Tuesday, April 29, 2008

VR Environments Therapeautic For Addicts

Article Date: 29 Apr 2008

Patients in therapy to overcome addictions have a new arena to test their coping skills - the virtual world. A new study by University of Houston Associate Professor Patrick Bordnick found that a virtual reality (VR) environment can provide the climate necessary to spark an alcohol craving so that patients can practice how to say "no" in a realistic and safe setting.

"As a therapist, I can tell you to pretend my office is a bar, and I can ask you to close your eyes and imagine the environment, but you'll know that it's not real," Bordnick said. "In this virtual environment you are at a bar or at a party or in a real-life situation. What we found was that participants had real-life responses."

Bordnick, of the UH Graduate College of Social Work, investigates VR as a tool for assessing and treating addictions. He studied 40 alcohol-dependent people who were not receiving treatment (32 men and eight women). Wearing a VR helmet, each was guided through 18 minutes of virtual social environments that included drinking. The participant's drink of choice was included in each scene. Using a game pad, each rated his or her cravings and attention to the alcohol details in each room. Each then was interviewed following the experience.

"What we found was that the VR environments were real enough that their cravings were intensified. So, now we can develop coping skills, practice them in those very realistic environments until those skills are working tools for them to use in real life," Bordnick said.

His VR environments, developed with a company called Virtually Better, feature different scenarios that an addict may find challenging: a bar with imbibing patrons, a house party with guests drinking and smoking, a convenient store with cigarettes and alcoholic beverages within reach, a designated smoking section outside of a building or a room with an arguing couple. The environments use actors in each scene as opposed to computer-generated characters. In addition, the study added another layer of realism. A device sprayed the air with scents the participant may encounter in the various scenarios - cigarette smoke, alcoholic beverages, pizza or aromas associated with the outdoors.

"This study shows us the value of using virtual reality as a tool for assessing and treating addictions. Future studies should explore the importance of environmental settings and other cues on cravings and relapse," Bordnick said.

His study is available online in the journal Addictive Behaviors.
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Bordnick also has VR environments to help soldiers from Iraq, those with a fear of flying, fear of public speaking and fear of heights.


He is funded by the National Institutes of Health, the National Institute on Drug Abuse and the National Institutes for Alcohol Abuse and Alcoholism.

For more information on the UH Graduate College of Social Work, visit http://www.sw.uh.edu/main/home.php.

Source: Marisa Ramirez
University of Houston

Monday, April 28, 2008

Treatment

Residential treatment centers usually offer a multi-faceted approach in assisting clients in their recovery from active addiction. The therapeutic and structured environments found in residential treatment centers can facilitate the important first stages of detoxification and withdrawal, setting the stage for a cleared mind to be able to absorb new ideas and concepts in healthy living, relapse prevention, behavioral changes, etc...

Depending upon your insurance coverage, many of the centers in the mid and high range may become affordable. You can contact the customer service department at your insurance company and check your covered benefits. In-network benefits can be as high as 80 - 100%, out of network benefits are often 50%.
Although each residential treatment center operates under different philosophies, certain general approaches are likely to be found in most. Among those are:

* Detoxification
* Drug and alcohol education
* Relapse prevention
* Family program
* Individual and group counseling
* Twelve-step recovery
* Anger Management
* Dual Diagnosis Education
* Self Harm Reduction
* Community Re-Integration

Friday, April 25, 2008

When people drink themselves silly.

The urge to binge mindlessly, though it can strike at any time, seems to stir in the collective unconscious during the last weeks of winter. Maybe it’s the television images from places like Fort Lauderdale and Cabo San Lucas, of communications majors’ face planting outside bars or on beaches.

Or perhaps it’s a simple a case of seasonal affective disorder in reverse. Not SAD at all, but anticipation of warmth and eagerness for a little disorder.

Either way, researchers have had a hard time understanding binge behavior. Until recently, their definition of binge drinking — five drinks or more in 24 hours — was so loose that it invited debate and ridicule from some scholars. And investigators who ventured into the field, into the spray of warm backwash and press of wet T-shirts, often returned with findings like this one from a 2006 study: “Spring break trips are a risk factor for escalated alcohol use.”

Or this, from a 1998 analysis: “The men’s reported levels of alcohol consumption, binge drinking and intoxication were significantly higher than the women’s.”

In fact, the dynamics of bingeing may have more to do with personal and cultural expectations than with the number of upside-down margaritas consumed. In their classic 1969 book, “Drunken Comportment,” recently out in paperback, the social scientists Craig MacAndrew and Robert B. Edgerton wrote that the disconnect between the conventional wisdom on drunken behavior and the available evidence “is even now so scandalous as to exceed the limits of reasonable toleration.”

