Time to Act: Helping parents deal with teens and drugs

Parents are always looking for help on how to parent when it comes to teens and drugs. Well, the new tool from drugfree.org, called Time To Act, may provide just the help parents want.

The tool has separate sections for parents who fear their kids may be trying drugs or for those who know for sure.

Check it out, it’s a great tool that can help a lot in terms of educating, guiding, and informing parents who are having trouble with teens, drugs, and parenting. NIDA also has a new tool called Family Checkup, developed by the Child and Family Center at the University of Oregon, that is aimed at helping parents communicate effectively with their kids when it comes to drugs.

More than anything, research has shown us that communication around the topic of teens and drugs and even more generally communication between parents and their kids about taboo topics, can be effective for reducing problems and for finding help sooner (see here for smoking related research).

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”

Treating alcohol withdrawal with benzodiazepines – Safe if mindful

Alcohol withdrawal can lead to some pretty horrible side effects

Contributing co-author: Andrew Chen

Alcohol withdrawal can be extremely unpleasant (see here for an overview). Symptoms vary from person to person, but most people will experience some negative symptoms of alcohol withdrawal if they try to stop drinking after long term use.

Mild to moderate symptoms include headache, nausea, vomiting, insomnia, rapid heart rate, abnormal movements, anxiety, depression, and fatigue. Severe symptoms of alcohol withdrawal include hallucinations, fever, and convulsions (known as DT’s or delirium tremens). Most people undergoing alcohol detox do not require hospitalization, but in severe cases, hospitalization may be necessary (1). Since their introduction in the 1960s, benzodiazepines have been the drug of choice for treating severe cases of alcohol withdrawal.

Benzodiazepines, or benzos for short, are a class of psychoactive drugs that work to slow down the central nervous system by activating GABA receptors. This provides a variety of useful tranquilizing effects. Aside from relieving symptoms of alcohol withdrawal, benzodiazepines are also commonly prescribed to treat insomnia, muscle spasms, involuntary movement disorders, anxiety disorders, and convulsive disorders.

The most common regimen for treating alcohol withdrawal includes 3 days of long-acting benzodiazepines on a fixed schedule with additional medication available “as needed.” (2)

The two most commonly prescribed benzos are chlordiazepoxide and diazepam. Chlordiazepoxide (Librium) is preferred for its superior anticonvulsant capabilities while diazepam (Valium) is preferred for its safety against overdose with alcohol. Short-acting benzos like oxazepam and lorazepam are less frequently used for treating alcohol withdrawal (1).

Compared to other drugs, benzos are the safest and most effective method for treating difficult alcohol withdrawal. However, benzodiazepines do come with their own potential for dependence and abuse. Ironically, symptoms of benzodiazepine withdrawal are quite similar to those of alcohol withdrawal. Tapering off dosage is the best way to prevent serious withdrawal symptoms. To avoid such complications, benzodiazepines are only recommended for short-term treatment of alcohol withdrawal.

In short

Benzos can be very useful for helping long terms alcoholics deal with the difficult withdrawal symptoms that can accompany the detox period. Just be mindful so as not to find yourself right back where you started.

Citations:

1. Williams, D., McBride, A. (1998) The drug treatment of alcohol withdrawal symptoms: A systematic review. Alcohol & Alcoholism. 33(2), 103-115

2. Saitz, R., Friedmn, L. S., Mayo-Smith, M.F. (1996) Alcohol withdrawal: a nationwide survey of inpatient treatment practices. 10(9), 479-87

Negative self-talk and addiction recovery

Everyone has internal beliefs about what they are, or aren’t, good at. For many these have become an implicit reality – facts about life that are rarely examined and never questioned. The “gravity” of our lives.

Negative self talk is often unecessarily self-defeatingWhen I review these internal beliefs with clients, especially those in early recovery but also others who don’t have trouble with addiction per se, we often find that they are packed full of negative self-beliefs and self-talk. Phrases like “I’m impatient/rude/stupid,” “I’m not good at doing _____,” or “I can’t handle _____” are so commonplace in psychotherapy circles that restructuring them can often become the focus of many sessions. And negative self-beliefs are a huge source of shame, and you know how I feel about that.

