Tricia Gooden wants to quit smoking.
“I keep seeing all those commercials on TV about people who are like dying – who have holes in their throats,” says the 24-year old office manager who has smoked on and off for six years. But a previous effort to kick her nicotine addiction with patches failed.
“Once you start it’s really hard to stop,” she laments.
Nicotine addiction has even been compared to narcotics like heroin or morphine, also known as opiates. Neuroscientist Dan McGehee, of University of Chicago says the relapse rates are much higher for tobacco users than the users of other drugs, citing approximately 40 percent relapse on average for all drugs of abuse compared to 80 to 90 percent for tobacco.
“Many factors contribute to this difference, and one of these is the addictive effects of these drugs,” he says.
McGehee’s recent study gives more evidence that nicotine and heroin have similar effects in the brain. He measured these effects in individual rat brain cells in lab dishes using a sophisticated technique to record electrical activity. He also measured the release of the pleasure chemical dopamine.
Nicotine and opiates increase dopamine release in the pleasure center of the brain. This center is also involved in the addictive properties of both types of drugs. Dopamine is also released in large quantities in response to experiences such as sex and running.
McGehee and his team applied nicotine and a heroin-like substance called endomorphin to brain cells. Because the two drugs work in completely different ways, the researchers did not expect to find that the cells in a particular area, called the nucleus accumbens, responded in an identical way to both drugs.
“We were a little surprised to see an effect that was so similar between these two different classes of drugs,” says McGehee.
Dopamine-releasing brain cells release only small amounts of dopamine until they are prompted by a stimulus to release large bursts of dopamine. The researchers knew from prior studies that nicotine caused the low level release of dopamine to be suppressed. This results in hypersensitivity in that brain area to dopamine, which can greatly enhance feelings of reward. In this study the scientists found that in the presence of the heroin-like substance, the neurons responded in the same way.
“And so when the sensitivity of those cells is enhanced, we believe that’s going to contribute in a big way to reward and motivation. So people that are exposed to drugs will go out and seek them again because it’s something that makes them feel particularly good,” explains McGehee.
But McGehee points out that this study only looked at first time exposure to both drugs, not at addicted individuals. In the future he would like to study what happens to the brain after long-term exposure to nicotine and drugs like heroin. He hopes that further research will lead to treatments to help people beat addiction to many different types of drugs. In the meantime people like Gooden, who says she smokes to cope with stress, will have to keep trying to break the habit in other ways.
Over dinner one day someone asked me a very interesting question: Why is it that people crave things like doughnuts and sweets and not life giving, cancer fighting foods like spinach and broccoli?
I simply said that’s an awesome question and that I’ve asked myself that question many times. In fact I also went on to say that although I’m a trainer I have many of the same struggles with food that most people have. It has always perplexed me why I crave sweets and not a bowl of spinach and broccoli. I mean how can this be that foods like broccoli, spinach, carrots etc… which provide nutrients that are vital to our well being don’t addict us like junk food does. I just have to walk by Crispy Crème doughnuts and I start fantasizing how delicious those little suckers will be.
In recent months I’ve come across some insights as to why many are addicted to or crave junk foods. Hopefully this information will at least motivate you to keep these foods out of your house. Outside of your house you will be tempted with many opportunities to eat these lifeless and addicting foods.
First he explains in his “You Are What You Eat” audio series that junk foods or non-foods are foods that:
1. Offer very little or no nutrition at all.
2. Force the body to the use its own nutritional stores to assimilate and digest the food.
It’s amazing that you are eating to nourish yourself with food but with non-foods you are actually depleting yourself of more nutrients thus creating a need for more nutrition.
These same non-foods also cause you to overeat and possibly become addicted to these foods.
The reason is as the foods enter your mouth your brain can sense if there is actually any nutrition (vitamins, minerals and enzymes etc…) present in these foods. If there isn’t then the brain simply signals you to keep eating until it finds nutrition. Problem with doughnuts, cookies and that soda pop is that there will never be any nutrition in that food. So what happens is you simply eat the whole box, or slurp down 20 oz of that soda. This then creates a big problem with your blood sugar because you’ve just taken in a great amount of worthless sugar which skyrockets your blood sugar level and forces your pancreas to secret an enormous amount of insulin to bring your blood sugar back down. Your blood sugar then plummets to very low levels and you feel horrible and guess what? Hungry again! And what better way to bring your energy level up than with good old worthless sugar laden nutrient-less junk food!
Can you see what I’m getting at here: These non-foods actually cause an addictive cycle similar to hard drugs and alcohol! In fact Paul Chek even talked about how scientists found that the addictive mechanisms of sugar and hard drugs are actually very similar.
You get high and feel great and then you crash and feel worse than ever and crave the same substances that got you high in the first place. This to me is amazing and very scary. Eventually what also happens as with hard drugs and alcohol is that you need more to get the same high. Now look at what’s happening to you: You’re eating a food that gets you high, robs you of valuable nutrition, makes you sick, gets you fat and on top of that makes you crave more of it.
The same reason you crave non-foods is the same reason you don’t crave spinach and broccoli. One could easily slug down 20 oz of soda but try doing that with spinach juice and you are likely to throw up. The reason for this is because with the brain will sense the enormous amount of nutrition coming in and say it’s enough. We naturally eat until we are satiated and it doesn’t happen with non-foods but happens easily with real foods.
With real foods you eat, feel good, don’t get bloated, don’t get high, don’t crash, don’t overeat, and just plain nourish yourself.
