Addiction Effects Discussed at San Diego Alcohol and Drug Rehab

Why can’t I just have a few drinks like other people and enjoy the experience? Instead once I get started drinking or using drugs, I can’t stop until I get drunk or pass out.

Addiction is a complex disorder that effects the Mind, Body, Spirit and Relationships.

MIND

As more research is done on the brain with SPECT scans, we can see the effects of chemicals on the dopamine levels in the brain,; this feel good chemical in our brain increases temporarily with alcohol and drug use then crashes when the episode is over, leaving us feeling increasingly anxious and depressed.

In order to change our mood and feel different, we ingest substances into our oral or nasal passageways, rushing substances to our brain, altering the way we think, and effecting our heart and our emotions. We then relate to others with chemically induced thoughts and feelings, distorting our honest communication. Then we wonder why other people are unhappy with the way we are behaving. And we begin to lose touch with what we really think and feel.

BODY

We wound the organs in our bodies with these toxic substances, then wonder why we feel hung over, sick or tired. We injure our brains, develop high blood pressure. The toxic substances pass through multiple organs in our body.

RELATIONSHIPS

We feel guilty about what was said or what we don’t remember. We deny that the use of alcohol and drugs is a problem. If someone mentions that we need help for our problem, we immediately defend our right to use alcohol and drugs and in the denying, we develop patters of lying, rationalizing, minimizing our use.

Avoidance of the problem leads to relationship difficulties such as excessive anger, physical and emotional conflict with those we love. Avoidance and denial of the developing addiction add medical problems such as high blood pressure, to the deteriorating effects of chemicals on the body.

SPIRIT

How can you tell if your alcohol and drug use is effecting your ‘spirit’? At a conference on addiction, in a room full of scientists and addiction researchers obsessed with the intricacies of the human brain, William C. Moyers, the son of journalist Bill Moyers, free from alcohol and crack for 14 years, author and an advocate of recovery and, stated:

"I have an illness with origins in the brain. . .but I also suffered with the other component of this illness," he told the gathered researchers and scientists, some of whom dutifully took notes. "I was born with what I like to call a hole in my soul. A pain that came from the reality that I just wasn't good enough. That I wasn't deserving enough. That you weren't paying attention to me all the time. That maybe you didn't like me enough."

The conference room was as quiet as it had been all day. "For us addicts," he continued, "recovery is more than just taking a pill or maybe getting a shot.. Recovery is also about the spirit, about dealing with that hole in the soul."

If you want to stop using alcohol or drugs, Lasting Recovery will help you heal your mind, your body, your relationships and your spirit. Call us today: 858-453-4315. We can help!

Culture of Intoxication in San Diego County

The desire for intoxication is the main reason people begin drinking alcohol or using legal and prescription psychoactive drugs and illegal drugs. Alcohol and drug treatment providers in San Diego County regularly see people for treatment who use alcohol, marijuana, cocaine, methamphetamine, and mind altering prescription drugs.

We are seeing an increase in the number of young heroin users who began using

non- prescribed psychotropic drugs, along with alcohol and marijuana. Once the intoxication begins, and the addiction progresses, people want a more intense experience, as the high isn’t as high as before. Some people who are using drugs realize that the stronger drugs are too dangerous and they are able to stop using the drugs. For others who are unable to stop, they move into the use of heavier opiates such as Oxycontin, and then into smoking and shooting heroin. Each day of drug use increases the chance of danger and deadly side effects.

The federal government’s War on Drugs has been directed toward illegal narcotics. Recent data from NIDA – National Institute on Drug Addiction – Monitoring the Future Survey, shows that, “seven of top 10 drugs being high school seniors are misusing legal prescription or over-the-counter medications.”

As a member of the treatment community in San Diego County, we are seeing younger people with more severe and dangerous addictions. The drug dealer is not necessarily the culprit in this addiction. It can be the parents medicine cabinets, the over prescribing by some physicians to give unnecessarily large amounts of pain medication to teenagers, and the proximity of Tijuana where purchasing prescription drugs is reported to be easy and done frequently. Prescription amphetamines, sedatives, tranquilizers, and the attention-deficit hyperactivity disorder medication Ritalin also were among the most popular drugs of abuse among high-school seniors, along with over-the-counter cough medications.

What’s the answer? We can learn through alcohol and drug addiction treatment that we can develop more reliance on living in reality, rather than seeking intoxication.

Living in sobriety is to experience the gift of being alive and alcohol and drug addiction treatment can help people to open the door to recovery.

Suboxone Treatment for Opioid-Addicted Youth in San Diego County

Short-term detoxification coupled with individual and/or group therapy in either a residential or outpatient facility for a few weeks or months is the current treatment as usual for opioid-addicted youth. Except for treating withdrawal during detoxification the typical program does not use agonist medications like suboxone on young addicts. Relapse rates for the current treatment as usual is quite high.

In a recent study in JAMA, Woody and his colleagues reported the results of a randomized trial that compared a 14-day outpatient detoxification using suboxone (detox) vs 12 weeks of outpatient treatment with suboxone (extended treatment). The study was open to young people between the ages of 14 and 21 years but less than 18% of the participants were below the age of 18; no 14 year-old and only one 15 year-old was enrolled in the study. The typical participant was about 19 years old. In addition to receiving suboxone, participants were scheduled for one individual and one group therapy session per week for 12 weeks.

The participants in the detox group had poorer outcomes than the participants in the extended treatment group. Less than 20% of the detox participants completed the study vs 70% of the participants in the extended treatment group. The detox participant on average attended 5 counseling sessions while the extended treatment participants attended 12 counseling sessions. The detox participants also had poorer post treatment outcomes at 6, 9 and 12 month follow-up. Among the detox participants between 17 and 28% produced negative urine tests for opioids, while 29 to 52% of the extended treatment participants produced negative tests.

Woody and colleagues noted that the small study size and the short study duration made it impossible to estimate the number of participants who actually recovered, which they defined as a "voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship." Their study suggests that higher rates of true recovery may be possible with longer use of effective medications coupled with longer and more intensive psychosocial treatment.

Reference: Woody GE, Poole SA, Subramaniam G, et al. Extended vs Short-term Buprenorphine-Naloxone for Treatment of Opioid-Addicted Youth: A Randomized Trial. JAMA. 2008;300(17):2003-2011.

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.

Arthur J. Farkas, Ph.D.

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.

Future Risks of Binge Drinking in San Diego County

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

1. 330% more likely to meet the diagnostic criteria for alcohol abuse
2. 280% more likely to suffer from some form of liver disease
3. 270% more likely to use tobacco
4. 270% more likely to meet the diagnostic criteria for alcohol dependence
5. 230% more likely to meet the diagnostic criteria for drug dependence
6. 180% more likely to lose their driver's license
7. 180% more likely to meet the diagnostic criteria for tobacco dependence
8. 160% more likely to use other drugs
9. 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.