Leslie Glass's Blog, page 390
February 28, 2018
10 Reasons Why Benedryl And Alcohol Don’t Mix
From Aaron Kandola @ Medical News Today: It’s the height of Spring allergy season, but before you grab your go-to pink and white allergy meds, stop and think. Benadryl is a widely used medication for treating allergy symptoms, but it can cause problems when mixed with alcohol. Benadryl is the brand name for an antihistamine known as diphenhydramine. The drug helps to reduce allergy symptoms, including rashes and coughs and irritated eyes, throat, and nose.
While it does not impact on the liver, Benadryl is a central nervous system (CNS) depressant, the same as alcohol. When it is taken with alcohol, the combined impact on the CNS can produce heightened side effects. In some situations, this interaction can produce very dangerous results.
Ten Risks Of Mixing Benadryl And Alcohol
There are many potential risks when mixing Benadryl and alcohol. Ten of them are listed here.
1. Drowsiness
Benadryl is a brand of antihistamines commonly used for allergies. Benadryl can cause side effects, including sedation and drowsiness, which impair coordination and reaction speed. Mixing Benadryl with alcohol can intensify these side effects and will impair a person’s daily functioning. This can be life-threatening if it involves certain activities, such as driving or operating heavy machinery.
2. Loss Of Consciousness
Some people are more prone than others to losing consciousness when sedated. In these people, combining Benadryl and alcohol is more likely to cause a loss of consciousness. This can be harmful due to the likelihood of falls and other accidents.
3. Dehydration
Benadryl and alcohol are both known to dehydrate the body. Mixing them can increase the risk of dehydration. This can cause discomfort at the time and may worsen a hangover.
4. Complications In Older Adults
Aging slows the body’s ability to break down alcohol so that it may stay in the system of an older adult for longer than someone younger. This slowdown increases the time a person will be at risk of a harmful interaction between Benadryl and alcohol.
5. Learning And Memory Impairment
Benadryl blocks the action of a neurotransmitter called acetylcholine. Acetylcholine is necessary for learning and memory, so blocking its action may temporarily impair these processes. Alcohol is also known to inhibit learning and memory temporarily. So, combining alcohol and Benadryl may again have a more noticeable effect on learning and memory.
6. Interactions With Other Types Of Medication
Benadryl may interact with cough and cold medication. Likewise, Benadryl may interact with other types of medication, which can heighten the side effects. Taking these other types of medications with alcohol could also increase the risk of side effects. Examples of medications that may interact with Benadryl include:
Antidepressants
Stomach ulcer medicine
Cough and cold medicine
Other antihistamines
Diazepam (Valium)
Sedatives
7. Other Sources Of Alcohol
Some types of medication, including cough syrup and laxatives, also contain alcohol. They can include up to 10 percent alcohol, which may interact with Benadryl. As a consequence, taking Benadryl with these medications when consuming very small amounts of alcohol may still increase the risk of adverse side effects.
8. Women Are At A Greater Risk
In general, females are more susceptible to alcohol-related harm. This is because their bodies typically contain less water for alcohol to mix with, meaning that the same amount of alcohol would be more concentrated in a female than in a male. Mixing Benadryl with alcohol may be particularly hazardous for females, as consuming smaller amounts of alcohol could trigger adverse interaction effects.
9. Misuse
As Benadryl and alcohol both cause drowsiness and sedation, it may seem tempting to exploit this combination as a sleeping aid. However, this can also heighten other adverse side effects that will interfere with sleep, such as nausea and dizziness.
10. Dementia
More studies are required to determine if mixing Benadryl and alcohol causes dementia. One study found that people who take one anticholinergic drug per day for at least 3 years have a raised risk of dementia. It should be noted that this study included all anticholinergic drugs, not just Benadryl.
Another study in 2018 found excessive alcohol consumption to be associated with a higher risk of dementia. It is possible that consuming large amounts of Benadryl and alcohol over long periods of time could be linked to an increased risk of dementia.
However, longitudinal research would be required in people who consume high levels of Benadryl and alcohol to know whether this has any effect on the risk of dementia.
Takeaway
The risks associated with mixing Benadryl and alcohol may not apply to everyone or every situation. It is possible that consuming small amounts of alcohol while taking Benadryl in a safe environment will cause no harm. However, the safest option is simply to abstain from alcohol while taking Benadryl.
Under no circumstances should Benadryl and alcohol be mixed before engaging in any activity that required mental alertness, such as driving. If someone else has either intentionally or unintentionally mixed Benadryl with alcohol, it is important to ensure they are in a safe environment, where they can rest, if need be.
It is best to consult with a doctor to determine when it would be safe to consume alcohol after taking Benadryl, as this will depend on other factors, such as age or other courses of medication.
Want to quit drinking but need help? Recovery Guidance lists treatment centers, support groups, and addiction physicians near you.
