Leslie Glass's Blog, page 386
March 14, 2018
Success At School Overcomes Abuse
University of Michigan The emotional and sexual abuse that some children endure can lead them to commit crimes later in life.
But when children achieve good grades and don’t skip school, the likelihood of self-reported, chronic criminal behaviors declines significantly, according to researchers at the University of Michigan and University of Washington.
This new ongoing study is one of the few in the nation to follow the same individuals over several decades to learn about how child maltreatment–described as physical, emotional and sexual abuse, as well as neglect–impacts development and how some are resilient.
“Child abuse is a risk factor for later antisocial behavior,” said study co-author Todd Herrenkohl, the Marion Elizabeth Blue Professor of Child and Family at the U-M School of Social Work. “Education and academic achievement can lessen the risk of crime for all youth, including those who have been abused (encountered stress and adversity).”
In addition to crime/antisocial behavior, the researchers also investigated effects on physical and mental health, drug and alcohol abuse, intergenerational transmission of violence, and socioeconomic disadvantage.
Previous studies about child maltreatment have not distinguished youth and adult chronic offenders from non-offenders and those who perpetrate antisocial behavior in adolescence only, who are called desisters.
“Given that offending in adolescence can persist into adulthood if left unaddressed, it is important to identify and act on factors that predispose individuals to ongoing patterns of antisocial behavior,” said Hyunzee Jung, the study’s lead author and a U-W researcher.
Data involved 356 people from childhood (ages 18 months to 6 years) in 1976-1977, school-age (8 years) in 1980-1982, adolescent (18 years) in 1990-1992 and adulthood (36 years) in 2010.
Parent reports, self-reports–which included crime/antisocial behavior–and parent-child interactions measured various types of abuse and neglect, and responses also factored educational experiences and criminal behavior against others or property.
The abuse led to people more likely to commit crimes, but this was not the case for those who had been neglected in their early years, the study shows.
Successful school experiences kept teens from both committing crimes and having antisocial behaviors. But for youths suspended in grades 7 to 9, the chronic offending habits and antisocial behaviors continued later in life, the researchers said.
Herrenkohl said the primary prevention of child abuse is a critical first step to reducing antisocial behavior at the transition from adolescence into adulthood.
“Strategies focused on helping school professionals become aware of the impacts of child abuse and neglect are critical to building supportive environments that promote resilience and lessen risk for antisocial behavior,” he said.
The study, whose other authors are U-W researchers Martie Skinner and Ashley Rousson, appears in the Journal of Interpersonal Violence.
The above story is based on materials provided by University of Michigan.
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E-cigarettes Raise Number Of Smokers
From Science Daily A new study finds that e-cigarette use could do more harm than good by substantially increasing the number of adolescents and young adults who eventually become cigarette smokers and marginally decreasing the number of adult cigarette smokers who quit.
The popularity of electronic cigarettes (e-cigarettes) has grown rapidly in the United States over the past decade. E-cigarettes may help cigarette smokers quit smoking, but they may also encourage transitions to start smoking cigarettes. Based on available evidence, Dartmouth researchers quantified the balance of health benefits and harms associated with e-cigarette use at the population level and found that e-cigarettes could substantially increase the number of adolescents and young adults who eventually become cigarette smokers.
The electronic cigarette (e-cigarette) industry is rapidly growing in the United States and the use of e-cigarettes is controversial. The controversy persists because researchers do not yet know if e-cigarette use results in more benefit than harm at the population level. New research from Dartmouth’s Norris Cotton Cancer Center, in collaboration with Moores Cancer Center at UCSD, UCSF School of Nursing, and University of Pittsburgh School of Medicine, quantifies the balance of harms and benefits using the most current scientific evidence.
“Although the tobacco industry markets e-cigarettes as a tool to help adult smokers quit smoking, e-cigarette use actually only marginally increases the number of adult cigarette smokers who are able to successfully quit,” says principle investigator Samir Soneji, PhD, Associate Professor at The Dartmouth Institute for Health Policy and Clinical Practice. “On the other hand, e-cigarettes may facilitate cigarette smoking initiation and confer substantial harm to adolescents and young adults once they are introduced to nicotine.”
Utilizing census counts, national health and tobacco use surveys, and published literature, Soneji’s team calculated the expected years of life gained or lost from the impact of e-cigarette use on smoking cessation among current smokers, and transition to long-term cigarette smoking among never-smokers. “E-cigarettes could lead to more than 1.5 million years of life lost because their use could substantially increase the number of adolescents and young adults who eventually become cigarette smokers,” says Soneji. The results of their research, “Quantifying Population-Level Health Benefits and Harms of E-Cigarette Use in the United States” are newly published in PLOS ONE.
