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”

Bath Salts – Pressing the Issue

Q &A – Dr. Adi Jaffe PhD Interviewed By Tony O’Neil of The Fix

“A man was attacked on the side of the highway, authorities find the attacker eating a the victims face, and only after multiple bullet wounds is the attacker stopped.” This Zombie-like behavior is common in Hollywood scary movies, but as of late the new “Bath Salt” epidemic has turned places is like Miami into a real life Zombieland, or at least that’s what we have been told.

UPDATE: We now know that the assailant in this case (Rudy Eugene) had only traces of marijuana in his blood and no evidence of bath salts use. However he was previously diagnosed as schizophrenic and we know that especially for those at risk, marijuana use is associated with psychotic breaks.

What are “Bath Salts”?

Bath Salts are a street name given to a number of meth like drugs, so we’re not talking about your everyday Epson salt here. Although drugs like MDPV have just been made illegal, most of these substances seem to be cathinone derivatives and are central nervous system stimulants that act through interruption of dopamine, norepinephrine and to a more limited extent serotonin function.

It’s very important to note that research on this is still in its early stages and so reports are limited. However, it seems that at low to moderate doses the most common effects for MDPV can be thought of as either meth-like or like very strong adderall or ritalin – so users experience stimulation, euphoria, and alertness. Mephedrone seems to act more like MDMA (ecstasy) than meth, at least in early animal research with these drugs. At high doses however, and obviously there is no one regulating the dose since these drugs are sold as if not for human consumption, the effects can look like psychosis. These are not necessarily very different from meth induced psychosis which can include panic attacks, severe paranoia, self-mutilation, and violence.

There are several confirmed research reports (individuals who had only MDPV in their system) of people injecting or snorting MDPV and developing severe psychosis, “running wildly throughout the local neighborhood,” foaming at the mouth and being combative when approached. Worse still, these individuals can develop severe organ failure, require intubation (breathing tube insertion through throat), and at times die even in the face of extreme medical intervention.

How do Bath Salts affect the nervous system?

These drugs tend to be sympathomemetic, which means they induce sympathetic nervous system activation – the increased heart rate, temperature, etc. This is also where they can be most dangerous even when people don’t develop the possible psychotic effects (due to organ failure from the hyper activation).

Can one become addicted to Bath Salts?

I think that there’s no question that this stuff can cause physical dependence. I personally know of a client at matrix here in west la who came in specifically for “over the counter stimulant addiction” to drugs like these. He was snorting, then injecting them and stayed up for days. Eventually he was hospitalized with severe agitation and mild psychosis. These high doses are almost certainly, based on what we know with meth and MDMA, also causing neurotoxicity (some of the effects irreversible).

What Harm Reduction model should be used for Bath Salts?

It seems that MDPV and mephedrone are indeed drugs worth worrying about, at least in so much as they are completely unregulated when sold “not for human consumption.” While their effects at low/moderate doses are not severe are can be thought of as related to those of other stimulants, at high doses they can be lethal and can certainly bring about serious negative psychological effects. I always think that there is some room for harm reduction when trying to get some control over abuse of such drugs. In this case, while it’s probably best to stay away completely, I would urge people who are going to use to be careful and not to use large amounts of this stuff before seeing how they react. The neurotoxicity and cardiac effects can be too extreme and may lead to severe irreversible consequences at high doses.

How can the media help resolve this epidemic?

Press coverage always makes more people aware of an issue than they were before the topic was covered. In this case, especially if we can sneak in some of the above harm-reduction messages along with the overall “don’t use this stuff” text we normally see, we might be able to use the opportunity to save some lives. I think, as I’ve said before, that people (especially kids) are going to be on the lookout for ways to change their experience no matter what. The question is how we react when they do things we don’t like and how does our reaction affect their future behavior.