They detailed the vast differences in the way people from diverse cultures behave after excessive alcohol. In contrast to nearby tribes, for example, the Yuruna Indians in the Xingu region of Brazil would become exceptionally reserved when rendered sideways by large helpings of moonshine. The Camba of eastern Bolivia would drink excessively twice a month. Sitting in a circle, they would toast one another, more lavishly with each pop.

In a Japanese island village, Takashima, people knew a drinking occasion had gone completely off the dials if villagers began to sing or, wilder still, to dance. Aggression, sexual or otherwise, was unheard of during these sessions.

Western cultures are more likely to excuse binge drinking as a needed mental vacation. “An awful lot of cultures have institutionalized bingeing as a kind of time out like Mardi Gras or New Year’s Eve, a culturally recognized period where a certain amount of acting out is acceptable,” said Dwight Heath, emeritus professor of anthropology at Brown.

Not to say that would-be bingers, when ordering that first tray of Irish car bombs for the table, think about discharging a cultural tradition. They have their own reasons. And those, too, shape subsequent drunken behavior.

In a series of studies in the 1970s and ’80s, psychologists at the University of Washington put more than 300 students into a study room outfitted like a bar with mirrors, music and a stretch of polished pine. The researchers served alcoholic drinks, most often icy vodka tonics, to some of the students and nonalcoholic ones, usually icy tonic water, to others. The drinks looked and tasted the same, and the students typically drank five in an hour or two.

The studies found that people who thought they were drinking alcohol behaved exactly as aggressively, or as affectionately, or as merrily as they expected to when drunk. “No significant difference between those who got alcohol and those who didn’t,” Alan Marlatt, the senior author, said. “Their behavior was totally determined by their expectations of how they would behave.”

In a repeat of the session performed for a coming documentary, one participant insisted that she could not have been drinking because alcohol always made her flush.

“We told her that, yes, in fact she was drinking it,” Dr. Marlatt said. “She immediately flushed.”

Somewhere between personal preferences and social custom, moreover, the peer group asserts itself. In a recent study, public health researchers in New Zealand conducted extensive interviews with teenage girls in one of two cliques at a high school. Both groups associated drinking with uninhibited behavior — and that is what they exhibited. But one group considered being uninhibited to include making out, and the other considered it to include far more.

In their discussion, Dr. MacAndrew and Dr. Edgerton acknowledged that Western societies, and certainly the United States, send multiple signals on bingeing. At times, the signals cross, as when movies show spring-break binging as sunburned, sexy fun, while health pronouncements make it look like an orgy of near-criminal behavior.

At other times, cultural expectations and personal preferences reinforce each other. The hope that a wild session might “reveal new things about myself” or “allow me to act completely out of character” is widely echoed in literature, pop culture and drinking lore. If the research is a guide, those hopes should be self-fulfilling at some level.

Unless, that is, the binge goes beyond any reasonable definition of excess. Then the amount of tequila consumed matters very much — and poison is poison in any culture.
http://www.nytimes.com

Tuesday, April 22, 2008

Talking To Veterns when in Despair

CANANDAIGUA, N.Y. — Nancy Nosewicz was busy fielding calls at the new national veterans hot line on a recent afternoon when someone from the Department of Veterans Affairs in Topeka, Kan., phoned. He had a 55-year-old Army veteran from the Northwest on the line who had called to complain about his benefits, but now the guy, drunk and crying, was talking about not wanting to live. Could Ms. Nosewicz pick up?

n a slurred voice, heavy from weeping, the veteran, named Robert, told her that he was homeless and wanted to “just lay down in the river and never get up.”

Ms. Nosewicz, a social worker, listened. Then in a voice firm and comforting like a big sister, she said: “We don’t want you to either. Today we’re not thinking about the alcohol or the housing, Robert. Today it’s about keeping you safe.”

She gave an assistant Robert’s phone number to find his address and alert local police to stand by. The chain of care resembled a relay race, with one runner trying not let go of the baton until the next runner had it in hand.

The veterans hot line is part of a specialized effort by the Department of Veterans Affairs to reduce suicide by enabling counselors, for the first time, to instantly check a veteran’s medical records and then combine emergency response with local follow-up services. It comes after years of criticism that the department has been neglecting tens of thousands of wounded service men and women who have returned from war zones in Iraq and Afghanistan.

On Monday, a class action suit brought by veterans groups opened in San Francisco charging a “systemwide breakdown,” citing long delays in receiving disability benefits and flaws in the way discharged soldiers at risk for suicide had been treated. Kerri J. Childress, a department spokeswoman, said Monday that there were an average of 18 suicides a day among America’s 25 million veterans and that more than a fifth were committed by men and women being treated by Veterans Affairs.

