Those of you not following All About Addiction on Facebook (you should) or paying attention to our updates on Twitter and such might not have known that I was recently informed that in order to become a psychologist in California (actually, to get registered as a Psychological Assistant, which allows someone to get experience towards becoming a fully licensed psychologist) I was going to have to submit to a 3-year probationary period of drug and alcohol testing. I was completely sober for almost 3 years between January 2002 and about September 2004 following an arrest and jail stint for drug possession and sales (see here for part of the story). In the summer of 2004 I decided to take on the classic “AA Experiment,” meaning that I wanted to see if having an alcoholic drink would bring me back to drug use as so many in my 12-step groups told me it would. I am happy to report, that 8 years later the answer is still no – I’ve been drug free since 2002 but have been drinking alcohol socially since 2004.
Aside from staying drug and crime free, I also received my PhD, published dozens of articles, set up All About Addiction, started writing for Psychology Today, and had my convictions set aside by my judge after completing 5 years of probation without a single dirty drug test or violation of any sort. But the California Board of Psychology wanted more, so they told me I had to test if I wanted to move forward. I was offended, consulted with many other professionals I know about what I should do, and threatened to request additional hearings before eventually succumbing. The bottom line is that the Board is almost all powerful and can ask me to do anything they want. Besides, I am a 9-felony ex-convict asking to become a psychologist – maybe I’ll never live down my past no matter what I do (for my take on stigma, read here). So I have a probation officer again and I have to stop drinking.
Last Wednesday I stopped drinking alcohol – having a final glass of wine with my wife who is being nice and joining me (for now) in not drinking. Ironically, I stopped last week because I thought my meeting with my probation representative was in two days – I was a week off. And apparently I was so concerned about not drinking any more that I only drank half of my glass (my wife didn’t actually touch hers). Still, I have been drinking a drink or two 3-4 times every week for a while now and had gotten used to my glass of wine as post-work stress relief. So I’m wondering what the experience will feel like having to give up my coping tool for at least 2 years.
I talk to addicts and alcoholics on a regular basis and my own social drinking has come up as an issue many times before. I always said it wasn’t a problem and many others have told me I’m wrong – that I am either in the midst of a relapse or that I was never really an addict. The latter point is moot and I can’t prove that at all, but I know that this little experience might be an interesting experiment (the reverse of the initial one if you will) to see if returning to drinking was indeed a cop-out.
Having this website and all, I decided I am going to write about it. I’ll be giving weekly (probably summaries) of my not-drinking experiences and how quitting drinking has affected me in my daily life. If something comes up in between updates I might write an impromptu post to talk about it. I’d love to hear your thoughts as comments here or on our Facebook page.
Week #1 – September 1th-15th (short week since I stopped on Tuesday)
As I mentioned, we never finished those last glasses of wine. Still, Thursday and Friday were stressful workdays (I am now up to about 65 hours of work per week) and I have to say that realizing I won’t be able to have my nightly alcohol serving was a bummer. I had that thought a few times throughout those workdays and on the way home. I know full and well that for me stress is a trigger for alcohol use. Thankfully, I was not actually tempted to open up anything and drink once I got home. This is still early on in the process, so obviously it does not mean that I won’t be tempted soon, but I was happy to find that resisting a drink was not a difficult task even when I would have usually had one.
Also, I realized that my weekly (or so) friendly get-togethers with a couple of guy friends are either going to have to change venues or I’m going to be the only guy not drinking at a Happy Hour. We’ll see. I’m sure they won’t mind but I’m not sure how I will feel. Lord knows some of my clients frequent bars without issue while others are triggered constantly… If I’m right about my lack of alcoholic drinking issues, it shouldn’t be a problem.
More to come!
You want to know more about addiction and we want to tell you, so here is this week’s wrap up of exciting news (well, some of it. ) A lot of news about addiction comes up every week and we want you to be informed!