I think that we can use the real information – possible death and psychosis, especially when snorted or injected – to alter the ways people use Bath Salts, allowing for a campaign that isn’t only looking to stop the use of the drug but that is focused on minimizing consequences. However it seems that the press isn’t covering the range of possible effects but is choosing instead to focus on the most outrageous. These types of scare tactics haven’t worked too well in the past for curving drug use, but it doesn’t hurt TV ratings so I don’t expect it to stop.

Will banning bath salts help?

I believe that in this case, as we can already see, we are once again going to be playing a cat and mouse game that congress seems happy to play. They’ll outlaw more components of Bath Salts (MDPV, mephedrone, and methylone apparently already are controlled) but new ones will continue to come out. To me, the question is whether we believe we will one day ban all psychoactive substances we have issue with or whether we will be successful in developing a strategy for dealing with their abuse in a way that helps recognize and intervene early.

I think that the banning approach makes it less likely that people with abuse problems, or even acute medical problems, will contact authorities for help. Worse yet, it makes it nearly impossible for us to get a handle on safer use practices for a specific drug as they all get replaced by new variations – often ones that are even more dangerous.

Although the press has made the Bath Salt epidemic much more like a Hollywood production than reality, there are issues that need to be addressed. I just don’t believe in scaring the public into action, I’d prefer if popular media were just honest with the public about these drugs so that people can draw their own conclusions.

The Creative Theory of Addiction Recovery

This is a guest post from Patrick Meninga of the Spiritual River website.

Since I first got clean and sober over 8 years ago, I have been creating a new life for myself. Talking about creation makes sense when I frame my recovery and how I have grown through the years, because it was always through deliberate change and deliberate action that I can look back and see how I have progressed in my personal growth.

Creation is a mindset in recovery….it is the attitude that is adopted by the winners in recovery. It doesn’t matter what exact program of recovery someone is working, be it the 12 step program or something else entirely. The winners in recovery, the people who are staying sober over the long run and really making growth in their recovery, they are the ones who are actively creating.

Creation goes beyond spiritual growth and takes more of an holistic approach. Essentially you have to treat the entire person for addiction, not just the spiritual malady. This is an important distinction because if you do not think in holistic terms then you might shut yourself off to possible avenues of growth in other areas of your life.

The creative mindset can help you to have a stronger recovery, by pushing you to grow in new ways. What then, are the critical steps to creating this new life for yourself? Let’s take a look:

1) Start with abstinence. Make this your number one priority and then start building on it. Early recovery is an awesome thing, because simple abstinence from drugs and alcohol can start opening up so many doors, so quickly. (This is why it’s called recovery, because you start recovering things you had previously lost: relationships, self esteem, perhaps a job, and so on). Make abstinence from drugs and alcohol the foundation of your recovery. Create a zero tolerance policy with yourself–that you will not use drugs or alcohol no matter what.

2) Use overwhelming force. I highly recommend that newcomers in recovery use this concept in order to make it through early recovery. The idea is to take whatever you think it is going to take in order for you to stay clean and sober and multiply it by ten. Examples:

* Don’t just go to treatment, go to long term treatment.

* Don’t just go to a meeting, go to a meeting every day (or several meetings a day).

* Don’t just go to a therapist, go to a therapist and actually act on the direction they give you.

You have to go above and beyond what you think is necessary in order to get through early recovery. So many people underestimate what it will take to stay clean, so you have to overcompensate in the other direction. Go big.

3) Focus on networking in early recovery. In early recovery, networking with others is of critical importance. We need help and support in order to recover. We also need to gain new knowledge.

4) Shift your focus as you progress to one of personal growth. Networking becomes less important at 5 years sober and even less so at 10 years. This does not mean that it is no longer a factor, it just becomes less important for you to network in order to stay clean and sober. As you progress, your own growth and personal development becomes a bigger part of how and why you stay clean. Therefore, you should motivate yourself to start growing holistically as you progress in your recovery. In other words, seek to grow in different areas of your life.

5) Focus on health. You should start treating yourself better in recovery as your self esteem repairs itself over the years. We abused ourselves for so long in addiction and that takes time to heal. Again, use a holistic approach. Seek to grow spiritually, but also start exercising, improve your diet, quit smoking, and so on. Look at your overall health and take care of your emotional well being as well.

