Alcohol and Prescription Drug Use in San Diego County - Are you Becoming Dependent?

Most people in Carmel Valley, Del Mar, La Jolla, San Diego and Scripps Ranch at least try drinking alcohol sometime during their life. Many others have been given a prescription for pain medication due to an injury, dental or surgical procedure. For many people, the substance makes them feel so good, that they look forward to the drink or pain pill, like a reward for having done a good job at work or school. Unfortunately, some people are genetically wired to like the drug or alcohol so much that they become physically dependent on the substance and physically have to drink more alcohol or take more pills to just feel normal. The amount of time it takes for this to happen varies with the person, gender and the substance. It can take from 6 months to a 2 years for prescription pain medication to become physically dependent and alcohol can take from 2-10 plus years for a person to become dependent. The pattern of symptoms though are similar:

-- drinking or using drugs to calm your nerves
-- occasional memory lapses after heavy drinking or drugging
-- thinking a lot about the next time you will have a drink or use drugs
-- hiding your drugs or alcohol
-- sneaking while you are drinking or doing drugs so you won't be found out
-- feeling guilty about drinking or using the drugs
-- difficulty in your relationships - angry or aggressive over small events
-- deep inside there is a feeling of helplessness; you are drinking or doing the drugs and can't even stop yourself, no how hard you try
-- beginning of depression with the frequent thoughts of feeling hopeless, futile.

If you feel you or a family member is suffering from the use of alcohol or prescription drugs, you may be suffering from a substance use disorder that is causing the problem. Seek help before the symptoms and consequences get more severe. We can help. Professional. Confidential.


Judy Saalinger, Ph.D., MFT, CAS

Will Alcohol and Drug Rehab Help My Relationship?

The impact of alcohol and drug use on relationships can be severe:
     ---arguments
     ---misunderstandings
     ---broken promises
     ---betrayal
     ---disappointment
     ---guilt and shame

Tense situations fueled by alcohol or drugs lower the threshold of our patience, impairs judgment and lessens impulse control, damaging a person or a family for life.  This cycle of destructive relationship interactions can continue until one or both of the people get off the sinking ship.

Alcohol Rehab helps you and your loved ones to:
     ---Recognize that alcohol and drugs are the problem, not the person
     ---Stop trying to change each other and learn to accept the other person
     ---Attend support groups to talk to others who understand
     ---Overcome mistrust and find hope
     ---Experience relaxation for the first time in a long time
     ---Be honest in their daily lives
     ---Recognize the cycle of addiction that leads to relapse and build in new recovery pathways.

I began working with people who suffer from addiction problems since 1981 and have seen hundreds of couples repair and strengthen their relationships with partners, parents, children, extended family, friends and  employers. Yes, Alcohol and Drug Rehab will help your relationship. Give yourself a chance to recover.

Judy Saalinger, Ph.D., MFT, CAS
Co-Owner and Clinical Director
Licensed Marriage and Family Therapist

Development of Alcoholism - Middle Stage

In addressing this Middle Stage of the disease of addiction here in San Diego County, you may be asking the question: Given the already negative effect of drinking alcohol, as outlined in the Early Stage, why do I keep on drinking?

The answer:
There is a growing illusion in this disease, that alcohol is continuing to have the same effects as it once had. We refer to this as Euphoric Recall.

People keep using alcohol for the effect they remember - the drug's action is pleasant or useful, including social or medical uses, and it allows people to temporarily feel more pleasure, less pain or discomfort or both.  People recall how alcohol used to help them feel more at ease in social situations.  Only now, in the Middle Stage of the addiction, the effects of the drugs have changed.

This Middle Stage is often called the Loss of Control Phase. During this phase drinking has different effects. Occasionally we can drink socially and do not crave the alcohol once we have been exposed to it. Other times we are confused as to why, drinking the same amount, it seemed to take us over.  As rationalization begins to dominate the individual, i.e., we make up excuses to ourselves and others as to why we drank more, or ended up in an embarrassing situation. Rationalization are the lies we tell ourselves and how we learn to avoid others because we are thoroughly confused at our behavior.  For many of us, we are able to control a lot of things in our life and think that if we just tried a bit harder, we could consistently control our alcohol use as well.  So we firmly tell ourselves that we will not drink more than two drinks at the next party, or that we will not drink at all.

