Leslie Glass's Blog, page 377

A Letter To My Younger Struggling Self

Hindsight is a wonderful thing. I wish I knew at my darkest times what I know now, six years sober. I wish I could go back to my 20 year-old younger struggling self and tell her what would happen if she continued on her path of destruction. I’d love to hold her hand, to comfort her, and give her some coping strategies for her overwhelming life—a life she just can’t make sense of. I’d love to tell her that it wasn’t her fault—that she was primed for this path—and that she could learn to love herself enough to stop her harmful and addictive behaviors.

This is what I would tell her:

Dear Younger Struggling Self,

It’s not your fault you are here: faced with overwhelming stressors in life, unable to cope, and no resources to grab on to. No one told you that you were enough. No one validated you, and no one showed you healthy coping strategies.

It is not your fault.

Alcohol, cocaine, starvation, and men are not the answer—even though they seem like the only thing that alleviates your overwhelming pain in life. I get it. I know your pain is so great that numbing has become your main purpose in life.

It doesn’t have to be that way.

If you were to visualize how this path works out—even though contemplating a future seems hopeless—you’ll see that the more you numb, the more pain you’ll cause yourself. And over time the numbing becomes harder and harder to achieve. This is a path destined for destruction: you’ll drink more than you’d ever imagine and you’ll do all the things you said you wouldn’t. You will turn into the very people you didn’t want to become.

Before you know it, you’ll be drinking every day—sometimes in the morning—and by the end of the week your bins will be overfilling with empty bottles that you’ll hide in shame. Your days will become clouded by hangovers—trying to get through without throwing up and taking a cocktail of pills. Your appetite for numbing will become insatiable.

And there will never be enough.

The pain will become so palpable that you’ll feel like you’re going insane. Sobbing, binging, purging, obsessing, deceiving, and denial will become your identity. “Liv the Liability” they’ll call you.

That Isn’t A Life, It’s Hardly Even An Existence

This path is like climbing into bed with the devil: it will only get worse.

It may feel like you’re continuing to enter a chasm of despair, but there is a way out. You don’t have to lose hope—it exists. Stop now. I know it seems like you might enjoy it—or even like it is the only coping strategy you have—but you truly don’t.

The more you drink, the more a piece of the real you dies—washed away in buckets of wine and blisters of empty pill packets. That isn’t a coping strategy at all.

It is a path towards an early death.

Trust Me When I Say It Is Possible To Stop

It is possible to live a life free of that crippling anxiety and brutal low self-esteem. It is possible to exist in this overwhelming world that feels so bright and so loud. You simply need to stop. Once you stop, you can learn all the ways to help cope with your troubles, and soothe your pain, way more effectively than using these substances. Self-soothing isn’t accessed at the bottom of the wine bottle, at the end of a line, or in a pill packet.

Know this: you have the power to stop the pain and you have the power to live your best life. You did not cause the pain you have been trying to escape for so long—the pain that has been drowning you.

You have the strength, power, and resilience to step over your pain, learn from it, and join the millions of other people who have walked your path. You’re really not on your own; there are people who will help you. If you take a leap of faith you’ll develop a life beyond your wildest dreams.

You ARE absolutely worth your best shot at trying.

Your older, wiser self.

What I have learned in my recovery—particularly these last few years—is that much of my pain is my childhood pain. I was trying to escape that pain in unhealthy ways. I began the process of healing through the practice of:

Trauma therapy
Somatic experiencing
Daily practices to calm my nervous system
Loving kindness toward myself
Creative outlets
Honoring my voice
Exercise and eating well, and
A community of like-minded people

My world—while not always easy—is much calmer, more fulfilling, and peaceful the other side of the bottle. I wish I knew then what I know now.

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Medical Marijuana Nixed for Sleep Apnea

Medical cannabis and synthetic marijuana extracts should not be used for the treatment of obstructive sleep apnea, according to a position statement from the American Academy of Sleep Medicine.

In November 2017 the Minnesota Department of Health announced the decision to add obstructive sleep apnea as a new qualifying condition for the state’s medical cannabis program. However, the AASM has concluded that sleep apnea should be excluded from the list of chronic medical conditions for state medical cannabis programs due to unreliable delivery methods and insufficient evidence of treatment effectiveness, tolerability and safety.

“Until we have further evidence on the efficacy of medical cannabis for the treatment of sleep apnea, and until its safety profile is established, patients should discuss proven treatment options with a licensed medical provider at an accredited sleep facility,” said lead author Dr. Kannan Ramar, professor of medicine in the division of pulmonary and critical care medicine at Mayo Clinic in Rochester, Minnesota.

The position statement is published in the April 15 issue of the Journal of Clinical Sleep Medicine.

Nearly 30 million adults in the U.S. have obstructive sleep apnea, a chronic disease that involves the repeated collapse of the upper airway during sleep. Common warning signs include snoring and excessive daytime sleepiness. After early animal studies demonstrated that the synthetic cannabis extract dronabinol improved respiratory stability, recent studies in humans have explored the potential use of dronabinol as an alternative treatment for sleep apnea.