The post 10 Reasons Why Benedryl And Alcohol Don’t Mix appeared first on Reach Out Recovery.
What Is SMART Recovery
Countless people have found recovery in 12-step groups. Yet only 1 in 10 people who need treatment for addiction receive it. Is it SMART to try something different? SMART recovery advocates give a resounding YES!
Founded in 1994, SMART recovery stands for Self-Management And Recovery Training. SMART has grown steadily since its inception. Tens of thousands of people gather weekly at more than 2,600 meetings in 25 countries. People anywhere in the world can attend another 30 weekly meetings online. Additionally, many more receive support through online chatrooms and message boards.
How Is SMART Different?
SMART uses Cognitive Behavioral Therapy and Motivational Interviewing to recognize and change their addictive behaviors. Their recovery program focuses on these four points:
Enhancing motivation;
Refusing to act on urges to use;
Managing life’s problems in a sensible and effective way without substances; and
Developing a positive, balanced, and healthy lifestyle.
SMART Recovery teaches people how to:
Quit alcohol and other drugs
Change other behavioral problems
Cope with urges using problem solving techniques
Does SMART Work?
Almost all of the research on recovery success has examined 12-step groups because they are:
Widespread
Easily accessible in communities, and
Often serve as referral resources for treatment programs and providers
However, a few initial studies that have been conducted on SMART, and the findings have been positive. The first review showed that attending more SMART Recovery meetings resulted in better alcohol outcomes. Review authors would like to do further research to see if SMART can provide similar results for individuals with substance use disorders.
You have choices in recovery. Visit Recovery Guidance to find therapists, recovery centers, and peer group meetings near you.
The post What Is SMART Recovery appeared first on Reach Out Recovery.
February 27, 2018
10 Suicide Warning Signs
From Helpguide.org: Feeling suicidal means that a person has more pain than they feel capable of coping with. Blinded by feelings of self-loathing, hopelessness, and isolation, a suicidal person can’t see any way of finding relief except through death. But despite their desire for the pain to stop, most suicidal people are deeply conflicted about ending their own lives. They wish there was an alternative to suicide, but they just can’t see one.
Suicide Warning Signs
Most suicidal individuals give warning signs or signals of their intentions. The best way to prevent a tragedy is to recognize these warning signs and know how to respond if you spot them.
1. Talking About Suicide
Any talk about suicide, dying, or self-harm, such as “I wish I hadn’t been born,” “If I see you again…” and “I’d be better off dead.”
2. Seeking Out Lethal Means
Seeking access to guns, pills, knives, or other objects that could be used in to attempt death.
3. Preoccupation With Death
Unusual focus on death, dying, or violence. Writing poems or stories about death.
4. No Hope For The Future
Feelings of helplessness, hopelessness, and being trapped (“There’s no way out”). Belief that things will never get better or change.
5. Self-loathing, Self-hatred
Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden (“Everyone would be better off without me”).
6. Getting Affairs In Order
Making out a will. Giving away prized possessions. Making arrangements for family members.
7. Saying Goodbye
Unusual or unexpected visits or calls to family and friends. Saying goodbye to people as if they won’t be seen again.
8. Withdrawing From Others
Withdrawing from friends and family. Increasing social isolation. Desire to be left alone.
9. Self-destructive Behavior
Increased alcohol or drug use, reckless driving, unsafe sex. Taking unnecessary risks as if they have a “death wish.”
10. Sudden Sense Of Calm
A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to attempt suicide.
If you believe that a friend or family member is suicidal, you can play a role in suicide prevention by pointing out the alternatives, showing that you care, and getting a doctor or psychologist involved.
If you spot the warning signs of suicide in someone you care about, you may wonder if it’s a good idea to say anything. What if you’re wrong? What if the person gets angry? In such situations, it’s natural to feel uncomfortable or afraid. But anyone who talks about suicide or shows other warning signs needs immediate help—the sooner the better.
Recovery Guidance lists a wide range of therapists and counselors who can help with depression and suicidal thoughts. Help is closer than you think.
For immediate help, contact:
National Suicide Prevention Lifeline – Suicide prevention telephone hotline funded by the U.S. government. Provides free, 24-hour assistance. 1-800-273-TALK (8255).
National Hopeline Network – Toll-free telephone number offering 24-hour suicide crisis support. 1-800-SUICIDE (784-2433). (National Hopeline Network)
The Trevor Project – Crisis intervention and suicide prevention services for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. Includes a 24/7 hotline: 1-866-488-7386.
The post 10 Suicide Warning Signs appeared first on Reach Out Recovery.
