Treat, Don’t Blame Addicts

Why We Should Treat, Not Blame Addicts Struggling to Get ‘Clean’

Journalist David Sheff’s son Nic began using marijuana and alcohol at the age of 12, then heroine and crystal meth. Sheff was baffled; his son transformed from an intelligent student and athlete into an addict living on the streets. At first he thought Nic was just being a wild teenager who needed some tough love. But after struggling to find Nic treatment — and keep him alive — Sheff realized that his son was dealing with a serious disease, more similar than different from diabetes, hypertension or even cancer.

With his personal experience and more than 10 years of research, Sheff concluded that addiction is a health crisis with a price tag of US$600 billion in combined medical, economic, criminal and social costs every year.

In a follow-up to his memoir “Beautiful Boy,” David Sheff has written a new book, “Clean: Overcoming Addiction and Ending America’s Greatest Tragedy,” in order to outline a slew of reasons why society and addiction treatments have largely failed to help the 20 million Americans with addictions.

Sheff asserts that the reason that addiction treatments overwhelmingly fail is because of how we view addiction. And he says correcting common misconceptions about the disease can be the first step towards improving the social support and medical treatment systems for those struggling with their addictions.

Below are the top myths about addiction, according to David Sheff.  


Myth No. 1: Good kids don’t use drugs, bad kids do. 

Myth No. 2: It’s impossible to prevent drug use. Kids who are going to use are going to use.

Myth No. 3: People who get addicted are weak and without morals.

Myth No. 4: Addicts must hit bottom before they can be treated.

Myth No. 5: You don’t treat drug problems with drugs.

Myth No. 6: The only way for addicts to stop using is by going to AA meetings.

Myth No. 7: Marijuana is not addictive. No one’s ever died from marijuana. It’s not a gateway drug. Marijuana shouldn’t be legalized.

Myth No. 8: America’s drug problem is unsolvable.

  • We’ve failed at solving America’s drug problem not because it’s impossible to do so, but we’ve been focusing on the wrong things. The main problem is that we’ve treated drug use as a criminal problem and drug users as morally bankrupt.
  • There are several developments that make me optimistic that we can lower drug use, treat addicts and potentially solve many of the problems in America caused by addiction:
  • There’s a growing understanding and acceptance that addiction is a disease and must be treated like we treat other diseases.
  • There are advances in treatment that will dramatically improve the likelihood that addicts will get well. There are also new prevention strategies, early assessment, and brief intervention strategies that work.
  • There is progress toward making sure that people who need treatment will be able to find programs that use evidence-based treatment.
  • There is a new organization founded called Brian’s Wish To End Addiction

The top myths about addiction above were adapted from content from David Sheff’s new book, “Clean: Overcoming Addiction and Ending America’s Greatest Tragedy. The views are his own.

Full story at; http://www.pbs.org/newshour/rundown/2013/04/addiction-mythbusters-understand-what-triggers-addiction-and-how-to-manage-the-disease.html

Drug Addiction Treatment

Principles of Drug Addiction and Alcoholism Treatment: A Research-Based Guide (Third Edition)

Principles of Effective Treatment

1. Addiction is a complex but treatable disease that affects brain function and behavior.  Drugs of abuse alter the brain’s structure and function, resulting in changes that persist long after drug use has ceased. This may explain why drug abusers are at risk for relapse even after long periods of abstinence and despite the potentially devastating consequences.

2. No single treatment is appropriate for everyone.  Treatment varies depending on the type of drug and the characteristics of the patients. Matching treatment settings, interventions, and services to an individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society.

3. Treatment needs to be readily available.  Because drug-addicted individuals may be uncertain about entering treatment, taking advantage of available services the moment people are ready for treatment is critical. Potential patients can be lost if treatment is not immediately available or readily accessible. As with other chronic diseases, the earlier treatment is offered in the disease process, the greater the likelihood of positive outcomes.

4. Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.  To be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems. It is also important that treatment be appropriate to the individual’s age, gender, ethnicity, and culture.

5. Remaining in treatment for an adequate period of time is critical.  The appropriate duration for an individual depends on the type and degree of the patient’s problems and needs. Research indicates that most addicted individuals need at least 3 months in treatment to significantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment. Recovery from drug addiction is a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug abuse can occur and should signal a need for treatment to be reinstated or adjusted. Because individuals often leave treatment prematurely, programs should include strategies to engage and keep patients in treatment.

6. Behavioral therapies—including individual, family, or group counseling—are the most commonly used forms of drug abuse treatment.   Behavioral therapies vary in their focus and may involve addressing a patient’s motivation to change, providing incentives for abstinence, building skills to resist drug use, replacing drug-using activities with constructive and rewarding activities, improving problem-solving skills, and facilitating better interpersonal relationships. Also, participation in group therapy and other peer support programs during and following treatment can help maintain abstinence.

7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.  For example, methadone, buprenorphine, and naltrexone (including a new long-acting formulation) are effective in helping individuals addicted to heroin or other opioids stabilize their lives and reduce their illicit drug use. Acamprosate, disulfiram, and naltrexone are medications approved for treating alcohol dependence. For persons addicted to nicotine, a nicotine replacement product (available as patches, gum, lozenges, or nasal spray) or an oral medication (such as bupropion or varenicline) can be an effective component of treatment when part of a comprehensive behavioral treatment program.

8. An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.  A patient may require varying combinations of services and treatment components during the course of treatment and recovery. In addition to counseling or psychotherapy, a patient may require medication, medical services, family therapy, parenting instruction, vocational rehabilitation, and/or social and legal services. For many patients, a continuing care approach provides the best results, with the treatment intensity varying according to a person’s changing needs.

9. Many drug-addicted individuals also have other mental disorders.  Because drug abuse and addiction—both of which are mental disorders—often co-occur with other mental illnesses, patients presenting with one condition should be assessed for the other(s). And when these problems co-occur, treatment should address both (or all), including the use of medications as appropriate.

10. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse.  Although medically assisted detoxification can safely manage the acute physical symptoms of withdrawal and can, for some, pave the way for effective long-term addiction treatment, detoxification alone is rarely sufficient to help addicted individuals achieve long-term abstinence. Thus, patients should be encouraged to continue drug treatment following detoxification. Motivational enhancement and incentive strategies, begun at initial patient intake, can improve treatment engagement.

11. Treatment does not need to be voluntary to be effective.  Sanctions or enticements from family, employment settings, and/or the criminal justice system can significantly increase treatment entry, retention rates, and the ultimate success of drug treatment interventions.

12. Drug use during treatment must be monitored continuously, as lapses during treatment do occur.  Knowing their drug use is being monitored can be a powerful incentive for patients and can help them withstand urges to use drugs. Monitoring also provides an early indication of a return to drug use, signaling a possible need to adjust an individual’s treatment plan to better meet his or her needs.

13. Treatment programs should test patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counseling, linking patients to treatment if necessary.   Typically, drug abuse treatment addresses some of the drug-related behaviors that put people at risk of infectious diseases. Targeted counseling focused on reducing infectious disease risk can help patients further reduce or avoid substance-related and other high-risk behaviors. Counseling can also help those who are already infected to manage their illness. Moreover, engaging in substance abuse treatment can facilitate adherence to other medical treatments. Substance abuse treatment facilities should provide onsite, rapid HIV testing rather than referrals to offsite testing—research shows that doing so increases the likelihood that patients will be tested and receive their test results. Treatment providers should also inform patients that highly active antiretroviral therapy (HAART) has proven effective in combating HIV, including among drug-abusing populations, and help link them to HIV treatment if they test positive.

