At Lasting Recovery, we understand the problems caused by alcohol and drug use. If you or a loved one is struggling with alcohol or drugs, and wants a caring outpatient alcohol and drug rehab to break free from the bonds of chemical dependency, there is hope. You can live a life free of chemical addictions and mend your emotional, relational, financial and legal challenges.
We believe after an effective detoxification from chemicals, treatment must include a combination of 12-step principles, in addition to addressing the full spectrum of our client's physical, intellectual, emotional, and spiritual needs. Chemical dependency is a progressive and chronic relapsing brain disease that affects the body, mind, emotions, family, workplace and the entire community.
Wednesday, December 3, 2008
Self-medication for Mood Disorders in San Diego
One of the reasons that people abuse alcohol and other drugs is to manage their emotional distress. This is known as the self-medication hypothesis. This hypothesis has been proposed as an explanation for the frequent co-occurence of anxiety and substance use disorders.
Recently, Bolton and his colleagues used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a large (n=43,093, age 18 years and older) nationally representative survey of the U.S. population to test the self-medication hypothesis. They looked at the rates of self-medication among individuals with four types of mood disorder: dysthymia, a milder form of chronic depression; major depression; bipolar I, a mood disorder that includes bouts of mania and depression; and bipolar II, a mood disorder that includes bouts of hypomania, less severe than full-blown mania, as well as depression.
Overall, nearly one-quarter (24.1%) of individuals with any of the four mood disorders listed above used alcohol and drugs to manage their moods. Self-medication was even more prevalent among individuals with bipolar disorder. During depressive episodes, 41.0% of individuals with bipolar I disorder and 34.7% of those with bipolar II disorder engaged in self-medication with alcohol and other drugs of abuse.
Men were more than twice as likely as women and divorced and widowed individuals more likely than others to engage in self-medication. On the other hand, African-Americans, Asians, Hispanics and Pacific Islanders and individuals over the age of 44 years were less likely to self-medicate. Thus, younger, divorced, white males with mood disorders are the subgroup in the population most likely to engage in self-medication.
Bolton and his colleagues also found that individuals who self-medicated for mood disorders were more likely to experience co-occuring anxiety and personality disorders than those who did not self-medicate for mood disorders. Self-medicating men were more likely to suffer from panic attacks while self-medicating women were more likely to suffer from generalized anxiety disorder. Both genders of self-medicators were more likely to meet the diagnostic criteria for dependent personality disorder.
Lasting Recovery as a dual diagnosis enhanced substance abuse treatment program can help individuals who suffer from mood and other mental health problems associated with their substance abuse/dependence.
Reference: Bolton JM, Robinson J, Sareen J. Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions. J Affect Disord. 2008, Nov 10.
Consequences of Youthful Cannabis Use in San Diego
Is cannabis use during adolescence and early adulthood an innocent diversion or does it have serious social outcomes in later life?
This is the question addressed by Fergusson and Boden in a recent study they published in the journal Addiction. To obtain their answer they followed a group a young people from the age of 14 until the reached the age of 25 years. They divided these young people into six groups based on the amount of cannabis they smoked between the ages of 14 and 21 years. The rates of cannabis use among these young people ranged from none to more than 400 times during this seven year period.
Fergusson and Boden found that the more cannabis these young people used before the age of 21 years the worse off they were between the ages of 21 and 25 years. Those with the highest rate of use were the least likely to have earned a college degree, had the lowest level of income, were most likely to be unemployed, and were the least satisfied with their relationships and with life in general.
Even after statistical adjustment for a range of possibly confounding variables including: family socioeconomic status and functioning, exposure to child abuse, personal adjustment and mental health, high school achievement, and other substance use. The relationship between increasing levels of cannabis use and lower educational, economic and satisfaction outcomes remained statistically significant.
This is just another finding in a growing body of evidence that heavy cannabis use early in life can have serious consequences in early adulthood.
Arthur J. Farkas, Ph.D.
Reference: Fergusson DM, Boden JM. (2008) Cannabis use and later life outcomes. Addiction, 103(6):969-76.
Binge drinking for men is defined as 5 or more standard drinks and for women as 4 or more standard drinks on a single occasion.
A standard drink is a 12 oz. can of beer or cooler; 8-9 oz malt liquor; 5 oz. glass of table wine; or 1.5 oz shot of 80-proof spirits.
According to a recent, large survey 14% of the U.S. population binge drink at least once a week.
In comparison with the 60% of the U.S. population who never binge drink, in the next three years the 14% of drinkers who binge at least once a week are
330% more likely to meet the diagnostic criteria for alcohol abuse
280% more likely to suffer from some form of liver disease
270% more likely to use tobacco
270% more likely to meet the diagnostic criteria for alcohol dependence
230% more likely to meet the diagnostic criteria for drug dependence
180% more likely to lose their driver's license
180% more likely to meet the diagnostic criteria for tobacco dependence
160% more likely to use other drugs
130% more likely to experience a divorce or separation
The risks are even higher for the 3% of drinkers who binge 5 or more times per week.
