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”

Addiction stories: How I recovered from my addiction to crystal meth

By the time I was done with my addiction to crystal meth, I had racked up 4 arrests, 9 felonies, a $750,000 bail, a year in jail, and an eight year suspended sentence to go along with my 5 year probation period. Though I think education is important to keep getting the message out about addiction and drug abuse, there is no doubt that addiction stories do a great job of getting the message across, so here goes.

My crystal meth addiction story

The kid my parents knew was going nowhere, and fast. That’s why I was surprised when they came to my rescue after 3 years of barely speaking to them. My lawyer recommended that I check into a rehab facility immediately; treating my drug abuse problem was our only line of legal defense.

cocaine linesI had long known that I had an addiction problem when I first checked myself into rehab. Still, my reason for going in was my legal trouble. Within 3 months, I was using crystal meth again, but the difference was that this time, I felt bad about it. I had changed in those first three months. The daily discussions in the addiction treatment facility, my growing relationship with my parents, and a few sober months (more sobriety than I had in years) were doing their job. I relapsed as soon as I went back to work in my studio, which was a big trigger for me, but using wasn’t any fun this time.

I ended up being kicked out of that facility for providing a meth-positive urine test. My parents were irate. I felt ashamed though I began using daily immediately. My real lesson came when I dragged myself from my friend’s couch to an AA meeting one night. I walked by a homeless man who was clearly high when the realization hit me:

I was one step away from becoming like this man.

You see, when I was in the throes of my crystal meth addiction, I had money because I was selling drugs. I had a great car, a motorcycle, an apartment and my own recording studio. After my arrest though, all of that had been taken away. I just made matters worse by getting myself thrown out of what was serving as my home, leaving myself to sleep on a friend’s couch for the foreseeable future.

Something had to change.

homelessI woke up the next morning, smoked some meth, and drove straight to an outpatient drug program offered by my health insurance. I missed the check-in time for that day, but I was told to come back the next morning, which I did. I talked to a counselor, explained my situation, and was given a list of sober-living homes to check out.

As I did this, I kept going to the program’s outpatient meetings, high on crystal meth, but ready to make a change. I was going to do anything I could so as not to end up homeless, or a lifetime prisoner. I had no idea how to stop doing the one thing that had been constant in my life since the age of 15, but I was determined to find out.

When I showed up at the sober-living facility that was to be the place where I got sober, I was so high I couldn’t face the intake staff. I wore sunglasses indoors at 6 PM. My bags were searched, I was shown to my room, and the rest of my life began.

I wasn’t happy to be sober, but I was happier doing what these people told me than I was fighting the cops, the legal system, and the drugs. I had quite a few missteps, but I took my punishments without a word, knowing they were nothing compared to the suffering I’d experience if I left that place.

Overall, I have one message to those struggling with getting clean:

If you want to get past the hump of knowing you have a problem but not knowing what to do about it, the choice has to be made clear. This can’t be a game of subtle changes. No one wants to stop using if the alternative doesn’t seem a whole lot better. For most of us, that means hitting a bottom so low that I can’t be ignored. You get to make the choice of what the bottom will be for you.

You don’t have to almost die, but you might; losing a job could be enough, but if you miss that sign, the next could be the streets; losing your spouse will sometimes do it, but if not, losing your shared custody will hurt even more.

At each one of these steps, you get to make a choice – Do I want things to get worse or not?

Ask yourself that question while looking at the price you’ve paid up to now. If you’re willing to go even lower for that next hit, I say go for it. If you think you want to stop but can’t seem to really grasp just how far you’ve gone, get a friend you trust, a non-using friend, and have them tell you how they see the path your life has taken.

It’s going to take a fight to get out, but if I beat my addiction, you can beat yours.

By now, I’ve received my Ph.D. from UCLA, one of the top universities in the world. I study addiction research, and publish this addiction blog along with a Psychology Today column and a number of academic journals. I also have my mind set on changing the way our society deals with drug abuse and addiction. Given everything I’ve accomplished by now, the choice should have seemed clear before my arrest – but it wasn’t. I hope that by sharing addiction stories, including mine, we can start that process.