Up and running since August, the hot line tries to respond to at least some of those in crisis. Over eight months, it has received more than 37,200 calls and made more than 720 rescues — sending out, from a narrow office here in upstate New York, emergency responders all over the country to find someone on a bridge, with a gun in his hand, with a stomach full of pills.

Paul Sullivan, the director of Veterans for Common Sense, one of the groups involved in the lawsuit, said of the department: “I’m pleased they’re responding. However, much more needs to be done so vets aren’t turned away from health care and don’t have to wait for benefits.”

Mr. Sullivan says suicidal patients have not been able to get care promptly; he cited the case of Jonathan Schulze, who was turned away twice from a Veterans Affairs hospital before he killed himself in January 2007.

“More than 600,000 veterans are waiting, on average, more than six months for disability benefits,” said Mr. Sullivan, who worked at the department monitoring benefits.

Experts agree that veterans are more likely, perhaps twice as much, to commit suicide as people who have never served in the military. Meanwhile, a study released last week by the RAND Corporation estimates that roughly one in five veterans of Iraq and Afghanistan has symptoms of post-traumatic stress disorder, which heightens the risk of suicide.

Yet whatever larger failings may exist, the staff of social workers, addiction specialists and nurses who keep the hot line running — 24 hours a day, seven days a week — can count at least some victories by the end of each shift.

Unique about this hot line, said Janet Kemp, the national suicide prevention coordinator with the department, is that now the counselors have medical information at their fingertips, which they use to connect vets with counseling near their homes. The model evolved from a new research program on suicide prevention paid for by the department.

“For years people thought that asking questions about suicide put the thought in people’s mind, but now we know that’s not true,” said Dr. Kemp, who travels throughout the country training V.A. staff.

The department is spending about $3 million to start and operate the hot line during its first year, said a spokesman, Daniel Ryan, and another $2.9 million on a mental health research center at the sprawling red-brick V.A. Medical Center in Canandaigua. Referring to the hot line’s relay model, Kerry Knox, the director of the new research center, said, “You don’t want them to fall through the cracks.”

With Robert, for example — whose last name was not provided for confidentiality — Ms. Nosewicz gradually nudged him to agree to be taken to a hospital and to give his name and Social Security number so she could check his file and put him in contact with the department’s suicide prevention coordinator in his area.

Meanwhile, Denise Slocum, a health assistant, relayed questions from the local police dispatcher. “The police are asking if you’re near an elementary school,” asked Ms. Nosewicz, who then nodded her head at Ms. Slocum.

“No, no, no — no handcuffs,” Ms. Nosewicz reassured Robert. “You’re going to go to the hospital.”

“Do you have a tissue to blow your nose? Then use your sleeve.”

“When they come in, you put them on the phone with me, and I’ll tell them to treat you with respect.”

Twenty minutes later, Ms. Slocum called the police again to confirm that Robert had been taken to a hospital. Ms. Nosewicz alerted the prevention coordinator. One is at each of the department’s 156 health centers.

Robert’s name was added to a board near the doorway so that the staff could follow up to ensure a local counselor actually met with him.

Of course, sometimes a crack is unavoidable.

“He’s going to do it. He’s really going to do it,” said Terri Rose, a counselor who was working the noon-to-midnight shift. She was wiping her red-rimmed eyes. A caller from Texas, who said he was 65 and a helicopter gunner in Vietnam, said he had a suicide pact with his friend, but the friend had gone off and killed himself. Now he, too, was ready to die, saying he had even found a coffin for $150, said Ms. Rose, who is an Air Force veteran herself. The veteran hung up and had stopped answering her calls.

Sometimes veterans have a lot of trouble asking for help, said Jacalyn O’Loughlin, a counselor. “They keep saying, ‘I’m sorry, I’m sorry, I’m sorry,’ ” Ms. O’Loughlin said. “Especially marines. They feel they’re weak if they reach out.”

Mr. Ryan said about half the calls to the hot line — 1-800-273-TALK (8255) — were from veterans, split fairly evenly between Vietnam and Iraq. Family members and friends also frequently call. About 30 percent of the veterans are women.

A couple of months ago, Ms. O’Loughlin said, a distraught woman called from Oregon who was driving to the woods and then threatened to “walk and walk and walk and never come back.” Ms. O’Loughlin rang the tiny silver bell on her desk to signal the health technician. The health tech checked the area code and phoned the closest Veterans Affairs health center.

