About Addiction: Alcohol and the Elderly, Oxycontin, and Drug Stigma

Are you ready for some more exciting information about addiction? Well, it’s here anyway so you might as well look. We try to make A3 the central place where you can find out about addiction matters (saving you the typing work) so if there are any topics we’re not covering, make sure to write us!

Drugs- Reducing Stigma, and Oxycontin

Victoria NewsStigma is often discussed when talking about addiction. The stigma a drug user is stamped with often deters them from seeking treatment. AIDS Vancouver Island is promoting Anti-Stigma Week, which runs until Feb. 14. Hopefully an activity like anti-stigma week will allow individuals to leave behind their fears about being stigmatized and seek treatment for their addictions. Continue reading “About Addiction: Alcohol and the Elderly, Oxycontin, and Drug Stigma”

Women, Trauma and HIV Transmission

Co-authored by Jamie Felzer

Just how much can the events of a traumatic childhood affect the likelihood of contracting HIV or other serious diseases in later life? Unfortunately, recent research shows that the effect can be profound, especially for women.The silver lining may be in our ability to reduce later HIV transmission by providing better intervention services post-trauma.

Childhood Trauma, Women and HIV/AIDS

In ways both surprising and predictable, it seems that even very early childhood trauma can be firmly linked to high risk behaviors and a higher risk of contracting HIV. And with AIDS now reported by the US Department of Heath & Human Services as the leading cause of death for African-American women between the ages of 25-34 (and the perhaps even more sobering H&HS assessment that African-American women are a staggering 21 times more likely to die from AIDS compared to non-Hispanic white women), this crisis has a particular impact on women of color.

The obvious conclusion is that those subjected to childhood trauma are more likely to engage in risky behavior in an attempt to relieve some of the chronic stress that often accompanies such experiences. Drug use, unprotected sex, heavy drinking and other accompanying behaviors can all seem like appropriate responses to mental and emotional stress, but that stress can also inhibit one’s ability to make safe choices in this context. This naturally leads to an increased risk for contracting sexually transmitted diseases and blood-borne pathogens. Factor in the simple biological reasons why women may be at an elevated risk of contracting HIV through any one encounter, and it becomes clear that many at-risk young women are not receiving adequate education on how to protect themselves against this threat.

Many young women with a history of trauma and elevated lifetime stress from sexual assault, violence or any of the myriad stressors that accompany low socioeconomic status may be inadvertently putting themselves at greater risk for contracting HIV and AIDS. As mentioned, these risks can commonly come from unsafe sex and the abuse of unknown drugs, potentially with non-sterile needles. Without a strong support system to help them adequately process the short and long-term effects of trauma, many young women end up developing symptoms of chronic anxiety and depression, conditions that can alter behavior and even ultimately lead to demonstrated higher rates of mortality. That these conditions also often co-exist with other health issues linked to lower socioeconomic status such as obesity and heart disease serves to further compound this risk. Stress has even been shown to speed the progression of the AIDS virus, making the disease itself more deadly.

And with a full 1/3 of the female population having reported some form of sexual assault or similar violent trauma, the sad reality is that the risks for contracting HIV among young women are, if anything, growing. It seems that one way to attack the HIV pandemic is by improving prevention, as well as intervention, services, for women affected by such early trauma. It might be a way to kill two, or even more, birds with one stone.

The benefits of marijuana: Things are far from all bad for weed

Marijuana can certainly be beneficial.

It’s true that essentially every drug has some abuse liability. However, somewhere in the vicinity of 85% of those who try any given drug will never develop abuse or addiction problems (yes there are probably variations based on specific drugs, but that’s a good estimate).  As we all know, marijuana is a drug that receives a lot of attention and drives intense debate when it comes to its benefits and harms.  While most of the posts on my site focus on the other 15%, there is, and continues to be, evidence for the benefits of marijuana and other drugs that directly activate cannabinoid receptors.

