Teens and drugs: Drug use statistics and treatment that works

Here are some drug use statistics:

  • Over 80% of teens engage in some form of deviant behavior (1).
  • Over 50% of high-school seniors admit to having used drugs (2).
  • Only 10%-15% of the population develop drug addiction problems related to their drug use (1).

The question is:

If the majority of teens experiment with drug use, and so few eventually develop drug addiction problems, should we be focusing on something other than stopping kids from trying drugs? Continue reading “Teens and drugs: Drug use statistics and treatment that works”

Small town heroin addicts – When drug use and overdose hit smalltown USA

We’ve already talked (see here) about the fact that well-off teens are in no way protected from the damages of drug abuse. We’ve even published a story by a reader who became addicted to heroin after another friend introduced her to snorting oxycontin pills. This recent article, published in the Washington Post, tells the story of a small Virginia town recently hit with their own small heroin epidemic.

cooking heroinWhen all was said and done, the residents of Centreville, VA would be left with 4 deaths and 16 convictions, a sad memory of the quiet town they thought they were living in.

This story is nothing if not a sad reminder that addiction doesn’t discriminate based on any factors we’re familiar with – race, money, age, or political leaning…

Click HERE for a link for some information on what to do in case someone you know is going through a heroin overdose

Addiction-brain effects: Sex addiction, neurotransmitters, and being love addicted

***A disclaimer: Sex addiction is a relatively new concept in science. I haven’t been able to find much research on the subject, so much of what is being said here is my interpretation of the current literature on sexual responsivity in humans.***

sexI’ve already mentioned that scientists are beginning to consider behavioral addictions (like gambling and sex) as being similar to drug addiction. We’ve also covered sex addiction on the site quite a few times.

Since we’d covered the addiction-brain effects of some of the major drugs’ (see here for opiates, crystal meth, and cocaine), I thought it’s time to write about the possible science behind sex addiction.

The sexual activity cycle

Scientists have divided human sexual interaction into 4 stages:

  1. Desire – Represents a person’s current level of interest in sex. It is characterized by sexual fantasies and a desire to have sex.
  2. Arousal – Includes a subjective sense of sexual pleasure accompanied by a physiological response in the form of genital vasocongestion, leading to penile erection in men and vulva/clitoral engorgement and vaginal lubrication in women.
  3. Orgasm – Involves both central processes in the brain and extensive peripheral effects. Orgasm is experienced by the peaking of sexual pleasure, release of sexual tension, rhythmic contraction of the perineal muscles and pelvic reproductive organs, and cardiovascular and respiratory changes.
  4. Resolution – The final stage of the normal sexual response cycle. There is a sense of release of tension, well being, and return of the body to its resting state.

After sexSex addicts don’t seem to have a problem with stage 3, and resolution is more like the end of sexual behavior. So we will focus the rest of our attention on the other stages 1 and 2.

Sex and neurotransmitters

While sex doesn’t involve the ingestion of substances, each of the above cycles does involve the release of many of the neurotransmitters we’ve already discussed (dopamine, serotonin, etc.).

In fact, there seem to be three major area in the brain that are activated during sex:

  1. The Medial Preoptic Area (MPOA) – This is one of the areas where all the sensory inputs to the brain converge. This. This area is crucial for the initiation of sexual response – the move from desire to arousal. It is mostly the release of dopamine within this area that supports sexual responding. Animals with lesions here can’t  mount or thrust.
  2. Paravantricular  (male) or ventromedial hypothalamus – These area are responsible for non-contact sexual responses. Dopamine is once again the main activating agent here.
  3. The mesolimbic system – Important for the motivation towards anything “good” this system is also very involved in motivation for sex, a big part of the desire and arousal stages. As with drugs, it is the release of dopamine with this system that increases the motivation for sex.

We haven’t discussed the first two area much, and from my understanding, their functioning is relatively specific to sexual response. However, we’ve certainly mentioned the mesolimbic system. This is the same system involved in the brain’s processing of opiates, cocaine, methamphetamine, and essentially all other drugs. It is also the system in charge of food motivation.

As you can see, dopamine is an activating neurotransmitter for sexual response. Serotonin on the other hand, plays an inhibitory role in sex. Through its activity on a number of brain area, serotonin reduces desire, arousal, as well as the ability to orgasm. The increase of overall brain-serotonin levels is one of the main reasons for reduced sexual responsivity in individuals who are taking SSRI antidepressants.

What about sex addiction?!

Aside from a few specific authors (like P. Carnes), scientists still find themselves struggling with whether or not behavioral addictions should be considered similar to drug and alcohol addiction or whether they are examples of compulsive, or impulsive, behaviors. I personally believe that these all share more common features than we may yet realize.