More money more problems? Rich teens and drugs

Teens raised in affluent homes display the highest rates of depression, anxiety, and drug abuse according to a recent article in Monitor on Psychology, the APA‘s monthly magazine.

One of our recent posts dealt with some of the issues unique to teens and drugs. In addition to the issues we’d already mentioned, the article named a number of reasons for the high prevalence of mental-health issues among affluent teens. Among them were an increasingly narcissistic society, overbearing parents, and an common attitude of perfectionism.

Each of these reasons are likely contributors to the prevalence of mental health and drug abuse issues among upper-middle-class (and above) teens. Still, as far as I’m concerned, the main take home message of the article is this:

Money truly doesn’t buy happiness – Rich teens and drug use.

While drug abuse research often focuses on the lower socioeconomic strata these recent findings indicate that being financially stable offers little in the way of protection from some of the most common psychological difficulties.

Thankfully, the researchers cited in the article gave some simple advice to parents:

  • Give children clear responsibilities to help around the house.
  • Take part in community service (to unite the family and reduce narcissism).
  • Reduce TV watching (especially of reality TV shows that glorify celebrity and excess).
  • Monitor internet use.
  • Stop obsessing about perfect grades and focus instead on the joy of learning for its own sake.

I couldn’t agree more with these recommendations. Having taught a number of classes myself, I have witnessed the ridiculous inflation in students’ expectations of top grades. I think it’s time we turned attention back to the family and reintroduce some of the basic skills that many addicts find themselves learning much too late… Often in recovery.

The brain after cocaine – White matter damage and addiction treatment

The brain damage left behind after long-term cocaine use can apparently tell us quite a bit about how well a cocaine addict will do in addiction treatment – as long as we assess the right kind of damage.

Different kinds of brain matter

I’ve talked before about the fact that use of cocaine, and other drugs, can bring about long-term changes in the brain that sometimes include the actual destruction of neural pathways. What you may not know is that brain matter consists of several different components including the cell bodies of neurons (known as gray matter) and the tracts of axons that transmit messages across the brain (known as white matter). There are other parts as well, but those are the two important ones to know for this article.

Gray matter is important because brain transmission isn’t possible without a cell body, which is its operations center. But white matter is equally important because without it, the messages don’t get anywhere. It’s like having a telephone without a communication network – The phone can work perfectly and no one will ever hear you speak.

Until recently, it’s been pretty hard to measure the structure of white matter because it consists of very thin bands that twist and turn throughout the brain. But recent advancements in fMRI imaging and analysis have allowed us to look at it by measuring the direction in which water molecules flow through white matter. It’s called DTI (Diffusion Tensor Imaging) and it’s pretty complicated, but all you need to know is that it lets us know a lot about the integrity of axons in the brain.

White matter and cocaine

Use of cocaine has already been shown to cause damage to brain white matter. A recent study conducted at Yale examined whether the degree of damage can tell us anything about how well people will do in addiction treatment. Researchers took 16 participants and gave them a host of tests as well as some brain scans before sending them off to an 8 week treatment program. The addiction treatment utilized was outpatient and provided different individuals with different combinations of CBT, medication (antabuse), individual, and group therapy. At the end of treatment, the number of clean urine tests (out of 56 total tests) was used as a measure of treatment success. The more clean urines, the better, something I think we need to adopt overall instead of the all-or-nothing view that abstinence is the only form of improvement.

The bottom line: Using three different measures, the researchers found that individuals with more damaged white matter provided less clean urines throughout the addiction-treatment period. Another important fact – the damages areas that were found to be associated with treatment success were found all over the brain. Interestingly, brain damage wasn’t associated with the length of drug use, but it may have been associated with the extent of use (in terms of years and amount used), something the researchers didn’t report on.

Brain matter and addiction treatment outcomes

One day, we’ll have a battery of tests that will let us tailor treatment more effectively towards specific addicts. Genetics, brains scans, and more, will be able to tell us where an addict is especially weak so that we can focus on those areas first. Some may need specific help with impulsivity and weakened learning systems whereas others may be better off with treatment that addresses past trauma and an oversensitive stress response system.