Ignoring Your Emotions Is Bad for Your Health. Here’s What to Do About It
However, what we learn in our society is not how to work with our emotions, but how to block and avoid them. We do it quite well: Between alcohol use, prescription drug use and screen time, there are a multitude of ways to avoid our feelings. When we do acknowledge them, we swat them away with mantras learned since childhood. (“Mind over matter,” “get a grip” and “suck it up” are familiar ones.) Thwarting emotions is not good for mental or physical health. It’s like pressing on the gas and brakes of your car at the same time, creating an internal pressure cooker.
Emotions have energy that pushes up for expression, and to tamp them down, our minds and bodies use creative tactics—including muscular constriction and holding our breath. Symptoms like anxiety and depression, which are on the rise in the U.S., can stem from the way we deal with these underlying, automatic, hard-wired survival emotions, which are biological forces that should not be ignored. When the mind thwarts the flow of emotions because they are too overwhelming or too conflicting, it puts stress on the mind and the body, creating psychological distress and symptoms. Emotional stress, like that from blocked emotions, has not only been linked to mental ills, but also to physical problems like heart disease, intestinal problems, headaches, insomnia and autoimmune disorders.
Most people are ruled by their emotions without any awareness that this is happening. But once you realize the power of emotions, simply acknowledging your own can help greatly.
Consider Frank, a patient of mine who was greatly bothered that he could not afford the kind of car he really wanted. Something as simple as Frank’s thwarted car desire triggered a mixture of sadness, anger, humiliation and anxiety. He also had physical symptoms, and although Frank had some inkling that his stomach troubles had to do with stress, he was unaware that emotions in particular were causing his intense stomach pains. Because he hadn’t paid attention to his emotions, he had no tools for what to do to feel better.
Current neuroscience suggests that the more emotions and conflicts a person experiences, the more anxiety they feel. That’s due, in part, to the vagus nerve, one of the main emotional centers of the body. It responds to emotions triggered in the mid-brain by sending signals to the heart, lungs and intestines. These signals ready the body to take appropriate and immediate action in the service of survival. The body is ready to react to perceived danger before the person is aware that an emotion has been triggered. It’s the reason why emotions aren’t under our conscious control. With Frank, for example, his eyes saw the car, and all of a sudden he felt sadness, humiliation and anger. His stomach went into an instant state of upset.
Frank’s stomach continued to hurt until, through therapy, he learned to tune into his body to recognize and separate out each emotion, name them and tend to them one at a time.
The role that emotions play in creating both physical suffering and healing is becoming a more popular focus in psychotherapy. Yet the growing field is still not part of mainstream standards of care. An education in emotions is still not mandatory in social work programs, doctoral programs in psychology and in medical schools.
Yet simply teaching people that emotions are not under conscious control would help them tremendously. Basic biology and anatomy explain that we cannot stop our emotions from being triggered, as they originate from the middle section of our brain that is not under conscious control.
However, when people are given education on emotions and skills for how to work with them, they can begin to feel better. Frank healed his stomach by allowing himself to feel sad. He mourned the loss about not getting his fancy car. He validated his angry feels after learning they were natural. And he learned specific skills to release his anger in ways that were healthy and not destructive to himself or others. He practiced self-compassion in response to his humiliation, and that decreased, too. Once he experienced all of his feelings, they passed, as core emotions do when they are deeply felt in the body. By working with his emotions, he changed the firing pattern of his vagus nerve and healed his stomach pain.
My clients tend to avoid painful or conflicting emotions in their lives—just as most of us do, because that’s what we were taught. But to heal the mind, we need to experience the emotions that go with our stories, and those are located in the body. When we are taught about the automatic nature of emotions and learn to identify and work with the core emotions beneath our anxiety, we feel and function better.
Hilary Jacobs Hendel is the author of It’s Not Always Depression.
Need help processing painful emotions? Recovery Guidance also lists counselors and therapist near you.
The post Ignoring Your Emotions Is Bad for Your Health. Here’s What to Do About It appeared first on Reach Out Recovery.
How Do I Enable You, Let Me Count The Ways
No one sets out to enable addiction. On the contrary, many start out with good intentions. We love the person struggling with addiction, and she’s in grave danger, so just this once, we bail her out of jail. Or he promised he’ll quit drinking. We want to believe him, but before we know it, we’re in a dangerous pattern of enabling.
When Compassion Becomes Problematic, It Is Enabling
In Codependent No More, Melody Beattie defines enabling:
“Enabling is therapeutic jargon that means a destructive form of helping.”
Gateway Types Of Enabling
Many spouses and parents start down the dark path of enabling by making excuses for the addict. “He’s sick,” we say. Or, “She’s got the flu.” We can’t, won’t, and certainly don’t want to tell family members and close friends about the problem. Dr. Claudia Black, an expert in co-dependency and addiction explains that when someone has a chemical dependency, three major rules that exist within the family:
Don’t talk to anyone about the real problem.