Results find that based on the existing scientific evidence related to e-cigarettes and optimistic assumptions about the relative harm of e-cigarette use compared to cigarette smoking, e-cigarette use currently represents more population-level harm than benefit. While tobacco control efforts have successfully led to a substantial reduction in youth cigarette smoking since the 1990s, e-cigarettes have the potential to slow or even reverse that trend.
Effective national, state, and local efforts are needed to reduce e-cigarette use among youth and young adults if e-cigarettes are to confer a net population-level benefit in the future. “E-cigarettes will likely cause more public health harm than public health benefit unless ways can be found to substantially decrease the number of adolescents and young adults who vape and increase the number of smokers who use e-cigarettes to successfully quit smoking,” says Soneji. “We also need to close the regulatory gaps that make e-cigarettes appealing to adolescents and young adults by reducing the availability of kid-friendly flavors (e.g., fruit-flavored e-cigarettes) and issuing product standards that reduce the level of known toxins and carcinogens in e-juice.”
Samir S. Soneji, PhD, is an Associate Professor at the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College. He is also a member of the Cancer Control Program at Dartmouth’s Norris Cotton Cancer Center. His research interests include the value of cancer care, tobacco regulatory control, and cancer screening, and focus on developing and applying innovative and quantitative methods to questions in tobacco control and cancer screening.
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Materials provided by Dartmouth-Hitchcock Medical Center. Note: Content may be edited for style and length.
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What Makes Teens Drop Out
From Science Daily While the national high school dropout rate has declined, many school systems still struggle with a high number of students who do not finish high school.
The factors that may lead to a student’s decision to leave school are complex, but a new study from the University of Georgia sheds light on how two behaviors — aggression and weak study skills — contribute to the problem.
“What we find in our study is that the students who are dropping out have complex behavioral and academic problems,” said Pamela Orpinas, a professor of health promotion and behavior at UGA’s College of Public Health and lead author on the study.
The returned benefit of reducing dropout can’t be overstated, she said. A good education can level the playing field for students who may face other challenges in their environment, such as living in resource-poor neighborhoods or an unstable home.
“Graduating from high school is almost like a miracle drug,” said Orpinas. “If you think of one thing that we could do to improve students’ health, it’s make sure kids have a good education and graduate from high school.”
The key to helping a student stay in school is spotting the signs and behaviors that put students at risk of dropping out earlier in their academic careers, she said.
Students exhibit both aggression and study skills early in school, and both behaviors have been independently associated with learning and success, or lack of it. Orpinas’ study is the first to track the two together over a period of seven years.
The researchers randomly selected 620 sixth-graders from northeast Georgia schools. Teachers completed a behavior rating scale for these students every year from sixth through 12th grade. Based on teacher ratings, the students were grouped into low, medium and high aggression trajectories from middle to high school, and into five study skills groups.
Orpinas was particularly interested in tracking behaviors that teachers could observe and, more importantly, affect their classrooms.
“You can examine dysfunction in the family or problems in a neighborhood, but there’s very little teachers can do about it. Aggression and study skills are issues that the teachers could manage in the classroom,” she said.
Students classified in the high aggression/low study skills group had a 50 percent dropout rate compared to students with low aggression and high study skills who had a dropout rate of less than 2 percent.
“That is a dramatic difference,” said Orpinas, “and the study illustrates how well these behaviors were able to predict dropouts across all groups of students.”
This study points to the importance of supporting schools and educators with the resources they need to detect and correct all behaviors that put students at risk, Orpinas said. It will not be enough to address just one of them, either aggression or study skills.
“Simple and single solutions do not work,” she said.
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Materials provided by University of Georgia. Note: Content may be edited for style and length.
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March 13, 2018
Surfing Therapy Helps Heal PTSD
Now the Navy has embarked on a $1 million research project to determine whether surfing has therapeutic value, especially for military personnel with post-traumatic stress disorder, depression or sleep problems.
Researchers say surfing offers great promise as therapy. It is a challenging exercise in an outdoor environment; people surf individually or in groups; military surfers who are reluctant to attend traditional group therapy open up about their common experiences when talking to other surfers on the beach.
“Lots of times it becomes therapy under the guise of recreation,” said Helen Metzger, head of the health and wellness department at Naval Medical Center San Diego. “They talk about surfing and then it gets into things that are deeper than that, common experiences, common traumas.”