More at; http://www.drugabuse.gov/publications/principles-drug-addiction-treatment

Teens Use Diverted Medical Marijuana

74 Percent of Teens in CO Substance Abuse Treatment Programs Used Diverted Medical Marijuana

Three-quarters of teenage patients in substance abuse treatment programs in Denver, Colorado said they used someone else’s medical marijuana, according to a new study.

The study revealed that 121 of 164 teenage patients (73.8 percent) have ever used medical marijuana prescribed to someone else.  Patients reported using diverted medical marijuana from one to 1,000 times, with a median of 50 times, suggesting that most adolescent patients have used medical marijuana on multiple occasions, according to Stacy Salomonsen-Sautel, PhD, a post-doctoral fellow at the University of Colorado Anschutz Medical Campus, Division of Substance Dependence. She reported the findings at the recent College on Problems of Drug Dependence, and the study appears online in the Journal of the American Academy of Child and Adolescent Psychiatry.

The study found that after adjusting for gender and race/ethnicity, teenage patients who used medical marijuana had an earlier age of regular marijuana use, more marijuana abuse and dependence symptoms, and more conduct disorder symptoms, compared with those who did not use medical marijuana.

As of the end of April 2012, Colorado has 48 registered medical marijuana users under the age of 18. Four of the 164 teenage patients in the study reported being evaluated for a medical marijuana card; however, only one teenage patient received a medical marijuana card. According to the Colorado Department of Public Health and Environment, 96,709 people in the state were registered as medical marijuana users as of April 30, 2012. This means 2.5 percent of the adults in Colorado are registered medical marijuana users, according to Salomonsen-Sautel.

“We don’t know what proportion of the marijuana they are using is medical marijuana,” Salomonsen-Sautel notes. She said the findings imply that there is substantial diversion from registered medical marijuana users. She and her colleagues say the results support the need for policy changes that protect against diversion of medical marijuana, and reduce teenager access to it.

From; The Partnership at Drugfree.org and Join Together

Emotional Eating

Overeaters Anonymous Offers Support for Emotional Eating

Overeaters Anonymous World Service Office

If you have struggled with your weight, you probably accept that you have a weight problem. But you may also have an eating problem. A key to maintaining a healthy weight is balance—in your diet and in your lifestyle. How and why you eat, however, can help determine if you have an eating problem.

Compulsive overeating, anorexia and other food issues are often triggered by emotions rather than hunger. The consequences of emotional eating run deeper than weight management. They impact your relationships, social life, self-image and overall health. Recovery requires more than willpower: it requires support to help you understand the links between your emotions and eating behavior.

Overeaters Anonymous (OA) offers a program of recovery from issues with food using a holistic approach that addresses individual physical, emotional and spiritual well-being. Built on a Twelve Step program patterned after Alcoholics Anonymous, OA offers social support, strength, encouragement and hope through meetings and other tools while respecting each other’s anonymity. There are no fees or dues—OA is supported by voluntary member contributions.

"For many members, OA is an excellent supplement to the professional healthcare services they receive," said Naomi Lippel, Managing Director for Overeaters Anonymous. "OA offers an ongoing support system and a program that has proven effective for thousands who have suffered from compulsive eating behaviors."

OA welcomes anyone suffering from an eating problem ranging from anorexia to binge-eating at any of its more than 7000 OA group meetings worldwide. For more information or to be put in contact with an OA representative, please call Tina Carroll at (636) 328-0216 or email her at media@oa.org.

About Overeaters Anonymous: Overeaters Anonymous, Inc. (OA), is a non-profit organization with the goal of supporting its members as they seek recovery from compulsive eating behaviors. More than fifty years since its founding, today OA serves approximately 54,000 members in over 75 countries. For more information, go to www.oa.org.

Alcohol Abuse Screenings at the Dentist

Health experts have warned that people who consume alcohol excessively are exposed to an extremely high risk of developing dental disease and mouth cancer.

Experts have also noted that in order to be able to keep things under control, treatment and constant screenings for alcohol abuse is extremely important. The published paper has been called “Alcohol misuse: screening and treatment in primary dental care”.

