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
Thursday, April 10, 2008
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
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
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
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
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
Sunday, March 30, 2008
Advice Pregnant Women Should Get About Alcohol Consumption
he National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Centre for Women's and Children's Health have today (26 March 2008) issued newly updated advice on the care that should be offered to women during their pregnancy. This advice is an update of the original document published in 2003, revising areas where new information has become available. It recommends that midwives and doctors provide women with evidence-based information about a range of key issues such as the risks and benefits of screening tests and lifestyle advice so they can make decisions that are right for them and their baby.
The guideline includes recommendations for doctors and midwives on the advice they should give to pregnant women about drinking alcohol. These recommendations are consistent with the advice issued in 2007 by the UK Chief Medical Officers. The NICE recommendations are that:
-- Pregnant women and women planning to become pregnant should be advised to avoid drinking alcohol in the first 3 months of pregnancy, because there may be an increased risk of miscarriage.
-- Women should be advised that if they choose to drink alcohol while they are pregnant they should drink no more than 1-2 UK units once or twice a week There is uncertainty about how much alcohol is safe to drink in pregnancy, but at this low level there is no evidence of any harm to their unborn baby.
-- Women should be advised not get to drunk or binge drink (drinking more than 7.5 UK units of alcohol on a single occasion) while they are pregnant because this can harm their unborn baby.
Further recommendations from the guideline include:The Sober Village can help with alcohol problems.
-- All women should be informed at the booking appointment about the importance for their own and their baby's health of maintaining adequate vitamin D stores during pregnancy and whilst breast feeding. Women may choose to take 10 micrograms of vitamin D per day.
-- Screening for sickle cell diseases and thalassaemias should be offered to all women as early as possible in pregnancy (ideally by 10 weeks).
-- The 'combined test' should be offered to screen for Down's syndrome between 11 weeks 0 days and 13 weeks 6 days.
-- Screening for gestational diabetes using risk factors is recommended in all women. At the booking appointment, the following risk factors for gestational diabetes should be determined: a) body mass index above 30 kg/m2 b) previous macrosomic baby weighing 4.5 kg or above c) previous gestational diabetes d) family history of diabetes e) family origin with a high prevalence of diabetes such as south asian, black caribbean and middle eastern.
Professor Sir Liam Donaldson, Chief Medical Officer says: "I welcome this updated NICE guidance as it further strengthens the advice from the UK CMO's that pregnant women or women trying to conceive should avoid drinking alcohol. NICE's guidance highlights this is most important at the beginning of pregnancy, when there may be an increased risk of miscarriage, and again reinforces that if they do choose to drink, to protect the baby, they should not drink more than 1 to 2 units of alcohol once or twice a week and should not get drunk. Pregnant women or women trying to conceive should seek further advice from their Midwives or GP."
Dr Gillian Leng, Deputy Chief Executive, and Executive Lead for this guidance says: "We recommend that doctors and midwives should advise women to avoid drinking alcohol when trying to get pregnant and during the first three months of pregnancy because there may be an increased risk of miscarriage. If they do choose to drink alcohol while pregnant, women should also be advised to drink no more than 1 to 2 UK units once or twice a week, and to avoid binge drinking during their pregnancy because this can harm their unborn baby.
"Due to changes in the evidence base and new availability of screening programmes, we have initiated this update earlier than planned. Having a baby is one of the most important times in a woman's life and healthcare professionals want to make sure this is a good and safe experience. This newly updated guideline will ensure that health professionals offer women the information and support they need to make decisions about their care that are right for them and their babies."
Dr Rhona Hughes, Lead Obstetrician and Guideline Development Group Chair says: "This guideline respects that it is a woman's right to make her own decisions about her pregnancy, based on the best available information. For example she may accept or decline tests that are offered and her healthcare team will respect the decision she makes. I recently met a family who had a baby with a learning disability - unsurprisingly they were worried that their second baby could have a similar problem but didn't know whether to accept all the screening tests they were being offered. Under the guideline, doctors would put this woman and her partner in touch with support groups and provide written information so that they can come to an informed decision about whether they want to go ahead and have screening tests."