Inevitably these negative self-beliefs and the associated shame are often the remnants of past experience, whether personal or “other” inflicted. Poor performance in some childhood activity, ridicule by peers, or harsh words from misguided parents can lead to seemingly permanent imprints on the world-view of the young, and then the older. Ironically, even seemingly self-assured views like “I am in control of my life” can become defeating when they turn into “I am a failure because I can’t handle this on my own.” We get that one a lot in addiction treatment from clients who think that they are weak because they’ve found themselves needing help. Again, this thought pattern leads to shame and often resistance to receiving the necessary addiction help.

As usual, a big part of dealing with these issues, from both a cognitive behavioral therapy (CBT) point of view and a humanistic one, is to examine their sources and test their appropriateness. It’s rare that these statements prove universally true and it’s even more infrequent that they turn out to have no connection to a small set of past hurts that happened long ago. In recovery from addiction, I often have clients look at how many other things in life they’ve needed help with – learning how to read, how to play sports, or how to do well at their job. We’re constantly relying on others for help, but when it comes to our psychological functioning we believe that we should be masters regardless of our level of training – a belief that I see as having no basis. But then again, I am a psychologist…

How to break negative self-talk and self-belief cycles

For readers who want to test their own beliefs and the existence of their own negative self-talks it helps to keep a written journal. Make a list of such negative self-beliefs that you are already aware of and try to be as aware as possible of negative self-talk as it happens over the course of one whole day. Write those down too. Now, using a whole line on a piece of paper (or a spread-sheet if you want to be super organized about this) create little spaces (columns) to write down a single situation in which those thoughts and beliefs come up for you in everyday life. In the nest column put down an objective assessment of what actually happened. In the last column write a short assessment of how close your initial internal dialog was to the “truth.”

Let’s use an example – Imagine getting an upset email from your boss that brings up your good old “I’m never going to succeed” negative self-belief. When you go to your journal and find the line for that specific negative belief you write “got upset email from boss” in column one and “boss was upset that I forgot to send out update email yesterday as expected” in column two. Now examine your current level of functioning at work in light of this specific mistake, past work occurrences, and the very near future.

If you’ve been held back from advancement repeatedly and been scolded, fired, or nearly fired for forgetting these sorts of things in the past, the belief might be a sign that you need to become active about finding ways to improve on this sort of forgetfulness in the future. But if such occurrences are relatively rare and haven’t caused negative consequences at work or other environments, then it sounds like the belief is an exaggeration of a much less frightening reality along the lines of “I don’t always perform perfectly at work.” I don’t know about you, but that sort of internal belief I can live with.

Now go on and do your homework – or are you a slacker?!

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!

Addiction recovery help by replacement

contributing author: Katie McGrath

It’s easy to see why some people search for ways to escape their everyday life. Daily obstacles and challenges are common, and sometimes, life can seem like a difficult, if not impossible, test of wills. Addiction recovery help is about finding another option.

People turn to many different coping methods, including addictive behaviors such as drinking alcohol, using drugs, or gambling (1). But many other behaviors that aren’t considered as deviant as those just mentioned can also develop unhealthy patterns, including excessive work, promiscuous or risky sex, and high adrenalin activities like car and motorcycle racing, skydiving, rock climbing, and other forms of “extreme sports.”

In fact, researchers have found that drug users and extreme sports athletes rationalize their respective involvements in very similar ways (2).

Unfortunately, if the activities are used for escape, people usually find the relief they get to be temporary. When the “high” is finished, they find their problems alive and well as life comes back at them full-force. A temporary distraction, no matter how exciting or effective (like extreme sports, alcohol, or drug use) is just that – temporary.

The idea of “switching addictions” has come up in psychological research in the past (4). The question is: Can addicts substitute their choice addiction for a behavior that is actually beneficial?