The study has also brought to light the fact that people generally do not visit their doctor (GP), unless they are extremely ill. On the other hand, people generally respect their regular dental visits, and therefore dentists are the professionals mostly suited to test patients for alcohol abuse issues.

If health professionals would start asking a few standard questions regarding the patient’s alcoholism problem, it would be much easier to help the patient fight against these issues.

Professor of Oral and Maxillofacial Surgery, Jonathan Shepherd clearly points out that people struggling with excessive alcohol consumption can develop cancer of the mouth, esophagus and larynx. The dental professionals may actually be the first who can discover these health complications.

There should be introduced an alcohol screening device which is extremely reliable and which can detect alcoholism, and then suggest the right path for treatment.

The paper notes that today in the UK approximately 1 in 5 men and 1 in 7 women are drinking excessively. If dental professionals would be the first to suggest the patient the importance of moderation in drinking, both the health and economic implications linked to excessive alcohol consumption could be considerably reduced.

Professor Shepherd further reveals that one of the main responsibilities of the dentist is to promote overall good health.

They are not only responsible for dental health promotion, but also for helping the patient fight off bad habits that lead to severe oral health complications, or to severe damages in any other major organ of the body.

The Government and the dentists should join their forces and provide proper screenings and treatments before it is not too late for the patient.

Genetics and Family Environment Influence Drug Abuse

Risk for Drug Abuse in Adopted Children Appears Influenced by Family, Genetics

In a national Swedish adoption study, the risk for drug abuse appears to be increased among adopted children whose biological parents had a history of drug abuse, according to a report published online by Archives of General Psychiatry.

Drug abuse is a worldwide public health problem and much effort has gone into understanding the nature of familial factors, the authors write in their study background.

Kenneth S. Kendler, and colleagues evaluated the association between genetic and environmental factors and the risk of drug abuse. Their study included 18,115 adopted children born in Sweden between 1950 and 1993, as well their biological and adoptive relatives. Researchers relied on national registries and health databases, as well as information about drug abuse from medical, legal or pharmacy records.

The adoptees, whose average age at last available information was 46.2 years, had a 4.5 percent prevalence of drug abuse compared with 2.9 percent in all of Sweden from the same birth years.

The authors suggest the risk for drug abuse among children given up for adoption by biological parents, of whom a least one had drug abuse, was 8.6 percent, which they note was "substantially and significantly elevated over that seen in children given up for adoption when neither biological parent had drug abuse (4.2 percent)."

"Risk for drug abuse in adopted children is increased by a history in biological parents and siblings not only of drug abuse but also of alcoholism, major psychiatric illness and criminal convictions," the authors note. "Risk for drug abuse in adopted children is increased by disruption in the adoptive parent-adopted child bond by death or divorce but also by a range of indices of a disturbed adoptive home environment and deviant peer influences such as parental alcoholism and sibling drug abuse, respectively."

Researchers also suggest a gene-environment interaction in the etiology (the study of the causes of a disease) of drug abuse.

"Adopted children at high genetic risk were more sensitive to the pathogenic effects of adverse family environments than those at low genetic risk. In other words, genetic effects on drug abuse were less potent in low-risk than high-risk environments," the authors conclude.

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Top Reasons for Not Getting Alcohol or Drug Treatment

Lack of Motivation to Quit and Health Coverage Are the Top Reasons for Not Receiving Needed Alcohol or Drug Treatment

An estimated 20.5 million people needed but did not receive alcohol or drug treatment in the past year, according to data from the 2010 National Household Survey on Drug Use and Health (NSDUH). The primary reason for not receiving treatment among those who were classified as needing—and felt they needed—treatment was not being ready to stop using alcohol or illicit drugs (40.2%). The second most commonly cited reason for not receiving treatment was having no health coverage and not being able to afford the cost (32.9%). People in need of alcohol treatment were more likely than those in need of drug treatment to cite not being ready to stop using (45.1% vs. 30.7%; data not shown), while those needing drug treatment were more likely to cite not having health coverage and could not afford the cost (41.8% vs. 30.9%; data not shown). Other reasons given were not knowing where to go for treatment, thinking that going to treatment might have a negative effect on their job or social relationships, or thinking that they could handle the problem without treatment (see figure below).