Reference: Dawson DA, Li TK, Grant BF. A prospective study of risk drinking: at risk for what? Drug Alcohol Depend. 2008; 95(1-2):62-72.
When asking an incoming client to our alcohol and drug addiction treatment program if they smoke and have they considered quitting, they respond with, “I can’t possible stop drinking and doing drugs, and stop smoking at the same time!” Yet, it has been recently shown by researchers that quitting smoking and drinking simultaneously may aid sobriety.
Join Together, a newsletter advancing effective alcohol and drug policy, prevention and treatment recently reported that people trying to quit drinking experience more cognitive improvements when they simultaneously stop smoking, as well. Researchers studied brain scans of 37 subjects in treatment for alcohol addiction and found that smoking alcoholics compared to non smoking alcoholics, did not recover some cognitive functioning. Skills such as decision-making, speed thinking, 3-D visualization and short term memory continued to be impaired. While it isn’t clear what differences in brain functioning were present prior to the smokers first cigarette, it is known that a higher percentage of people with ADHD, anxiety disorders and bi-polar disorder, are smokers.
I smoked my first cigarette at age 10 and by age 14, I was a daily smoker. After trying to quit at least 50 times, I finally did it. But only after I was able to get off of a 10 year addiction to prescription drugs. Not an easy feat by any means. Now I understand why it was so hard…my decision making skills were eroding, I couldn’t think very fast and my short term memory was weak. No wonder I couldn’t stay quit. I couldn’t remember that I had told myself that I wasn’t going to smoke anymore. Seems that is the way of all addictions; we say we will quit, then forget what we said and start drinking or doing drugs again.
Join Together notes that experts say that a delay in addressing nicotine addiction could lead to chemical-dependency relapse if smokers try to quit while in early recovery. If clients aren’t ready to quit smoking and drinking at the same time, we encourage people to wait until they have developed several relapse prevention tools before they begin the quitting process. Relapse into smoking can take a person back to their active addiction whether it be alcohol or drugs. There is research to indicate that people who quit smoking crack cocaine and cigarettes have increased recovery rates as a result of not experiencing the triggering effects of a similar oral and physical sensations and class of drugs.
In San Diego county, with smoking bans in the workplace and restaurants, we see fewer of our clients who are still smoking by the time they come for treatment. Education and awareness of the effects of the drug nicotine addiction are important in overall health and wellness.
We are pleased to note that Art Farkas, Ph.D., our co-owner and co-director, published over 40 articles in peer reviewed journals related to smoking cessation while on the faculty of the School of Medicine, University of California San Diego. The facts speak for themselves.
Recent news articles have addressed the facts that prevention does not decrease the uptake of drug use among youth and young adults.
Most of the young people in San Diego county use drugs and alcohol for effect: the drug's action is pleasant or useful (this includes medical use); it allows people to temporarily feel more pleasure, less physical or emotional pain or discomfort, or both. People use drugs to relax, the media is filled with messages that social events, parties, ball games, going to the beach, dinner with friends, or partners, or drink to feel more romantic. For 85-90% of the population, it isn't a problem, nor is it an addiction.
Alcohol and drug use becomes a problem when the negative effects outweigh the positive, and a person keeps using it anyway.
The reason for starting on alcohol and drugs in the first place is experimentation. Most alcoholics and addicts began the use of marijuana, cigarettes, alcohol, cocaine or methamphetamine at about age 14 or 15, as experimentation. Many will try prescription drugs, including tranquillizers and opiate pain medications. Opiate medications temporarily reduce painful emotions as a result of divorce, parental conflict, relationship conflict, loss of the first love and reduce anxiety when meeting new groups of people. About 85-90% try it once and never again. This group report they are having recreational experience. The other 10-15% develop a chemical addiction with the substances and are unable to stop. They don't realize that their bodies are predisposed through genetics, stress, and trauma, to want to continue using the chemicals despite the negative effects. The euphoric recall, of the first encounter then drives the obsession to use despite the negative consequences.
The positive effects of alcohol are calming, with reduced fear, anxiety and anger. There is an increased feeling of well-being, confidence and it is sleep inducing, reducing physical pain or discomfort. The negative effects include drowsiness, disorientation, blackouts, and impaired motor coordination. Add to this, impaired judgment in making any decisions, nausea and vomiting with minor overdose, unconsciousness/coma/death with large overdose, and there are problems in the home, work and adding to the overload in emergency rooms.
If you are living in San Diego county and alcohol and drugs are a problem for you, take the actions to switch beverages and recreational activities. There are plenty of non alcoholic beverages and healthy stimulating fun activities to do in San Diego, on any day of the week. If you need support for stopping your alcohol and drug use, call AA or NA for help in locating a meeting close to you. If you want more education, group treatment and understanding of addiction, recovery and relapse prevention for alcohol or drug use, including prescription drugs given initially for chronic pain, call us at Lasting Recovery. We can help you find the best help for your situation.
