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

Late Stage Alcoholism in San Diego County

Throughout San Diego County, in areas of La Jolla, Mission Valley, Pacific Beach, and Coronado, people are struggling with trying to stop drinking, and others have given up, thinking to themselves that they are hopeless and why bother, they are unable to stop and stay stopped.  Other men, women and young people continue drinking by telling themselves that their problems with alcohol are not that bad.

In denial, these folks may minimize the consequences of using and blame the family or friends for complaining.  Denial of addiction is based on the mistaken belief that the person does not have a problem because they still have a job, a family and do not drink every morning.

Some are still working, others have quit or lost their jobs. Some are homeless, but most are at home through San Diego county, being cared for or enabled (actually leading to more severe progression of the disease), by family or friends who wish the person would stop drinking, and yet do not know how to get them to stop.

Living in Late Stage alcoholism is the image of what most people think of when the words alcoholism is mentioned - drinking from early morning, lost job, abandoned by family, multiple legal offenses and treatment programs without gaining substantial periods of recovery.

There are hundreds of people getting sober each day in San Diego.  In the Middle and Late Stages of alcoholism and addictions, they call treatment centers and ask for help.  They ask for Outpatient or Inpatient detoxification ; ask their doctors for help, or go online and check out the alcohol treatment programs or alcohol rehabs in their area.  They show up at AA meetings.

These folks even tell us they are relieved when they get a DUI, knowing that this will be a chance for them to get help to stop drinking.

Identification of the Lat State of Alcoholism:
---the person drinking thinks that responsibilities interfere with drinking.
---loss of job
---radical deterioration of family relationships
---unreasonable resentments
---loss of will power
---onset of lenthy drunks
---moral deterioration
---urgent need for morning drink
---geographic escape attempted (I won't drink in this new town)
---urgent need for morning drink
---impaired thinking
---loss of family
---successive and lengthy drunks
---unable to initiate action
---obsession with drinking
---all alibis exhausted

If you are reaching out for help give us a call here at Lasting Recovery. If we are unable to help yo and your family with our outpatient detoxification, intensive outpatient alcohol and drug program we will refer you to a program that will work for you. If you are a family member and are unable to encourage your family or friend into treatment, we can recommend an Interventionist that will be of help to your family.
Call us at 858-453-4315.

Do not wait any longer.  The stakes are too high.

Judy Saalinger, Ph.D., MFT, CAS

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

Development of Alcoholism - Early Stage

Every day in San Diego people are feeling confused and asking themselves why they drank an entire bottle, or 2, of wine. Some people have told their wife, husband, friend or child that they were not going to drink more than 2 small glasses. Or that they were going to quit drinking. Some people begin to justify this drinking episode with the thoughts that they changed their mind, or it wasn't that bad, or they could not have an alcohol problem because they do not drink in the morning, or before 5pm, or drink and drive.

How do we know if our drinking is a problem?

Many millions of people are social drinkers and many millions more are just crossing over the line from social drinking into the early stages of alcoholism, or the addiction to alcohol.

The American Society of Addiction Medicine defines addiction as a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.  They define this disease to be 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.

The time it takes from the early stage of the disease,  to the last stage of addiction, where there are severe medical, family or legal consequences ,varies between men and women.  Research has shown that men process the alcohol more quickly in their bodies, and the severe effects take an average of 15 years to show up.   Women, who process the alcohol more slowly, thereby staying in the body longer before it is discarded, the damage occurs within an average of 8 years.

SYMPTOMS OF THE EARLY STAGE
     --- An increase in alcohol tolerance.  It takes more than 2 standard drinks to obtain a change in mood.

     --- Drinking to calm nerves.  Alcohol or drugs become the favored way to reduce stress, quiet generalized anxiety and fears of the unknown in relation to work, family, finances, or health issues.

     --- Desire to continue when others stop.  The loss of control or impaired control begins to take over most drinking experiences.  The 2 standard drinks is many times not enough to feed the developing compulsion to drink larger amounts.