Nina Khazeaezadeh, Consultant Midwife, Supervisor of Midwives and Guideline Development Group member: "As a midwife in one of the busiest maternity units in the country, I know that this guideline will really benefit the midwives and doctors looking after women during pregnancy, as well as the women themselves. Women are already receiving good antenatal care but this guideline will bring it up to a gold standard and ensure that all women are receiving the same high quality care. For example, it will ensure that healthcare professionals provide women with consistent information about how many antenatal appointments they will receive and what will be discussed at each of these, such as advice on breastfeeding and nutrition. By giving women good information at the right stages in their pregnancy they will be best placed to make decisions that are right for them and their baby."
Jennifer Elliott, Service User Representative and Guideline Development Group member says: "When I was pregnant with my first child I didn't really understand why tests such as those for Down's syndrome were being offered to me or even that they were being offered at all - as a result l did not feel in control of my pregnancy. This guideline firmly places women at the centre of decision making about their care - all women will be given information about why screening tests are carried out, what other decisions testing might lead to and be able to discuss their concerns and ask questions. By ensuring that women are informed about their pregnancy, they will feel less anxious and more likely to have a positive experience."
1. The guidance is available at http://www.nice.org.uk/CG62.
2. One small glass of wine = 1.5 units
3. Five small glasses of wine = 7.5 units
About NICE
1. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.
2. NICE produces guidance in three areas of health:
-- public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
-- health technologies - guidance on the use of new and existing medicines, treatments and procedures within the NHS
-- clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS
http://www.nice.org.uk
The guideline includes recommendations for doctors and midwives on the advice they should give to pregnant women about drinking alcohol. These recommendations are consistent with the advice issued in 2007 by the UK Chief Medical Officers. The NICE recommendations are that:
-- Pregnant women and women planning to become pregnant should be advised to avoid drinking alcohol in the first 3 months of pregnancy, because there may be an increased risk of miscarriage.
-- Women should be advised that if they choose to drink alcohol while they are pregnant they should drink no more than 1-2 UK units once or twice a week There is uncertainty about how much alcohol is safe to drink in pregnancy, but at this low level there is no evidence of any harm to their unborn baby.
-- Women should be advised not get to drunk or binge drink (drinking more than 7.5 UK units of alcohol on a single occasion) while they are pregnant because this can harm their unborn baby.
Further recommendations from the guideline include:The Sober Village can help with alcohol problems.
-- All women should be informed at the booking appointment about the importance for their own and their baby's health of maintaining adequate vitamin D stores during pregnancy and whilst breast feeding. Women may choose to take 10 micrograms of vitamin D per day.
-- Screening for sickle cell diseases and thalassaemias should be offered to all women as early as possible in pregnancy (ideally by 10 weeks).
-- The 'combined test' should be offered to screen for Down's syndrome between 11 weeks 0 days and 13 weeks 6 days.
-- Screening for gestational diabetes using risk factors is recommended in all women. At the booking appointment, the following risk factors for gestational diabetes should be determined: a) body mass index above 30 kg/m2 b) previous macrosomic baby weighing 4.5 kg or above c) previous gestational diabetes d) family history of diabetes e) family origin with a high prevalence of diabetes such as south asian, black caribbean and middle eastern.
Professor Sir Liam Donaldson, Chief Medical Officer says: "I welcome this updated NICE guidance as it further strengthens the advice from the UK CMO's that pregnant women or women trying to conceive should avoid drinking alcohol. NICE's guidance highlights this is most important at the beginning of pregnancy, when there may be an increased risk of miscarriage, and again reinforces that if they do choose to drink, to protect the baby, they should not drink more than 1 to 2 units of alcohol once or twice a week and should not get drunk. Pregnant women or women trying to conceive should seek further advice from their Midwives or GP."
Dr Gillian Leng, Deputy Chief Executive, and Executive Lead for this guidance says: "We recommend that doctors and midwives should advise women to avoid drinking alcohol when trying to get pregnant and during the first three months of pregnancy because there may be an increased risk of miscarriage. If they do choose to drink alcohol while pregnant, women should also be advised to drink no more than 1 to 2 UK units once or twice a week, and to avoid binge drinking during their pregnancy because this can harm their unborn baby.