This is important because one of your biggest insurances against relapse becomes your self esteem. If you feel good about yourself and value your life highly then it becomes less likely that you will relapse. Therefore, make it a point to take care of yourself in as many ways as possible. Live healthy in recovery and this help you in the fight against relapse.

6) There is only one hurdle in long term recovery: to overcome complacency. This is your only real hurdle as you move into long term recovery. You have to somehow be actively on guard against the subtle threat of relapse through becoming complacent. So how can you do that?

Push yourself to grow. Push yourself to learn new things. And here is one of the big shortcuts that will really help in overcoming complacency: continue to work with other recovering addicts and alcoholics on a regular basis. If you do this consistently and make a habit of it, then your recovery will be a lot stronger because of it.

If you start using some of these ideas and follow these strategies in your recovery, then you will notice after a while that you really have been creating a new life for yourself. It is not enough for us to simply get sober and sit around being passive all day….we need to get active, get involved, have a vision of some sort (a vision of helping others is particularly powerful). Take the idea of creative recovery and try to work it into your life, and you will start noticing the benefits right away.

Patrick Meninga is a recovering addict who writes at the Spiritual River about addiction recovery. Check him out if you are interested in learning more!

Promising new medical treatment options for drug addiction!!!

Researchers are attacking the issue of drug addiction from multiple angles, and the results seem to be more and more ways to help. Some promising new developments in pharmacological (as in medication) therapies include a new cocaine-vaccine, as well as expanded use of Buprenorphine, for the treatment of opiate (heroin, morphine) addiction.

  • These medications are best used along with behavioral treatment in order to increase to probability of treatment success.
  • By reducing cravings, as well as reducing the effects of the drugs themselves, these medications can increase the length of time that patients will stay in treatment, which is the most reliable way of producing better treatment outcomes.

What else is new aside from medications?

There are also some exciting developments in the behavioral treatment, including Contingency Management (CM), a treatment method that tries to reteach addicts positive, drug-free behaviors by reinforcing those over the use of drugs. While some people still have problems with programs that use CM because of the notion of rewarding drug addicts for not using drugs, I say use whatever works!

Lastly, as early as 2003, researchers have noted that proper drug treatment may take longer than the 14-30 day programs that are currently being offered (1). In fact, while the article I’m referring too speaks specifically about methamphetamine addiction, we now know that the long use of many drugs, including cocaine, leads to long lasting brain changes that can take up to a year to show significant recovery.

I personally think that proper drug treatment for long time addicts (anyone with more than a year or so of heavy use) should take on the order of 6 months to a year, and should be supplemented by some outpatient post-care for an extended period of time (I’m far from the only one calling for this, see article 2). It’s the only sensible thing to do given the long term changes that such drug use creates in the brain…

I think it’s about time that insurance companies step up the plate and recognize that the huge cost of drug problems for our society (estimated at more than $100 billion annually) can be vastly reduced by providing sound, scientifically based, medical treatment options for those who need it.

citations:
(1) Margaret Cretzmeyer M.S.W, Mary Vaughan Sarrazin Ph.D., Diane L. Huber Ph.D., R.N., FAAN, CNAAc, Robert I. Block Ph.D. & James A. Hall Ph.D., LISW( 2003) Treatment of methamphetamine abuse: research findings and clinical directions. Journal of Substance Abuse Treatment Volume 24.
(2)
A. Thomas McLellan, PhD; David C. Lewis, MD; Charles P. O’Brien, MD, PhD; Herbert D. Kleber, MD (2000). Drug Dependence, a Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation. Journal of the American Medical Association, Volume 284, pp. 1689-1695.

Question of the day:
Do you know anyone who’s been through residential drug treatment?
How long were they in for?
How many times?
Did it help?

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.

How much alcohol is too much drinking? Knowing your BAC can be key!

There has been some research suggesting that training people to better estimate their Blood Alcohol Content (BAC), can help reduce accidents and improve risk-taking while drinking among college students (see here and here respectively).