However, dronabinol has not been approved by the U.S. Food and Drug Administration for the treatment of sleep apnea, and its long-term tolerability and safety are still unknown. Furthermore, there have been no studies of the safety and efficacy of other delivery methods such as vaping or liquid formulation. Treatment with the use of medical cannabis also has shown adverse effects such as daytime sleepiness, which may lead to unintended consequences such as motor vehicle accidents.

“Until there is sufficient scientific evidence of safety and efficacy, neither marijuana nor synthetic medical cannabis should be used for the treatment of sleep apnea,” said AASM President Dr. Ilene Rosen. “Effective and safe treatments for sleep apnea are available from licensed medical providers at accredited sleep facilities.”

There are more than 2,500 AASM-accredited sleep facilities across the U.S. Treatment options for sleep apnea include CPAP therapy, which uses mild levels of air pressure, provided through a mask, to keep the throat open while you sleep.

Story Source:

Materials provided by American Academy of Sleep Medicine. Note: Content may be edited for style and length.

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Virtual Reality Helps Addicts Practice Saying ‘No’

From Modern Healthcare:

What if there were a safe space for patients with an addiction to practice saying “no” to drugs or alcohol? A Tennessee graduate student is experimenting with virtual reality to deliver just such therapy.

In this virtual reality experience, the patient can walk to a “bar,” hang out with “strangers” and say “no” when someone offers the participant a drink. They can also relax by interacting with floating spheres in a colorful, animated landscape while listening to music.

Virtual reality may have many practical applications for addiction recovery.

“This world kind of helps them escape their own realities and come into a completely abstract universe and then deliver a therapeutic intervention,” Noah Robinson, a Vanderbilt University clinical psychology graduate student, says in a video explaining the therapy.

“If you can create an intervention that is as accessible for the addict as the drug, perhaps they can choose the intervention over the drug,” Robinson told Research News at Vanderbilt.

Robinson has partnered with a Nashville-area rehab center to let its patients try his treatment method from initial intake through post-treatment. “VR can help regulate their emotions as a substance might, but it’s not physically addictive,” he said.

The low-risk, high-tech therapy method in development could offer an alternative to seeing a therapist. “Instead of having to wait until the next day to go to a meeting or wait until the next week to see their therapist, they can immediately put on the headset and be removed from all the cues related to what’s prompting them to want to use the drug and get some of the support that they’re seeking.”

Photo: Adobe

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Addiction Rehab Is Broken. Can Technology Fix It?

From Wired:

MY DAD’S COMPANY had season tickets to the White Sox. On muggy Midwest summer days we’d go as a family—always sitting in the same seats, 25 rows above first base.

I told this to a counselor I’ll call Bill, when he asked me to remember a childhood memory. It was part of the confrontational circle, a form of group therapy with a self-explanatory name. A half-dozen other clinicians looked on as Bill laid into me. “I bet you don’t go to those games with your family anymore, do you?” Bill asked in a way that felt more like telling. I shook my head no.

My time in rehab for an opioid addiction left me humiliated and desperate to know why my friends were dying. Now a wave of app developers are trying to do things differently.

It was the summer of 2012, and the beginning of my third round of treatment for an opioid addiction I’d been trying to kick since I was 17. Now, I was 22 and out of excuses for where all my money went. I’d confessed to my mom that the pills I’d been using had escalated to heroin. At the behest of a counselor, I checked in to a residential program, the kind of rehab you probably recognize from television, the kind reserved for serious cases.

This confrontational circle felt more like gaslighting than therapy. Bill’s voice filled with anger when he called me selfish, a liar, a junkie: all the words I called myself. I tried to tell the therapists that my whole body hurt and that I didn’t think my addiction was a “spiritual malady,” like they’d suggested. Bill kept at me. He poked fun at my withdrawal symptoms. He insisted I was arrogant and intellectualizing; I needed to feel the gravity of my situation. Toward the end of the session, I looked up at the other therapists. Their eyes were aimed at the floor.

My stint in rehab occurred at one of the oldest and most reputable treatment institutions in America. Yet the various components of the program were designed to embarrass me—a brutal technique that has little scientific evidence to suggest that it works. In the Handbook of Alcoholism Treatment Approaches, William Miller, a clinical psychologist, ranks the confrontational approach I endured as 45th out of 48 treatments in terms of effectiveness. Hallucinating on psychedelics ranks 32nd. Educational lectures, which we did for an hour or two each day, rank last.

In the US, the treatment community mythologizes “addicts” and “alcoholics”—terms that I’ve stopped using—as developmentally arrested juveniles, and most programs are based on these assumptions. We’re thought of as whiny ingrates who stop maturing the day we start using. Ever since my demeaning stint in rehab, I’ve been trying to reckon with the sorry state of addiction treatment in the United States. That’s what led me to become a journalist who covers drugs and addiction: I wanted to understand why some mental health disorders are treated with medication and effective therapy, while addiction remains stuck in the murky world of folk wisdom. I wanted to understand why so many of my friends were dying.

Little did I know, as I embarked on my search to untangle the field’s failures, that a group of researchers were attempting to reinvent rehab, using technology I’d never heard of.