"Due to changes in the evidence base and new availability of screening programmes, we have initiated this update earlier than planned. Having a baby is one of the most important times in a woman's life and healthcare professionals want to make sure this is a good and safe experience. This newly updated guideline will ensure that health professionals offer women the information and support they need to make decisions about their care that are right for them and their babies."
Dr Rhona Hughes, Lead Obstetrician and Guideline Development Group Chair says: "This guideline respects that it is a woman's right to make her own decisions about her pregnancy, based on the best available information. For example she may accept or decline tests that are offered and her healthcare team will respect the decision she makes. I recently met a family who had a baby with a learning disability - unsurprisingly they were worried that their second baby could have a similar problem but didn't know whether to accept all the screening tests they were being offered. Under the guideline, doctors would put this woman and her partner in touch with support groups and provide written information so that they can come to an informed decision about whether they want to go ahead and have screening tests."
Nina Khazeaezadeh, Consultant Midwife, Supervisor of Midwives and Guideline Development Group member: "As a midwife in one of the busiest maternity units in the country, I know that this guideline will really benefit the midwives and doctors looking after women during pregnancy, as well as the women themselves. Women are already receiving good antenatal care but this guideline will bring it up to a gold standard and ensure that all women are receiving the same high quality care. For example, it will ensure that healthcare professionals provide women with consistent information about how many antenatal appointments they will receive and what will be discussed at each of these, such as advice on breastfeeding and nutrition. By giving women good information at the right stages in their pregnancy they will be best placed to make decisions that are right for them and their baby."
Jennifer Elliott, Service User Representative and Guideline Development Group member says: "When I was pregnant with my first child I didn't really understand why tests such as those for Down's syndrome were being offered to me or even that they were being offered at all - as a result l did not feel in control of my pregnancy. This guideline firmly places women at the centre of decision making about their care - all women will be given information about why screening tests are carried out, what other decisions testing might lead to and be able to discuss their concerns and ask questions. By ensuring that women are informed about their pregnancy, they will feel less anxious and more likely to have a positive experience."
1. The guidance is available at http://www.nice.org.uk/CG62.
2. One small glass of wine = 1.5 units
3. Five small glasses of wine = 7.5 units
About NICE
1. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.
2. NICE produces guidance in three areas of health:
-- public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
-- health technologies - guidance on the use of new and existing medicines, treatments and procedures within the NHS
-- clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS
http://www.nice.org.uk
Friday, March 28, 2008
The Effects and Remedial Measures of Crack Cocaine and Gambling
Cocaine - what is it?
Cocaine is an illegal drug which is used in most inner cities. This drug is widely used. Crack cocaine and powder cocaine are the two products of cocaine. The powder cocaine is regarded as the drug of middle class families and is always associated with good money. The punishments for possessing crack cocaine is severe than that for possessing powder cocaine.
Crack cocaine - What is it?
The chemical cocaine is crack. When the cocaine is chemically processed to remove the hydrochloride it cracks or snaps due to heating and smoking so it is usually called
as crack cocaine and the name of the process is called as freebasing. Crack is usually sold in small cylindrical glass and in small quantities (300-500mg). Each of these vessels can be used for 2-4 inhalations which last for 10 to 20 minutes. Its wide availability, ease of concealment and low cost has increased its use. The powder cocaine is usually mixed with sodium bicarbonate or ammonia, which can be snorted or smoked.
What does it do?
Crack disturbs the central nervous system and the autonomic nervous system. It increases the neurotransmitter’s level which creates a heightened sense of pleasure, euphoria and increased energy.
The Human Brain and Addiction
The brain is one of the most vital organs of our body. It is the center of command. For a normal human the brain weighs about 1400gms. The brain has different centers which are designated for different purposes. Lobes which are present in the brain process the information that is sent by the sense organs for instance the occipital lobes receives information from our eyes. The thinking center is called the cerebral cortex which is at the top of the whole brain. Here all the information like language, math and strategies are processed. It is also responsible for survival, memory and things like appetite and thirst. The brain stem at the base controls the heartbeat rate, breathing, sleeping and it also does things which we can’t even think of.