I’m including a recent piece from one of our readers, telling us about her first over-21 drinking experience in Las-Vegas. I think this story exemplifies that young adults may often consume more alcohol than they are aware of while underestimating its effects Continue reading “How much alcohol is too much drinking? Knowing your BAC can be key!”

The appeal of anonymous internet sex – Weiner is not alone

I’m going to come right out and say it – I’ve been in Anthony Weiner’s shoes.

Anthony Weiner resignsFortunately for us, my family and I didn’t have to go through all of this on public television and no-one asked me to resign my position because my sexual misdeeds were never publicized. But after all my efforts and successes quitting the drug addiction that had plagued my life I had to deal with a darker, more secret, set of issues that almost brought down everything I’d worked so hard to build. Sex can be tricky.

So yes, somewhere out there are explicit pictures I sent to women I met online although I had long ago erased the sexy pictures they had sent my way. It was part of the purging process I went through with my wife as we tried to build our trust after a simply devastating betrayal; a long purging process that to some extent is still going on more than a year after everything came out. Like I said: Sex – tricky.

The day I was found out was probably the most embarrassing, gut-wrenching, ego-shattering day I will ever experience. It trumped going through a cavity search on my way to jail or seeing my family in the courtroom as I plead guilty to count after count in my drug case. There’s nothing quite as humbling as standing in front of the person you love admitting you betrayed them, lied to them, and did so repeatedly with multiple people.

A number of pieces I read on the topic suggested that feeling “hot” or “sexy” was the most important factor in Weinergate prompted me to write this piece even though I’ve obviously been mulling this over since the whole Weiner-sex thing became public. There is no doubt that impressing these random women and getting their approval of my sexuality was an important part of the appeal for me and it’s true that this is not something many men experience in their everyday life. Still, I don’t think it was the only part and it certainly didn’t feel like the most important.

As I’ve written about numerous times in regard to my drug use and addiction, I have impulsivity issues. I always have and likely always will although I’ve learned to function relatively well with them. The problems arise when the behaviors I engage in are kept private and for me, online sex-chatting with women was a pretty normal thing that had started in the days of MySpace and continued on unabated. The problem was that I obviously wasn’t going to let anyone in on the extent of it. When I would get in relationships online chatting would take a backseat,  but it never really disappeared.

There’s something appealing, at least for someone like me, about the idea of unattached women who are ready to act a little “dirty” whenever we were both in the mood without really expecting anything in return. The more involved I got the more resources I found for finding these women and the more effort I put into impressing them so I could get what I wanted in return. In some ways, it gave me a way to hold onto the freedom of being single without having to cross some imaginary physical boundary I had convinced myself was the real version of “cheating” I knew I wasn’t to cross (full disclosure – I’d already done that).

When you combine a long single life, the immediate gratification of online sex-chatting/image-swapping, and bad impulse control you end up with some pretty messy results. I ended up using every opportunity I could to get a glimpse of the next picture a woman sent me, read an explicit message, or follow up on a response to a picture I’d sent. I no longer had drugs and this semi-anonymous sex was my quick fix. The rush was very similar and given the relationship between my old meth use and sex it makes a lot of sense.

At first I’d diagnosed myself as a sex-addict, which seemed fitting given my experience with drugs and my previously-mentioned impulsivity. Now I think that at least a good portion of it has to do with the above influences along with a pretty distorted view of the male-female relationship I had put together from my early exposure to porn. But I’ll leave at least some of that to a later date.

For now, whether it offends others or not, I feel Anthony Weiner’s pain. I am almost certain that as deliberate as this behavior seems to everyone else it had become so compartmentalized in Anthony’s head that even he didn’t know the extent of it. Shameful, taboo, and somewhat compulsive behaviors tend to do that. I know they did for me. I hope he gets to keep his family as I got to keep mine. It took a lot of work and understanding from my amazing wife, but it’s possible. Sex is tricky, especially when it’s secret.