     --- Occasional memory lapses after heavy drinking.  Research has shown that after only a few drinks, the alcohol can produce impairments in memory that is detectable.  The degree of impairment is directly related to the amount of alcohol consumed.  When large amounts of alcohol are consumed quickly, as in a binge, the brain and body are overloaded and unable to metabolize the substance.  This is the beginning of the brain deficits that occur. Most notably the effects are seen  in the lack of ability to transfer new information from short term to long term storage, as in a blackout. 

     ---Secret irritation when your drinking is discussed.  Many people begin to feel some confusion and guilt about their drinking, and start to rationalize to themselves and others as to why they continue drinking.

Rationalizing, a thought distortion, is the beginning of the development of the psychological defense system of denial.  If there is no help requested by the person,  or an intervention by the family, workplace or legal system to point out the beginning of the problem of early stage alcoholism, the disease will progress.

Next - Part 2 of 3 - Development of Alcoholism - Middle Stage

Thanks for reading and passing along this information.

Judy Saalinger, Ph.D. MFT, CAS

What is Not-At-Risk Drinking?

Looking for alcohol in Del Mar or Carmel Valley? You can find large amounts of it for purchase in the grocery stores, pharmacies, restaurants, bars, gas stations, mini marts and  liquor stores, throughout the north coastal areas.

Some people can ignore the multimillion dollar advertising campaign to get you to either order or pick up the alcohol for consumption, while other are seduced into purchasing alcohol regularly and enjoy evening drinks with their friends and family.

Still others will purchase alcohol daily to keep themselves from needing to enter a detoxification and treatment program,  in full alcohol withdrawal with shakes and the possibility of a life threatening seizure. Which one are you?  Are you safe from the risks of becoming the daily drinker, or the alcoholic?

The National Institute of Alcohol Abuse and Alcoholism (NIAAA) has examined the scientific literature to determine what constitutes not-at-risk drinking.  The staff at NIAAA examined the physical, mental, social and legal risks associated with drinking and identified the amount men and women can drink without increased risk.  Based on their analyses, the NIAAA recommends that:                      
--Men should consume no more than 4 standard drinks per day and no more than 14 standard drinks per week.
--Women,  who process alcohol differently than men, should consume no more than 3 standard drinks per day and no more than 7 standard drinks per week.
--People 65 years of age and older should not drink more than one drink per day.

A standard drink equals a 12 oz. beer or cooler, 8-9 oz malt liquor, 5 oz of talble wine, or 1.5 oz of 80 proof spirits.  Depending on the type of spirits and recipe, one mixed drink can equal from one to three or more standard drinks.

People who exceed the recommended daily limit have engaged in binge drinking.  

Of the people who HAVE NOT exceeded the recommended daily and weekly limits in the past year  (72% of the U.S. population over age 18), less than 1 in 100 will eventually meet the diagnostic criteria for either alcohol abuse or dependence.

People who HAVE engaged in binge drinking at least once in the previous 12 months (16% of the U.S. Population over the age of 18), 1 in 5, or 20% will eventually meet the diagnostic criteria for either alcohol abuse or dependence.

 People who exceed both the limits recommended  for daily and weekly use, which is 10% of the U.S. population over the age of 18, 50% or 1 out of 2 people will eventually meet the diagnostic criteria for either alcohol abuse or dependence.

Finally, people who exceed the recommended weekly limit but never binge drink (2% of the U.S. population over the age of 18) about 1 in 12 or 8% , will eventually meet the diagnostic criteria for either alcohol abuse or dependence.

If you want to be safe and reduce your risks for becoming alcohol dependence, don't exceed the daily (a binge) or weekly limit. This is no guarantee, however that trying to reduce the consumption will work,  as there are genetic as well as environmental risks factors that lead to continued use despite consequences.   If you have tried to reduce your consumption and been unsuccessful, you are not alone. Alcoholism is often described as having an allergy of the body and an obsession of the mind. The overconsumption, fueled by the obsession to continue drinking, can lead to blackouts, personality changes,a loss of self esteem, physical problems, and problems with family, friends, employers and the law.