How does our brain communicate?
The brain communicates through special cells called neurons. These brain cells send and receive messages. The messages are in the form of an electric impulse and it travels along the axon of the neuron. A chemical compound called neurotransmitter is released at the end of the axon and then it travels to the other neurons. Then the messages are processed and the chemical is released back, reabsorbed to the sending neurons. Our brain releases different kinds of neurotransmitter depending upon the kind of work we do.
How does drug influence our brain?
The drugs we use have similar shape and size as that of the natural neurotransmitters. These drugs inside our brain cause to start an unnatural chain reaction of electrical charges, which causes the neurons to release neurotransmitter of their own kind. Some drugs act like a pump which causes to release more neurotransmitter, which creates feelings of high pleasure.
What are the side effects and remedial measures?
The side effects of crack cocaine are deadly. Some of them are increased blood pressure, increased heart rates, increased anxiety and hyperactivity, nausea sensation and vomiting, decrease in appetite and easily vulnerable to heart attacks and strokes. When the person uses overdoses for a long period of time, the blood will have certain amount of poisonous toxics forever. Because of crack being rapidly absorbed by the blood, it induces the user to consume more. Moreover consuming this drug causes the user to be depressed and it also induces to consume more which may lead to mental instability. Crack cocaine is usually combined with a number of impurities which always makes the presence of side effects and toxicity. It’s very difficult to improve health without medical treatment. Many of the individuals who use crack cocaine experience withdrawal symptoms when they stop using it because of the addictive nature of the drug. Feelings like intense cravings, irritability, hunger and anxiety prevent the persons from stopping from using crack.
Gambling Addiction
Does genetic component have influence on gambling addiction?
There are no genetic, physical or psychological influences found for becoming an addict. It is proved from the research that no chromosomal defect has satisfactorily linked to gambling and does not run in families.
What is the treatment for gambling addiction?
There is no certain cure for gambling addiction. It may take years to get rid of gambling. The individual must attend counseling. Alcohol and smoking must be strictly prohibited. They should be treated with drug therapy. Moreover pure determination and strong desire of the individual himself to stop his activities can be the only cure.
A major lifestyle change is required to prevent the worst behavior to re occur.
What are the addiction treatments available for crack cocaine?
The crack cocaine is a powerful addictive drug and even with a short time usage the individuals become so addictive that they start to experience withdrawal symptoms like depression and irritability when they stop using it. The individuals are unable to improve their health without medical help. The person must undergo counseling for a long time to come out of addiction.
Wednesday, March 26, 2008
The Surprising Truth About Addiction
The Surprising Truth About Addiction
By PsychologyToday.com
Change is natural. You no doubt act very differently in many areas of your life now compared with how you did when you were a teenager. Likewise, over time you will probably overcome or ameliorate certain behaviors: a short temper, crippling insecurity.
For some reason, we exempt addiction from our beliefs about change. In both popular and scientific models, addiction is seen as locking you into an inescapable pattern of behavior. Both folk wisdom, as represented by Alcoholics Anonymous, and modern neuroscience regard addiction as a virtually permanent brain disease. No matter how many years ago your uncle Joe had his last drink, he is still considered an alcoholic. The very word addict confers an identity that admits no other possibilities. It incorporates the assumption that you can't, or won't, change.
But this fatalistic thinking about addiction doesn't jibe with the facts. More people overcome addictions than do not. And the vast majority do so without therapy. Quitting may take several tries, and people may not stop smoking, drinking or using drugs altogether. But eventually they succeed in shaking dependence.
Kicking these habits constitutes a dramatic change, but the change need not occur in a dramatic way. So when it comes to addiction treatment, the most effective approaches rely on the counterintuitive principle that less is often more. Successful treatment places the responsibility for change squarely on the individual and acknowledges that positive events in other realms may jump-start change.