Don’t trust. Psychological and/or physical safety are often missing in addictive households which produces mistrust.
Don’t feel. People living with addiction are often in such desperation that the only way to cope is by repressing (ignoring, restraining, or hiding) their feelings or just not feeling anything at all.
Some enablers graduate to doing things for the addict that he, she, or they can do for themselves. Perhaps a Mom will do laundry for her adult son or balance her 30 year-old’s checkbook. The goal here is often to keep peace. This may include “mind reading” by anticipating these wants and doing them ahead of time. Perhaps the house is kept sparking clean to keep the addict calm.
Covert Types Of Enabling
As addiction progresses, so does the need to enable. In this phase, the enabler often ignores other negative behaviors that the addict is demonstrating such as:
Abuse (physical, emotional, sexual)
Throwing things
Storming out of the home in anger
Driving with the children while drunk
Losing a job due to work consequences of the addiction (coming in late, being drugged on the job).
Other covert types of enabling include rescuing the addict from consequences. Instead of giving the addict time to feel the consequence by staying in jail, parents will bail the children out. Instead of making a spouse use the bus to get to work, a husband will drive his wife to work.
Driven by fear, codependents often take over as the family spokesperson, speaking on behalf of the addict. They also walk on eggshells, making sure her food is on the table when she gets home. In other cases, they prevent catastrophes by driving him to the bar to get drunk. Defeated, they reason, “He’s going anyway.”‘
In extreme cases, a loved one might even help the addict stay in the addiction by buying the drug of choice for him.
Enabling Hurts The Enabler
Eventually, the enabler ends up doing almost everything for the family – working, raising the children, being involved with the kids’ activities. They do things that they don’t want to do and will say “yes” to anything that might keep peace in the family. And finally, the enabler does not take care of him or herself physically, emotionally, socially, intellectually, or spirituality. The focus is always about the addict and the addiction.
When Children Enable
Sometimes an older child will take on a parental role to help instead of being allowed to be a child (doing all the cooking, laundry, etc.). When children are given excuses for the addiction-driven behaviors, it makes it even more difficult to say “no” to their parent(s) or sibling(s). Children often believe they cause their parents addictions and will defend the addict’s behavior.
How To Quit Enabling
Having an inability to set boundaries gets the enabler in trouble. The enabler gives up his or her life to take care of the addict. In recovery, we learn not to cause or prevent a crisis. Little by little, learn how to get your life back by doing healthy behaviors. Put the focus back on you. Meet your physical needs first. Ultimately, to restore balance, the enabler must start denying whatever the addict wants. This is often uncomfortable and frequently challenging. Consider getting support from a family group like Al-Anon, Nar-anon, or Celebrate Recovery.
If you and your family fit this role of enabler, take charge of your life by getting help. Recovery Guidance lists local crisis and treatment centers that can help you even if your loved one continues down the path of addiction.
The post How Do I Enable You, Let Me Count The Ways appeared first on Reach Out Recovery.
February 26, 2018
Florida School Shooting Reveals Gaps In Mental Health System
From Melissa Healy @ LA Times: After Adam Lanza burst into Sandy Hook Elementary School and gunned down 20 students and six educators, Connecticut’s Office of the Child Advocate tapped Julian Ford to help make sense of the shooting. A professor of psychiatry at the University of Connecticut School of Medicine and a practicing psychologist for 35 years, Ford served on an expert panel that conducted a detailed review of Lanza’s brief life to look for “any warning signs, red flags, or other lessons that could be learned.”
The resulting report painted a picture of an odd, sensitive child with significant communication difficulties who became an anxious and withdrawn adolescent. By the time he became a young adult, he was depressed and profoundly isolated, connecting only with his mother, online games and websites that trafficked in extreme violence.
At every turn, the report saw missed opportunities to treat Lanza’s multiple interpersonal and mental health difficulties — he had been diagnosed with autism spectrum disorder, obsessive-compulsive disorder and severe anxiety — and to draw him out of his profound isolation. After years of having fallen through the cracks, Lanza’s shooting rampage on Dec. 14, 2012, underscores the need to “identify and assess youth from a very young age, the importance of effective mental health and educational service delivery, and the necessity of cross-system communication amongst professionals charged with the care of children,” the report concluded.
Ford spoke with the Los Angeles Times about the emerging picture of Nikolas Cruz, the confessed gunman who shot and killed 17 people at Marjory Stoneman Douglas High School in Parkland, Fla., on Feb. 14 and his similarities to Lanza.
What parallels do you see between Nikolas Cruz and Adam Lanza?
Each case and each individual is unique, of course. But what struck me is both were extremely isolated young men who didn’t feel they fit in, and felt a profound sense of alienation from virtually all human relationships.