“For many of our patients, exercise is the best medicine, and exercise in the natural environment is even better,” said James LaMar II, a physician at the Naval Medical Center San Diego and a volunteer in the hospital’s surfing program. “Surfing is a way back to a healthy life, the kind of life they had before they were traumatized.”
The military saw a 65 percent increase in mental-health diagnoses among active-duty personnel between 2001 and 2011, according to a 2013 study done by the Congressional Research Service. Cases of PTSD increased by 650 percent, according to the study, and more than 900,000 individuals were diagnosed with at least one mental disorder during that decade.
The Navy study, led by clinical psychologist Kristen Walter, analyzes questionnaires answered by service members before, during and after a program of surfing one day a week for six weeks.
The first group of 14 active-duty Marines and sailors in the six-week surfing program all had shown signs of major depressive disorder, some with signs of PTSD, researchers said.
To the researchers, the initial results suggest that surfing can lead to a decrease in insomnia and feelings of anxiety, and a decline in an overall negative view of life and other symptoms of depression.
The study, which began last year, will follow up with participants to check on their sleeping patterns and whether improvements in their mental outlook have been long-lasting.
The study also plans to test the hypothesis that while hiking is beneficial, surfing is even more so. While some patients will go surfing, others will be taken on hikes.
When the three-year study is complete, there will have been 118 participants in surfing groups and 43 in hiking groups.
For physicians who have treated service members, the initial upbeat results are not surprising.
“I’m a believer,” said Cmdr. Natalie Wells, preventive medicine physician and director of military population health at the Naval Health Research Center in San Diego.
“It’s huge that Navy medicine is thinking outside the box,” said Betty Michalewicz-Kragh, an exercise physiologist at the hospital and director of the surfing program.
Physicians in the military medical system and the Department of Veterans Affairs are hoping the study will prove that surfing is therapy, not just recreation.
“We all know it’s good; we can see it,” said Capt. Eric Stedje-Larsen, a pain management specialist who worked in the San Diego surfing program before being assigned to the Navy hospital in Portsmouth, Va. “For some folks, there is nothing like it. But we need science to get the administrators onboard.”
The surfing program at the Naval Medical Center San Diego began in 2008 when therapists were helping an Army staff sergeant from Hawaii whose right leg and right hand were blown off in Iraq. He asked whether he would ever surf again. Therapists took him surfing and, over time, were impressed as he regained strength and self-confidence.
A second patient, a Coast Guard seaman whose leg was amputated in a motorcycle accident, joined the soldier. Soon a surfing program was created for other amputees and then for patients with mental-health problems.
The idea that surfing can relieve the trauma of war is not new. An expansive exhibit at the California Surf Museum in Oceanside, close to Marine Corps Base Camp Pendleton, is titled “China Beach: Surfing During the Vietnam War and the Healing Power of Wave-riding.”
“It’s peaceful, but it’s also an adrenaline rush,” said retired Lt. Gen. John Toolan, who led combat troops in Iraq and Afghanistan. “Surfing is great therapy for young guys and for old guys like me, too.”
A surfing program by the Los Angeles-based Jimmy Miller Foundation brings instructors and psychologist Kevin Sousa to Camp Pendleton twice a month. Sousa follows service members with physical and mental injuries into the waves to offer surfing instruction and look for signs of emotional problems or distress. When the surfing session is over, he helps lead an informal group discussion on the beach.
“We believe we can heal each other one wave at a time,” said Kris Primacio, manager for ocean therapy at the foundation.
The foundation, along with VA Greater Los Angeles Healthcare System, supported an early study of the therapeutic value of surfing. Led by occupational therapist Carly Rogers, the 2014 study found that surfing, coupled with individual counseling, group therapy, other exercise programs and medication, can help alleviate symptoms of psychological distress.
Jonathan Sherin, director of Los Angeles County’s mental health department, was a physician with VA during the Rogers study.
“Surfing exposes individuals to the awe of nature,” he said. “It’s good for a population that has turned inward from people and the outside world.”
On a recent sunny day, service members, many of them from the Wounded Warrior Battalion, assembled on the beach at Camp Pendleton to listen to instructors from the Jimmy Miller Foundation.
One of the surfers was Sgt. Maj. Brian Fogarty, a veteran of Iraq and Afghanistan. While Fogarty surfed, his PTSD service dog Blade, a 2-year-old boxer, stayed on the beach and watched. Fogarty will retire soon and join the PTSD Foundation of America. He plans to sing the praises of surfing.