We this stage progresses without help, we are unable to keep our commitments to not drink, so we begin making excuses or lying about drinking.  We may drink in bars or restaurants to hide the evidence of bottles if we drink at home.  Many of us then decide that going out socially to drink alcohol becomes such a disaster that we would rather stay at home and drink.

Our anxiety is actually increasing as the alcohol does progressively more damage to the brain and body.  Nutrition is negatively affected, and  important vitamins and minerals are depleted. At the same time, we ironically keep remembering that alcohol once reduced fear, anxiety and even anger. It used to help us feel more confident, helped us sleep and reduced physical discomfort.

Instead, what alcohol actually does is cause drowsiness, disorientation and blackouts.  Alcohol may impair our motor coordination and cause impaired judgment.  Some people will receive a DUI, have an extra marital affair, or make poor financial decisions while under the influence.  We may experience nausea or vomiting after drinking - a minor overdose.  In this Middle Stage there are increased memory blackouts and the beginning of early morning tremors.  Toward the end of this stage, many people begin to break their rules about not drinking before 5, or noon and start earlier and earlier in the day and eventually drink alcohol in the morning.  The compulsion to drink overrides commitments we have make to ourselves, to our families, friends and employers.

We then avoid family and friends, and experience a loss of other interests.  The efforts to control the drinking fail repeatedly.  We are unable to discuss problems as the alcohol has taken over our days and nights.  At the end of this stage, we find ourselves drinking alone. If this sounds like a portrait of your life right now, reach out and ask for help.

If  we reach out for help now, we will avoid the Late Stage of alcoholism.  Our Staff at Lasting Recovery can answer any questions for you or your family member about getting help with detoxification or intensive outpatient treatment.   If we are unable to meet your needs for detoxification and outpatient care, we will refer you to a program that can. Give us a call at 858-453-4315.

Judy Saalinger, Ph.D., MFT, CAS

Tranquillizer and Sedative Dependence in San Diego Neighborhoods

More and more people who suffer from anxiety or sleeplessness are prescribed medications from their doctors.  Some pople find that using these drugs to get high is a dangerous game. Young people are overdosing from using xanax along with opiate medications. We see young people whose have stalled their lives, from Carmel Valley, Del Mar, La Jolla and Encinitas due to the fact that they are suffering from having become dependent on drugs.

These medications are often obtained by young people from drug dealers and older people who tend to go to their physicians.  Being unaware that the increasing physical dependence is taking over, these people will take the prescribed 30 days of medications in 2-3 days, leaving them desperate to get more medications.  I have spoken with men and women of all ages who were surprised when they found they had taken the entire prescription in a few days, as if they could not get enough. Just like the person who finds that they now cannot stop at just two drinks, the compulsion to drink more or to use more of the drugs overpowers them and their physiological addiction is beginning to take control of their life.  Whether it is alcohol or prescription drugs, people are confused and feeling guilty, and desperate, some people will begin to shop for more alcohol or doctors who will fill the prescriptions for the narcotics.  Others will go on the internet and order a large supply of drugs which are then delivered within a day or two.  Some people who are not addicted will go to Mexico to purchase the drugs from the pharmacies who sell to them without a prescription.

If you find that you are physically dependent on these medications, do not try to detox yourself. Withdrawal from alcohol, valium, librium, xanax and ambien,can cause severe anxiety symptoms, including seizures.

Lasting recovery Outpatient Detoxification offers confidential medically supervised detoxification from alcohol and prescription drugs. Our Medical Director, Michael Markopoulos, MD can help you with early recovery cravings for alcohol including Naltrexone, and Suboxon for opioid dependence.
You do not have to recover alone. Call Lasting Recovery for help with your chemical dependency treatment needs.

Judy Saalinger, Ph.D., MFT, CAS

Women Alcohol Drinkers Face Breast Cancer in San Diego County

Ladies and Girlfriends, be aware of what you consume!

The official word the UK Department of Health, as reported in Joined Together, a service for the latest information on alcohol and drug dependence and effective treatment, reports that women who drink regularly face an increased risk of breast cancer by 50%.