If  you or someone you love is unable to consistently control the amount of alcohol they are drinking, seek help now by using the assessments on our website, www.lastingrecovery.com,  to  to determine if you have a problem. There are solutions.  If you would like more information, give us a call at 858-453-4315.

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

Alcohol Detox in San Diego County

Do you ever feel sick of drinking alcohol and want to stop. Are the symptoms of withdrawal so uncomfortable that in the past you gave up and went back to drinking and hating yourself for it?
Be  motivated to go through the detox and achieve recovery! You are worth it. And you can do it.

Adequate detoxification is important to beginning the longer process of complete physical and psychological withdrawal from alcohol.  The proper management of this first stage will maximize your chances of lasting rehabilitation, by providing a net of safety and reduction of harm during alcohol or drug withdrawal.  You deserve to have a new beginning.


How do you know if you are already in withdrawal from alcohol or just suffering a bad hangover?  The onset of alcohol withdrawal usually occurs between 6 and 24 hours after the last drink, and an uncomplicated withdrawal usually lasts between 1-4 days.


The first thing to do is decide if you or your loved one will need an outpatient or an inpatient detoxification. The greater the amount of alcohol consumed in a day and the longer the period of time of drinking or ingesting drugs in the body, the greater the  chances of a complicated withdrawal, which means an inpatient detox would be safest.


To determine if you or someone you love is suitable for an outpatient detoxification which usually lasts from 1-4 days, look at the following list:
      1.  Not severely dependent
      2.  No previous complicated withdrawal (no seizures, disorientation, confusion or hallucinations)
      3.  No concurrent illness, injury or recent surgery
      4.  No significant use of other psychotropic drugs that could aggravate withdrawal
      5.  You are motivated to achieve abstinence
      6.  A reliable caretaker is available.




Daily drinking by men of more than 6 standard drinks (1.5 ozs)  a day, and women more than 4 a day, places a person at high risk for a complicated withdrawal. Weekly drinking of 42 standard drinks of alcohol for men and more than 28 for women places a person high risk. Other individual, drug and factors in the environment can effect the level of risk for alcohol related problems.


A simple withdrawal, manageable in an outpatient detoxification can begin by seeming like a hangover or a case of the flu, and usually occurs between 6 and 24 hours after the last drink.  Some symptoms include:
     --tremulousness
     --perspiration
     --increased pulse
     --increased temperature
     --nausea, vomiting and diarrhea
     --restlessness, agitation
     --anxiety
     --insomnia, sleeping disturbance
     --fears
     --depression
     --headaches


If you would like more information on our detoxification program for alcohol, drugs or prescription drugs, including Suboxon, give us a call. We can help you 7 days a week.


Judy Saalinger, Ph.D., MFT, CAS

Outpatient treatment for women who love wine in San Diego and Carmel Valley

According to a recent British survey, 8 out of 10 bottles of wine consumed at home are purchased by women. Drinking wine has replaced the social connection of having a cup of coffee with friends.

The problem is that women do not think drinking wine 3-4 times a week is a problem. Most women who call an outpatient alcohol and drug treatment program for alcohol treatment are dependent on wine.

Wine is packaged and sold throughout grocery stores, and many women think it is a food item. Wine is displayed in the vegetable section, the bread and bakery section, the candy section, end aisles, front aisles, the potato chip section and all sections in between. It’s no wonder that women in Carmel Valley, Del Mar, Encinitas, La Jolla and Scripps Ranch purchase and drink it. Consumers are seduced by hundreds of millions of dollars spent in research and marketing by the brewers to get the women to pick up the bottle of wine.

I have heard college educated women say that they could not have an alcohol problem, because they only drink wine. They think alcohol is a food group. And it is not.