Nevertheless, for addicts, the subjective experience of a substance, or behavioral, addiction is similar. It is an inability  to control a behavior in the face of repeated negative consequences that is often accompanied by a need for more and a reduced sensitivity to the act.

Given my recent reading on the brain processes involved in normal human sexual response, I’ve developed my own early theory about sex addiction:

Given that many of the same neurotransmitters are involved in the regulation of sex, it is my belief that sexual addicts or those experiencing sexual compulsions, fall into one of two categories that probably overlap to some extent:

  1. Individuals who have reduced inhibitory capacity (like those with impulse control disorder, ADD, or ADHD for example). These individuals find themselves acting out relatively impulsive behaviors that others without such dysfunction seem to effortlessly control. Given what we know about impulse control disorders, it is no wonder that these individuals often find themselves engaging in more than one such behavior, including drug, sex, and other poossibly addictive activities.
  2. Those who’ve had sex paired with a strong neurological response – Given the important role of dopamine in all rewarding activities (what scientists call appetitive response), it is very possible that two or more rewarding experiences that are linked may increase the brain’s response to any of the individual rewards.

neurons that fire togetherLet me explain the last point: In neuroscience, there’s the concept that Neurons that fire together wire together,” which is to say that events that happen at the same time, if they are strong enough, may form their own neural networks. If something strongly negative (like violence) happens in conjunction with sex, the experience might lower sex responsivity. However, if a strongly rewarding event happens at the same time, the link might serve to enhance response for both future sexual experiences and the linked event.  The people in the first group are likely to often fall into this category due to their use of psychoactive substances. Drugs release huge amounts of dopamine, which may then become linked with sexual response, making sex seeking as strong as drug seeking.

So that’s my take, for now, on sex addiction. Like other addictions, it has to do with the exposure to a very rewarding event that in a subset of individuals ends up developing an exaggerated response or an inability to control it. Since feeling of love and intimacy can often be just as rewarding, people often refer to themselves as love addicted, and not sex addicted.

Sources:

1) A. G., Resnick, & M. H. Ithman (2008). The Human Sexual Response Cycle: Psychotropic Side Effects and Treatment Strategies. Psychiatric Annals, 38, pp. 267-280.

2) E. M. Hull, D. S. Lorrain, J. Du, L. Matuszewich, L. A. Lumley, S. K. Putnam, J. Moses (1999) Hormone-neurotransmitter interactions in the control of sexual behavior. Behavioral Brain Research, 105, 105-116.

Take Charge of your Life: Another adolescent substance abuse prevention program that doesn’t work.

In a previous post we talked about the ineffectiveness of the school-based substance abuse prevention program called D.A.R.E. (Drug Abuse Resistance Education). We reported data from a meta-analysis of 11 studies which showed no significant effect of D.A.R.E. in reducing drug use. A recently published study examined the effectiveness of another school-based program called Take Charge of Your Life (TCYL)
TCYL was developed in 1999 as part of the Adolescent Substance Abuse Prevention Study (ASAPS). The ASAPS was a response to the criticism D.A.R.E. was receiving at the time. The goal of the study was to create a more effective program that could utilize D.A.R.E. funding and resources.
The TCYL curriculum consists of 10 lessons in the seventh grade and 7 lessons in the ninth grade which are all taught by trained D.A.R.E. Officers. The TCYL lessons inform students of the personal, social, and legal risks involved with drug use and provide accurate statistical data on drug use. The general philosophy of TCYL is to actively engage students and allow them to make a choice to not use drugs. Like D.A.R.E., the TCYL courses teach communication, decision-making, assertiveness, and refusal skills.
To determine the effectiveness of TCYL, 20,000 seventh graders were enrolled in the study and followed through the ninth grade. Roughly half of these students received the TCYL curriculum while the other half did not.
The results from the study show a negative effect, where TCYL actually increased alcohol and cigarette use among baseline nonusers, compared to students who did not receive TCYL. Clearly, this is not what the developers of TCYL were hoping to see. However, what is equally interesting from the results is a positive effect, where TCYL decreased marijuana use among students who were already using marijuana when the study began. This finding reinforces the idea that people can be affected by the same program differently.
Perhaps the lesson to be learned from the mixed results of TCYL is that prevention programs need to be designed to take into account people’s individual differences. The traditional “one size fits all” approach to prevention may not be the most effective
*D.A.R.E. has not adopted the TCYL curriculum and will continue to teach the relatively new “keepin’ it REAL” curriculum, whose effectiveness has yet to be determined.

Teen smoke

Contributing co-author: Andrew Chen

In a previous post we talked about the ineffectiveness of the school-based substance abuse prevention program called D.A.R.E. (Drug Abuse Resistance Education). We reported data from a meta-analysis of 11 studies which showed no significant effect of D.A.R.E. in reducing drug use. A recently published study examined the effectiveness of another school-based program called Take Charge of Your Life (TCYL).

