best to seek advice for the medical issue from a trained and educated medical professional. To make the process of quitting marijuana safer and less risky you can try any of the following methods:
1. Medical supervision and the use of medicines.
This method means that you’ll follow your doctor’s recommends on how to stop taking marijuana. Getting a medical clearance means that your condition will be evaluated by your doctor and you’ll be prescribed with medications to ease your withdrawal discomfort.
New medications prescribed during marijuana addiction treatment are:
Baclofen works by eliminating the reward effects or positive sensations associated with marijuana abuse.
Vistaril (Hydroxyzine) is prescribed to help you reduce anxiety during withdrawal.
The protocol is to test you before and after you quit smoking marijuana. Medical supervision also includes developing an individual plan for reduction of marijuana daily doses between you and your doctor, or a plan to go cold turkey.
2. Tapering or slowly reducing doses.
This method can help ease your withdrawal symptoms and reduce cravings. Gradual tapering is recommended for those who have not succeeded coming off marijuana cold turkey. It is a longer lasting process than cold turkey but possibly more successful in the long-term. Tapering plans are unique for each individual, created along with a doctor, and tailored to a patient’s’ individual needs.
3. Go to a detox clinic, especially if you use other drugs.
Detox centers allow you to recover in a safe and drug-free environment. Detox programs usually begin with an assessment where you’ll be examined about your length and frequency of marijuana use, drinking, or other drugs. Addiction counselors at the detox clinic will compile a medical history file and develop a withdrawal symptom management course specifically designed to meet your needs.
Trained physicians and nurses at the detox clinic will help you minimize withdrawal symptoms while keeping you safe. Medical staff at the detox facility will always be available to help you handle any physical stress or emergencies and ensure that your marijuana detox is successfully done.
4. Consider rehab.
If you are a long time marijuana user and have developed an addiction, you will highly benefit from a structured and tailored to your needs treatment program. Inpatient treatment programs have an integrated approach which includes:
Introduction to the program and to life without marijuana.
Marijuana detox.
Pharmacological and psychological therapy to help you better cope with withdrawal.
Physical, emotional, and mental health support during the treatment process.
Aftercare programs that teach you about relapse coping techniques.
Tips For Tapering Marijuana
TIP #1 Avoid carrying big bag with you. Instead, make a gradual reduction plan
Decide how much you’ll smoke each day and how much you’ll reduce. Then reduce your marijuana into daily bags or daily joints. In order for this to work you need to stick to your daily dose and avoid taking joints from others.
TIP #2 Take longer breaks between each dose of marijuana
Find other things that will occupy your mind other than smoking. This way, you’ll prolong the hours between every next dose and you’ll have less difficulty reducing your daily intake. For example, you can start going home or going to bed earlier to shorten the hours during which you usually smoke.
TIP #3 Gradually cut the number of joints you smoke a day.
If you currently smoke 6 a day, smoke 6 for 3 days, then 5 for 3 days, then 4 for 3 days, and so on until you quit marijuana for good.
TIP #4 Stick to your plan!
The idea of tapering is to help you physically and psychologically accustomed to less marijuana, but this can only work if you have control over how much you consume and don’t give into pressure from your friends.
Originally published by Addiction Blog:
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