‘mHeath,’ short for mobile health, is a new kind of treatment delivered by smart phone, not dissimilar from the deluge of programs you’ll find in the app store. But unlike mobile meditation apps or therapy-by-skype, these treatment apps are designed by clinical researchers and offer programs to curb addiction that are based on scientific evidence.

I wanted to understand why so many of my friends were dying.

Most importantly, these apps buck one of the oldest stereotypes of treatment—that unmooring a person from their life is the only way to curb addiction. Granted, apps alone aren’t a panacea that alone can reform the rehab industry. But by building flexible programs that fit the nuances of their clients’ lives, this mini-movement of doctors, researchers, and developers is attempting to give addiction treatment a modern makeover—a welcome smoke signal in the midst of a massive crisis.

For the most part, addiction treatment has skirted evidence-based medicine, flourishing outside the mainstream. Since the gospel of Alcoholics Anonymous spread in the early 1940s, the abstinence-based group has held an outsized influence on rehab. AA teaches that addiction is created by the loathsome qualities of one’s character. People who are fearful, selfish, and willful turn to alcohol (and drugs); rid them of their deplorable personality and their dependence will follow. The result is what we have today, a mostly unregulated for-profit industry that continues to preach abstinence and character building as the answer to addiction.

That’s especially true when it comes to opioid addiction. A 2015 study found that patients who received only counseling were twice as likely to die from a fatal overdose than their counterparts who received medications for opioid use, like buprenorphine and methadone. But fewer than half of the 12,000 licensed addiction treatment facilities in the US offer medication for treating opioid addiction. The reason for this goes back to the folk wisdom of mainstream substance abuse treatment: To treat addiction, one’s body must be chemical free. At the facility I went to in Minnesota, for example, even the coffee was only half-caffeinated.

As it stands, standard rehab boasts only moderate success. On average, about 40 to 60 percent of people who receive treatment will slide back into addiction, according to the National Institute on Drug Abuse. That’s just the rate for patients who’ve been through quality programs, staffed by professionals with advanced clinical degrees. The relapse rate for fly-by-night or more old school operations is likely much higher. (They didn’t participate in the drug abuse institute’s study.) Still, as the overdose crisis takes more and more lives, politicians like Chris Christie and Bernie Sanders have made anodyne calls for more rehab “beds,” to serve the roughly 20 million people who meet criteria for a substance use disorder.

Here’s where apps come in. They are made by clinical researchers, who, with the help of developers and designers, deliver a program to your smartphone. But unlike most in-patient facilities, these app-administered treatments are beginning to operate with oversight. In September 2017, Pear Therapeutics’s app called reSET became the first of its kind to be approved by the Food and Drug Administration, a process that ensures that the treatment has been through rigorous testing and proven effective. The conditions are so dire, and the demand is so great, that the FDA recently expedited the approval process for Pear’s new app for opioids, called reSET-O.

Of course, some cases require more support than others. By the time I was 17, my life was a series of six-hour cycles: Get high, be sick, repeat. At a time when I was supposed to be seeking out new experiences, my world was confined to my opium bunker of an apartment. I had few friends and lots of dealers, many of whom barely spoke English: Our common language was the metric system. Back then, had apps been around, I probably wasn’t the ideal candidate.

But as several national surveys suggest, severe cases like mine are the exception, a stereotype reinforced by the harrowing tales of addiction memoirs. In real life, addiction is as varied as the people who experience it, and the majority of people recover from their addiction without formal treatment. Surveys show that many drug users manage to maintain a semblance of normalcy: They go to school, hold down jobs, and stay in reasonably healthy relationships. Yet in the one-size-fits-all world of rehab, people who display any sign of problematic using are convinced to fly to expensive centers in Southern California or Florida to get the wakeup call they need.

The premise of mobile treatment apps is that there’s nothing magical about treating addiction. There’s no moment when the clouds part and a spiritual awakening takes hold. Curbing addiction is much like stopping a bad habit or shifting any deeply ingrained behavior; like smoking or nail-biting, it takes time, support, and constant effort to change. You’re on your phone all day, the apps suggest, why not curb a harmful behavior, without missing work for three months? They allow for time and room for the messy process of addiction to slowly untangle: You don’t need to wait until the problem gets worse, they suggest, you can get help now.

Search addiction treatment in Apple’s app store and you’ll get some 10,000 results. Right now, only a few apps offer evidenced-based treatment, but that number is about to balloon. President Trump’s Opioid Commission emphasized the need to use telemedicine and technology—like mobile health apps—to reach rural communities affected by overdoses. For less severe cases of addiction, like people who are still able to hold down a job, apps like Annum and Ria Health involve zero in-person interaction and are designed to help reduce heavy drinking patterns. Other apps fit into the space after rehab: Outfits like WeConnect and Sober Grid operate like social networks for people to stay connected post-treatment, while Triggr Health uses machine learning to predict when a patient is headed for a relapse.

Even though many of these programs are digitizing common rehab practices, they present their methods with a modern spin. For instance, rather than using loaded phrases, like “clean,” to describe abstaining from drugs, Triggr Health uses a more medically accurate (and less morally loaded) word: “remission.” Rather than proselytizing abstinence as the only route to recovery, many of these apps use phrases like “wellness” and “quality of life” to describe the users’ ultimate goal.