Some of the shown benefits of marijuana

THC, the active ingredient in cannabis, is known to cause sedation, euphoria, decrease in pain sensitivity, as well as memory and attention impairments.  But there are some aspects of the cannabinoid receptors that have been shown to be effective in AIDS, glaucoma and cancer treatments.

Stimulation of cannabinoid receptors causes an increase in appetite and therefore helps with the wasting syndrome often seen as a side effect in AIDS treatments or those with eating disorders. Since THC activation decreases intra-ocular pressure, another area in which marijuana has been proven to be effective is in the treatment of glaucoma.  THC’s anti-emetic (or anti-vomiting) properties also make it a very useful tool for combating the side effects of cancer treatments.

Still, the activation of cannabinoid receptors is not synonymous with smoking weed. In fact, there are a number of other possible ways to consume THC and other cannabinoid-receptor activators. Also, THC is a potent immune suppressing agent, so in someone who already has a compromised immune system, such as AIDS patients, marijuana and other THC compounds could increase the risk of infection.

Future promise for the use of THC in medicine

There is some evidence that of the 2 major THC receptors (CB1 and CB2), one is associated with the immuno-suppression that occurs after chronic usage and the other is associated with the the more beneficial aspects we’d discussed. In the future, we may be able to produce a compound that activate only the behavioral effects and could therefore be used more safely for AIDS patients. Marijuana lovers will say that we should leave things as they are, but I’m all for less immuno-suppression with my cancer therapy.

Again, just because activation of THC receptors can provide the above benefits does not necessarily mean one should smoke marijuana. As usual, the benefits and risks have to be considered and one has to reach an educated, informed, conclusion. Still, there’s little doubt that in some situations, the use of marijuana, or other THC activators is not only prudent, but indeed recommended.

Co-authored by: Jamie Felzer

Meth + Viagra = HIV and STDs?? Sex marathons and their danger

Co-authored by: Jamie Felzer

Sex marathons…what does that sound like to you?  Lots of sex, with multiple partners, for an extended period of time? Bingo! Come on down and collect a prize!!!

Why sex marathons can be dangerous

The combination of crystal meth and Viagra can leave users at a very high risk for contracting sexually transmitted infectionsSex marathons are where people have sex for a prolonged period of time, and often do so with multiple partners where they may seldom use protection.  Clearly this could cause some potential dangers.   All these dangers CAN be prevented (by using condoms, lubrication, and strict hygiene).  What makes these activities even more dangerous is the addition of crystal meth to help participants stay up for these long sex marathons and the prescription drug, Viagra to make sure they can perform sexually during these marathons. Put those two ingredients together and you have a powerfully volatile cocktail.

A collection of studies have been conducted with both hetero- and homosexual males involving the combination of these substances.  It was shown that those who generally used Meth were more likely to have sex, have sex with multiple partners and also more frequently not use protection. Particularly worrisome was the finding that homosexual men who used Meth and were HIV positive were the least likely to use condoms and were also the most depressed. members of this population often had 10 or more sex partners, thus quickly promoting the spread of STDs including HIV (if protection is not used).

Protection is VITAL in combating the spread of HIV

Taken together, these studies reveal that the consumption of Viagra is highly associated with insertive sexual behaviors.  This means that heterosexual men on Viagra more often partake in anal sex and homosexual men on Viagra more often partake in insertive sexual behaviors rather than receptive sexual behaviors. All insertive sexual behaviors have a high chance of causing the transmission of STDs because of the high amount of blood flow and low amount of protective tissues that reside in that area of the body.

Remember the ways of contracting HIV: Anal sex, vaginal sex, IVs and any other form of infectious blood mixing, and mother to child transmission.

Those who used a cocktail of Viagra, Meth and poppers (a form of Nitrates) increased the risk of contracting HIV, Syphilis and Hepatitis B over 100%!! While these drugs can sometimes be used without major complications, the concoction of them together creates a dangerous mix that puts everyone involved at a higher risk of contracting blood-borne diseases.  So, participate in sex marathons at your own risk but no matter what know your status and be sure to use protection!  Regardless of what the studies show, you can beat statistics by using caution during sex.