On most days, military members can be found on several beaches in the San Diego area.
Nick Horin, 36, an Army staff sergeant and Iraq combat veteran, lives in the Aspire Center, a VA residential rehabilitation treatment site. He has been diagnosed with PTSD.
“I had a lot of anger after Iraq; I wanted to hurt people,” Horin said at a beach in La Jolla. “Surfing is the only way to take the edge off my anger without drinking or taking drugs.”
A few days later, the latest participants in the San Diego hospital’s surfing program and the study met at the beach in Del Mar.
Marine Cpl. Angel Lopez, 21, was severely injured in a motorcycle accident. “I can’t ride anymore, but maybe I can surf,” he said. “This is another step to keep going.”
One of the volunteers at Del Mar was Nico Marcolongo, a retired Marine major. Surfing, he said, helped him overcome PTSD after Iraq. He is convinced it will help others.
“Overcoming a challenge gives them a sense of empowerment,” Marcolongo said. “They stop thinking of their injuries and start thinking about the waves.”
You have choices in recovery. Visit Recovery Guidance to find therapists, recovery centers, and peer group meetings near you.
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March 12, 2018
Opioid Treatment Conflicts In The Spotlight
The more than 2,000 conference attendees heard about signs of hope on the budgetary and clinical front—but unfortunately against a backdrop of continually escalating overdose and death rates in many communities. AATOD president Mark Parrino reported on the latest group of states that now offer Medicaid reimbursement for services in federally regulated opioid treatment programs (OTPs): Illinois, Indiana, Kentucky and West Virginia. He promised that strong advocacy efforts will continue in the dozen states that still lack Medicaid reimbursement for OTP services.
At the same time, Parrino expressed hope regarding newly introduced legislation in Congress that would bring about a range of covered OTP services as part of Medicare Part B coverage. “We’re closer to the first Medicare Part B benefit ever,” he said.
Parrino also clarified AATOD’s support for comprehensive treatment that goes beyond medication. “Medication alone is not sufficient to treat long-term substance use disorder with opioid addiction,” he said.
Host state’s approach
The state substance abuse services director in the conference’s host state emphasized a multi-pronged approach to combating the opioid crisis, featuring a significant emphasis on the role of peer support and on care delivery in non-traditional locations such as homeless shelters and police stations.
Arlene Gonzalez-Sanchez, commissioner of the New York Office of Alcoholism and Substance Abuse Services (OASAS), said that since 2011, New York has added around 4,000 new OTP treatment slots, between new programs and capacity expansions of existing OTPs. New York now has just over 100 OTP locations.
“We are all going to act forcefully to promote medication-assisted treatment because we know this is the way to go,” Gonzalez-Sanchez said.
She also highlighted legislative reforms in the state that have sought to improve access to treatment, including the elimination of prior authorization provisions for insurance coverage of medically necessary inpatient treatment and of medications to treat addictions.
Stigma across borders
Also at the March 12 morning plenary session, the president of the World Federation for the Treatment of Opioid Dependence outlined barriers to success that influence the course of treatment worldwide. Icro Maremmani, MD, told the audience that voices as prominent as that of Pope Francis have an impact here, as the Pope once referred to opioid agonist medications as “a hidden way to surrender.”
Maremmani urged attendees to embrace “neutral, precise and respectful” language toward their patients, where “tapering off” should replace “detox” and “opioid agonist treatment” should help retire the use of “substitution therapy.”
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Childhood Trauma Linked To Schizophrenia
From Science Daily: People with schizophrenia may now benefit from more effective, tailored treatments and greater self-empowerment, thanks to research establishing a link between childhood trauma and some of schizophrenia’s most common symptoms.
Researchers from Orygen, the National Centre of Excellence for Youth Mental Health; the University of Melbourne; Port Phillip Prison and University Hospital of Gran Canaria Dr Negrin, Spain, have shown that childhood sexual, physical and emotional abuse are associated with severe hallucinations in schizophrenia and other psychotic disorders.
The study’s strongest finding was that hallucinations in those with psychotic disorders were associated with all types of childhood trauma, said Dr Sarah Bendall, the study’s lead author and head of trauma research at Orygen.
“This means there’s something about childhood trauma that leads some people to develop hallucinations,” Dr Bendall said.
The meta-analysis, which analysed 29 studies on childhood trauma and psychotic symptoms, also found that childhood sexual abuse was associated with delusions.