And, unlike the majority of residential centers, including the one I went to, none of these apps shies away from medication. In fact, for some apps like Annum and BioCorRx (which launched a beta version in September 2017), medication is central to their treatment approach. On top of a digital regimen, an app like Annum connects the user with a psychiatrist board certified in addictions who can remotely prescribe craving-reducing drugs that will be delivered by mail.

In places like Florida and California, the residential treatment industry has been dubbed the Wild West of health care. This lack of regulation has traditionally been a boon for hucksters looking to convert their beachside homes into “treatment centers.” But these lax standards have also left an opening. “We looked at the entirety of the landscape and saw a lack of clinical evidence across the board,” says Corey McCann, CEO of Pear Therapeutics. “That’s a gross failing of the field; patients deserve better.”

Because apps are pre-programmed, they provide some protection against rogue counselors, like Bill, who might offer a vastly different experience than has been written into a treatment plan. And within these programs, the apps are designed to leave room for users to set their own goals—vastly different from my tour in rehab, where I was punished for not adopting the pre-packaged abstinence-or-nothing approach.

Cassandra McIntosh, a psychologist specializing in counseling, believes that this all-or-nothing abstinence methodology leads to worse outcomes. Unlearning compulsive, near-automatic behaviors, will inevitably involve numerous attempts, but if you drink or use in a rehab, even a single time, you’re liable to get kicked out. “When you send heroin addicts to rehab, they’re at risk of overdosing,” she says. The reason: After weeks of abstinence, our tolerance to opioids diminishes, creating an astronomically high risk of overdosing in cases of relapse.

Medications like buprenorphine and methadone cut that risk by half or more. McIntosh helped design an online platform for Workit Health, one of the first companies to provide Web and app-based treatments. From the company’s home base in Ann Arbor, Michigan, Workit Health offers remote access to apps, including online text and video chats with coaches and counselors for $75 a week. Workit Health also has a brick-and-mortar clinic for medication consults and recovery support group meetings. (A more minimal program, priced at $25 a week, involves access to an online addiction program and a weekly check-in with a coach.)

Workit Health’s offerings feel a little like a class: You write in a “craving log,” and do exercises under categories like “Body” and “Mind.” One Workit Health user, Lindsey, who struggled with opioids, tells me she found the prompts easy to follow; they were often as simple as: Did you give yourself 15 minutes today to walk and clear your head? But the exercises are based on Cognitive Behavioral Therapy and Motivational Interviewing, two techniques that research suggests work better than the 12-step approach I was taught. (Workit Health’s treatment for alcohol did have an abstinence-based bent to it, one user tells me.)

Not everyone is gung-ho on treatment apps. Therapists and psychiatrists fear that insurance companies will find the low cost of apps enticing, leaving patients who require other kinds of treatment without appropriate options. (A low-end stint in rehab can run $14,000 a month; compare that to $300 for a monthly app subscription.) Some, like my own therapist, argue that the intimate client-therapist relationship can’t be replicated on a screen. And in-person treatment leaves less room for evasion. You’re forced to show up as you are, in whatever state of mind. (This may be true, though a 2014 meta-analysis found that “internet-delivered cognitive behavior therapy” was as efficacious as face-to-face therapy sessions.) Though most apps take steps to keep data secure, many still fear putting their intimate medical information online.

Yet the most powerful effect of a more informal approach to rehab might be de-stigmatizing addiction treatment. Brandon Bergman, associate director of Harvard Medical School’s Recovery Research Institute, told me that clinically vetted apps might appeal to users who are already comfortable using technology. According to Bergman’s research, 11 percent of the 22.4 million US adults who have resolved their substance use problem used “recovery-related online technology,” like Facebook groups, subreddits, or a phone app that wakes you up with a motivational slogan. Treatment that resembles these more informal options provides a gateway to other kinds of assistance.

“As long as treatment is seen as this big ordeal, you’ll have a swath of people who don’t want any help,” Bergman says. But if it’s on your smartphone? “You’ll have way more people engaging with recovery processes,” he says. Aside from being rigorously tested by some of the field’s leading psychiatrists, treatment apps may ultimately make it easier for people to get over that first hurdle: finding help.

Ultimately, my recovery happened in spite of my residential stint. With my parents’ financial support, I found a therapist and a psychiatrist who could help me manage my depression and guide me to a fulfilling career. I made friends who convinced me I wasn’t damaged goods and who taught me what self-compassion looks like. Many of these friends are people I found online—I’m delighted to be part of a tight-knit addiction bubble on Twitter. Of course, online forums are not treatment, but being online and connecting with readers gives me the kind of solidarity and community that I thought only AA meetings could provide.

And, on paper at least, I sound like a success story. After rehab, I finished college and then a master’s in journalism. Now I write (precariously) for a living. But if we’re going by the molecules in my bloodstream—THC and ethyl glucuronide, probably from an edible or a gin and tonic trying to finish this story—then I’ve failed the abstinence that defines traditional recovery.

On paper at least, I sound like a success story.

