About Addiction: Prescription Medication, Anti Smoking, Alcohol, Ecstasy, and Marijuana

We have the newest links about addiction. This week we feature info on cough medicine, prescription medication, smoking, alcohol, ecstasy, and marijuana. Let us know what you think and leave us your feedback.

Cough and Prescription Medication

CNN Health: The trend for kids to abuse cough medicine is either back, or never left since my days in high-school. Kids get high from a large dose of dextromethorphan, the active ingredient in Robitussin, hence the trend’s nickname “Robo tripping”.

Health Day: Substance abuse treatment admissions of prescription medication (mostly pain relievers) have increased over 400 percent during 10 years. The proportion of admissions for abusers increased from 2.2 percent in 1998 to 9.8 percent in 2008.

Anti Smoking Campaign

New York Times: According to federal officials, the nation has failed to reach its 2010 health goal of reducing high school smoking to 16 percent. They called in report for a resurgence of anti-smoking advertisements.

USA Today: New York became the first American city to require stores to post 4-square-foot warnings showing the physical effects of smoking near tobacco displays or smaller ones at each register. Last month, a few retailers and the nation’s three big tobacco companies sued the city to stop the posters.

Alcohol and Binge-Drinking

Journal Watch: Binge-drinking adolescents are 2.3 to 3.0 times more likely than non-bingers to continue this behavior into their 30s. Striking changes in brain morphology persisted even after alcohol cessation in monkeys exposed to alcohol.

Science Daily: Teens tend to increase their alcohol consumption in summer. Experts suggest parents monitor their children during summer breaks.

Cesar Fax: Of the sexually active high school students 22% reported that they used alcohol or drugs before their last sexual intercourse. Males are significantly more likely than females to report using alcohol or drugs prior to having sex.

Ecstasy and Marijuana

The Partnership: Last year Ecstasy use showed a 67 percent increase, and last year marijuana use showed a 19 percent increase, reversing a declining trend. Could decriminalization and medical marijuana be the reason?, high

Los Angeles Times: An estimated 555,000 Americans older than 12 have used Ecstasy in the last month. Ecstasy is a synthetic amphetamine that is been around for nearly 100 years. If you haven’t read about the death’s at the Los Angeles area rave EDC look here.

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.

Triggers and relapse, a craving connection for addicts

I’ve already written about one reason why cravings make quitting difficult (find it here). However, cravings and triggers are not just abstract concepts; they are well known, important players in addiction research and I think they deserve some more attention.

What are triggers?

A trigger can be thought of as anything that brings back thoughts, feelings, and memories that have to do with addiction (like a computer reminding a sex addict of porn). In addiction research, these are often simply called cues. The word comes from learning research in which a reward (or punishment) is paired with something (the cue).

For instance, in Pavlov‘s classic experiment, a dog heard a bell ring right before it would get served its daily portion of meat. The dog quickly learned to associate the bell with food, and would begin salivating as soon as the bell would ring, even before the food was presented. In this case, the bell was the cue, and food the reward it was paired with.

The story in drug addiction is similar. I’m sure many of you can relate to the overwhelming memories and emotions that seem to come out of nowhere when you hear music you used to get high to or pass a street where you used to buy drugs (or sex). Each of those examples is a trigger that is simply bringing about a similar reaction to Pavlov’s dog’s salivation. Seeing these things, or hearing them, creates an immediate response to the reward that it was paired with, the drug!

Triggers, cravings, drugs, and relapse

As if matters needed to be made worse, triggers not only bring about responses that make you think about the drug. In fact, over and over in learning and addiction research, it’s been shown that triggers actually bring back drug seeking, and drug wanting, behavior. As soon as a cue (or trigger) is presented, both animals and humans who have been exposed to drugs for an extended period of time, will go right back to the activity that used to bring them drugs even after months of being without it. In fact, their levels of drug seeking will bounce back as if no time has passed. Sound familiar?!

Given these findings, is it any wonder that cravings bring about relapse in so many addicts who are trying to quit? If simply thinking about, or hearing, something that was always tied to drugs can bring about such a strong response, what is an addict to do?

Is there a solution for addicts??