The study was published last month in the journal Schizophrenia Bulletin, and provides the missing link for clinicians who have long theorised about the association between childhood trauma and hallucinations and delusions.
Dr Bendall said providing this evidence was a crucial first step in developing tailored, sensitive and effective treatments for trauma-based psychotic symptoms.
Around one in every 100 people will experience a psychotic disorder in their lives, with the majority developing symptoms at 18-25 years old. Psychotic symptoms can include detachment from reality, hallucinations, delusions, disorganised thinking, and lack of motivation or emotion.
Until now, treatments for trauma in psychosis have focused on post-traumatic stress disorder rather than specific symptoms such as hallucinations and delusions.
Dr Bendall said the new research would not only help refine treatments for patients with psychotic disorders but may also help to empower young patients.
“When young people come to youth mental health services, we should be assessing for trauma and for emerging psychotic symptoms, and treating them as soon as they emerge,” Dr Bendall said.
“We can also arm young people with some of this research knowledge and then they can make decisions about the factors that may have caused their psychosis to develop or continue. It’s a very empowering thing to be able to give people that information.”
Find counselors, therapists, and programs that can help you get started at Recovery Guidance.
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Canada Has New Idea To Treat Opioid Addiction
From Science Daily: In 2016, the rate of opioid-related deaths in Canada was 7.9 per 100,000 (a total of 2861 deaths), and the number of deaths continues to increase. The opioid epidemic affecting both Canada and the United States is fuelled by a combination of overprescribing as well as the influx of highly potent illegal synthetic opioids, such as illicitly manufactured fentanyl.
A new Canadian guideline for managing opioid use disorders lays out the optimal strategies for the treatment of opioid addiction, including recommending opioid agonist treatment with buprenorphine-naloxone as the preferred first-line treatment. The guideline, published in CMAJ (Canadian Medical Association Journal), was created for a wide range of health care providers to address an urgent need for evidence-based treatment of opioid use causing overdoses and death.
“Opioid use disorder is a public health emergency nationwide and this guideline provides a blueprint for health practitioners to step up and provide evidence-based care,” says Dr. Julie Bruneau lead author of the pan-Canadian guideline group and a physician at the Centre hospitalier de l’Université de Montréal.
“Traditionally, resources for the treatment of opioid addiction have been scarce, and guidelines outlining best practices and practices to avoid have been lacking,” says Dr. Evan Wood, senior author and director of the BC Centre on Substance Use at St. Paul’s Hospital and the University of British Columbia.
To address the traditional gaps in knowledge in this area, the guideline aims to provide Canadian health care professionals and health authorities with national clinical practice recommendations for treating opioid use disorder. The review panel included 43 health care practitioners with broad experience who are part of the Canadian Institutes of Health Research’s Canadian Research Initiative in Substance Misuse (CRISM). The guideline group also involved people with opioid use disorder experience, and considered patient values and preferences in developing its recommendations.
Key recommendations:
Start opioid agonist treatment with buprenorphine-naloxone whenever possible to reduce risk of toxicity, illness and death
In people who respond poorly to buprenorphine-naloxone, consider transitioning to methadone treatment
Start opioid agonist treatment with methadone when buprenorphine-naloxone is not the preferred option
In people who respond well to methadone and who want simpler treatment, consider transitioning to buprenorphine-naloxone
In patients who do not respond to the above therapies, consider slow-release oral morphine, prescribed as daily witnessed doses
Avoid withdrawal management alone without transition to long-term treatment to reduce risk of relapse and death.
Opioid agonist treatment with buprenorphine-naloxone is recommended as first-line treatment because of its better safety record, including lower risk of overdose and lower risk of breathing suppression; ease of use, especially in rural and remote areas where daily witnessed ingestion is not practical; dosing flexibility; and milder withdrawal symptoms if stopping treatment, making it a better option for people with milder opioid dependence.
Beyond recommending best practices, like the use of buprenorphine-naloxone as first-line treatment whenever possible, the guideline also identifies how certain common practices in the Canadian health care system should be avoided — specifically, how offering withdrawal management as an isolated strategy for the treatment of opioid use disorder actually increases rates of overdose.
“With these recommendations laid out, there is an urgent need for health systems to look at the historical gaps in care and invest in providing timely and evidence-based treatment, says Dr. Bruneau, who is also a professor in the Faculty of Medicine at Université de Montréal. “By encouraging physicians to work alongside their patients to identify the safest, most effective approach first, these new guidelines ensure the best science and evidence are integrated into care.”