As this research shows, brain scans can offer us a glimpse into the aspects of an addict’s brain that have been compromised. But we’re not there yet – right now, all we know is that certain genes, brain function patters, and experiences, are associated with a greater risk for addictive behavior or a lower chance of recovery. Getting better at more specifically tailoring treatment is still a little farther than we’d like.

Citation:

Jiansong Xu, Elise E DeVito, Patrick D Worhunsky, Kathleen M Carroll, Bruce J Rounsaville & Marc N Potenza (2010). White Matter Integrity is Associated with Treatment Outcome Measures in Cocaine Dependence, Neuropsychopharmacology 35, 1541–1549.

Drug use cravings, obsessions, and trying to get clean…

When I first got sober, everything I thought about had something to do with drugs. It wasn’t just that I always thought of getting high, but everything in my life was tied to drugs, especially crystal meth.

Adi Jaffe playing music now sober

My drug use centered life

I used to make music in my studio, but I was always smoking crystal meth while doing it; I had a few girls I was “seeing,” but I got high with almost all of them (if they weren’t into it, I’d sneak a smoke in the bathroom alone). Every one of my friends was on drugs. I paid my rent with cocaine, made my money from selling anything you could think of, and overall, was simply surrounded by the stuff.

The drug use to craving connection

If you haven’t heard about this yet, memories are reconstructions of the past. When you remember something, your brain doesn’t just pull it out of some secret drawer like you were told when you were a kid. Instead, the different areas of your brain involved in making the memory (like your visual cortex, your olfactory bulb, and your language areas) light up all over again, re-exposing you to those same old thoughts, feelings, and senses.

Knowing that, it’s not surprising that cravings are so difficult to handle. Who wants to re-experience getting high with their best friend, their girlfriend, or in their favorite place over and over while trying to get sober? It’s literally maddening, sometime to the point where you just say “screw it” and run out to do it all over again (as in relapse).

I told my sister the other day that when I think about smoking glass (another name for crystal meth), the thing I miss the most is the white puff of smoke that fills the room. We used to call it “Dragon’s Breath” and I was pretty talented at producing the biggest clouds. It freaked her out a little to know that I could possibly still miss something about meth after everything that happened.

Even though I felt that it was necessary to calm her, I know that the addicts reading these pages know what I’m talking about. Of course I still miss smoking  crystal meth sometimes; Given everything I now know about drugs, which is a lot given the fact that I’ve spent 8 years studying nothing but drugs, I’m surprised I don’t miss the stuff more.

Drug use, reward, and what’s next

Almost every drug I know of eventually gets down to activating your reward center. Meth does so in a way that’s so extreme (like I said in an old post, it literally floods your brain with DA), that I’m surprised I ever managed to come out of it. I definitely know why it felt like such hard work.

So when a craving comes, don’t think of it as a sign that your failing. If that were true, there would be no survivors of addiction. Instead, recognize what your brain is doing, allow it, then think about the changes you’re trying to make. As the memory gets reconstructed, those new aspects you’re thinking about, those that have to do with your recovery and the positive changes you are making, will incorporate themselves into those old memories.

This, along with everything else you’re doing, will make the cravings less and less threatening, allowing you to stay sober even when they come through.

Time to get high- Circadian rhythms and drug use

Contributing Co-Author: Andrew Chen

Like most living creatures, humans have internal biological clocks known as circadian rhythms. These internal cycles synchronize our bodies with the Earth’s 24-hour day/night cycle and prepare us for predictable daily events (1). Circadian rhythms regulate a number of bodily functions including temperature, hormone secretion, bowel movements, and sleep (2). Recent research suggests that drug use may disturb our circadian rhythms, possibly influencing our decisions to take drugs.

Moon

Environmental drivers of drug use

Our biological clocks are set by external cues from the environment, called zeitgebers (3). The most familiar to us are light and food. However, research on rats has shown that opiates, nicotine, stimulants, and alcohol also have the ability to alter the phase of circadian rhythms independent of light or food (1). Drug use has long been associated with major disruptions in the human sleep cycle. Cocaine, crystal meth, and MDMA users often go without sleep for days, and these sleep disruptions can continue long after people stop using drugs. In fact, sleep disturbance outlasts most withdrawal symptoms and places recovering addicts at greater risk for relapse (3).