“And lo and behold, that suicide prevention coordinator knew her just by her first name,” Ms. O’Loughlin said. The tech called the police and the coordinator called the woman’s husband, getting the car’s make and model. Ms. O’Loughlin kept her on the line; when she hung up, Ms. O’Loughlin called her back. “This went on for hours,” she said. “I could hear her getting out of the car. I could hear the rustling from the leaves.”

Meanwhile, the police and her husband were driving up and down roads. They spotted the car, dashed through the trees and found her. She had a bottle of pills in her hand but had not yet swallowed them.

Sometimes, the victories are smaller but no less satisfying. That morning, Ms. Nosewicz spoke to a veteran whose house was destroyed by Hurricane Katrina; he had been relocated to a different state.

“He called crying because he can’t find a job, saying ‘my teeth are so rotten and my mouth stinks,’ ” Ms. Nosewicz said.

Dental referrals are not exactly part of the job description, but Ms. Nosewicz tried dental schools in his area until she found a school to do the work. “He was crying on the phone,” she recalled, “and said, ‘Thanks so much. Thanks so much.’ ”

All in all not a bad day’s work, Ms. Nosewicz said, as she got ready to leave. “Three rescues, four consults and one set of teeth.”
Source: http://www.nytimes.com/

Saturday, April 19, 2008

Alcohol Abuse in Soldiers

Alcohol Abuse in Soldiers

A lot of soldiers returning home from wars have become alcoholics. It is true that the loneliness as well as the pressure while out in the battle field makes soldiers resort to drinking sprees, alcohol dependency and sometimes drug dependency.

Soldiers should remember though that the abuse of alcohol as well as the misuse of medications or drugs can result to harmful and risky behaviors that include but are not limited to pub fights, spousal abuse, even unexpected deaths so it is a must to engage in responsible drinking. Below are some tips that would help one drink responsibly:

Before drinking and in the course of drinking, make sure that your stomach has food because eating food with starch and high protein will slow down the rate of the effects of alcohol hitting you.

Drink slowly but surely as fast drinking will make the drinker more intoxicated. Drinking no more than one drink every hour will result to the drinker not being drunk fast

Try drinking non alcoholic drinks in between your intake of alcoholic drinks as this will result to alcoholic drinks not having a greater effect on you.

Remember this HALT! This is easy to remember and stands for “Never Drink if you have the following feelings: Hungry, Angry, Lonely, or Tired.”

And of course, let us not forget (though it may be a cliché, it can save lives). Do not drink and drive. Always make sure that the person who will be driving the vehicle is sober, otherwise, just take a cab or any other public transportation.

Following these tips will help you (soldiers) avoid alcohol abuse as well as symptoms or ailments partnered with alcoholism such as: PTSD. PTSD or Post Traumatic Stress Disorder when coupled with alcoholism will automatically cause a lot of trouble. It is a type of anxiety disorder that usually results from trauma that comes from physical injury, a serious threat of death or the death of someone close. As early as the 6th century BC, PTSD has been observed in war veterans.
It has been observed that people with PTSD have a greater risk of developing alcoholism and most alcoholics are even diagnosed with the said disease. Around eighty percent of war veterans undergoing treatment for PTSD have been detected with alcohol abuse disorders. These people have a tendency to commit suicide once they become depressed especially if they are over the age of 65. Binge drinking is also a frequent activity in soldiers/veterans as it is used as a tool to forget traumatic memories for a short period of time.

Alcoholism also disrupts your relationship with your partner and may lead to violence as it is evident in spousal abuse committed by intoxicated soldiers. Aside from conflicts, problems in intimacy have also been observed. PTSD symptoms are stimulated more with alcoholism. The effects of PTSD treatments are also lessened by alcohol abuse.
Soldiers amongst all professionals have the great responsibility of avoiding alcoholism. It is a must to follow tips in avoiding too much drinking not only for your safety but also for the safety of your loved ones and the people who look up to you.



Need help with alcohol abuse?

Wednesday, April 16, 2008

Moderate Drinking Increases Breast Cancer Risk

Even moderate alcohol consumption increases the risk of a common form of breast cancer in post-menopausal women, according to research presented at the American Association for Cancer Research 2008 annual meeting in San Diego.

The study, reported by UPI April 14, found that even one or two drinks per day increased risk of developing ERplus/PRplus breast cancer, and the more a woman drank, the higher her risk. ERplus/PRplus is a form of breast cancer classified as positive for both the estrogen and progesterone receptors.

"Our study shows that not only does a small amount of alcohol significantly increase the risk of breast cancer, it increases the risk of the most common type of breast cancer, responsible for around 70 percent of cases," said lead researcher Jasmine Lew, from the National Cancer Institute.

The data show as much as a 51 percent increased risk of breast cancer in women who drank three of more glasses of alcohol daily compared to women who did not drink at all.