I went to rehab when I was 22. Now I’m 28, and I look back on my treatment experience with bewilderment. I’ve known more than a dozen people—friends from high school and treatment, some sources—who’ve died from drug overdoses. They were all “treated,” went abstinent, and eventually died from an overdose. Conventional thinking would conclude that they failed their treatment. But I don’t see it that way. They didn’t fail treatment, it failed them. When I sat through that confrontational circle five years ago, I experienced a field clinging to tradition. But this new generation of providers gives me hope that people struggling with addiction can receive care that recognizes their dignity.

Photo: Adobe

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Am I Enabling When I Help

People have many excuses for enabling, so it’s a really good question to ask yourself, have you ever said something like this: “Oh, he’s just had a hard day at work and needs to unwind with a few drinks.” Or maybe this,  “My son is very sensitive, so I need to take care of that for him.” We take on the role of an enabler for many reasons and often aren’t aware that it’s a problem.

Helping Vs. Enabling

Enablers believe that pardoning the misbehavior of a loved one, or stepping in to fix something, is just helping out. And who wouldn’t want to help a loved one. A wife makes excuses for a drinking husband; a mother thinks she is helping by doing something for her child rather than having him do it for himself.  When we’re enablers, we support poor choices and inhibit personal development in ones we love. We are constantly moving boundaries trying to facilitate their change. Ask yourself, Is it working.

I had a friend who really believed she was being a good wife by buying alcohol for her alcoholic husband.  She made excuses when his drunken behavior was noticed by others.  She saw this as loyalty.  In reality she was enabling his drinking without consequence, and he ultimately died from alcoholism.  This may sound like an extreme situation, but it is a result of the simple daily decisions we make to allow others to make poor choices, or in the case of the mother mentioned above, in not allowing others to make their own choices at all.

Generosity and acts of service are the hallmarks of an enabler, controlling is the dark side of that.

On one hand benevolence is the motivating factor for helping. On the other, is the fear of losing control.  When we take on the choices of others as if they were our own, we control and we disable. We decide that our choice for them is better than the ones they make for themselves. Being an enabler is often an unconscious behavior, it is just something that we do. We slide into the role with nary a thought to the ramifications for our loved ones.

The solution empowers everyone.

It is far more empowering to stand back and be supportive of the choices of others – whatever they may be – than to direct their lives in the way that we think they should go. Enabling in a positive manner can come through support of loved ones’ decisions that allows them to take responsibility for their own actions and consequences. Empowerment for everyone is moving from “doing for” and “making excuses for” to allowing loved ones to experience their own personal development. It won’t always go well, but it is the process of growth that recovery requires.

This ROR exclusive was co-written by: Kathleen Benzaquin

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A Drug To End Addiction? Scientists Are Working On It.

From The NY Times:

Scrambling for ways to contain America’s out-of-control opioid crisis, some experts in the field are convinced that one bit of good advice is to just say no to the enduring “just say no” antidrug message. Addiction, they say, is not a question of free will or a correctable character flaw, as a lot of people would like to believe. Rather, it is an affliction of the brain that needs to be treated as one would any chronic illness.

A drug that could block the delivery of opioids from blood to brain, giving addicts a path to recovery.

One possible approach, an experimental vaccine, draws attention in this offering from Retro Report, a series of short video documentaries exploring major news stories of the past and their lasting impact. This vaccine would be intended principally for men and women already hooked on heroin or related opioids like Oxycodone and fentanyl — people who would be at risk of death should they detoxify and then relapse, as all too many do.

If it works, the vaccine would stop opioids by effectively blocking them from reaching the brain by way of the circulatory system. At the same time, it would not interfere with other treatments for addicts, like methadone and buprenorphine, or with a compound like naloxone that reverses overdoses.

The vaccine is designed to create high levels of antibodies, said Dr. Gary Matyas, an immunologist who has been developing it at the Walter Reed Army Institute of Research, in Silver Springs, Md. “You inject heroin, the antibodies basically grab all the heroin, bind it all up, and the heroin can’t cross the blood-brain barrier,” he told Retro Report. “And so there’s no high.” Presumably, in time, the heroin would be expelled from the body like any waste product.

“It would be part of their therapy for recovering,” Dr. Matyas said of addicts. “If they mess up and take a dose of heroin, the heroin won’t work.”

But will the vaccine itself work? It still must be tested on humans, and that is not a speedy process; it could take a decade or more, Dr. Matyas said, for there to be “a licensed product.” Among the questions are how large the dosages would have to be and how often they would need to be administered. Nonetheless, he is encouraged by the success he has had with lab mice and rats.

A lot is riding on his experiments. Coming to grips with the opioid epidemic is obviously a national imperative as overdoses soar and more than 52,000 Americans die of them each year, an average of one every 10 minutes. While President Trump has proclaimed it a public health emergency, he has yet to offer specific solutions other than to urge the death penalty for drug dealers.

His health and human services secretary, Alex M. Azar II, has gone further, endorsing an expansion of what is known as medication-assisted treatment and saying he wished to “correct a misconception that patients must achieve total abstinence.” Speaking in February at a gathering of the National Governors Association, Mr. Azar said that addicts “need medicine to regain the dignity that comes with being in control of their lives.”