The rhythm of drug use

Circadian rhythms could also be the reason why people show 24-hour patterns of drug use. A study of urban hospitals found that overdose victims are admitted to hospitals more around 6:30PM than any other time of the day (2). Fluctuations in drug sensitivity, effect, and reward value are believed to be regulated by genes that control circadian rhythms. In other words, our biological clocks are telling us when to get high.

Researchers are just beginning to explore the relationship between circadian rhythms and drug use. Future understanding of this relationship will help us explain how drug addiction develops and develop better ways to treat it. It’s possible that offering specific aspects of treatment as certain point in the circadian rhythm can improve the probability of success.

Citations:

1. Kosobud, A. E. K., Gillman, A. G., Leffel, J. K., Pecoraro, N.C., Rebec, G.V., Timberlake, W. (2007) Drugs of abuse can entrain circadian rhythms, The Scientific World Journal, 7(S2), 203-212

2. McClung, C.A. (2007) Circadian rhythms, the mesolimbic dopaminergic circuit, and drug addiction, The Scientific World Journal, 7(S2), 194-202

3. Gordon, H.W. (2007) Sleep, circadian rhythm, and drug abuse, The Scientific World Journal, 7(S2), 191-193

80s style is back, cocaine use included!

Everyone knows that trends come back around, and with the resurgent popularity of gigantic sunglasses, eye-bleeding neon, electronic music and metallic spandex (or so we at A3 are told), it seems that the 1980’s have firmly replanted their flag in the public consciousness, down to a sequel to that seminal testament to 80’s excess, Wall Street, in theaters later this summer. Of course, as that film and many more were quick to point out, much of that characteristic 80’s exuberance was derived from an illicit, dangerous, source, and that too, it seems, is making something of a comeback.

Cocaine use is growing in Florida

A study of data collected at the University of Florida has shown that cocaine use in their area seems to have doubled since the beginning of 2000, according to a number of key measures used to assess drug use. The report notes that the number of cocaine deaths per capita in the first half of the decade almost doubled (from 150 per 100,000 in 2000 to nearly 300 in 2005). And the study is quick to point out that these cases are coming disproportionately from college-towns and opulent upper-class communities, evoking the very 80’s image of the white powder as an infamous vice of choice for the rich and privileged.  The phenomenon seems to be global, with law enforcement and public health officials from Sydney to Dublin sounding the alarm; here in the United States, a 2008 National Survey on Drug Use and Health said that approximately 36.8 million Americans, 14.7% of the population aged 12 and older, had tried cocaine at least once in their lifetimes.

Past effects of surges in cocaine use?

For many of these Americans, that “once” (or perhaps more) probably occurred in the early to mid 1980s, during the so-called “Cocaine Crisis.” During this period, rising rates of abuse (both of powder cocaine and crystallized/crack form), the subsequent surges in both crime and serious health complications and the related emerging research on real addictive and dangerous properties of the drug all combined to petrify the media, polarize the population and spur the government into aggressive, often misguided action to combat what was seen as a rapidly growing threat.

As several articles note, the cocaine-related deaths of high-profile celebrities such as John Belushi and basketball star Len Bias (whose death was of particular significance to the alarmists, as it was alleged that it was his very first time using the drug) shattered the previously widely held view of cocaine as a harmless and non-addictive substance. Despite the oft-repeated cliché that cocaine was once so commonplace that it was a Coca-Cola ingredient , it bears remembering that there were still grave misconceptions about its potency less than 30 years ago.

Cocaine use, cocaine treatment, and the future

Clearly, the drug problem as it relates to America in particular has much to do with the political and criminal elements that complicate our own mission, which aligns more closely to the assessment and treatment of addicts in the manner best for their own health and the overall benefit of society. Even in a vacuum, however, cocaine is a highly addictive, extremely dangerous drug, and even if a relatively small percentage of those who try drugs end up categorically addicted to them, a doubling of use is a potential doubling of people addicted, which might be the most disturbing 80’s comeback not involving Boy George.