Citations:

Fisher, Dennis G; Reynolds, Grace L; Napper, Lucy E. Current Opinion in Infectious Diseases. Issue: Volume 23(1), February 2010, p 53–56.

Fisher, D. G., Malow, R., Rosenberg, R., Reynolds, G. L., Farrell, N., & Jaffe, A. (2006). Recreational Viagra use and sexual risk among drug abusing men. American Journal of Infectious Diseases, 2, 107-114.

Heroin Addiction and HIV infection – Dirty needles and a place for harm reduction

Co-authored by: Jamie Felzer

Many people today know about the dangers and risky behaviors (sharing needles, unsafe sex, and mother-to-child transmission) that can increase the risk for HIV/AIDS infection. The question lies in whether or not they are able to take appropriate actions to prevent contracting the disease themselves.

Heroin addiction, dirty needled, and HIV infection

Many heroin addicts, especially those that are homeless or extremely poor, will use whatever heroin they can get, regardless of the risk it puts them in.  A study done in a San Francisco park frequented by almost 3000 IV drug users found that in times of heroin withdrawals, addicts would use dirty  needles, sometimes with visible traces of blood still on them. The need to overcome their withdrawal was more important to them than worrying about the risk of contracting HIV or any of the other countless diseases that can be contracted from such use.

Many of the users surveyed were poor and sometimes didn’t even have enough money to buy their own supply of heroin so they often pooled together what they had with others. They all shared the heroin, cooker and needle to get a fix for the time being.

Regardless of the consequences of HIV contraction, users needed their heroin.

In this community many of the users knew about the risks of sharing needles and were well aware of recommendations that they not share needles or bleach them.  The users actually found health outreach workers slogans patronizing because although they would have  loved not to have to worry about sharing needles, often the more imminent need is getting that fix or suffer being extremely sick from withdrawals.  Given the relatively rare harm-reduction sources available, they were able to use the clean needles given out by some health organizations but at other times had to be resourceful and use what they had regardless of the possible consequences.

There are 1.2 million people living with HIV in the US right now out of a 33.2 million total in the world. 2.5 million people recently acquired the disease and 18% of those new infections were from injection drug users (IDU).  HIV/AIDS is a preventable disease. If we allow users to have easier access to clean needles, we can help decrease the number of IDU infections. If you aren’t sure what your status is, get tested! HIV Testing

Here’s a great resource for finding needle exchanges operating in the U.S. : NASEN

Citation:

Social Misery and the Sanctions of Substance Abuse: Confronting HIV Risk among Homeless Heroin Addicts in San Francisco. Philippe Bourgois; Mark Lettiere; James Quesada. Social Problems, Vol. 44, No. 2  (May, 1997), pp. 155-173. University of California Press on behalf of the Society for the Study of Social Problems.

UNAIDS Website

Drug use isn’t the problem – Addiction and the question of legalization or decriminalization

I don’t keep it a secret that I used to have a very serious drug problem. If you haven’t read it by now, my drug use started early on along with a whole bunch of high-school friends. They smoked weed, I wanted to fit in, and the rest is history.

But guess what? Most of them turned out fine.

Drug use versus addiction

Only about 3 of us ended up screwing up a major part of our lives because of our drug use. One friend died 8 years later from AIDS after finding out way too late about an HIV infection he got from shooting up heroin. Another dropped out of college and never made it back. I developed a massive habit that only grew bigger when I shifted from simply using drugs to selling them. Then I got arrested, served a year in jail and went to rehab. That sucked.

The thing is that I don’t think drugs were the source of our problem.

I’m pretty sure I’m going to get my own genetic code sequenced some time in the near future in order to certify this, but I think we all had way too much of the impulsive, rush-seeking in us to allow the rules of society to keep us down. If it wasn’t for the drugs, something else would have probably gotten us sooner or later. I know that, to date, my own love for speed (as in miles per hour) and motorcycles already got me in 3 pretty serious accidents.

What I know now is that once you start using drugs on a regular basis the issue of how you got there no longer matters. Your brain controls your behavior and when drugs control your brain, you’re out of luck without help.