The End of Opioid Addiction?– According to a joint international study by the University of Adelaide and the University of Colorado, published in the Journal of Neuroscience, the scientists have discovered an essential receptor in the brain that can cause opioid addiction, and there is a drug that can block this receptor without interfering with pain relief! The drug is called (+)-naloxone and it works by binding to the specific receptors in the immune system that ordinarily trigger the drug’s addictive properties and preventing the opioids from interacting with them, thus reducing the body’s addictive response to the opioid drug. This new drug is a variant of the drug naloxone, which has been used for many years to treat overdoses. However, this study is the first clear link to its effect on preventing addiction. According to the leaders of the study, clinical trials may even begin within the next 18 months!
Scientists discover internet-addiction gene?– Internet addiction is defined as someone who obsessively thinks about the internet and whose sense of well-being is negatively impacted if they can not get access to the internet. According to the findings of German scientists, published in the September issue of Journal of Addiction Medicine, problematic users more often carried a variation of the CHRNA4 gene, which is typically linked to nicotine addiction. While this receptor in the brain has been known to be essential in nicotine addiction, this is the first neurological link to internet addiction that has been discovered. The study’s lead author, Christian Montag, acknowledged that more large-scale studies need to be done to further examine this connection between internet addiction and the CHRNA4 gene, however he insists that there is enough clear evidence to support a genetic predisposition to internet addiction.
Your childhood’s effect on your adult life– It has long been accepted that traumatic experiences in one’s childhood can have long-lasting effects on a person well into their adult life. According to new research at Cambridge University, suffering a traumatic experience in childhood may increase one’s risk of drug addiction. The compulsivity and impulsiveness linked to addicts are also found in people as a result of a traumatic childhood. While having a traumatic experience in one’s childhood does not mean they will automatically become an addict, just as not having a traumatic experience does not make one immune to addiction, coming from this kind of background does make one more at-risk of becoming an addict.
Is Marijuana Addictive?– There has long been a debate on whether or not marijuana is an addictive drug. Recently, it has been ranked number one on a list of the top five most commonly abused prescription drugs used by post-50 year olds. According to a 2011 report from The National Survey on Drug Use and Health, 3 million adults older than 50 have illegally used the drug and “out of 4.8 million older adults who used illicit drugs, marijuana use was more common than non-medical use of prescription medicines among the 50-to-59 age range.” All of this evidence leads to a need to differentiate between addiction and dependency. In this article, Robert DuPont, M.D. and Laurel Dewey debate the addictiveness of marijuana by arguing their point of view. As evidence of its addictiveness, DuPont points out that, since 2000, admission for treatment of marijuana abuse ranks higher than that of heroin, methamphetamine, cocaine and prescription painkillers. Of 7.1 million people with dependence or abuse of drugs other than alcohol or tobacco in 2010, 4.5 million had marijuana dependence. That’s 63 percent of everyone with illicit drug dependence or abuse! Contrarily, Dewey uses many personal experiences to show her side of the argument. She points to a 1974 study, conducted at Virginia Commonwealth University, that proved that the cannabinoids in the marijuana plant shrunk cancerous tumors and killed cancer cells, leaving healthy cells alone. She adds that, in the thousand years of its use, no one has ever died of marijuana use. Both authors use much more evidence for their side, which you can read about by clicking the link above. Read both views and form your own opinion!
Alcohol and Drug Use in Schools– With kids going back to school across the country, there have been many different studies on alcohol and drug use amongst the youth. In a survey led by SAFE Inc. (Substance Abuse Free Environment), there were mixed results. While the number of students who have tried alcohol has actually decreased, marijuana and amphetamine use have both increased. The survey targeted eight-, tenth-, and twelfth-graders, and showed that those tenth-graders who reported using alcohol in the last month dropped from 31 percent in 2010 to just 22.7 percent this year. It also decreased slightly in the eight- and twelfth-graders. Of the troubling findings, the most troubling may have been the increase in prescription stimulant abuse, such as Adderall and Ritalin. The most dramatic increase was among twelfth-graders, more than doubling from 3.8 to 8.5 percent. Marijuana use also showed increase both in the last month and in lifetime use amongst eighth- and twelfth-graders, although there was a slight drop by tenth-graders.