That kind of isolation — that sense of not fitting in with a peer group — in no way accounts for an act of violence. But it is very seriously problematic. As that isolated young child becomes a young adult, he is not going to be able to recognize the impact of actions he might take or understand how they might hurt others — from words or small gestures to large, much more consequential actions.
Cruz is reported to have put a swastika on his backpack, a gesture his mother said he did not understand. Lanza was judged by a Yale psychiatrist to require intensive help “using communication that is appropriate to setting, listener, context, or purpose.”
In both cases, this is about not getting other people’s perspectives and the fact they might see things differently. That includes not understanding that their actions or the symbols they wield might be hurtful.
One issue for both these young men seems to be a kind of emotional numbness. We certainly associate that with several psychiatric disorders, such as post-traumatic stress disorder. But it can happen to people who simply are not really tuned into their own or other peoples’ emotions.
Emotional literacy or intelligence is really very crucial for young adults. They have to be able to recognize that other people can feel injured, can have other perspectives, even when they don’t feel it’s warranted. That perspective-taking, or empathy, is lacking in Cruz or Lanza. It’s a very serious psychological and emotional impairment.
The common denominator is the detachment, the isolation, the emotional disconnection. That’s a challenge for every teen transitioning into adulthood, and most kids make that successfully because they’re either able to figure out for themselves or they have adults in their lives who can help them learn to connect. But some parents or caregivers, even thoughtful and caring ones, don’t know what to do to help a child to fit in. We really, as a society, need to think carefully about how we help parents in that predicament.
What role does the online world play in that process?
It’s a blessing and a curse.
Online media provides a wealth of opportunities to interact and connect. But they do not provide the basis for personal relationships. Most adolescents and young adults come to recognize there’s a fundamental difference between going online and actually having a close personal relationship. But for kids who are not fitting in, that’s a very attractive alternative: You can hide or disguise who you are and what you’re thinking.
Adam Lanza became drawn into online communities that were very toxic. He appeared to be trying to substitute those virtual interactions for actual personal connections.
While we’re still learning about the situation with Nikolas Cruz, it’s quite possible that he, too, was trying to find some sense of personal connection through social media, but instead found encouragement for hate and even violence.
Both kids appear to have had identifiable mental health problems. How is it that they seemed to fall through every crack?
We all need to think about what are we asking of the mental health system. The mandate to providers is to help individuals and families when they’re having acute psychological problems, and to help individuals with more long-term persistent problems — such as schizophrenia, bipolar disorder or chronic severe depression — to maximize their quality of life and their safety.
But in between those acute crises and chronic psychiatric disorders, there are many individuals who go through their childhood and adolescence feeling disconnected from person-to-person relationships, or essentially have no meaningful personal relationships. Conventional mental health treatment is really not designed to address this.
There’s this big gap, and that crack is where these young men seem to have fallen through.
It sounds like there could be a lot more kids like them.
There are a lot of people like them who are suffering and need help. They may be recognized as having problems, as was the case with both Lanza and Cruz, but are able to maintain just enough of the appearance of fitting in to be viewed as needing social or educational accommodations, but not therapeutic help. Their parents often make heroic attempts to help them “get by,” while either not recognizing the severity of their child’s problems (as appeared to be the case with Mrs. Lanza) or feeling helpless and becoming detached emotionally from their child (as appeared to be the case with Mr. Lanza).
Although these young adults often are described as having a personality disorder, in most cases this is not fundamentally a problem of personality, but of social communication, emotion regulation, information processing, decision-making and problem-solving. Their personalities have not fully formed as a result of those difficulties. Other people tend to feel uncomfortable and unable to connect with them. That results in a vicious cycle in which their difficulties push away the very people from whom they need connection.
The mental health system is not really funded or mandated to help people who are profoundly disconnected but essentially not intensely symptomatic. So they’re easily missed.
Still, they are struggling, and the people in their lives often don’t know how to get them on track. They tend to be the wheel that’s not squeaky enough. And in very rare cases, the outcome is violence.
Cruz’s public defender described him as a “broken human being.” Do you see Cruz and Lanza as broken?
When people struggle because they do not relate to other people, or when people find them difficult to get along with, those individuals typically get labeled as “broken” — or technically, with having personality disorders. I don’t think it’s helpful. It’s very stigmatizing. It leads others to conclude they have a disorder they can never recover from.
The common denominator is not that they have a broken personality, but they have been unable to master how to relate to other people, especially when other people do things they don’t understand or find hurtful. And that’s a person who’s likely to be viewed as odd and shunned or bullied, and as a result to withdraw or occasionally to lash out.
Both of these young men relied on their mothers to buffer them from the world. But Lanza’s mother was considering a move that would have taken him away from his childhood home, and Cruz’s mother died in November. How might loss, or the prospect of it, affect troubled young adults?