"This suggests that a woman should evaluate consumption of alcohol along with other known breast cancer risk factors, such as use of hormone replacement therapy," Lew stated.

Thursday, April 10, 2008

Learning the 12 Steps of Alcoholics Anonymous

Treatment centers and 12-step programs offer counseling, psychotherapy, support groups, and family therapy.3 These 12-steps consist of:
1. We admitted we were powerless over alcohol--that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.3
In addition, medications can also aid in suppressing withdrawals or cravings and in blocking the effects of drugs.

The National Intervention Referral process gives an example of a step-by-step approach to how intervention works. First, contact and intervention facility and speak to a staff member. Second, set up a meeting with an intervention specialist to discuss the history and circumstances of the person in crisis. Third, before the actual intervention occurs, the intervention specialist will meet with the family and friends to discuss each person’s role in the intervention, their boundaries, and the consequences for the substance abuser if he or she does not follow through with the intervention. Fourth, conduct the intervention. Fifth, after the intervention has taken place, the intervention specialist will continue to spend time with the abuser and provide transportation to an arranged-in-advance treatment center. Sixth, once the individual is undergoing treatment, the intervention specialist will continue to keep contact with him or her. The intervention specialist will remain active in the recovery process and act as a liaison between the family and the recovering patient.1 According to National Treatment Referral; the treatment centers with the greatest success rate are those treating the whole person. These treatment centers are offering physical and psychological assistance, education and training.4

In conclusion, a drug and alcoholism intervention can and will save the life of a loved who is addicted to drugs and alcohol. Families and friends must choose to not look the other way but to proactively seek help for themselves and the substance abuser.
Source: addictionsearch.com

Tuesday, April 8, 2008

Choosing the right mental health therapist

Why is this choice so important?

Therapy is a collaborative process, so finding the right match-someone with whom you have a sense of rapport-is critical. After you find someone, keep in mind that therapy is work and sometimes can be painful. However, it also can be rewarding and life changing.

Can a therapist share what I have said during therapy?

You can rest assured that all mental health professionals are ethically bound to keep what you say during therapy confidential. However, therapists also are bound by law to report information such as threats to blow up a building or to harm another person, for example.

What are the steps for choosing a therapist?

1. See your primary care physician to rule out a medical cause of your problems. If your thyroid is "sluggish," for example, your symptoms-such as loss of appetite and fatigue-could be mistaken for depression.
2. After you know your problems are not caused by a medical condition, find out what the mental health coverage is under your insurance policy or through Medicaid/Medicare.
3. Get two or three referrals before making an appointment. Specify age, sex, race, or religious background if those characteristics are important to you.
4. Call to find out about appointment availability, location, and fees. Ask the receptionist:
* Does the mental health professional offer a sliding-scale fee based on income?
* Does he or she accept your health insurance or Medicaid/Medicare?
5. Make sure the therapist has experience helping people whose problems are similar to yours. You may want to ask the receptionist about the therapist's expertise, education, and number of years in practice.
6. If you are satisfied with the answers, make an appointment.
7. During your first visit, describe those feelings and problems that led you to seek help. Find out:
* What kind of therapy/treatment program he or she recommends;
* Whether it has proven effective for dealing with problems such as yours;
* What the benefits and side effects are;
* How much therapy the mental health professional recommends; and
* Whether he or she is willing to coordinate your care with another practitioner if you are personally interested in exploring credible alternative therapies, such as acupuncture.
8. Be sure the psychotherapist does not take a "cookie cutter" approach to your treatment-what works for one person with major depression does not necessarily work for another. Different psychotherapies and medications are tailored to meet specific needs.
9. Although the role of a therapist is not to be a friend, rapport is a critical element of successful therapy. After your initial visit, take some time to explore how you felt about the therapist.
10. If the answers to these questions and others you come up with are "yes," schedule another appointment to begin the process of working together to understand and overcome your problems. If the answers to most of these questions are "no," call another mental health professional from your referral list and schedule another appointment.

What is the difference between psychiatrists and clinical social workers?

Two kinds of therapists warrant special note: psychiatrists and clinical social workers. Psychiatrists are medical doctors and can prescribe medication. Clinical social workers are trained in client-centered advocacy and can assist you with information, referral, and direct help in dealing with local, State, or Federal government agencies. As a result, they often serve as case managers to help people "navigate the system." Clinical social workers and many other mental health professionals cannot write prescriptions. However, nurse practitioners that specialize in psychiatry and mental health can prescribe medication in most states. And, under a new law, psychologists in New Mexico can prescribe medications after receiving training (New Mexico State Legislature, 2002).