But that approach is not embraced by everyone in the Trump administration, and it is not clear where the White House will ultimately land on the matter of medicinal intervention. A notable advocate of abstinence is Attorney General Jeff Sessions, who invokes language borrowed from the long-ago “war on drugs” in framing substance abuse as a moral failing. Echoing verbatim the phrase made famous in the 1980s by Nancy Reagan, then the first lady, Mr. Sessions said in October that “we’ve got to re-establish, first, a view that you should just say no. People should say no to drug use.”

That’s probably reasonable advice to an adolescent who has yet to so much as puff on a marijuana joint or take a swig of booze, said Thomas McLellan, who was deputy director of the Office of National Drug Control Policy in the Obama administration. But it’s another story with someone already on drugs. “If you’re talking about a person who’s addicted to opioids and is in a very bad situation, ‘just say no’ is perfectly ridiculous,” Mr. McLellan told Retro Report.

He was equally dismissive of those who regard methadone maintenance and other regimens as no more than crutches that substitute one form of dependency for another. “As a matter of fact, they are a crutch,” he said. But he added, “They make crutches for people who are having trouble standing on their own.” The treatments are no different from, say, insulin injections for diabetics, guiding people through troubled moments when they are “very vulnerable to relapse.”

“They’re an insurance policy,” Mr. McLellan said. More to the point, he said, “they reduce craving and, most importantly, they prevent overdoses.”

Along that line, the vaccine being developed by Dr. Matyas, which is intended to be effective as well against H.I.V., the virus that causes AIDS, would in theory block heroin from reaching the brain and binding to protein receptors there. Thus it would (a) eliminate, or at least appreciably minimize, the euphoria that the drug produces in users who relapse, and (b) end the risk of respiratory depression that accompanies an overdose, causing the addict to stop breathing.

While it will take years for his discovery to be tested thoroughly and approved by the federal authorities, Dr., Matyas has faith in the potential to help turn this crisis around. In that vein, he invoked a famous addict, the actor Philip Seymour Hoffman, who died in 2014 having succumbed to what was believed to be a lethal mixture of heroin and other drugs.

The vaccine would not end an addict’s craving for opioids, the immunologist said. As with Mr. Hoffman, relapses are to be expected, and the vaccine would have to be re-administered at regular intervals. But by keeping users from getting high, the medication would greatly reduce the risk of overdoses. That’s the “true vision” of the vaccine, Dr. Matyas said: to ward off the pattern of relapse and overdose that killed Mr. Hoffman and ended a great stage and film talent.

Photo: Adobe

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Same Mission Broader ROR Vision

The ROR vision is broadening to meet the growing need for recovery help. Google research shows that some 750,000 people search the Internet every day for addiction help. Since Reach Out Recovery (ROR) launched its unique magazine format site seven years ago, dozens of referral sites and recovery treatment centers have used the same style to appear as information sites instead of treatment centers. These are misleading for people seeking reliable information. ROR is the safe resource people really need.

ROR is the only addiction/recovery nonprofit whose sole agenda is education, prevention and support for healthy living. In seven years nothing about ROR’s mission has changed. ROR provides a daily newspaper and over 600 original articles on many subjects, providing a varied user experience for different ages, stages of recovery, and interests.

The ROR platform serves the 23 million people living the recovery lifestyle; the millions of addiction sufferers desperately seeking accessible information about treatment and long-term recovery; and the 120 million people impacted by addiction. Without government funding or advertising from the treatment industry, ROR has provided free and reliable information in an engaging and easy to read format for seven years. The growth of our audience is our proof that this underserved audience is hungry for hope and information.

Broader ROR Vision

ROR has begun its first campaign to raise funds for sustainability from the audience it serves like other nonprofit media groups: from private foundations, companies that support recovery, and visitors like you. ROR now has a shop. You will begin to see the fashion forward recovery pins on your friends and coworkers, recovery posters, the movie that started it all, the co-dependent cookbook, and many other products to promote healthy living and the recovery cause.

Memorial and Honors

Other ways the public can support ROR is to add a friend or loved one who’s rocking recovery to our Honors page. For those who are mourning a lost loved one, the ROR Memorial page is great way to create a lasting memory and support ROR with a small donation at the same time.

Recovery Guidance Portal

What is the Recovery Guidance Portal you see on ROR? Recovery Guidance is a free resource for visitors and subscription site for providers, developed by the founder of ROR. Using the most advanced technology, Recovery Guidance automatically delivers the closest providers to every visitor no matter where they are. Recovery Guidance’s sole purpose is to give addiction and mental healthcare consumers direct access to the full spectrum of care needed for long term recovery, and a review system (like Health Grades) to see what others have to say about the care they received.

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Stress and Addiction

From: Psychology Today

Stress is a key risk factor in addiction initiation, maintenance, relapse, and thus treatment failure (Sinha & Jastreboff, 2013). Stressful life events combined with poor coping skills may impact risk of addiction through increasing impulsive responding and self-medication.

While we can’t eliminate stress, we need to find ways to manage it.