Some research suggests that they can.

Yoga is one of he activities that may help drug addicts refocus their attention

Activities like exercise (running, yoga, and such), art (painting, photography), and other hobbies (such as gardening), may provide a source of comfort for drug users looking for a way to “fill in” the void left by drugs and/or alcohol. Each of these activities may provide the repetitive, mindful, pursuit that people who are prone to addiction may seek without many of the harms and dangers.

When I stopped getting high, one of the hardest things was figuring out what to do with my free time that didn’t involve using drugs. It was what I was used to doing when I was happy, sad, or bored. Now, I would be all those things, but the drugs weren’t there. It took me more than a year to get comfortable with movies, the gym, and books as replacements for what I knew how to do best – using drugs.

Running and other forms of exercise can be useful in recovery

In future posts, we’ll go over some specific ideas for changing behavior that may be useful for addicts trying to stop. We’ll also suggest specific strategies to keep from developing unhealthy habits even in these new, more constructive habits, while keeping them long-term. Addiction recovery can be tough, but actively replacing activities can help.

Question of the day:
If you’ve quit drugs or other addiction, do you have any suggestions regarding new habits you picked up that helped you in developing a new, healthier life?

Citations:

1. Hart, A. D. When coping becomes addiction.

2. Larkin, M., Griffiths, M. D. (2004). Dangerous sports and recreational drug-use: Rationalizing and contextualizing risk. Journal of Community & Applied Social Psychology, 14, pp. 215-232.

Saving lives made easy – Treating opiate overdose with intranasal naloxone

oxycodone-addiction-big1Contributing co-author: Andrew Chen

Imagine that you and your friend have been using heroin (or another opiate). A few hours go by and you notice your friend is progressively becoming more and more unresponsive. You check on him and find that his breathing is shallow, his skin is cold, and his pupils are constricted. You recognize these as signs of opiate overdose and call for help. Now what?

Well… If you had some naloxone around, you might be able to treat the overdose and save your friend’s life before the paramedics even arrive.

Naloxone hydrochloride (naloxone) is the standard treatment for opioid overdose. Naloxone works by blocking opioid receptors, thereby removing opioid agonists, such as heroin or oxycodone, from those same receptors. As a result, the overdose is reversed and death is prevented.

What makes naloxone great is that it has no potential for abuse. In fact, it makes the user feel pretty crappy.

Naloxone is typically delivered through an injection, which makes it pretty much useless in many situations. However, it can also be delivered using an intranasal spray device. This intranasal form of naloxone is getting lots of attention recently because it is relatively easy to administer.

In 2006, The Boston Public Health Commission (BPHC) implemented an overdose prevention program, providing training and intranasal naloxone to 385 individuals deemed likely to witness an overdose. These individuals were often family members of opiate users or drug-using partners.

15 months later, the BPHC conducted a follow-up:

  • Contact was made with 278 of the original participants.
  • 222 reported witnessing no overdoses during the 15-month span.
  • 7 had their naloxone stolen, lost, or confiscated.
  • 50 reported witnessing at least one overdose during the 15-month span. Together, these 50 individuals reported a total of 74 successful overdose reversals using intranasal naloxone!

The BPHC program is not the only example of successful use of naloxone in opiate overdose prevention programs. Similar programs have popped up in Chicago, New York, San Francisco, Baltimore, and New Mexico.

Unlike injections, using a nasal spray isn’t rocket science. All of the participants in the BPHC program were trained by non-medical public health workers, which makes the idea relatively cheap. As the data shows, the participants were able to effectively recognize an opiate overdose and administer intranasal naloxone. By targeting at-risk populations and providing proper training, distribution of intranasal naloxone can help in saving lives.

For more information, check out our post Addiction and the brain part IV – Opiates

Citation:

Doe-Simkins, M., Walley, A.Y., Epstein, A., & Moyer, P. (2009) Saved by the nose: Bystander-administered intranasal naloxone hydrochloride for opiod overdose. American Journal of Public Health. 99(5)