We at A3 have long been saying that there is something seriously wrong with the way addiction treatment is being regulated and with the addiction treatment system that has sprouted up as a result. Now, a government report created for the California Senate Rules Committee called “Rogue Rehabs: State failed to police drug and alcohol homes, with deadly results” (see here) supports our notion and extends them in alarming ways. Among the major findings:
- Over the past decade, the California department in charge of regulating residential drug and alcohol programs consistently failed to catch life threatening problems [with addiction treatment facilities].
- Many addiction treatment facilities in California are providing medical care in clear violation of their licenses and often by under-trained staff.
- Addiction treatment providers are accepting patients that are far too impaired (as in sick) for them to handle because they would rather take the money than turn away a patient.
- These problems have led to several deaths within the California addiction treatment system in the last decade.
Obviously these findings are extremely disturbing and cases like the one studies in the report of Brandon Jacques, a patient who died while under the care of MorningSide Recovery’s care, could have been prevented with more attention and transparency in our system. The idea that addiction treatment facilities that are not equipped to handle severe cases are taking them just for the money is sickening and antithetical to the reason for their existence. As far as I’m concerned, such unethical flouting of patient care should lead to an immediate revocation of their license and a ban for the management from the field.
The most distrubing factor to my mind is the fact that many of these providers know that what they are doing is wrong. But they also know that more than 50% of people who are looking for addiction treatment are doing so for the first time and have no idea what to ask, what addiction services they need, or how to assess whether a facility is appropriate. That means they can take advantage of them with fancy websites and the use of terms like “holistic treatment” that mean little and promise much. It’s disgusting and flies in the face of everything our field is supposed to stand for. It’s also the main reason I worked so hard to develop our Rehab-Finder, which while far from perfect and in need of serious work that I can’t afford to put into it, tries to fix these problems by recommending treatment that is appropriate given the specific issues a client is dealing with. We are currently conducting a study with UCLA on the effectiveness of tools like this and I am committed to figuring out a safer way to help those in need find the right addiction treatment for them.
Importantly, the report also makes a number of recommendations:
- Allow for medical service provision at addiction treatment facilities but legislate strict oversight and accountability paid for by agency fees.
- Medical detox facilities should be required to have medical directors.
- Establishing requirements and procedures for death investigations at addiction facilities.
- Strict oversight of programs found to admit clients it is not fit to treat including immediate license suspension.
- Information sharing between addiction treatment licensing boards and medical boards.
We think it’s time that addiction treatment providers be held to the same standard that other medical facilities are held to. It might help finally close the gap in terms of recovery outcomes. Running as a relatively unregulated industry does not help patients, it does not help move the field forward, and although they can’t see it it does not even help the treatment providers who are behaving unethically since many of them are eventually forced to close and face lawsuits. It’s time to move forward on this.
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).
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Here at All About Addiction we keep talking about fixing addiction and treating addiction given the suffering that addicts go through. But there are certainly some positive things that go along with being addicted and we figured we should point those out. SO here they is are top 10 addiction list:
Top 10 great things about being addicted
1. You get to do whatever you want whenever you want to do it – For many addicts, schedules are not an issue and consistent commitments no longer exist. This means that any given day can feel like a vacation. It’s a great thing, although much of it gets taken up by looking for drugs, preparing drugs, trying to get money for drugs, or recovering. Still – vacation time!
2. Being comfortable sleeping on a floor – This is a bit dependent on the specific drug (or drugs) you’re addicted to but it’s pretty common for addicts to be seen sleeping in bizarre places, positions, and clothing. Passing out on the floor may not sound good to you if you’re not actively using drugs, but it can’t be that bad if so many people do it for hours at a time. Hey, I once passed out half on a couch and half on the floor while on the phone!
3. You don’t have to bother yourself with family obligations – Not only has most of your family probably stopped inviting you to events because being seen with you embarrasses them, but when invited you rarely show up (see #1 above) so they stopped trying. Besides, not liking to be tied down to specific times, addicts would rather do other things (like drugs) then hanging out with family and having to listen to stories, eat food, or play with children.
4. People don’t annoy you with conversation – Whether because addicts seem aloof or unhappy or because they can smell bad, people seem less likely to engage addicts in random conversations. Of course, this doesn’t apply to other people you meet at your drug dealer’s house or the late-night liqueur store, but those “friends” can often tell you where to get more drugs, so it’s not really a bother (more on this later). Cops also don’t apply to this category.