(N=an estimated 1,341,000 U.S. residents ages 12 and older classified as needing and perceiving a need for—but not receiving—treatment)

  • Not Ready to Stop Using 40.2%
  • No Health Coverage and Could Not Afford Cost 32.9%
  • Might Have Negative Effect on Job 11.5%
  • Might Cause Neighbors/Community to Have Negative Opinion 11.3%
  • Could Handle the Problem Without Treatment 9.9%
  • Did Not Know Where to Go for Treatment 9.3%
  • Did Not Feel Need for Treatment at the Time 7.8%
  • Did Not Want Others to Find Out 6.8%
  • No Transportation/Inconvenient 6.3%

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Drug-addicted anesthesiologists pose danger

Anesthesiologists – the doctors who keep patients alive during surgery, who essentially take over our breathing – make up just three per cent of all doctors, but account for 20 to 30 per cent of drug-addicted MDs. Experts say anesthesiologists are overrepresented in addiction treatment programs by a ratio of three to one, compared with any other physician group, an occupational hazard that could pose catastrophic risks to their patients.

Their drugs of choice are most frequently fentanyl and sufentanil, opioids that are 100 and 1,000 times more potent than morphine. They “divert” a portion of the doses meant for their patients to themselves, slipping syringes into their pockets.

And later, alone in the bathroom or the call room, when the drug hits their own bloodstream, the relief, the sense that all is well in the world, the mild euphoria, is immediate.

See full story via Drug-addicted anesthesiologists pose danger.

What Addiction is Not

What Addiction is Not – God of Our Understanding – Jewish Spirituality and Recovery from Addiction.

The truth is that most people, including addicts themselves, have no idea what addiction really is. When being honest, the addict will tell you that he or she has no better an understanding of the problem than you have. Addiction confounds us; it frustrates us; it scares us. This has been the way it’s been since time immemorial. That’s why for millennia the only response to the town drunk was either to lock him up for good or to allow him to run raving in the streets. How else should one deal with a problem that makes no sense?

Most people, including addicts themselves, have no idea what addiction really is.

There is an old Jewish saying: “Knowing the disease is half the cure.” (Yes, the rabbis have been saying that for centuries already.)

So what is the disease of addiction?

Full story at; http://www.chabad.org/library/article_cdo/aid/1761298/jewish/What-Addiction-is-Not.htm

Guide on Drug Treatment

Guide to drug abuse treatment NIDAGovernment Publishes Guide on Drug Abuse Treatment

The National Institute on Drug Abuse (NIDA) has published a free guide to choosing a drug abuse treatment program. “Seeking Drug Abuse Treatment: Know What to Ask” recommends questions that individuals and families who are struggling with addiction should ask to help them make an informed choice.

“Treatment options can vary considerably, and families often don’t know where to begin,” NIDA Director Nora Volkow said in a news release. “This booklet highlights the treatment components that research has shown are critical for success, to help people make an informed choice during a very stressful time.”

Many recent scientific advances have changed addiction treatment, but not all treatment centers have kept up with these changes, according to the Los Angeles Times. The guide recommends asking the following questions:

•    Does the program use treatments backed by scientific evidence?
•    Does the program tailor treatment to the needs of each patient?
•    Does the program adapt treatment as patients’ needs change?
•    Is the duration of treatment sufficient?
•    How do 12-step or similar recovery programs fit into drug addiction treatment?

The guide provides information on medications, evidence-based behavior therapies, the realities of relapse, and the role of community-level support.

By Join Together