Consider the experience of American soldiers returning from the war in Vietnam, where heroin use and addiction was widespread. In 90 percent of cases, when GIs left the pressure cooker of the battle zone, they also shed their addictions—in vivo proof that drug addiction can be just a matter of where in life you are.
Of course, it took more than a plane trip back from Asia for these men to overcome drug addiction. Most soldiers experienced dramatically altered lives when they returned. They left the anxiety, fear and boredom of the war arena and settled back into their home environments. They returned to their families, formed new relationships, developed work skills.
Smoking is at the top of the charts in terms of difficulty of quitting. But the majority of ex-smokers quit without any aid—neither nicotine patches nor gum, Smokenders groups nor hypnotism. (Don't take my word for it; at your next social gathering, ask how many people have quit smoking on their own.) In fact, as many cigarette smokers quit on their own, an even higher percentage of heroin and cocaine addicts and alcoholics quit without treatment. It is simply more difficult to keep these habits going through adulthood. It's hard to go to Disney World with your family while you are shooting heroin. Addicts who quit on their own typically report that they did so in order to achieve normalcy.
Every year, the National Survey on Drug Use and Health interviews Americans about their drug and alcohol habits. Ages 18 to 25 constitute the peak period of drug and alcohol use. In 2002, the latest year for which data are available, 22 percent of Americans between ages 18 and 25 were abusing or were dependent on a substance, versus only 3 percent of those aged 55 to 59. These data show that most people overcome their substance abuse, even though most of them do not enter treatment.
How do we know that the majority aren't seeking treatment? In 1992, the National Institute on Alcohol Abuse and Alcoholism conducted one of the largest surveys of substance use ever, sending Census Bureau workers to interview more than 42,000 Americans about their lifetime drug and alcohol use. Of the 4,500-plus respondents who had ever been dependent on alcohol, only 27 percent had gone to treatment of any kind, including Alcoholics Anonymous. In this group, one-third were still abusing alcohol.
Of those who never had any treatment, only about one-quarter were currently diagnosable as alcohol abusers. This study, known as the National Longitudinal Alcohol Epidemiologic Survey, indicates first that treatment is not a cure-all, and second that it is not necessary. The vast majority of Americans who were alcohol dependent, about three-quarters, never underwent treatment. And fewer of them were abusing alcohol than were those who were treated.
This is not to say that treatment can't be useful. But the most successful treatments are nonconfrontational approaches that allow self-propelled change. Psychologists at the University of New Mexico led by William Miller tabulated every controlled study of alcoholism treatment they could find. They concluded that the leading therapy was barely a therapy at all but a quick encounter between patient and health-care worker in an ordinary medical setting. The intervention is sometimes as brief as a doctor looking at the results of liver-function tests and telling a patient to cut down on his drinking. Many patients then decide to cut back—and do!
As brief interventions have evolved, they have become more structured. A physician may simply review the amount the patient drinks, or use a checklist to evaluate the extent of a drinking problem. The doctor then typically recommends and seeks agreement from the patient on a goal (usually reduced drinking rather than complete abstinence). More severe alcoholics would typically be referred out for specialized treatment.[note: I volentaraly (and desperatly) signed into a six week place upstate, I was not "referred" (just another example of how it really comes down to the individual} A range of options is discussed (such as attending AA, engaging in activities incompatible with drinking or using a self-help manual). A spouse or family member might be involved in the planning. The patient is then scheduled for a future visit, where progress can be checked. A case monitor might call every few weeks to see whether the person has any questions or problems.
The second most effective approach is motivational enhancement, also called motivational interviewing. This technique throws the decision to quit or reduce drinking—and to find the best methods for doing so—back on the individual. In this case, the therapist asks targeted questions that prompt the individual to reflect on his drinking in terms of his own values and goals. When patients resist, the therapist does not argue with the individual but explores the person's ambivalence about change so as to allow him or her to draw his own conclusions: "You say that you like to be in control of your behavior, yet you feel when you drink you are often not in charge. Could you just clarify that for me?"