5. Not having a boss breathing down your neck – Having a boss who can tell you what to do and when to do it can suck. Most addicts can’t hold a job for too long though, so they don’t have to worry about it. Granted, not having a job can affect you finances (as in cause you not to have money), which puts a damper on #1. Still, since you can be comfortable sleeping anywhere (see #2) it doesn’t really matter if you can’t afford a place to live. Besides, if you owe your dealer money, he’ll be breathing down your neck enough.
6. Pesky mortgage, rent, and car payments are rarely an issue – Money issues like rent, mortgage, and such are without a doubt one of the most troubling aspects of living in a capitalistic society. For addicts who have homes and cars, the competition between paying for those or paying for drugs can be fierce (worse if you’re addicted to gambling). Often times, drugs win, which removes the need to worry about it. As listed in the above points, not worrying about these things leaves you free to be on permanent vacation, sleep on the floor, or enjoy not having a boss… or job.
7. You can be late to anything when you’re an addict – Most people get yelled, or at least scoffed, at when late to events but not addicts. As we pointed out above, addicts don’t get invited to as many things and rarely make it at all when they do. Being late is actually a successful outcome for a drug addict. Drug dealers are often late themselves, and while they can be upset if you’re late when picking up, they’ll take your money and give you drugs, which is all that matters anyway.
8. Sleeping in becomes a way of life – We already mentioned that addicts seem to be able to sleep anywhere, but we didn’t mention that they can also sleep in late, or even all day. Meth addicts can crash for days and others simply don’t get out of bed or their room for days at a time. Of course, if you’re a heroin addict or alcoholic and have been using for a while, you may have to wake up in the middle of the night to get a fix because withdrawal can start within a few hours. But then you get to stay there as long as you’d like. Neat!
9. Not worrying about hygiene, looking good or fit – Vanity is for the meek and worrying about things like health, skin, hair, and showers is beneath those who are concerned with more basic needs like feeling good and surviving. You might be thinking already that given some of the above points about lack of work, money, and a reliable living situation, vanity might also be difficult for many in active addiction. You’d be right. The choice between brushing your teeth, taking a shower, or working on your next hit is not one that requires much thinking. Hygiene can wait.
10. Getting a group of very close friends that relate – Like in recovery, addicts tend to associate almost exclusively with others who use their drug(s) of choice. This means that your friends know, and care, a lot about everything you care about. They can recommend good spots to shoot up, places to get rigs, smoke-shops that are open late, and other relevant information most people would be stumped about. Those friends are likely also experiencing the rest of this list, so they can relate! Unfortunately, some of these friends might steal from you, lie to you, or even beat you up because they want your drugs, money, or due to a psychotic break. Nothing is perfect though…
We could probably think of more, but I think that this top 10 list gets at some of the most basic things that active addiction is great at providing. We’d love to hear more thoughts from people who are either still using or those of you who have quit. Family members’ thoughts would also be welcome but annoyingly they usually notice the “bad” things about addiction more often and that’s a bummer.
A recent open label study found some support for the effectiveness of a Risperidone injection, given once every 2 weeks, in reducing crystal meth (speed) use.
The 22 patients who participated reduced their weekly crystal meth use from an average of 4 times per week to only 1 time per week. The difference between those who were able to stay completely clean and the others seemed to have to do with the levels of Risperidone in the blood.
The nice thing about using an injection as addiction treatment is that it removes the possibility of patients choosing not to take their medication on any given day. Such non-adherence to treatment is very often found to be the reason for relapse.
This study will need to be followed up by placebo-controlled double-blind studies, but given Risperidone’s action as a Dopamine antagonist, I suspect that those trials will also show a strong treatment effect. The promise of medicines as addiction treatment cures always seems great, but I believe that at best, they can be an additional tool to be used in conjunction with other therapies.
The question will be whether the side-effects common with antipsychotic medication will be well-tolerated by enough people to make the drug useful for addiction treatment.