TCYL was developed in 1999 as part of the Adolescent Substance Abuse Prevention Study (ASAPS). The ASAPS was a response to the criticism D.A.R.E. was receiving at the time. The goal of the study was to create a more effective program that could utilize D.A.R.E. funding and resources.

The TCYL curriculum consists of 10 lessons in the seventh grade and 7 lessons in the ninth grade which are all taught by trained D.A.R.E. Officers. The TCYL lessons inform students of the personal, social, and legal risks involved with drug use and provide accurate statistical data on drug use. The general philosophy of TCYL is to actively engage students and allow them to make a choice to not use drugs. Like D.A.R.E., the TCYL courses teach communication, decision-making, assertiveness, and refusal skills.

To determine the effectiveness of TCYL, 20,000 seventh graders were enrolled in the study and followed through the ninth grade. Roughly half of these students received the TCYL curriculum while the other half did not.

The results from the study show a negative effect, where TCYL actually increased alcohol and cigarette use among baseline nonusers, compared to students who did not receive TCYL. Clearly, this is not what the developers of TCYL were hoping to see. However, what is equally interesting from the results is a positive effect, where TCYL decreased marijuana use among students who were already using marijuana when the study began. This finding reinforces the idea that people can be affected by the same program differently.

Perhaps the lesson to be learned from the mixed results of TCYL is that prevention programs need to be designed to take into account people’s individual differences. In addition to previous drug use, developers need to understand how race, gender, personality, and other individual variables affect the success or failure of their program. Without this understanding, “one size fits all” programs like D.A.R.E. and TCYL can easily end up causing more harm than good.

*D.A.R.E. has not adopted the TCYL curriculum and continues to teach the relatively new “keepin’ it REAL” curriculum, whose effectiveness has yet to be determined.

Citation:

Sloboda, Z., Stephens, R.C. , Grey, S.S., Teasdale, B, Hawthorne, R.D., Williams, J., and Marquette, J.F. (2009) The adolescent substance abuse prevention study: A randomized field trial of a universal substance abuse prevention program. Drug and Alcohol Dependence. 102(1-3)

About addiction: Exercise, stigma, marijuana, and friendhip.

Here we are again. I’ve been slacking on this, but check out the new crop of great articles about addiction. As usual, if you press the title of this post, you’ll be rewarded with our relevant posts!!!

MSNBC: Exercise may help prevent substance abuse – Here’s an article that reports on some of the findings I’d recently talked about here.

Addiction Inbox: Treating addicts like human beings – About the stigma and shame associated with addiction.

Addiction tomorrow: Marijuana – a gateway drug?

Addiction recovery basic: Friendship in recovery – Having social support and friends is important, especially when trying to make huge changes in lifestyle like quitting an addiction.

Struggling with my addiction: Recovery, addiction, and the everyday stuff

I’ve written about my own struggles with my addiction on here numerous times. I’ve used crystal meth, ecstasy, cocaine, marijuana, alcohol, LSD, mushrooms, and more, though the first few were the ones that really got me.

After an extended career as a dealer and addict, I turned a new leaf and made a new life for myself. It took a couple of rehabs and a hefty jail sentence. Still the link between my addiction and my recovery is not always strong.

My notions regarding the strong relationship between addiction and personality factors like attention-problems, impulsivity, sensation-seeking, and others comes from both my research and my personal experience. I’ve seen the genetic, behavioral, and clinical manifestations; I’ve also lived it firsthand.

I’ve always been known for doing things I wasn’t supposed to and then feeling sorry for them (or not). It was true when I was 5, long before my first sip of alcohol. Sadly, I’m realizing it is still true now and will most likely be true forever.

I can’t keep anything organized in my head. I never could. I was the kid who lost his house keys 5 times a year, forgot about midterms and finals, let alone school assignments, and who could never remember birthdays, anniversaries, or other important dates and times. These days, I’ve learned to rely on my pda/phone to help me with at least some of those things and it’s made my life much easier. But the underlying problem remains.

The problem is that I’m still impulsive and I still do things I shouldn’t. It’s a constant struggle to pull myself back, a very conscious struggle most of the time. When I say that addiction can be treated, it doesn’t mean that it actually disappears, though for me, it has certainly taken a backseat. If anything, it was after getting sober that I realized my drug use was so tied up with sex that I most likely had developed a sex addiction as well.

I’m not sober now (I drink socially), but I’m very aware of my intoxication level when I drink and rarely let it get out of hand. I can count on one hand the number of times I’ve gotten actually drunk in the five years or so since I began the forbidden “AA experiment.” It works for me, though it might not be for everyone.