Opioid use disorder is often a chronic, relapsing condition associated with increased morbidity and risk of death. However, with appropriate treatment and follow-up, individuals can reach sustained long-term remission.
In a related commentary, Drs. Joseph Donroe and Jeanette Tetrault from the Yale University School of Medicine, New Haven, Connecticut, write “this national guideline describing the pharmacologic management of opioid use disorder is timely and needed to address the expanding epidemic of opioid use disorder and overdose. Importantly, the guideline is geared toward front-line providers, who are vitally important to decrease the existing treatment gap.”
Next steps include increasing education of health care providers about recognizing and managing opioid use disorders and chronic pain, reducing stigma associated with substance use disorders, expanding prescribing access to opioid agonists and expanding access to harm reduction services.
The guideline was funded through the Canadian Research Initiative in Substance Misuse (CRISM), a network funded by the Canadian Institutes of Health Research (CIHR).
Need help with an opioid addiction? Recovery Guidance is literally here for you. Our listing site shows treatment and addiction physician choices right where you are.
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March 11, 2018
Breaking The Denial Cycle
The denial cycle has a special meaning for families coping with substance use. We all have denial in our lives. Denial is a way to help us to cope with overwhelming problems, thoughts, feelings, and behaviors. At times, denial is a healthy coping skill. For example, if you just found out your child was killed in an accident, denial of your feelings can help you to initially cope with overwhelming trauma. Once you are able to look at the facts and have emotional support, you can begin to let the feeling of horror, sadness, grief, abandonment, loss, and other feelings in. This is the body’s way of helping you to cope with such trauma. The same can be said when dealing with some kinds of disease. If you deny that you will succumb to a terminal or progressive disease, it may help your overcome it. But it doesn’t work this way with Substance Use Disorder. Here are 6 ways denial keeps the unhealthy cycle going from generation to generation.
What Is the Denial Cycle
There are plenty of reasons we want to deny that substances may be destroying our family. We just don’t want it to be so. We may also want to protect each other from the stigma that accompanies this chronic relapsing brain disease. Denying the symptoms of cancer doesn’t make it go away, and the same is true for SUDs. The unhealthy process of denial keeps us from allowing any feelings to bubble up. In the family of addiction, not only is the person suffering from substance use in denial about the disorder, but the other family members may also be in denial. Here are 6 areas where the cycle of denial in an unhealthy family system needs to be broken to become healthy now, and to prevent the cycle from being repeated in future generations.
Honesty Denial keeps families from being honest with each other. If members deny that a loved one is suffering from SUD. This allows them to cope by ignoring the reality of the situation.
Blame Denial makes family members believe only one person is the cause of the family problems. Even when family members think the loved one has an SUD, denial may keep them from seeing it as a family illness for it is only a problem for the substance user. This denial keeps them from accepting their own part and responsibility in an unhealthy family system.
Normalcy Denial allows family members to try and maintain normalcy in the family. When family members believe that that some members just drink or drug a little too much now and then, there are no problems that need to be addressed.
Secrecy Denial that keeps the secrets means that family members don’t have to tell others about a problem because there is no problem. With everything hidden, they don’t have to get help for the person with SUD or the rest of the family.
Feelings Denial means family members don’t have to feel. Feelings can be difficult where substance use and denial are working together. If everyone is told to deny there is a problem, then no one has to take action for their own behaviors, such as enabling the substance users. Also, it can be scary to feel some feelings such as abandonment, sadness, fear, hopelessness, shame, and guilt, especially when these feelings come about by the family problems. Denial allows family members to pretend these feelings don’t exist.
Thoughts Denial makes it easier to cope with thoughts, feelings, and behaviors by putting all issues aside. If Dad is drinking and beating up Mom, then hiding in a bedroom and not talking about the abuse and not trusting anyone, as well as denying the fear and sadness, keeps a child from having to cope with adult issues.
Breaking The Denial Cycle
Dr. Claudia Black, one of the leading experts on addictions and codependency writes
There are 3 major rules within families with SUD: don’t talk, don’t trust, don’t feel.
Don’t talk means to use excuses instead of talking about and facing the problem. Not talking is a way to keep the dysfunction a secret from yourself as well as others. Don’t trust means that those outside the family aren’t told of the behaviors because they may try to force a change. It also means that children learn to keep secrets by not trusting anyone, including the parents, and not talking about what is really going on in the home. Don’t feel comes from not talking and trusting, for feelings become dangerous as the entire family refuses to allow their true feelings to come out. In order to break the cycle denial has to be the first thing to go. Awareness, Acceptance, and Action are the cure for denial.