Miller's team found that the list of most effective treatments for alcoholism included a few more surprises. Self-help manuals were highly successful. So was the community-reinforcement approach, which addresses the person's capacity to deal with life, notably marital relationships, work issues (such as simply getting a job), leisure planning and social-group formation (a buddy might be provided, as in AA, as a resource to encourage sobriety). The focus is on developing life skills, such as resisting pressures to drink, coping with stress (at work and in relationships) and building communication skills.
These findings square with what we know about change in other areas of life: People change when they want it badly enough and when they feel strong enough to face the challenge, not when they're humiliated or coerced. An approach that empowers and offers positive reinforcement is preferable to one that strips the individual of agency. These techniques are most likely to elicit real changes, however short of perfect and hard-won they may be.
No matter what approach in recovery you are taking it's always important to have a network of support. If you need help with addiction and would like to have some support please visit us at The Sober Village, where we do recover and will support you in your efforts.
By PsychologyToday.com
Change is natural. You no doubt act very differently in many areas of your life now compared with how you did when you were a teenager. Likewise, over time you will probably overcome or ameliorate certain behaviors: a short temper, crippling insecurity.
For some reason, we exempt addiction from our beliefs about change. In both popular and scientific models, addiction is seen as locking you into an inescapable pattern of behavior. Both folk wisdom, as represented by Alcoholics Anonymous, and modern neuroscience regard addiction as a virtually permanent brain disease. No matter how many years ago your uncle Joe had his last drink, he is still considered an alcoholic. The very word addict confers an identity that admits no other possibilities. It incorporates the assumption that you can't, or won't, change.
But this fatalistic thinking about addiction doesn't jibe with the facts. More people overcome addictions than do not. And the vast majority do so without therapy. Quitting may take several tries, and people may not stop smoking, drinking or using drugs altogether. But eventually they succeed in shaking dependence.
Kicking these habits constitutes a dramatic change, but the change need not occur in a dramatic way. So when it comes to addiction treatment, the most effective approaches rely on the counterintuitive principle that less is often more. Successful treatment places the responsibility for change squarely on the individual and acknowledges that positive events in other realms may jump-start change.
Consider the experience of American soldiers returning from the war in Vietnam, where heroin use and addiction was widespread. In 90 percent of cases, when GIs left the pressure cooker of the battle zone, they also shed their addictions—in vivo proof that drug addiction can be just a matter of where in life you are.
Of course, it took more than a plane trip back from Asia for these men to overcome drug addiction. Most soldiers experienced dramatically altered lives when they returned. They left the anxiety, fear and boredom of the war arena and settled back into their home environments. They returned to their families, formed new relationships, developed work skills.
Smoking is at the top of the charts in terms of difficulty of quitting. But the majority of ex-smokers quit without any aid—neither nicotine patches nor gum, Smokenders groups nor hypnotism. (Don't take my word for it; at your next social gathering, ask how many people have quit smoking on their own.) In fact, as many cigarette smokers quit on their own, an even higher percentage of heroin and cocaine addicts and alcoholics quit without treatment. It is simply more difficult to keep these habits going through adulthood. It's hard to go to Disney World with your family while you are shooting heroin. Addicts who quit on their own typically report that they did so in order to achieve normalcy.
Every year, the National Survey on Drug Use and Health interviews Americans about their drug and alcohol habits. Ages 18 to 25 constitute the peak period of drug and alcohol use. In 2002, the latest year for which data are available, 22 percent of Americans between ages 18 and 25 were abusing or were dependent on a substance, versus only 3 percent of those aged 55 to 59. These data show that most people overcome their substance abuse, even though most of them do not enter treatment.
How do we know that the majority aren't seeking treatment? In 1992, the National Institute on Alcohol Abuse and Alcoholism conducted one of the largest surveys of substance use ever, sending Census Bureau workers to interview more than 42,000 Americans about their lifetime drug and alcohol use. Of the 4,500-plus respondents who had ever been dependent on alcohol, only 27 percent had gone to treatment of any kind, including Alcoholics Anonymous. In this group, one-third were still abusing alcohol.