I have noted the increase in prescription drug dependence among young adults ages 17-25 who are addicted to prescription drugs. For residents in San Diego County, the problem of abusive distribution of prescription drugs is further compounded by our close proximity to Tijuana. Teenagers stream across the border to Tijuana and come back with any narcotic prescription drug they want. The story I hear when treating these young people, is that if you are tall enough to put your money on the counter, the clerk will sell you the prescription drugs. Here's information on another side of the problem, an article from Join Together.org.
California Targets Top Abusers of State Prescription Drug System
The California attorney general's office has announced a crackdown on prescription drug fraud that will start by targeting 50 individuals with the most extensive track record of visiting multiple doctors and pharmacies to get drugs, the Imperial Valley News recently.
California Attorney General Edumnd Brown Jr. reported that prescription drug addicts are abusing the system, draining time and money from hundreds of doctors and pharmacies who are there to help real sick people. He noted the dangerous cycles of fraud and abuse.
A statewide campaign was launched in June to address prescription drug abuse and make it easier for doctors to keep track of prescription drug records. The plan includes a proposal to ensure health professionals access to computers with real-time updated information describing patient prescription drug histories.
The initiative has led to dozens of arrests of individuals suspected of gaming the system to fraudulently obtain large quantities of controlled prescription drugs.
Commentary - Prescription Drug Dependence
Prescription Drug Dependency is a growing problem in our communities. Media advertising and the ease physicians have in prescribing opiate pain medication and tranquillizers, from teenagers to the elderly, has contributed to the excessive number of prescription pill addicts.
The addiction generally begins because a patient is experiencing a physically or emotionally painful condition for which they either receive an opiate to reduce the symptoms of physical pain or a tranquillizer or sedative medication to reduce anxiety and promote sleep. After the initial symptoms have decreased, the dependency upon them may be developing. Who is prone to become addicted to these meds?
Men and women who have a prior history of not being able to easily stop their drinking, who drink in excess of 1-2 drinks at a sitting.
Men and women who have a family history of alcoholism or drug addiction.
Taking a look at our addiction history, whether to alcohol, marijuana, cocaine, methamphetamine, or prescription drugs will help us determine if we have the potential to abuse or become dependent on prescription drugs. There are healthier methods of pain reduction and relaxation. Turning to a drug only increases the problem.
Reprinted from Join Together - Advancing effective alcohol and drug policy, prevention and treatment Unmet Need for Drug Treatment October 7, 2008 Research Summary
According to data from the 2007 National Survey on Drug Use and Health (NSDUH), 82% of the estimated 7.5 million who needed treatment for an illicit drug problem in the past year did not receive it. While there are many reasons for not receiving treatment, a primary one appears to be a lack of perceived need. Nearly all (91%) of those who were assessed as needing but did not receive treatment for illicit drug problems said that they did not feel that they needed treatment. Similar results were found for alcohol treatment. A lack of perceived need for treatment may mean that people don’t think they have a problem, they think their problem is not serious enough to warrant treatment, or they think they can handle their substance use problem on their own.
Reprinted from CESAR Fax, a weekly, one-page overview of timely substance abuse trends or issues, from the Center for Substance Abuse Research (CESAR) at the University of Maryland.
COMMENTARY
Use of chemical substances has increased dramatically over the past years due to exposure through the media, increased glamorization and use of substances for recreation and availability to people of all ages. The people I see in treatment are the lucky ones. They are part of the 18% or 1,350,000 this year who did receive some form of treatment for this devastating brain disease. Why? What is the reason they are in treatment for their addictions and not others? The main reason is that they overcame their Denial. Denial is psychological term for a group of behaviors that evolve to protect oneself from reality.
Addiction is subtle in the way in takes over a person's life. Like a cancer is remains undetected until it creates severe enough problems to get your attention. Addiction is a chronic and progressive disease, and has specific symptoms in the Early, Middle and Late stages. Most people don't think they are addicted, even though they may realize that they are experiencing difficulty stopping or cutting down on a substance (alcohol, cocaine, marijuana, meth, tranquillizers, opiate pain medications, heroin and others). As denial begins, we minimize the amount we use or the consequences, and avoid anyone who might ask us why we are drinking or using more. We may feel guilty for our behavior change. For many of us, we believe we know what an alcoholic or addict looks like and acts like, and it isn't us. Our psychological defense mechanisms then attempt to avoid reality and convince others and ourselves that we don't have a problem with alcohol and drugs.
If you have had consequences related to your use, or anyone has suggested to you that you may have a problem with alcohol, marijuana, stimulants or opiates, take the quiz on our website and save yourself. No one else can do it for you.