The point is that nowadays, I have too much going on in my life that I love to throw it all away over getting high. My fiance, my education, and my work are important to me. The thoughts are still there, but I don’t act on them. It took a lot of work to get here and I seriously hope that I never have to put that work in again, but recovery, addiction, and my everyday stuff can still be a struggle.

You have to build the life you want and do your best to make maintaining that life a priority. It’s not easy, but it can be done. Look here for an exercise that can help you figure out what that life should even look like.

Addiction brain effects : Opiate addiction – Heroin, oxycontin and more

Okay, we’ve talked about crystal meth and cocaine and how they affect the brain during drug use. As I mentioned, both cocaine and meth interfere with the way the brain stores and cleans up important neurotransmitters, including, most importantly, Dopamine and Norepinephrine.

opiates-morphine & heroinThe class of drugs known as opiates, which includes morphine, heroin, codeine, and all their derivatives (including oxycontin), acts on the brain in a completely different manner. Since our goal at All About Addiction is to explain drug use and abuse as comprehensively as possible, let’s turn our attention to this opiate addiction next.

Heroin, morphine, oxycontin, vicodin and other opiates

While cocaine and crystal meth work by disrupting the normal functioning of molecules responsible for cleaning up released neurotransmitters, opiates work by activating actual receptors that naturally occuring neurotransmitters activate. Substance like this are known as agonists; they perform the same action (identically as, to a lesser, or greater extent) as a substance the body already manufactures.

In the case of morphine, heroin, and most other opiates, the most important receptors activated are knownOpiate Receptors as µ-opioid receptors. Activation of the µ-opioid receptors is associated with analgesia (suppression of pain), sedation, and euphoria, which makes sense given the relaxing, pleasure inducing effects of opiates.

Natural opioids (also called endogenous opioids), which include endorphins, are used by the body to relieve pain and increase relaxation, especially during periods of extreme stress. These are the chemicals that make sure we can function during accidents, like after breaking our leg…

Opioids and dopamine

Opioids also increase the amount of dopamine in the brain indirectly. As I mentioned in the earlier posts, dopamine is thought to be the reward indicator in the brain. Unlike crystal meth and cocaine, heroin and its relatives increase the activity of dopamine neurons by releasing the hold that other neurons (that use GABA) have on them. Think of this as the release of pressure on a hose spraying water on a lawn. When the pipe is pinched, only so much water can get through, but once the clasp is released, water can flow in greater quantity; this is essentially what opiates do.

Heroin addiction and long term opiate use

Like I said before, this doesn’t sound so bad, does it? All we’re talking about here is the increasing of the functioning of system that already exists in the brain. The problem isn’t so much in the process, the problem starts when this system gets activated for long periods of time.

HeroinHeroin addicts, and other frequent users of opiates complain about the extreme discomfort they feel when they stop using the drugs. This discomfort has been described as the worse case of the flu you could imagine. Doesn’t sound too appealing, does it? In fact, withdrawal symptoms associated with stopping opiate use are at least one of the main reasons many users return to the drug after trying to clean up. This in addition to all the other effects of the drug on the brain to make wanting to stop so much harder.

The reason for the pains and aches? Given the overactivation of its pain suppression system, the body not only reduces its own supply of opioids, but it also turns up the sensitivity on its pain receptors. Heroin users notice this as an increase in tolerance, but they compensate for it by simply using more. However, when they stop, they’re left with a body unable to suppress its own, hyper sensitive pain system. The results are more than uncomfortable, they’re simply excruciating…

Another common complaint of addicts is diarrhea. This, again, is simply the reversal of the constipation caused earlier by heroin’s actions on opioid receptors that are present in the peripheral system (outside the central nervous system).

I’ve heard addicts speak online about the slow recovery from opiate addiction and I want to dispell a myth here:

Opiates DO NOT stay in your system for weeks or months – The drug itself is gone from the body within days. The reason for the continued suffering is the slow adjustment of your brain and body back to the way things were before the drugs. Think of how long the tolerance took to develop… Now play the tape back in reverse. That’s what happening to you. You can help relieve the pain, but know that if you use anything in the opiate family, you’re making the process last much longer…

So, in summary: As usual, the actions of opiates on the body and brain are not all the severe, extreme, or inappropriate. Opiates are still used in medicine for pain suppression, not only because they work, but because the potential for abuse when used in this way are minimal to non-existent. However, as with all drugs, continued, chronic, abusive use of opiates will change the way your body functions in ways that will produce the exact opposite effects of those users like so much. This leaves people not only with possible addiction problems, but also with a terrifyingly uncomfortable return back to normal functioning.

Addiction help

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