Source: SAMHSA's National Mental Health Information Center

Sunday, April 6, 2008

Cultivating Belief in you Goals

By: LeeDavidhcz

The Belief That You Can Do It and more importantly, That You Will!

First, You must choose one goal and commit to it's achievement. It seems that this is always the starting point isn't it? It must be something that you feel you can not live without, or you must develop that feeling for it to work. Remember, reasons first, then action.

Did you choose one? Are you commited to making it a reality in your life? Did you decide that you must have it and absolutely will have it? Is it do or die? Are your reasons for having it, strong enough to propel you forward right now and compel you to action when you may not 'feel' like it? If not, then choose another one, this is no time to waste your energy on something you are not serious about.

Aggressively research and brainstorm all the ways you can get this goal. Do not consider any negative thoughts at this time. There is another time for that. Write them down quickly as you think of more. Use shortforms and abbreviations if you have to, but keep the flow of thought going for as long as it takes. This is a tremendously important part of the process.

Remember those negatives that kept coming up throughout the above? What challenges or problems will come up when you start taking action? What do you see happening or preventing you from getting what you want? Write these down also. Be honest with yourself, if you think it, write it down. There is no such thing as unimportant thought. It is all important, vitally important!

Next, come up with solutions that will take care of these problems. Write down multiple answers to each problem. Stay positive and focused on your target. Write down everything that comes to mind. All those things that could keep you from succeeding, come up with tons of ways to deal with them. This will give you unstoppable confidence in your ability to have what you want.

Break down your solutions into action steps, into small workable tasks that you can complete quickly. Break each step down into 5 smaller actions. Then break those down into 5 smaller ones. Keep breaking down tasks until you have absolute belief in yourself that you can and will do it, right now, today!. In fact, Break them down until they are ridiculously simple!

Small, simple actions are easy to accomplish, and when these particular actions are put together, they equal the goal result that you want. Belief becomes automatic because you "know" that there is nothing standing between you and your goal.

All that is left is to work your plan. You created it, you are commited to it, you must do it, so just do it, and go get your goal. Start with the first step and complete it right now, today. So what are you waiting for? Go For It!

Are you still here? Go get that goal! LOL!

No plan is perfect so there will inevitably be obstacles and distractions, little things which will stand in your way for temporary periods of time. When this happens, just break these down. And start again . . . and again. Stay flexible and adjust your approach when these occur. Believe, and have faith in the long term.

Adjust your plans and actions as necessary until you have what you want. The result is in the bag, it is a sure thing, all that will change are the strategies, and the timing. You will prevail. This is true. If this is a major complex goal, you will want to work it backwards through smaller goals, and then break them down into action steps.

Focus on the solution instead of the fear or doubt. This strategy will work for any goal you pick. Focus on what you want continuously, with passion, and with absolute faith, knowing that you have absolutely done everything necessary. Act with that level of belief, and certainty that causes miracles to happen! Go make your miracle!

Article Source: http://article2008.com

Thursday, April 3, 2008

Yale Study Suggest Evolutionary Source of Alcoholisms Accidental Enemy

Some change in the environment in many East Asian communities during the past few thousand years may have protected residents from becoming alcoholics, a new genetic analysis conducted by Yale School of Medicine researchers suggests.

The study by Hui Li and others in the laboratory of Kenneth Kidd, professor of genetics, psychiatry and ecology & evolutionary biology, will be released April 2, in the journal PloS One.

Scientists have long known that many Asians carry variants of genes that help regulate alcohol metabolism. Some of those genetic variants can make people feel uncomfortable, sometimes even ill, when drinking small amounts of alcohol. As a result of the prevalence of this gene, many, but not all, communities in countries such as China, Japan and Korea have low rates of alcoholism.

Last year Kidd's team reported evidence that recent natural selection in East Asia had caused one particular variant of the alcohol-regulating gene to become common. In this new paper Li and others in Kidd's team analyzed this variant in the DNA of individuals in many different population groups in several more East Asian countries.

They uncovered evidence that the variant became widespread through natural selection in only some of those East Asian populations - specifically, the Hmong- and Altaic-speaking groups. Those genetic clues, say the scientists, suggest that something was different in the environment of those populations and that the genetic difference assisted survival in that environment. The researchers have not yet identified that environmental difference and say the genetic change could be triggered by any number of factors, such as the emergence of some new parasite.

That these populations turn out to be less prone to the ravages of demon rum, says Kidd, "is just a serendipitous event'' of evolution. "What this finding does is highlight that something important in recent human history has affected the genetic composition of many East Asian populations," he notes.

Kidd's team was studying a variant of one of a set of related genes that code for alcohol dehydrogenases, enzymes that help in metabolism of alcohols, including ethanol. Variants of those enzymes have been known for many years to protect the individuals carrying them against alcoholism.