For now, the simplest way to break the trigger-response connection is simply repeated exposure without the reward. As bizarre as this may seem, staying away from the triggers can make their ability to bring back the old drug-behavior stronger. Obviously, this isn’t something that should be undertaken lightly. I’m currently working on putting together a drug treatment system that specifically addresses these issues so that with help, users can eventually release the hold that triggers have over them.

In the meantime, be honest with those around you, and if you’re seeing a therapist, or a good case manager, tell them about your triggers so that you can hopefully start talking about them, and re-triggering them in a safe environment. As always, feel free to email me with any questions you might have.

How does it all start? My thoughts on addiction causes and substance abuse

I was talking with a friend the other night, and he asked me my opinion about the line between addiction and normal behavior. He was wondering whether I think that everyone who looks at porn is a sex addict.

I don’t. (see some of our posts on sex addiction here)

Still, the conversation made me feel like writing something about my views on addiction causes. So here goes:

For the addicts who are still unaware, the line between normal- and addictive-behavior tends to blur again and again until it seems like more of faded smudge on their life. For those looking at addicts from the outside, the line normally seems so clear and so far away that they rarely believe it can be crossed back again.

I don’t personally believe that addiction per se is where things started for most people. By this I mean that no matter how hard we look, I believe that we will never find the elusive “addiction gene“, genes, or trigger.

Having been in the thick of it, I think that substance abuse is nothing but one possible outcome of set of circumstances, both biological and environmental, that lead some individuals down a particular path.

Impulsivity and other addiction causes

As I mentioned in earlier posts, addiction, at least to drugs (and I believe other addictions as well) is very closely related to a set of psychological conditions that have to do with impulse control problems.

I believe that individuals with increased impulsivity are simply more prone to putting themselves in situations that are inherently dangerous to their well-being. A simple example from non-drug related behavior might be one-night stands.

A typical person with no impulse control issues may hold off on sex if the only option was to have it unprotected. They may think to themselves “I need to stop, this could seriously affect the rest of my life.”

A person who has a reduced ability to control initial impulses may have the exact same thought and yet go through with the action, leaving them feeling remorseful and anxious the next day, but still having put themselves at risk.

This is a very common occurrence among sex-addicts. The thoughts are there, the knowledge is there, the ability to connect those to actions is seriously lacking. While some people make moral judgments about this fact, I’ve seen enough research that connects this problem to biological processes and genetics that I’m now resigned to the fact that at least on some level, the issue is physical and neurochemical.

Addiction help – Cures, treatment, and solutions

Still, I think the battle is far from lost. I strongly believe that education, informed by actual knowledge rather than misguided mythology, can put people in a better position to deal with the issues even if their source is outside of their control.

Even aside from pharmacological treatments (as in medications) that can help, there are endless ways to help people learn to be in better control of their actions once they are aware of their initial deficit. That is how AA and many other support groups function. People within them ask others about decisions they’re making BEFORE they act on them.

We know already that when it comes to drugs, the equation changes once the person starts using regularly and for long periods of time.

Chronic substance abuse further breaks down the brain’s ability to control impulses by reducing functioning specifically in the prefrontal-cortex; the part of the brain right behind your forehead which is thouught to be the center of the brain’s control tower.

The cycle seems too obvious: Impulse control difficulties leading to dangerous behavior which leads to further impulsivity issues and so on…

The treatment, like the progression of the condition itself, needs to be long. I don’t believe that any 30 day treatment program will be able to resolve a condition that took years to develop. Still, the issue of treatment will come up again here. This is enough for now…

Question of the day:
Do you have any insights from your own experiences as to how addiction develops?

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

The many different options to getting sex addiction help

We’ve talked about the fact that sex addiction (or love addiction) is defined by the inability to regulate sexual behavior despite negative consequences. We also mentioned already that it affects millions of Americans. But how does one get sex addiction help?

Addictive sexual behaviors can range from compulsive masturbation and porn watching, to compulsive cheating, to pedophilia. If left untreated, sexual addiction can severely interrupt daily functions and prevent meaningful relationships from forming. Fortunately, specialized treatment centers for sexual addiction are becoming more and more available. In fact, David Duchovny, an actor known to have sexual compulsion issues, just checked himself into one of those treatment centers.