There is a definite parallel here. Both of these young men had very important relationships with their mothers. When their mothers were no longer present or were less able to provide the kind of balance and support both young men clearly needed, their connection to the rest of society — to other human beings — is frayed or even lost.
It’s not all about mothers. It can be a father, a teacher, a coach. But if there’s only one relationship, and that relationship has to fulfill all those needs, that puts a kid at risk. No caregiver can alone be the connector to the rest of humanity, and no caregiving relationship can last forever.
Had you known much of what you learned about Lanza, could you have predicted he was capable of such violence?
I absolutely would not have predicted he’d have been capable of such extreme violence, and people who knew him well and who have studied prediction of violence much more than I have say there was no way they could have predicted it.
What we could predict is that he was going to struggle with conflict and isolation and withdrawal. And that as that struggle became more profound and exhausting, he would break down in some way.
So what could have been done differently?
One thing that increases the likelihood an Adam Lanza or a Nikolas Cruz will act on violent impulses is access to weapons that make that possible. And secondarily, involvement in groups — whether on the internet or any other forum — that strongly endorse violence as a solution to problems.
When you have the combination of those two things, in a person who’s confused, who has difficulty feeling empathy toward others, and who feels hurt and aggrieved by others, that individual may then decide the solution is to be the person who has the power, and be the one who takes action. He may conclude that violence is the only solution.
Fortunately, in most cases, people who have come to that extreme juncture don’t have the access to weapons, or there are people or institutions that intervene to help them.
But unfortunately, it’s impossible for any of us to predict who is going to go from being troubled and isolated to actually harming others.
It must be very humbling.
It is. It really means we can’t rely on prediction and identifying the bad guys. Because we’ll misidentify some who aren’t bad guys, and we’ll fail to identify others who may become bad guys.
We have to shift from a strategy of trying to find the bad guys and neutralize them to a framework of identifying what the core dilemma is, and what we can do on behalf of the many, many individuals who grow up with only a tenuous connection to other people and find themselves confused by and disconnected from their own emotions. Most of these people will never be violent. But they deserve and require some additional assistance beyond that which is now available.
Need help exploring difficult topics with your teens? Recovery Guidance lists counselors and therapists near you.
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Is Addiction An Opportunity
Years ago, I studied “The Hero’s Journey” because I wanted to write the hero’s story. Back in the day, we girls didn’t think of ourselves as taking that hero’s journey ourselves. We weren’t brave. We were just girls. But I thought if I ever had the opportunity, I could write about it. I could write a column for a newspaper, or a bestselling novel, maybe win an academy award, if I ever wrote a movie.
But it was just a dream to keep me going. In those days, I had no way of knowing that girls would be soldiers, would win Nobel prizes, and not just work at high level jobs, they would run companies, even countries. It was unthinkable. But it happened in one generation.
Recovery Begins As A Way To Survive
Addiction recovery is a little like the evolution of the female in the 20th Century. And it might be helpful to think about it that way. Recovery begins as just a way to survive, like my dream to write. But the empowerment recovery brings often takes people beyond any goal they could possible set for themselves. Recovery can relieve the pain of family traumas and bring peace. That’s a positive feature of addiction that hasn’t been examined or talked about much. Even if we lose the battle for someone we love, recovery and a new desire to help others restores us.
Advantage Over Other Diseases: The Doc is Not In Control of the Treatment
Surprisingly, there is an upside to having addiction as opposed to some other deadly disease. Addiction is not the only progressive disease that can kill you if you don’t get treatment for it, but it is the only disease for which only the patient can decide the outcome. The doctor is not in charge. The patient is in charge. The patient can say, yes. Or no. When the patient says yes, and begins to let go, a real change occurs.
Change Happens Because Of Personal Choice
This change can’t be court- or parent- ordered. It can’t be therapied away. Or rehab mandated. The change comes about almost entirely by embracing the illness. A totally weird concept so counter-intuitive not everyone can do it. It’s very scary. Imagine embracing cancer, and then getting well. Imagine embracing depression and getting well. It’s a different kind of embrace, of course, from the “I love you embrace” that originally feeds the addiction. It’s more like “yeah, that was me. I did it. It worked for a while, but now I’m done.” And that idea has to take root and be embraced every day. Just think for a minute how hard that is to do.
Care-givers have a specially difficult journey that’s also not talked about enough. To give up what you love the most, whether it’s a drug, or a loved one, is the bravest thing a person can do and it makes heroes of us all. Can you think of the addiction in your life as an opportunity?
Want to get started on your recovery journey? Recovery Guidance is a free-to-patients listing site where YOU determine your treatment.
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Why Significant Childhood Trauma Is So Tough To Process
From Dr. Tian Dayton, Forgiving Parents: Breaking the Chain of Anger, Resentment and Pain – Triggered pain is so confusing to decode and deal with. Primarily, emotional responses to childhood trauma are recorded by the parts of the brain that were developed early in our evolution. This area of brain memory is often referred to as the “reptilian” or “old” brain.