Yet women are frequently drinking and isolating at home, becoming more depressed and anxious, and feeling more and more lonely. Why the loneliness? We have given our personal power over to the substance in a bottle. We think it will change our mood state and give us a euphoric feeling, yet the downside is that we become depressed and anxious, feeling guilty because we cannot keep our commitment to just have one or two drinks.


Women often have a 2 drink rule. If a women has a problem with being unable to consistently control the amount and effects of alcohol, feels urgency to drink and sneaks or hides alcohol, she could be in the early stage of alcohol dependence.

Two drinks does not seem like it provides effective emotional effects, e.g. a mood change, and a sort of compulsion takes over. The needs of the body to satisfy the growing physical and psychological need for alcohol, undermine her thoughts, emotions and behaviors. In this case, women cannot consistently control the amount of alcohol they are drinking and the 2 drinks turns into 6 or 8 drinks, an overload to the mind and body.

Drinking alcohol whether it be wine, beer, vodka or whiskey, while ignoring the feedback from others that the alcohol is a problem just adds to the confusion and need to drink more.

If drinking wine is beginning to be a problem for you, call us for outpatient alcohol treatment, where you can attend during the day, from 10-1pm, or evening from 6-9pm. Take the steps now to get back your health. Now is the time to decide and act.

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

San Diego County Responds to the Amethyst Initiative

The Amethyst Initiative

PART 1

The Amethyst Initiative is a recent movement of over 130 college presidents requesting the nation lower the legal drinking age. This absurd suggestion not only could endanger young lives but it reveals backwards thinking by professionals who should be looking out for those they serve (Hazelden, 2008).

Underage drinking is on the rise. Ten percent of Alcoholics Anonymous members are under the age of 30 (Alcoholics Anonymous, 2007). This community-based support network responded to the needs of young people when Alateen spurred off from Al-Anon – a support group for loved ones of alcoholics. Among 12-20 year olds, over 47% are current drinkers and 26% meet the criteria for alcohol abuse and dependence compared to 9.6% of those over the legal drinking age (Discovery Health, 2009).

In 1988, 21 became the legal minimum drinking age in all 50 states. The U.S. Department of Transportation states that in spring of 2004, over 18,000 lives were saved through decreases in alcohol-related accidents, which are the leading cause of death of young people in our country (Hazelden, 2008).

Although severe health problems associated with alcohol abuse are not as common in adolescents, studies show that young people set themselves up for these risks when they drink heavily from an early age. Brain damage can occur, as alcohol affects the maturation of young tissue. Lasting effects to long-term memory and learning skills are evident in adults who began drinking at an early age. Drinking can also elevate liver enzymes and effect growth and development. In fact, consuming alcohol during puberty adversely affects the maturation of reproductive organs and can upset the hormonal balance for normal development of organs, bones and muscles (NIAAA, 2006).

Discovery Health (2006) has stated that almost all (96.8%) of the adult drinkers with alcohol abuse and dependence began drinking prior to the age of 21. A common phrase in Alcoholics Anonymous regarding young drinkers is, if you're not an alcoholic, you're studying hard to be one. This may be true for many young people. If so, why would we lower the legal drinking age and invite them to try it on for size?

Over one third of United States alcohol sales are to underage and/or abusive drinkers (Discovery Health, 2009). It seems the financial interests of the alcohol industry may be weightier than the interests of our young peoples health. Lowering the legal drinking age certainly would not solve these problems but only serve to exaggerate them.

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.

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.

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

Alcohol and Drug use in San Diego County

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.

Judy Saalinger

Drug and Alcohol Addiction Forum

ADDICTION FORUM
What does Evidence-Based Practice have to do with Addiction Treatment?

HAZELDEN, a national nonprofit organization founded in 1949 to help people reclaim their lives from the disease of addiction, in collaboration with Lasting Recovery, NCADD San Diego, and Visions Adolescent Treatment Centers, is offering a free educational forum.

Date: Friday, October 17, 2008
8:30am - Registration and Continental Breakfast
9 - 10:30 a.m. - Presentation

Location: Handlery Hotel, San Diego

Reservations: 888-257-7800 x 4204