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.

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!”

Addiction stories: Hellish Heroin – Bambi’s heroin addiction story

Opiate Addiction can be a horrible thing whether it's to heroin, hydrocodone, oxycontin, or any one of a number of available opiates. This is only the first in a series of addiction stories we will have on the site.Addiction stories seem to have an impact that objective research can never have. This is another in a series of addiction stories submitted by our readers. I hope that everyone will benefit from learning about others’ experiences. There’s no doubt that Bambi’s experience of escalation in use from what seemed initially innocent is a common one. If you, or someone you know, needs help with their opiate addiction, try our rehab-finder for the best way to get reliable, verified, rehab recommendations.

A harrowing tale of heroin addiction:

When most people hear the word heroin, some things come to mind. Those of you who have never even thought of doing a drug like heroin, would never understand. And for those of you who you know who you are, whether you have found your way out, or are slowly still slipping away… Believe me, if you know who you are, then you know how it is. Realizing you’re addicted to something doesn’t hit you, until you mentally find your way out by accepting what has happened and letting go with only one hell of a memory. Continue reading “Addiction stories: Hellish Heroin – Bambi’s heroin addiction story”

Ray Charles – The movie, the legend, and the heroin addict

The movie Ray told the amazing story of an artist who struggled with heroin addiction and won.In 2004, only a few short months after Ray Charles passed away, Hollywood celebrated the life and legacy of the legendary R&B singer in a critically acclaimed biographical film. Anchored by a stunning performance by Jamie Foxx, “Ray” would go on to win two Academy Awards and introduce a younger generation to a giant of American song. But director Taylor Hackford’s most impressive feat may have been the film’s nuanced, evenhanded portrayal of Charles’ behind the scenes battle with serious heroin addiction.

In the attempt to portray his life in full, the film starts, appropriately, at the beginning, with a young Ray Charles Robinson growing up in the poverty of 1930’s Georgia. With his hard-working mother emphasizing the strength and resilience he would need to make it in an unforgiving world, a young Ray would find his fortitude tested immediately, when he witnessed his younger brother’s accidental drowning, a scene that would haunt him for the rest of his life. When he began to lose his vision shortly thereafter, his mother challenged him to overcome it, telling him that it was up to him to never let anyone or anything make him into a cripple.

In response, Ray was able to channel his energy into his earliest love: the piano. By 1948, he was performing at bars in and around the Seattle area. It was here that he was first introduced to drugs in the form of marijuana, which venue promoters would offer him in order to calm pre-performance nerves. As he signed a record deal and hit the road in support of his career, the stresses of life on tour began to sink in. With that came depression, and what that, drugs. Plagued by flashbacks of his brother’s death, he found two new ways to escape- women, and heroin.

Though marriage, children and skyrocketing career success could have all potentially acted as stabilizing factors for his life, Ray’s depression and guilt over the death of his brother had taken hold, and he was now as addicted to womanizing as he was to heroin. Neither would prove to be beneficial for his long-term stability, as his wife would discover both in short order. Heroin addiction, as Ray was to find out, is never something you can keep on the side.

Neither, it seems, were the women. By 1956, Ray Charles had brought one of his lovers- a backup singer named Margie- into his band, and his life. When an unexpected pregnancy pushed their relationship to the breaking point, he had inspiration for one of his most famous songs (“Hit The Road, Jack”), but it was to serve as yet another signpost along his road to personal ruin. Although the turmoil would inspire him to take a powerful stand for the burgeoning Civil Rights Movement by refusing to play at segregated clubs in the South, his demons were never far, as the film shows by dramatizing his arrest on tour for possession of heroin. Though supported by friends and family, he again finds himself unable to kick his powerful heroin habit.

The film goes on to portray what might be called the lowest period in the life of Ray Charles, where, despite great personal success, the singer is forced to deal with the death of his lover (and mother of his 3-year old son) Margie and a second arrest for heroin possession in Montreal while on tour. Sent this time to court-ordered rehab, the film pulls no punches as Foxx effectively channels the deep physical, mental and emotional torment of heroin withdrawal. Dope sick and hallucinating, Charles remembers his mothers words: stand on your own two feet. Don’t let anyone make you into a cripple.” It is then, and only then, that he realizes that he has allowed his heroin addiction to cripple him more than his blindness ever could. It is a powerful statement about the insidious strength of drug addiction.

After getting out of rehab, Ray Charles stayed clean for the remainder of his life. As one of the greatest American entertainers of all time, his songs, image and career were always going to survive the test of time. However, thanks to the film Ray, he will also be remembered for a success that readers of this site know is just as challenging and monumental- winning a brave battle with a deadly drug addiction to heroin.

If nothing else, the movie “Ray” teaches us that recovery from addiction is possible though it may not be easy and may not look pretty from the outside. Regardless of the depths of the “bottom” addicts dig themselves into, it’s possible to make the climb back to a healthy, full, life. Though celebrities often find recovery from drug addiction difficult due to the stresses of their job, the relatively low expectations of success, and the fact that they’re surrounded by “yes (wo)men” who sometimes act in ways that sabotage success in recovery, it’s still possible to quit drugs even under those conditions. Remember that recovery is possible, and with the right tools and program, even likely.