Shifting The Family Balance
Denial in families with SUD makes everyone as as sick as the person(s) with SUD . When one member goes into recovery with counseling, 12-step meetings, and/or substance abuse treatment, the rest of the family must also be involved in their own recovery through these same processes. This will begin by talking, trusting others, and feeling.
If you need help to make your family healthy again, check out Recovery Guidance for a free resource to locate addiction and mental health professionals near you.
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Challenges Of Dating In Recovery
There are some very real challenges to dating in recovery from Substance Use Disorder (SUD). This is the official name for addiction. Remember that substance use changes brain function. SUD is defined as a chronic, relapsing brain disease. No judgement here. It is what it is. When you have a disease and you are dating, you have to take into account how that disease has changed you and your behavior, and the way other people react to what you have. There is plenty of stigma attached to substance use, and not enough understanding of what it takes beyond just not using substances to become a healthy person again. Those in recovery need to learn a whole new way of being before healthy relationships can be established. And this goes for family members coping with the disease in a loved one as well. Everyone is impacted and hurt by this disease. Everyone needs to understand it, and use tools to heal.
Recovery Experts Say It Takes Two Years For The Brain To Heal
Dating in early recovery means being with someone who hasn’t fully recovered from the effects of substances on the brain. You can’t just stop drinking and be the very best you can be. Negative behaviors that were learned in use will still be with you. An effective treatment program should include therapy and some kind of 12 step program (AA, Al-Anon, Smart Recovery, Celebrate Recovery are a few examples) as well as family and other kinds of support to learn a healthier way to manage life and relationships.
What Do People In Recovery Have To Learn
People who have SUD love to overdo whatever they love. It’s a disease of too muchness. This too muchness that makes life so messy has created cover-up strategies to hide or excuse the behaviors. Those in new recovery are very familiar with the survival skills that worked for them in substance use, but do not work for them in recovery. Honesty has gone by the wayside a long time ago. Manipulation of others is another behavior that goes along with substance use, as well as not taking responsibility for incidents that hurt others. These behaviors occur with very good people, and can be reversed with time. Old habits can change, but not overnight.
Dating in Recovery What comes first
In early recovery, so much is new, and often painful. People feel shame for what has occurred. They feel the stigma that others often have about their illness. And they may feel they have missed out on life, and their peers are doing much better than they are. In addition, alcohol or other substances have been masking many of their emotions for years. Now, in recovery people are raw and vulnerable. They have to start over without knowing what fun is, what honest relationships look like and feel like. They may feel an emotional spectrum in brighter colors, but not how to negotiate the ups and downs that come with relationships of all kinds.
For all of us who have experienced the recovery journey, this is the time to slow down and concentrate on finding the real you. The new you, and there is a new you, will emerge from this journey. Being with others who are experiencing the same things, will help you to live comfortably with who you really are and what your life can be on the other side of addiction. Sponsors, therapists, recovery coaches, and those in the programs with you will help you come out of your shell and move forward. Dating during this period is not a good idea.
Anxieties Abound When Dating Does Begin
Here are some things people in recovery worry about.
Will my date accept the fact that I am not drinking alcohol or using drugs anymore? This worry assumes you are dating people who still drink and party. A good idea is not to date people who are either still in active use, or are “normies” who enjoy having a drink or two but stop when they feel they’ve had enough. People who think they need to be drinking to have a good time are not a good choice for those who need another, safer way to have fun. Later on many people feel more comfortable around people who have a drink or two. But it’s never fun to be with heavy drinkers or druggers.
Is my addiction/recovery going to determine our next date? This worry is about whether a person’s SUD and/or recovery by itself will be the reason he (or she) doesn’t get a second date. Rest assured that your personality and authenticity as a person is what will determine your attractiveness, not your history with substances as long as you have responsible behaviors to go along with your personality.
Will dating trigger a relapse? This is a legitimate concern. If you want to be part of the drinking crowd and feel that you have to join in, or someone is urging you to have a drink, or a smoke, or a pill, you are definitely at risk for a relapse. So, who you date matters, and what you do on your dates also matters.
Tips For Sober Dating:
Stick with your program and attend meetings, therapy and coaching, as well as follow-up doctor appointments
Be honest with your date about your SUD and recovery because open communication and truthfulness is the base for a strong lasting relationship.
Learn to accept the response of your date. There will be times that he (or she) will be able to handle your SUD and recovery without judgment and sometimes not
Make absolutely sure, above all, that your sobriety comes first. Your sobriety is a matter of life or death.