The particular gene studied, a variant of the ADH1B gene, is very common in some East Asian communities, as high as 90 percent in some areas.

But he also noted that lower rates of alcoholism in many of the Asian communities may well be due to cultural as well as genetic causes.

"If a large part of the people got sick after they ate one particular food or drank a particular drink, you would not find many social situations where that food was served,'' Kidd said.

The study will be available online April 1 at http://www.plosone.org/doi/pone.0001881.

http://www.yale.edu

Tuesday, April 1, 2008

Drug Overdose Deaths

According to a little noticed January report from the Centers for Disease Control (CDC), drug overdoses killed more than 33,000 people in 2005, the last year for which firm data are available. That makes drug overdose the second leading cause of accidental death, behind only motor vehicle accidents (43,667) and ahead of firearms deaths (30,694).

What's more disturbing is that the 2005 figures are only the latest in such a seemingly inexorable increase in overdose deaths that the eras of the 1970s heroin epidemic and the 1980s crack wave pale in comparison. According to the CDC, some 10,000 died of overdoses in 1990; by 1999, that number had hit 20,000; and in the six years between then and 2005, it increased by more than 60%.

http://stopthedrugwar.org/files/naloxone.jpg
naloxone, the opiate overdose antidote
"The death toll is equivalent to a hundred 757s crashing and killing everybody on board every year, but this doesn't make the news," said Dan Bigg of the Chicago Recovery Alliance, a harm reduction organization providing needle exchange and other services to drug users. "So many people have died, and we just don't care."

Fortunately, some people care. Harm reductionists like Bigg, some public health officials, and a handful of epidemiologists, including those at the CDC, have been watching the up-trend with increasing concern, and some drug policy reform organizations are devoting some energy to measures that could bring those numbers down.

But as youth sociologist and long-time critic of the drug policy establishment's overweening fascination with teen drug use Mike Males noted back in February, the official and press response to the CDC report has been "utter silence." That's because the wrong people are dying, Males argued: "Erupting drug abuse centered in middle-aged America is killing tens of thousands and hospitalizing hundreds of thousands every year, destroying families and communities, subjecting hundreds of thousands of children to abuse and neglect and packing foster care systems to unmanageable peaks, fostering gun violence among inner-city drug dealers, inciting an epidemic of middle-aged crime and imprisonment costing Americans tens of billions of dollars annually, and now creating a spin-off drug abuse epidemic among teens and young adults. Yet, because today's drug epidemic is mainly white middle-aged adults -- a powerful population that is "not supposed to abuse drugs" -- the media and officials can't talk about it. The rigid media and official rule: Drugs can ONLY be discussed as crises of youth and minorities."

The numbers are there to back up Males' point. Not only are Americans dying of drug overdoses in numbers never seen before, it is the middle-aged -- not the young -- who are doing most of the dying. And they are not, for the most part, overdosing on heroin or cocaine, but on Oxycontin, Lorcet, and other opioids created for pain control but often diverted into the lucrative black market created by prohibition.

Back in October, CDC epidemiologist Leonard Paulozzi gave Congress a foretaste of what the January report held. Drug death "rates are currently more than twice what they were during the peak years of crack cocaine mortality in the early 1990s, and four to five times higher than the rates during the year of heroin mortality peak in 1975," he said in testimony before the House Oversight and Investigations Committee.

"Mortality statistics suggest that these deaths are largely due to the misuse and abuse of prescription drugs," Paulozzi continued. "Such statistics are backed up by studies of the records of state medical examiners. Such studies consistently report that a high percentage of people who die of prescription drug overdoses have a history of substance abuse."

But there is more to it than a mere correlation between increases in the prescribing and abuse of opioid pain relievers and a rising death rate, said Dr. Alex Kral, director of the Urban Health Program for RTI International, a large nonprofit health organization. Kral, who has been doing epidemiological research on opioid overdoses for 15 years, said there are a variety of factors at work.

"There hasn't been a big increase in heroin use," he said. "What's changed has been prescription opiate drug use. Oxycontin is probably a big part of the answer. The pharmaceutical companies have come up with good and highly useful versions of opioids, but they have also been diverted and used in illicit ways in epidemic fashion for the past 15 years."

But Kral also pointed the finger at the resort to mass imprisonment and forced treatment of drug offenders as a contributing factor. "What happens is that people who are opiate users go into prison or jail and they get off the drug, but when they come out and start using again, they use at the same levels as before, and they don't have the same kind of tolerance. We know that recent release from jail or prison is a big risk factor for overdose," he said.