It’s Monday and you get another great summary of news and research about addiction that have been making noise this week. If you care about addiction and about recovery, you know you want to stay abreast of what’s important and A3 wants to give you just that! So read on..
Recovery High: A new kind of high school: Across the country, new kinds of high schools are popping up called “recovery high schools”. At these schools kids and teachers aren’t just focused on grades, they are helping the students recover from their drug addiction and alcohol addiction. For teens entering addiction treatment, 75 percent relapse within the first year, often due to the return to the environment that facilitated the use in the first place. While the long-term effectiveness of these schools is still being evaluated, they are showing promise; and with the recent passage of the Affordable Care Act allowing for increased options for recovery, don’t be surprised to see these kind of high schools becoming more and more common. To see the video check out this link.
Prescription Painkillers leading teens to Heroin: According to national data from the Centers for Disease Control and Prevention, the number of deaths from prescription drug overdose tripled between 2000 and 2008. Experts point to the ease of access teens have to prescription pills, such as Percocet’s and Vicodin, from emergency rooms, dentist offices, and especially unfinished prescriptions in household medicine cabinets as one of the main reasons for the increase. These drugs have been found to at times lead teens to heroin, which provides a more intense version of the same high for a fraction of the price. As a result, in the decade from 1999 through 2009, the yearly deaths of people aged 15 to 24 from heroin overdose shot up from 198 to 510.
Heroin abuse becoming a national epidemic: Heroin use and death is still on the rise, exploding in use over the last couple years, fueled by the Baby Boomers. The Boomers increased use of prescription drugs can quickly lead down a road to heroin; once the prescription runs out or the cost gets too high, the more available, cheaper heroin becomes an attractive option. While its use has been increasing nationwide, the statistics from Oregon this past year give an example of the entire nation’s problem. Last year alone, there were 143 heroin-related deaths in Oregon, a 59 percent increase from the year before and almost the entire nation’s total from a decade ago! Marion County, in particular, has already seen more deaths so far this year than in all of 2011. Heroin is on the rebound, no longer a “dormant drug”, and, with its drastic increases recently, should be addressed sooner rather than later.
Addiction: Disease or moral failing? One of the most common questions regarding addiction is the debate on whether it is a disease or a moral failing. A recent article by Dr. Marc Lewis addresses the question from both sides. He starts by pointing out the common critiques that “you don’t ‘catch’ addiction”, “you don’t treat addiction with medications or expect a cure”, and “you don’t ‘have’ addiction” like you would “have” a cold or other disease, in order to show why addiction should not be considered a disease. However, he then counters with the comparison to type II diabetes, which fits the mold of the earlier critiques, yet is never questioned as being a disease. In fact, having type II diabetes is not seen as a “moral failing” and it seems addiction is following this path and becoming more frequently seen as a disease rather than a moral failing. Truth is, addiction is likely going to continue being seen as straddling these two domains.
A cautionary tale of Fentanyl addiction: Fentanyl, a new painkiller, is becoming the next in a line of destructive and deadly prescription drugs. According to Dr. Michelle Arnot, Fentanyl is 100 times stronger than morphine and 750 more potent than codeine. The article tells the tale of a man who lost his “perfect wife” to Fentanyl addiction. Prescribed as patches to be sucked on, addicts soon learn to smoke them in order to get a greater effect. Shortly after her abuse began, the “perfect wife” was going through a month’s supply in under a week. This led to pawning her children’s and family’s belongings, turning her into someone no one recognized. One day, her husband came home from work to find her dead. Now, her husband wants her story to serve as a warning to anyone else becoming entangled with Fentanyl.
Helping siblings of addicts: When addiction leads to a fatality, almost everyone who knew the victim is affected. However, they are affected and handle it in different ways. Most people know about the grief parents feel when losing a child, and they are given support and programs to help deal with it. Siblings, on the other hand, have often gone overlooked in the coping process, largely because they do not grieve in the same way as parents. The emotional needs, and even physical needs, of addicts’ siblings can often be neglected in favor of the addict while they’re still alive and in favor of the parents needs after an addict’s passing. Now, programs such as GRASP (Grief Recovery After a Substance Passing) are popping up with the goal of helping these siblings cope.