The BBC reported recently that women who consume more than 14 standard units of alcohol weekly raise their risk of developing breast cancer by 50 percent. A standard unit is 5 oz, or about 5 glasses of wine per standard bottle. The majority of women drinkers,who live in Carmel Valley, Mission Hills, La Jolla,  Rancho Santa Fe, and Del Mar, who come to intensive outpatient alcohol treatment to receive treatment and recovery, have reported drinking from 1-2 bottles of wine in an evening, adding up to 10 standard units at one sitting!

If you or someone you love is drinking 3 or more bottles of wine in a 7 day week, the chances of breast cancer risk increases by 50%.

With stronger wines being poured into bigger glasses these days in bars and restaurants, a single glass of wine can contain up to 3.5 units of alcohol. Most women don’t realize how much they are drinking.

Experts say that alcohol use causes about 2,000 breast-cancer cases a year in the U.K. How many cases in the U.S. are related to drinking?

If you are a woman and would like to cut down on your alcohol intake, give us a call. Helping women to live healthy and productive lives is our mission.

Judy Saalinger, Ph.D., MFT, CAS

San Diego County Responds to the Amethyst Initiative

The Amethyst Initiative

PART 2

Combating underage drinking must come from education and community support. The beginning of alcohol and drug use is becoming more prevalent in junior high, as this is when hormone-driven risky behavior begins. Educators, counselors and administrators should be trained to see the signs of early use in teens. Counselors should be trained in intervention techniques and communication with students families. This should be true for facilities through college and trade schools.

Families need to stay involved in their young ones lives. The most successful discussions with young people are non-accusatory, supportive and engaging. Discuss the facts, get all the information and help find solutions through support rather than using scare tactics. This loving support will give young people a sense of self-worth and the confidence to be drug-free (Dr. Rob, 2003).

City and school law enforcement must stand firm on zero-tolerance laws regarding underage drinking. Despite many states adopting these laws, consistent enforcement wavers. The National Institute on Alcohol Abuse and Alcoholism, stated in 2006 that when the first eight States to adopt zero-tolerance laws were compared with nearby States without such laws, the zero-tolerance States showed a 21-percent greater decline in the proportion of single-vehicle night-time fatal crashes involving drivers under 21, the type of crash most likely to involve alcohol. Resources must be available to see these laws into action.

Alcohol is widely available and promoted to young people in America today. Though underage drinking use is regarded as a normal part of growing up by some people, it is dangerous for the drinker and the community as evident by the number of alcohol-related accidents and crimes. Adolescents are at greater risk for development of health-related issues due to alcohol abuse and adverse consequences including risky behavior and poor school performance.

Lowering the legal drinking age would not help the problem of underage drinking but aggravate it. William Cope Moyers, executive director of the Hazelden Center for Public Advocacy and a recovering alcoholic said, "Twenty-one is not working according to the college presidents statement. But from my own experiences a long time ago, 18 never worked either" (Hazelden, 2008).

References

Alcoholics Anonymous (2007). Young people and AA. New York, NY: Alcoholics Anonymous World Services.Discovery Health (2006).

Underage drinking nets alcohol industry billions. Dr. Rob (2003). Teen center: teens and risky behavior – One nurse's plea to teens.

Hazelden (2008). Debate to lower drinking age builds despite 21'a success.

NIAAA (2006). Alcohol alert. Retrieved January 17, 2008, from http://pubs.niaaa.nih.gov/

Spears & Spears (2008). In tandem: reading and writing for college students. New York, NY: McGraw-Hill.

Your comments are appreciated. Given that most adults who suffer from alcohol problems began in their teens, keeping the age of drinking at 21 seems the most prudent decision.

Tamra Anderson, Clinical Administrator

Lasting Recovery

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.

Down Side to Alcohol and Drug Use in San Diego County

PART 11
Alcohol and drug use can start off as recreational; relaxing after work, social use at parties and with friends. The problems of excessive use of alcohol and drugs can create problems in our bodies, brains, in our relationships, problems at work and with the legal system. The following statements will help you to understand the progression of alcohol and drug use from recreational to addiction. The sooner one gets help for alcohol abuse and dependence, the fewer problems the individual user and family has to resolve.