Of those who never had any treatment, only about one-quarter were currently diagnosable as alcohol abusers. This study, known as the National Longitudinal Alcohol Epidemiologic Survey, indicates first that treatment is not a cure-all, and second that it is not necessary. The vast majority of Americans who were alcohol dependent, about three-quarters, never underwent treatment. And fewer of them were abusing alcohol than were those who were treated.
This is not to say that treatment can't be useful. But the most successful treatments are nonconfrontational approaches that allow self-propelled change. Psychologists at the University of New Mexico led by William Miller tabulated every controlled study of alcoholism treatment they could find. They concluded that the leading therapy was barely a therapy at all but a quick encounter between patient and health-care worker in an ordinary medical setting. The intervention is sometimes as brief as a doctor looking at the results of liver-function tests and telling a patient to cut down on his drinking. Many patients then decide to cut back—and do!
As brief interventions have evolved, they have become more structured. A physician may simply review the amount the patient drinks, or use a checklist to evaluate the extent of a drinking problem. The doctor then typically recommends and seeks agreement from the patient on a goal (usually reduced drinking rather than complete abstinence). More severe alcoholics would typically be referred out for specialized treatment.[note: I volentaraly (and desperatly) signed into a six week place upstate, I was not "referred" (just another example of how it really comes down to the individual} A range of options is discussed (such as attending AA, engaging in activities incompatible with drinking or using a self-help manual). A spouse or family member might be involved in the planning. The patient is then scheduled for a future visit, where progress can be checked. A case monitor might call every few weeks to see whether the person has any questions or problems.
The second most effective approach is motivational enhancement, also called motivational interviewing. This technique throws the decision to quit or reduce drinking—and to find the best methods for doing so—back on the individual. In this case, the therapist asks targeted questions that prompt the individual to reflect on his drinking in terms of his own values and goals. When patients resist, the therapist does not argue with the individual but explores the person's ambivalence about change so as to allow him or her to draw his own conclusions: "You say that you like to be in control of your behavior, yet you feel when you drink you are often not in charge. Could you just clarify that for me?"
Miller's team found that the list of most effective treatments for alcoholism included a few more surprises. Self-help manuals were highly successful. So was the community-reinforcement approach, which addresses the person's capacity to deal with life, notably marital relationships, work issues (such as simply getting a job), leisure planning and social-group formation (a buddy might be provided, as in AA, as a resource to encourage sobriety). The focus is on developing life skills, such as resisting pressures to drink, coping with stress (at work and in relationships) and building communication skills.
These findings square with what we know about change in other areas of life: People change when they want it badly enough and when they feel strong enough to face the challenge, not when they're humiliated or coerced. An approach that empowers and offers positive reinforcement is preferable to one that strips the individual of agency. These techniques are most likely to elicit real changes, however short of perfect and hard-won they may be.
No matter what approach in recovery you are taking it's always important to have a network of support. If you need help with addiction and would like to have some support please visit us at The Sober Village, where we do recover and will support you in your efforts.
Monday, March 24, 2008
Drug Addiction and Alcohol Abuse
For help with drug addiction and alcohol abuse please visit the sober forums at The Sober Village
A drug addiction alcohol abuse is very complex and normally comes with life-threatening issues. For families and friends who suffer on this kind of abuse by their loved ones usually get confused in the process of how they will proceed on the treatments.
Majority of the people is very unfamiliar with chemical dependencies, drug addictions and alcoholism. Because of this, people end up making inappropriate choices of not getting the best help possible or even worse. Detoxification is the initial step in the rehab process of a drug addiction alcohol abuse.
Let's go over to some drug addiction alcohol abuse principles that you can learn and get yourself familiarize with.
There is no single drug addiction alcohol abuse treatment that is appropriate for all individuals. Complementing the several drug abuse settings, interventions, and services to each individual's particular problems and needs is very critical to their ultimate success in returning to the productive functions in the society, workplace and family where you belong.
Drug addiction alcohol abuse treatments are needed to be readily available as individuals who are addicted to drugs may be uncertain about entering the treatment as well as taking advantage of the opportunities when they are ready for rehabilitation.