Is the answer legalization or decriminalization?

I think legalization is a mistake. Making a drug legal gives the impression that the state sanctions its use. Heroin, cocaine, crystal meth, ecstasy, and yes, even marijuana cause problems for people. I think that sending any other message is dangerous.

It’s not a coincidence that most people with substance abuse problems in this country (about 15 million) are pure alcoholics. Want a guess at the second biggest group? The marijuana dependent group is about 5 million strong. The rest of the drugs pick up only a few millions in total. Any move towards the legalization of any new drugs will most likely increase their use and therefore the number of addicts.

Still, decriminalization could be the answer. I’ve been meaning to write a post about Portugal’s decriminalized system for a while and haven’t gotten around to it. The bottom line? People found with illegal drugs are given a ticket and sent before a committee. The more visits one has in front of the committee the more forceful the push towards treatment. Still, unless a drug user commits another crime aside from the  possession of drugs they aren’t sent to jail.

As it stand right now, 30%-40% of our prisoners are in for simple drug offenses. That means not only billions in wasted incarceration costs every year, but also billions and billions more useless dollars thrown away at future sentences, court costs, and more (health care, probation and on and on). As it stands now recidivism rates, especially within the addict population are at 70% or higher! Unless these people get treatment, they will go back to jail! It’s that simple. Really.

So what should we do?

Many people aren’t going to like my view point. Those of us in the addiction field are supposed to scream as loudly as possible that drug are bad and that their eradication should be a major goal of our system. I disagree. Sue me.

I think we need to put the money we’re putting into jailing drug addicts into treatment. Even if it saves no money in the present (it will) we’ll be seeing huge savings over time as less of these people go to jail, more of them earn wages and pay taxes, and less of them make wasteful use of other resources like emergency rooms and social services.

And guess what? It will make our society better. We’ll start taking care of our citizens instead of locking them up. We’ll be showing Americans that we believe they can overcome rather than telling them we’d rather see them rot in jail than help them. We’ll be cutting down the number of single parent households and along with them god only knows how many more seemingly endless problems.

That’s my story, an I’m sticking to it.

Reduce HIV Transmission – Shooting up, clean needles, and addiction treatment

Co-authored by: Jamie Felzer

We’ve talked often on this  site about many of the negative things that often come along with heavy drug use. We’ve not yet talked about any of the factors that make injection drug use even worse. Users inject cocaine, crystal meth, and heroin, or any combination of these.

Shooting up and disease

In addition to all of the other, addiction-relevant, factors we’ve talked about on here, injection drug use brings about the worry of blood borne pathogens, especially HIV and Hepatitis C.  While it may not always be easy to find clean needles or worry about cleaning a needle between uses there are steps that can be taken to reduce the risk of transmission.

1. Get Tested!!  HIV/AIDS testing is available all over the world, often for free.   Having another STD or illness can easily kill someone with AIDS. Know your status!

President Obama just finalized a plan to revoke the 22 year travel ban on those living with HIV/AIDS.  This will significantly reduce the stigma of HIV/AIDS and should bring about more testing centers and education.  See this video to hear Obama.

2. While it may not always be easy, take great care to try to check the needle for visible signs of blood before injecting. If you think the needle may have been used before, clean it with bleach or another disinfectant.

3. Utilize the free clinics around your town that give out free, clean needles.  They are there to help you!!  Use these addiction support centers for clean needles and other equipment (like the bleach I mentioned earlier).

4. Talk about it! Regardless of where you may live, the group of people you hang out, studies have shown that talking about this subject matter increases awareness and can decrease chance of infections.  Being informed is your most important tool. For more info check out AIDS Global Information or AIDS Action.

5. Get help! Treatment options are widely available and they serve as a very effective method for reducing risky behaviors.  We can offer you placement help if you’re in southern California, but even if not SAMHSA has a relatively good addiction treatment locator – Check it out.

Citation:

CAPS Fact Sheet: What are IDU HIV Prevention Needs?