4. Often progressive and fatal means that the disease persists over time and that physical, emotional, and social changes are often cumulative and may progress as alcohol or drug use continues. Addiction to alcohol or drugs causes premature death through overdose, organic complications involving the brain, liver, heart and many other organs, and by contributing to suicide, homicide, motor vehicle crashes, and other traumatic events.

5. Impaired control means the inability to limit alcohol or drug use or to consistently limit any drinking or drugging occasion, the duration of the episode, the quantity consumed, and/or the behavioral consequences of using the substances.

6. Preoccupation in association with alcohol or drug use indicates excessive, focused attention given to the drug or alcohol, its effects, and/or its use. The relative value thus assigned to alcohol or drugs by the individual often leads to a diversion of energies away from important life concerns.

7. Adverse consequences are alcohol/drug-related problems or impairments in such areas as: physical health (e.g., alcohol withdrawal syndromes, liver disease, gastritis, anemia, neurological disorders); psychological functioning (e.g., impairments in cognition, changes in mood and behavior); interpersonal functioning (e.g., marital problems and child abuse, impaired social relationships); occupational functioning (e.g., scholastic or job problems); and legal, financial, or spiritual problems.

8. Denial is used here not only in the psychoanalytic sense of a single psychological defense mechanism disavowing the significance of events, but more broadly to include a range of psychological maneuvers designed to reduce awareness of the fact that alcohol or drug use is the cause of an individual's problems rather than a solution to those problems. Denial becomes an integral part of the disease and a major obstacle to recovery.


________________________________________

This definition was prepared by the Joint Committee to Study the Definition and Criteria for the Diagnosis of Alcoholism of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine.

If you would like more help for yourself or a family member, give us a call at 858-453-4315.

Judy Saalinger, Ph.D., MFT, CAS

Are you questioning the downside to your alcohol or drug use

Today I received a call from a 37 year old man who was confused about his alcohol use. He drank alcohol only on the weekends, and he gladly reported that he did not have any legal problems, did not drink in the mornings and he believed his alcohol use was not interfering with his work. Then his wife told him to pack his bags and leave, the next time he decided he was going to drink.

His alcohol use, however was interfering with his family. He brought home alcohol every night, and extra for the weekend, as he usually got started drinking by noon. His evening drinking started as soon as he got home, and sometimes he started in the parking lot of the liquor store. He would think about the alcohol around noon, when he began counting the hours until he could get off work and go the liquor store. He would get so excited, as he imagined himself getting home and having a shot and some beers to relax. His wife nagged him about his routine behavior, as she saw he preferred his drinking more in the evening than spending time with her or his family.

He started drinking when he was age 16, and then he only drank on the weekends. When he came in, I gave him this information:


1. Addiction is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by continuous or periodic: impaired control over alcohol or drugs, preoccupation with drugs or alcohol, use of addictive substances despite adverse consequences, and distortions in thinking, most notably denial.

2. Primary refers to the nature of addiction as a disease entity in addition to and separate from other pathophysiologic states which may be associated with it. Primary suggests that addiction, is not a symptom of an underlying disease state.

3. Disease means an involuntary disability. It represents the sum of the abnormal phenomena displayed by a group of individuals. These phenomena are associated with a specified common set of characteristics by which these individuals differ from the norm, and which places them at a disadvantage.

Part II tomorrow.

Trying to stop drinking or using drugs is difficult for those people who are more progressed in their disease. Women generally have difficulty with alcohol and drug use sooner than men due to sex differences. If you need help and want to get back on the road of living your life safe and healthy, seek help now.

Judy Saalinger, Ph.D., MFT, CAS

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!

Denial - The Barrier to Alcohol and Drug Treatment in San Diego

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.

Judy Saalinger

Mental health and Addiction Parity Bill

Making mental health and addiction parity with other medical illnesses is a must for our society. The problem with the this bill currently passed both houses is not parity. In other words, it doesn't have to be included in insurance policies. Mental Health and addiction, are symptoms of brain changes that have occurred,just as a change in various other organs have changed as the result of a disease. The price paid is untold suffering, creating loss of families, wounded children, divorces and losses to our economy and our society. Providing adequate mental health and addiction health care for our society will bring the ability to use our brains in creative, solution focused ways for us to restore ourselves as a nation.

Judy Saalinger, Ph.D, MFT, CAS
Clinical Director