An effective rehabilitation attends to different needs of the individual in accordance to drug used. To be effective, it must address the individual's drug use and any associated legal, vocational, social, psychological, and medical problems. An individual's plan must be evaluated continually and modified if necessary to ensure that the plan meets the changing needs of the person.
An individual may require varying combinations of services and rehabilitation components during the course of recovery of drug addiction abuse. It is a very critical approach to be appropriate to the individual's gender, age, culture and ethnicity. Staying in rehabilitation for a period of time is critical for drug abuse treatment effectiveness. Some research indicates that for most individual, the edge of important improvements is reached in about three months in drug abuse treatment. After this edge is reached, there would be additional drug abuse treatments for producing further progress towards recovery of the individual.
Most people often leave drug abuse treatment pre-maturely because there are programs that include strategies to keep and engage patients in drug abuse treatment. Counseling, whether it's group or individual and other behavioral therapies are the essential components of effective drug addiction alcohol abuse treatments.
A drug addiction alcohol abuse is very complex and normally comes with life-threatening issues. For families and friends who suffer on this kind of abuse by their loved ones usually get confused in the process of how they will proceed on the treatments.
Majority of the people is very unfamiliar with chemical dependencies, drug addictions and alcoholism. Because of this, people end up making inappropriate choices of not getting the best help possible or even worse. Detoxification is the initial step in the rehab process of a drug addiction alcohol abuse.
Let's go over to some drug addiction alcohol abuse principles that you can learn and get yourself familiarize with.
There is no single drug addiction alcohol abuse treatment that is appropriate for all individuals. Complementing the several drug abuse settings, interventions, and services to each individual's particular problems and needs is very critical to their ultimate success in returning to the productive functions in the society, workplace and family where you belong.
Drug addiction alcohol abuse treatments are needed to be readily available as individuals who are addicted to drugs may be uncertain about entering the treatment as well as taking advantage of the opportunities when they are ready for rehabilitation.
An effective rehabilitation attends to different needs of the individual in accordance to drug used. To be effective, it must address the individual's drug use and any associated legal, vocational, social, psychological, and medical problems. An individual's plan must be evaluated continually and modified if necessary to ensure that the plan meets the changing needs of the person.
An individual may require varying combinations of services and rehabilitation components during the course of recovery of drug addiction abuse. It is a very critical approach to be appropriate to the individual's gender, age, culture and ethnicity. Staying in rehabilitation for a period of time is critical for drug abuse treatment effectiveness. Some research indicates that for most individual, the edge of important improvements is reached in about three months in drug abuse treatment. After this edge is reached, there would be additional drug abuse treatments for producing further progress towards recovery of the individual.
Most people often leave drug abuse treatment pre-maturely because there are programs that include strategies to keep and engage patients in drug abuse treatment. Counseling, whether it's group or individual and other behavioral therapies are the essential components of effective drug addiction alcohol abuse treatments.
Thursday, March 20, 2008
Help with Drinking Online
If you found your way to this article it's probably due to a curiosity, an uncertainty, or simply information. If you or someone you know needs help with alcohol or substance abuse there is help online. There is a vast network of resources to help you find your answers and solutions.
Because of the many information resources provided by the world wide web many individuals or seeking help and information online before consulting with anyone face to face. Be it at an AA meeting where that is just to scary to think about or even the shame of discussing your problems with alcohol or other substances with a doctor or just unfathomable to many. If you need help with alcohol or drug abuse or have a family member or friend that you are painfully watching slip into the depths of addiction please visit many of the recommended sites of the Sober Sources Network.
Help is only a click away!
Sober Source Network
The Sober Village
Sober Teens Online!
Because of the many information resources provided by the world wide web many individuals or seeking help and information online before consulting with anyone face to face. Be it at an AA meeting where that is just to scary to think about or even the shame of discussing your problems with alcohol or other substances with a doctor or just unfathomable to many. If you need help with alcohol or drug abuse or have a family member or friend that you are painfully watching slip into the depths of addiction please visit many of the recommended sites of the Sober Sources Network.
Help is only a click away!
Sober Source Network
The Sober Village
Sober Teens Online!
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