Do not rush dating. Make an emotional assessment whether you are ready or not for dating. Perhaps you need to work on yourself for a longer period.
Dating in recovery is possible. It is only natural to want that special someone to be with and love. Just remember that sober reference, (experiencing the ups and downs of everyday life without drama or falling into crisis mode) is necessary to build the foundation of stability that healthy relationships require.
For a free resource to find counselors, therapists, and programs near you check out Recovery Guidance.
The post Challenges Of Dating In Recovery appeared first on Reach Out Recovery.
March 10, 2018
Beware Acetaminophen Is Over Used
From Science Newsline A new study reveals that acetaminophen use and over-dosing rise in cold/flu season in the United States, primarily due to increased use of over-the-counter combination medications treating upper respiratory symptoms. Another study reports that acetaminophen is the most commonly used analgesic in France, with more high-dose tablets being consumed in recent years. The findings, which are published in the British Journal of Clinical Pharmacology, indicate that individuals should take special care to follow labeled dosing directions for acetaminophen-containing products.
Acetaminophen is an active ingredient present in hundreds of over-the-counter and prescription medications indicated for pain and fever, including medications used to treat symptoms associated with colds, flu, allergies, and sleeplessness. While safe when taken as directed, taking too much acetaminophen can harm the liver. To examine acetaminophen use and to estimate the prevalence of excess intake, a team led by Saul Shiffman, PhD, of Pinney Associates and the University of Pittsburgh, and David Kaufman, ScD, of Boston University Slone Epidemiology Center, asked individuals to complete daily medication diaries for 7 days. For the study, 14,481 US adults who used acetaminophen in the preceding 30 days were sampled from multiple online research panels from 2011 to 2016.
The investigators found that 6.3% of acetaminophen users exceeded the maximum adult daily dose of 4 grams (4000 mg) on at least one day during a week they used acetaminophen. All told, the 4 gram limit was exceeded on 3.7% of the days that the participants used acetaminophen medications. Use patterns changed with the cold/flu season. Cold/flu symptoms were more likely to be experienced and treated with acetaminophen-containing medications during cold/flu season. The odds of taking more than 4 grams of acetaminophen in a day increased 24% in cold/flu season compared with the off-season (6.5% during cold/flu season versus 5.3% during the off-season). This was primarily due to increased use of over-the-counter combination medications designed to treat upper respiratory cold/flu symptoms.
“This is the first multi-year, year-round study that includes detailed data on how consumers used acetaminophen medications,” said Dr. Shiffman. “The study findings suggest the importance of educating consumers about acetaminophen and counseling them about appropriate use and safe dosages of these medications.” Dr. Shiffman noted that Johnson and Johnson Consumer, which sponsored the study, has used these findings to develop education for both patients/a> and health professionals. “Getting this message out is especially important during cold/flu season, when people may be more likely to treat illness symptoms with acetaminophen combination products, sometimes without even realizing they contain acetaminophen,” Dr. Shiffman stressed. “As we are in the midst of a particularly severe cold/flu season, it’s important for consumers to be aware of the limits on acetaminophen use.”
Another study that examined trends in the use of pain medications in France found that over the last decade, acetaminophen–also known as paracetamol–remained the most-consumed analgesic in the country, while the use of oxycodone (an opioid) increased significantly.
“To our knowledge, this is the first published study analysing consumption trends for both non-opioids and opioids over the last decade in France. Long-term surveillance over the past 10 years has highlighted quantitative and qualitative changes in analgesic consumption patterns in France,” said co-author Philippe Cavalié, PhD, of the French National Agency for Medicines and Health Products Safety.
There was a 53% increase in the use of paracetamol between 2006 and 2015, and the 1000-mg tablets of paracetamol (which are not available in the United States) were the most-used drug among adults since 2008. Their consumption increased over the 10-year period by 140%, whereas consumption of the 500-mg tablet pack decreased by 20%.
Also, despite sharing common regulations for medications, different patterns of pain medication use were observed across Europe in 2015. France ranked first and third place respectively for paracetamol and mild opioid consumption, but its use of strong opioids was among the lowest.
“The very widespread analgesics consumption that we have documented raises the concern of overuse and misuse, as well as addiction to opioids,” said Dr. Cavalié. “It appears very useful to accurately monitor user profiles and trends of misuse and to carry out appropriate preventive measures–such as education of patients and health professionals to increase appropriate use of medications and early detection of misuse.”
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