Sex addiction help options

There are a number of behavioral and pharmacological therapies that are commonly used to treat compulsive sexual disorders. This review of sex addiction help options is not exhaustive by any means, but it’s long, so take your time:

Individual therapy can help patients address any underlying issues that may be contributing to their abnormal sexual behavior. Surveys of sex addicts show that up to 40% have anxiety disorders, 50% have substance abuse disorders, and 70% have mood disorders (1). Resolving these issues can greatly increase a patient’s chances for a successful recovery from sexual compulsion. There are many different forms of individual-psychotherapy, including Freudian, humanistic, and object centered. The important thing is to find a therapist that fits the patient’s individual style and that makes them feel comfortable.

Cognitive-behavioral therapy (CBT) is very common in treating sexual addiction. CBT teaches its patients to correct irrational thoughts, beliefs, and feelings that lead to addictive sexual behavior (1). In practice, this is often done by role playing, journal keeping, and actual workbook homework. By adopting a healthy mindset, patients can better understand their urges and prevent relapse into unhealthy sexual behaviors. CBT can be practiced within individual sessions or as a form of group therapy.

Group therapy and 12-step programs based on the Alcoholics Anonymous model provide a non-hostile environment where patients can share their experiences and provide support for each other during recovery. Shame, a major issue for sexual addiction, is often best dealt with in a group setting. (2)

Family counseling and couples counseling are also common during recovery. Counseling can help rebuild trust and intimacy that has been lost as a result of compulsive sexual behavior (3). Like individual therapy, these forms of counseling allow for a slightly more tailored, personal approach.

Drug therapy may be used in conjunction with psychotherapy to treat sexual addiction. Selective serotonin reuptake inhibitors (SSRIs) and lithium have been reported to reduce the frequency and intensity of urges to engage in addictive sexual behaviors (2). In more serious cases of sexual addiction such as sexual predation, gonadotropin-releasing hormone and chemical castration agents may be administered to reduce sexual drive. These forms of therapy can allow a reduction in the compulsions that drive the behavior, sometimes allowing the patient to better focus on the therapeutic efforts.

Sex addiction bears great resemblance to substance abuse. However, the goal in treating sexual addiction is not abstinence, but the development of healthy sexual practices (who wants a life without sex?). Compared to substance abusers, it generally takes longer for sex addicts to adopt a healthy lifestyle.

What to expect from sex addiction help

The first year is the most turbulent and poses the greatest risk for relapse as the patient is often experiencing difficulties with their occupation, relationships, or health as a result of their addiction. From the second year of recovery and onward, patients begin to regain the ability to form meaningful relationships and move forward in their personal life (4). However, patients often find that the struggle with their addiction is ongoing, at least for the first few years of their “recovery.” Considering how long it took for the unhealthy habits to develop, it’s no surprise that a substantial amount of time is often needed to reconfigure them.

The important thing is to have support and to take your time. My wife and I work with couples and individuals who struggle with sex addiction and intimacy issues and often times, in addition to the work, it requires patience and the passage of time. Success often comes on the 2nd, 3rd, or even on a later treatment attempt. If the motivation is there, the chance of beating sexual addiction is good. Keep your focus and try different options or combinations.

If you’re interested in working with us, please contact us and we will be in touch as soon as possible.

Citations:

1. Briken, P., Habermann, N., Berner, W., and Hill, A.(2007) Diagnosis and Treatment of Sexual Addiction: A Survey among German Sex Therapist, Sexual Addiction & Compulsivity,14:2,131 – 143

2. Schneider, J.P. & Irons, R.R. (2001) Assessment and treatment of addictive sexual disorders: Relevance for chemical dependency relapse, Substance Use & Misuse, 36(13).

3. Salisbury, R.M.(2008) Out of control sexual behaviours: a developing practice model, Sexual and Relationship Therapy,23:2,131 – 139

4. Goodman, A. (1998) Sexual addiction: Diagnosis and treatment, Psychiatric Times, 15(5)