Stress normally refers to adversity or hardship such as poverty or grief. Biologically, stressful events cause a rise in blood levels of stress hormones (such as cortisol). Fight-or-flight is the normal response to stress. That is, all the blood goes to the muscles so that you’re ready for action.

It is important to distinguish between chronic and normal stress. Moderate and challenging stressors with limited duration are perceived to be pleasant. In fact, some individuals seek “stressful” situations (sensation-seekers or seeking out novel and highly stimulating experiences) that promote the release of stress hormones. However, intense, unpredictable, prolonged stressors (e.g., interpersonal conflict, loss of loved ones, unemployment) produce learned helplessness and depressive-like symptoms. Chronic stress increases the risk for developing depression, the common cold, influenza, tension headaches, grinding teeth, or clenching the jaw and tensing the neck and shoulders (McEwen, 2003).

Trauma in early childhood is a key factor for making people more vulnerable in later life (Keating, 2017). The link from early adversity to later life problems runs through social epigenetics. High levels of stress experienced in early life can cause methylation of key genes that control the stress system. That is, early adversity alters our genetics. When this happens, we live in a constant state of emergency.

The workplace provides almost routine exposure to chronic stress.

Work related stress may include factors such as the demands of the job, the ability to have control over decisions and the degree of social support within the workplace. People in jobs where they don’t perceive themselves to have a lot of control are susceptible to developing clinical anxiety and depression, as well as stress-related medical conditions like ulcers and diabetes (Marmot, 2006).

The stressful event or circumstance itself is not harmful. What matters is how the person appraises (interprets) the stressor and how he or she copes with it. One can use reappraisal as a coping strategy by viewing situations differently (e.g., it is no longer a big deal). One can also cope with stress by smoking, drinking, and overeating. What is important is the meaning that the event or circumstance has for the individual (Lazarus, 2006).

There is solid evidence for the link between chronic stress and the motivation to abuse addictive substances (Al’Absi, 2007). For instance, research in human studies shows that adverse childhood experiences such as physical and sexual abuse, neglect, domestic violence, and family dysfunction are associated with increased risk for addiction. People with an unhappy marriage, dissatisfaction with employment, or harassment, also report increased rates of addiction.

The experience of adverse rearing during childhood and adolescence(childhood abuse and neglect) indirectly increases risk for addiction through decreased self-control (Lovallo, 2013). Young adults at risk for substance abuse are known to have decreased self-control and emotional control. Their addictive behavior is the result of their experiences and the environments in which they were brought up.

Photo: Adobe

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Digital Addiction Increases Loneliness, Anxiety and Depression

From SF State News:

A new study finds that smartphone use can cause anxiety and be similar to other types of substance use. Smartphones are an integral part of most people’s lives, allowing us to stay connected and in-the-know at all times. The downside of that convenience is that many of us are also addicted to the constant pings, chimes, vibrations and other alerts from our devices, unable to ignore new emails, texts and images. In a new study published in NeuroRegulation, San Francisco State University Professor of Health Education Erik Peper and Associate Professor of Health Education Richard Harvey argue that overuse of smart phones is just like any other type of substance abuse.

SF State study suggests ways to outsmart anxiety causing smartphones


“The behavioral addiction of smartphone use begins forming neurological connections in the brain in ways similar to how opioid addiction is experienced by people taking Oxycontin for pain relief — gradually,” Peper explained.

On top of that, addiction to social media technology may actually have a negative effect on social connection. In a survey of 135 San Francisco State students, Peper and Harvey found that students who used their phones the most reported higher levels of feeling isolated, lonely, depressed and anxious. They believe the loneliness is partly a consequence of replacing face-to-face interaction with a form of communication where body language and other signals cannot be interpreted. They also found that those same students almost constantly multitasked while studying, watching other media, eating or attending class. This constant activity allows little time for bodies and minds to relax and regenerate, says Peper, and also results in “semi-tasking,” where people do two or more tasks at the same time — but half as well as they would have if focused on one task at a time.


Peper and Harvey note that digital addiction is not our fault but a result of the tech industry’s desire to increase corporate profits. “More eyeballs, more clicks, more money,” said Peper. Push notifications, vibrations and other alerts on our phones and computers make us feel compelled to look at them by triggering the same neural pathways in our brains that once alerted us to imminent danger, such as an attack by a tiger or other large predator. “But now we are hijacked by those same mechanisms that once protected us and allowed us to survive — for the most trivial pieces of information,” he said.


But just as we can train ourselves to eat less sugar, for example, we can take charge and train ourselves to be less addicted to our phones and computers. The first step is recognizing that tech companies are manipulating our innate biological responses to danger. Peper suggests turning off push notifications, only responding to email and social media at specific times and scheduling periods with no interruptions to focus on important tasks.


Two of Peper’s students say they have taken proactive measures to change their patterns of technology use. Recreation, Parks and Tourism major Khari McKendell closed all of his social media accounts about six months ago because he wanted to make stronger face-to-face connections with people. “I still call and text people but I want to make sure that a majority of the time I’m talking to my friends in person,” he said.