"The last piece of the puzzle is drug treatment," Kral said. "Besides the tolerance problems for people who have been abstaining in treatment, there has been an increase in the use of methadone and buprenorphine, which is a good thing, but people are managing to overdose on those as well."

There are means of reducing the death toll, said a variety of harm reductionists, and the opioid antagonist naloxone (Narcan) was mentioned by all of them. Naloxone is a big part of the answer, said the Chicago Recovery Alliance's Bigg. "It's been around for 40 years, it's a pure antidote, and it has no side effects. It consistently reverses overdoses via intramuscular injection; it's very simple to administer. If people have naloxone, it becomes much, much easier to avoid overdose deaths."

"Naloxone should be made available over the counter without a prescription," said Bigg. "In the meantime, every time a physician prescribes opioids, he should also prescribe naloxone."

"For a couple of years now, we've been talking about trying to get naloxone reclassified so it's available over the counter or maybe prescribed by a pharmacist," said Hilary McQuie, Western director for the Harm Reduction Coalition. "The problem is that you don't just need congressional activity, you also need to deal with the FDA process, and it's hard to find anyone in the activist community who understands that process."

Harm reductionists also have to grapple with the changing face of drug overdoses. "We're used to dealing with injection drug users," McQuie admitted, "and nobody really has a good initiative for dealing with prescription drug users. In our lobbying meetings about the federal needle exchange funding ban, we've started to talk about this, specifically about getting naloxone out there."

But while the overdose epidemic weighs heavily on the movement, no one wants to spend money to bring the numbers down. "This is a very big issue, it's very present for harm reduction workers," said McQuie. "But we haven't done a lot of press on it because there is no funding for overdose prevention. We have a very good program in San Francisco to train residential hotel managers and drug users at needle exchanges. It's very cheap; it only cost $70,000, including naloxone. But we can't get funders interested in this. We write grants to do this sort of work around the state, and we never get any money."

Perversely, the Office of National Drug Control Policy also opposes making naloxone widely available -- on the grounds that it is a moral hazard. "First of all, I don't agree with giving an opioid antidote to non-medical professionals. That's No. 1," ONDCP's Deputy Director of Demand Reduction Bertha Madras said in January. "I just don't think that's good public health policy."

But even worse, Madras argued that availability of naloxone could encourage drug users to keep using because they would be less afraid of overdoses. And besides, Madras, continued, overdosing may be just what the doctor ordered for drug users. "Sometimes having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation and snap into having someone give them services," Madras said.

"The drug czar's office argues that if you take away the potential consequences, in this case, a fatal overdose, you facilitate the use, but betting someone's life on that is just cruel and bizarre," snorted Bigg.

RTI's Kral noted that there are now 44 naloxone programs run by community groups across the country. "It would be wonderful if there were more of them, because they are staving off a lot of deaths, but they are controversial. The ONDCP says they condone drug use, but you can't rehabilitate a dead drug user."

While battles over naloxone access continue, said Bigg, there are other things that can be done. "We need to engage people, and that means overcoming shame," said Bigg. "Every couple of months, I get a call from a family that has lost a member to drugs and I ask them if they're willing to come forward and talk to reporters to stop it from happening again, and they say 'let me think about it,' and I never hear from them again.

Another means of reducing the death toll would be to start local organizations of people whose friends or family members have died or are still using and at risk. "We could call them 'First Things First,' as in first, let's keep our folks alive," he suggested.

"When people found out naloxone is out there, that it's this medicine that has no ill effects -- it has no effect at all unless you're using opioids -- and that it can't be abused, and that their family member could have had it and still be alive, that's a hard thing to realize," said Bigg. "Everyone who has lost a loved one wants him back, and to think he could still be alive today if there were naloxone is a bitter, bitter pill to swallow."

Despite the apparent low profile of drug policy reform groups, they, too, have been fighting on the overdose front. "We worked to pass groundbreaking overdose prevention bills in California and New Mexico," said Bill Piper, national affairs director for the Drug Policy Alliance. "We're working to advance overdose prevention bills in Maryland and New Jersey. We had a bill in 2006 in Congress that would have created a federal grant program for overdose prevention," he said, pointedly adding that not a single federal dollar goes to overdose prevention. "We've tried to introduce that in the new Congress but can't find someone to take a lead. To be frank, few politicians care about this issue. Their staff care even less."

A massive public education campaign is needed, said Piper, adding that DPA is working on a report on this very topic that should appear in a few weeks.

In the meantime, while politicians and drug war bureaucrats avert their gaze and deep-pocketed potential donors keep their purses tightly closed, while the nation worries about baseball players on steroids and teenagers smoking pot, the bodies pile up like cordwood.
Drug War Issues Overdose Prevention
Politics & Advocacy ONDCP - Congress