The Brain Freezes Painful Childhood Trauma
The cortex is where we do much of our critical thinking. It’s where we think about what we’re feeling and make sense of it. When we were deeply hurt, say as children, we may have been too scared or frozen to process what was happening around us. The cortex didn’t modulate the memory. Our child-aged brain wasn’t mature enough to:
Reflect upon
Think about
Quantify or
Categorize particular painful events
Thus, they could not be worked through, nor could we rationally read the situation. Many of us were left to make sense of the trauma, only using the powers of reason and the emotional maturity available to us at the time.
The adults in the situation were often too preoccupied with their own problems. The didn’t help us understand what was happening around us. As a result, when these fragments of unprocessed memory get triggered in the present, they have no context. They’re all out of order and can get mindlessly blasted onto the surface of our current lives.
We feel like we felt when the original events happened: defenseless and vulnerable, with whoever hurt us having all the power.
These intense feelings seems to relate only to the current situation but, in truth, our past is co-mingling with present. Even though they originated in the past, they get interpreted as if it belongs exclusively to the present. We end up trying to make sense of an adult situation through our child mind.
All Of Us Have These Little People Inside
It helps if we’re on speaking terms with that part of us. When the child self gets scared and wants to hide or hit or cry or yell, our adult self can help. Our adult self can recognize what’s going on and extends a secure hand to their small fingers. This is how we grow. This is also how we can keep the innocence, talent, spontaneity and creativity that is also part of this side of us, and still function as reasonably healthy adults.
You notice I say reasonably. I think psychology has unwittingly put forward some unattainable idea of the “model” person that is about as far flung from the actual norm as a size four is for the average American woman. It just isn’t what’s out there, and if we hold ourselves to that standard we’ll only feel bad. We’re all only human, why should we kill ourselves trying to be perfect?
Women’s Bodies Handle Trauma Differently
Think of trauma in evolutionary terms. Early woman had a lot to worry about. So nature, in its infinite wisdom, built a protective apparatus into her. When she sensed that she was in danger, she went into the protective modes that nature encoded into her. Extreme states of fear cause the body to spurt chemicals like epinephrine and norepinephrine, both of which are associated with standing and fighting or fleeing for safety, commonly known as the fight-or-flight response.
In women, however, more recent research reveals that oxitocin is also released. According to a recent UCLA study by Drs. Klein and Taylor, women even “respond to stress with a cascade of brain chemicals that cause us to make and maintain friendships with other women.” In other words, our survival mode is connect and nurture, not only fight or flight. This “touch” chemical encourages women to bond with other women, and to take care of children and get them to safety.
Need help getting over a difficult childhood trauma? Recovery Guidance lists counselors and therapists near you.
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10 Colorado ERs Handed Out 35,000 Fewer Opioids In 2016
“Percocet or Vicodin,” explained ER doctor Peter Bakes of Swedish Medical Center, “medications that certainly have contributed to the rising opioid epidemic.”
Now, though, physicians are looking for alternatives to help cut opioid use and curtail potential abuse. Ten Colorado hospitals, including Swedish in Englewood, Colo., participated in a six-month pilot project designed to cut opioid use, the Colorado Opioid Safety Collaborative. Launched by the Colorado Hospital Association, it is billed as the first of its kind in the nation to include this number of hospitals in the effort.
The goal was for the group of hospitals to reduce opioids by 15 percent. Instead, Dr. Don Stader, an ER physician at Swedish who helped develop and lead the study, said the hospitals did much better: down 36 percent on average.
“It’s really a revolution in how we approach patients and approach pain, and I think it’s a revolution in pain management that’s going to help us end the opioid epidemic,” Stader says.
The decrease amounted to 35,000 fewer opioid doses than during the same period in 2016.
The overall effort to limit opioid use in emergency departments is called the Colorado ALTO Project; ALTO is short for “alternatives to opioids.”
The method calls for coordination across providers, pharmacies, clinical staff and administrators. It introduces new procedures, for example, like using non-opioid patches for pain. Another innovation, Stader said, is using ultrasound to “look into the body” and help guide targeted injections of non-opioid pain medicines.
Rather than opioids like oxycodone, hydrocodone or fentanyl, Stader said, doctors used safer and less addictive alternatives, like ketamine and lidocaine, an anesthetic commonly used by dentists.
Lidocaine was by far the leading alternative; its use in the project’s ERs rose 451 percent. Ketamine use was up 144 percent. Other well-known painkillers were used much less, like methadone (down 51 percent), oxycodone (down 43 percent), hydrocodone (down 39 percent), codeine (down 35 percent) and fentanyl (down 11 percent).