Senior Sierra Hinkle, a Holistic Health minor, says she has stopped using headphones while out walking in order to be more aware of her surroundings. When she’s out with friends, they all put their phones in the center of the table, and the first one to touch theirs buys the drinks. “We have to become creative and approach technology in a different way that still incorporates the skills we need but doesn’t take away from real-life experience,” said Hinkle.

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How Chronic Early-Life Stress Raises PTSD Vulnerability

From Science Daily:

Medical researchers may have discovered how chronic stress experienced early in life increases vulnerability to post-traumatic stress disorder later in life.

A collaboration between investigators at Massachusetts General Hospital and Khyber Medical University in Pakistan may have discovered how chronic stress experienced early in life increases vulnerability to post-traumatic stress disorder (PTSD) later in life. In their report published in Translational Psychiatry the researchers describe finding that chronic stress induces a persistent increase in the hormone ghrelin, both in a rat model and in human adolescents. Rats with stress-induced ghrelin elevations were more vulnerable to an excessive fear response long after the stressful experience, a vulnerability that was eliminated by long-term blockade of ghrelin signaling.

Stress experienced early in life increases vulnerability to PTSD later in life.

“Ghrelin is called the ‘hunger hormone,’ and while it does play an important role in appetite, it has many other effects,” says Ki Goosens, PhD, of the MassGeneral Institute for Neurodegenerative Disease, who led the study. “Several teams have shown that repeated stress exposure increases circulating ghrelin levels in many organisms, but those studies examined ghrelin shortly after the stressor exposure ended. Ours is the first to show that traumatic stress increases ghrelin in humans — specifically in adolescent humans — and the first to look at ghrelin elevation over long time periods after the end of the stressor.”

Considerable evidence supports the impact of early-life stress on brain function.

Adolescents are known to have increased emotional reactions to their experiences, and stress may enhance that reactivity, increasing vulnerability to several mental health disorders. Since areas of the brain such as the prefrontal cortex that regulate fear-responsive structures including the amygdala continue to develop during adolescence, stress-induced disruption of the developmental process during adolescence could interfere with those regulatory circuits.

To investigate the potential long-term impact of chronic stress on ghrelin levels, the researchers conducted a series of experiments. Chronic stress was induced in a group of adolescent rats by immobilizing them inside their cages daily for two weeks. A control group was handled daily by research team members over the same time period. Not only were ghrelin levels in the stress-exposed rats significantly higher 24 hours after the last stress exposure, as previously reported, they also remained elevated 130 days later, roughly equivalent to 12 years in human lifespan.

To investigate whether long-term stress produced similar persistent ghrelin elevation in humans, the researcher enrolled 88 children from the Khyber Pukhtunkhwa province of Pakistan, an area affected by more than a decade of terrorist activity. The participants averaged around age 14 at the time of study, and some had either experienced a personal injury or lost a family member in a terrorist attack around four years prior to entering the study. The control group consisted of children who had not experienced those specific types of trauma.

Blood tests revealed that circulating ghrelin levels in the trauma-affected children were around twice those of the control group. Based on interviews with the children and their parents, trauma-affected children also had differences in their sleep, emotional regulation and social isolation, compared with the control group. And while all participants had a body mass index (BMI) within the normal range, the BMIs of trauma-exposed children were significantly lower than those of the control group.

To test the long-term impact of stress-induced ghrelin elevation in the rat model, the research team exposed two other groups of animals to 14 days of either chronic stress induction or daily handling. Two weeks later both groups went through a standard behavioral protocol called fear conditioning, which trained them to expect an unpleasant sensation — a mild but not painful foot shock — when they heard a specific sound. After they learn that association, animals will typically ‘freeze’ in expectation of the shock when they hear that sound. Compared to the control animals, the chronic-stress-exposed rats showed a stronger fear memory by freezing longer during the sound when it was not paired with a shock.

To test whether blocking ghrelin signaling could reduce the stress-enhanced fear response, the researchers administered a drug that blocks the ghrelin receptor to groups of rats over three different schedules — throughout both the two-week chronic stress induction period and the two weeks prior to fear conditioning, during the stress induction period only or during only the two weeks between stress induction and fear conditioning. While blocking the ghrelin receptor for the full four weeks did eliminate the stress-induced enhanced fear response, blocking ghrelin signaling either only during or only after stress induction did not prevent the enhanced response.

“It appears that blocking the ghrelin receptor throughout the entire period of ghrelin elevation — both during and after stress — prevents fear enhancement when the animals subsequently encounter a traumatic event,” says Goosens. “But only blocking the receptor during stress, when ghrelin is initially elevated, or after stress, when it remains elevated, does not prevent the fear-enhanced, PTSD-like response.”

She adds, “Previous work from my lab shows that exposing brain cells to high levels of ghrelin reduces their sensitivity to the hormone, which we call ‘ghrelin resistance.’ We’ve also shown that ghrelin inhibits fear in unstressed individuals, and we believe that stress-induced ghrelin resistance interferes with that inhibition. Finding a way to reverse ghrelin resistance could have important therapeutic implications. The ability to identify individuals who are more vulnerable to the detrimental effects of stress, as well as the ‘tipping point’ when they become vulnerable, could enable early intervention with either therapy or medication.”

Photo Credit: Adobe

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