“We all see the carnage that this opioid epidemic has brought,” Stader said. “We all see how dangerous it’s been for patients, and how damaging it’s been for our communities. And we know that we have to do something radically different.”
Claire Duncan, a clinical nurse coordinator in the Swedish emergency department, said the new approach has required intensive training. And there was some pushback, more from patients than from medical staff.
“They say ‘only narcotics work for me, only narcotics work for me.’ Because they haven’t had the experience of that multifaceted care, they don’t expect that ibuprofen is going to work or that ibuprofen plus Tylenol, plus a heating pad, plus stretching measures, they don’t expect that to work,” she said.
The program requires a big culture change, encouraging staff to change the conversation from pain medication alone to ways to “treat your pain to help you cope with your pain to help you understand your pain,” Duncan said.
Emergency medical staff are all too familiar with the ravages of the opioid epidemic.
They see patients struggling with the consequences every day. But Bakes, the ER doctor at Swedish, said this project has changed minds and allowed health care professionals to help combat the opioid crisis they unwittingly helped to create.
“I think that any thinking person or any thinking physician, or provider of patient care, really felt to some extent guilty, but … powerless to enact meaningful change,” Bakes said.
The pilot project has proven so successful that Swedish and the other emergency departments involved will continue the new protocols and share what they learned. Stader said the Colorado Hospital Association will help spread the word about opioid safety and work toward its adoption statewide by year’s end.
“And I think if we did put this in practice in Colorado and showed our success that this would spread like wildfire across the country,” Stader said.
The 10 hospitals that collaborated on the project include Boulder Community Health, Gunnison Valley Health, Sedgwick County Health Center, Sky Ridge Medical Center, Swedish Medical Center, UCHealth Greeley Emergency and Surgical Center, UCHealth Harmony Campus, UCHealth Medical Center of the Rockies, UCHealth Poudre Valley Hospital and UCHealth Yampa Valley Medical Center.
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Baclofen Isn’t The ‘Wonder Drug’ It Promised To Be
From Science Daily: A new study, published in the Addiction journal, conducted by researchers from the University of Liverpool highlights the ineffectiveness of a specific drug treatment for alcohol use disorders.
Baclofen is a medication which has been used since the 1970s as an anti-spasticity treatment. More recently it has been used as a treatment for alcohol use disorders.
Baclofen has a key advantage compared with currently licensed medications: it is excreted largely through the kidneys. It is therefore possible to give baclofen to people suffering alcohol-related liver disease, a patient population with very high needs, and who often can’t tolerate licensed drug treatments.
‘Wonder drug’
Many studies have found baclofen to be successful in treating alcohol use disorders, some have claimed it a wonder drug capable of curing alcoholism.
Following a number of successful clinical trials the use of use of baclofen increased massively and sales of the drug have soared in some countries.
In more recent years, there have been a growing number of studies which directly compare baclofen against placebo on a number of outcome measures. Often these outcome measures are drink-related, e.g. rate of abstinence at the end of the medication trial, or number of heavy drinking or abstinent days during the trial.
However, there are other measures, potentially related to why baclofen might work (i.e. its mechanism of action). Several possibilities have been identified; firstly baclofen may reduce craving for alcohol, secondly there are reports that baclofen reduces negative mood states, such as anxiety and depression, which are known risk factors for harmful drinking.
Abstinent rates
Researchers, Dr Abi Rose and Dr Andy Jones, from the University’s Addiction Research Team conducted a meta-analysis on all 12 clinical trials comparing baclofen with placebo on at least one of the described drinking outcomes, craving, anxiety, or depression.
Meta-analysis is an advanced statistical procedure that allows the researcher to merge the results of all the studies regarding a specific topic into a quantitative measure representing the size of the overall effect of one variable on another variable. Thus, meta-analysis provides more accurate and reliable outcomes compared to the single experiment.
The researchers found that baclofen led to higher abstinent rates compared with placebo, and that eight individuals would need to be treated with baclofen for one to remain abstinent due to the medication.
However, all other outcomes failed to show an effect of baclofen: baclofen did not increase abstinent days or decrease number of heavy drinking days during treatment, neither did it reduce rates of alcohol craving, anxiety or depression.
Issues highlighted
Dr Rose, said: “Our research highlights several issues with the existing body of trials. Many of the studies only recruited a limited number of patients, so maybe too small to find an effect.
“The existing trials also differ on a number of factors, such as the dose of baclofen given and the length of treatment. Importantly, the pharmacokinetics of baclofen (how it moves in the body) are not well-understood, so there may be individual factors influencing the effectiveness of baclofen that we do not yet understand.”
Dr Jones, said: “This new meta-analysis shows that baclofen is no more effective than placebo on a range of key outcome measures, suggesting that the current increasing use of baclofen as a treatment for alcohol use disorders is premature.”
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