More and more people rely upon the daily use of prescription medications. According to the Centers for Disease Control (CDC), it is estimated that in the United States alone, almost half of all people are taking at least one prescription medication while 1 in 6 people are taking three or more medications (Source: CDC 2004 Press Release).
There is no question that when used and dispensed properly, prescription drugs do improve health and save lives. However, the unfortunate fact remains that along with the good prescription drugs provide, there is always the risk of a medication error occurring when the drug is dispensed and taken. In fact, medication errors occur all too frequently, sometimes with deadly results.
Medication safety begins with you. Here are some steps you can follow to help your family avoid medication errors:
- Always make sure your doctor’s office and your pharmacy know all of the prescription medications, herbal supplements, vitamins and over-the-counter medications your family member is taking and any known allergies they may have. This can help prevent dangerous drug interactions, allergic reactions, or overdoses. Keep a current list of all the medications your family members take and make sure you update it when something changes. This medication list should include information such as the name of medication taken, the strength, form (pill, liquid, etc.), how often taken, and when the medication was started.
- Have all your prescriptions filled at the same pharmacy. Pharmacies have computer programs that can check for harmful drug interactions between different medicines being taken at the same time as well as possible allergic reactions. However, in order for this to work, the pharmacy needs to know all medications, vitamins, and supplements you or your family members are taking as well as any known allergies. Having all your prescriptions filled at one pharmacy also allows your medical providers to access all your medication information from one source. This can save valuable time and confusion.
- If possible, get your new prescriptions in writing to take to the pharmacy to be filled. Mistakes can happen when prescriptions are called in by phone — remember playing “the telephone game” as a child? One child will whisper to another child who will repeat the same thing to another child and so on until the last child says out loud what he or she heard. Remember how the end story never matched the beginning one? Unfortunately, this can happen with prescriptions too. Written prescriptions eliminate errors due to communication problems over the telephone.
- Make sure you know from your doctor’s office the following information about the drug being given: name, strength, directions for taking/using it, number/amount given, and why the drug is being given. You may need your doctor or someone from his/her office to write this information down for you on a separate sheet of paper. (Never write on, or alter, a prescription you are given from your doctor.) Knowing this information can help you double check that you did receive the right medication from your pharmacy. This step acts as a double check that your written prescription was filled as your doctor intended. It is especially important to understand as much information about a new medication before you leave your doctor’s office. Additional prescription medication information can also be found in reference books available at your local library or bookstore (pill books, PDR), or at on-line sites like
- If you are simply refilling a prescription, be sure the refilled drug matches the drug your family member has been taking. If they do not match exactly, then you need find out why. If you are used to receiving little orange tablets and instead you have been given larger white tablets, you need to find out what is going on. You may have been given a different company’s drug or you may have been given the wrong drug. Do not have your family member take any questionable refill medications until you can check with your pharmacist to make sure you have the right medication. If the medication is different, check with your doctor to see if your family member is supposed to take a different medication.
- If you are filling a prescription for a child, an elderly person or someone who is extremely overweight or underweight, make sure the doctor and pharmacist know the age and weight of the patient. Medication amounts are often based upon the weight of the patient especially for children. Also, some medications are not given to children until they reach certain ages. Similarly, some medications should be avoided for senior citizens.
- Have your family member take all medications as instructed (right number of doses, avoid certain foods, etc.) and keep a list of any problems they experience while on a medication. Problems should be shared with your doctor’s office. They can help you decide how serious the problem is and if adjustments to your medication are needed.
- Making sure you get the right medications in a hospital or nursing home is much harder to do since you do not see original packaging and you may be receiving some medication through an I.V. (receiving drugs through a vein). In addition, you may be sleeping or not feeling well when the medication is given. In these cases, do the best you can and always ask what medications are being given and what they are for. Be sure the person who is giving the medication is aware of any allergies you may have. If you are the patient and are not able to ask questions, then have your patient advocate (who knows your medical and prescription history) find out what drugs have been prescribed for you and why. Your patient advocate can then help verify if you are receiving the correct medications. You can do the same thing for a family member if you are their patient advocate. Some hospitals and pharmacies are now beginning to use bar code systems and other technology to help prevent drug-dispensing errors. However, not all hospitals are doing this yet, and no system is perfect. Therefore, it’s still best to double-check what drugs are being given to you at all times.
Marijuana is a common drug used extensively in both the Americas and Europe. While widely regulated against by law, it is probably the most commonly used ‘illicit drug’ in the Western World (Next to underage use of alcohol.)
Many people are more interested in how to get marijuana than how to quit marijuana.
Most people who have experimented with drugs report having used marijuana, as it is considered by many to be a relatively harmless drug, at least when compared to the likes of heroin, crack, speed and LSD.
There are a number of controversies surrounding this naturally occurring psychotropic substance:
Is it addictive, and if so, how addictive is it?
Unlike nicotine, crack, and caffeine, where chemical dependence can be realized with very low exposure to the active chemicals, most drug enforcement and treatment organizations list marijuana in the top ten to twenty lists of addictive substances.
The battle over the addictive properties of marijuana rage on between opponents and proponents of this drug. Most agree that the addiction results from an acquired dependency to the brain chemical changes produced by marijuana rather than a physical dependency to any chemical in the plant itself.
Those arguing against the addictive classification of this drug site that many people have had little trouble quitting, even after years of heavy use.
However, since many who want to give up marijuana use need help to find out out how to quit marijuana, it is clear that, like alcohol, marijuana can lead to dependency in at least some people.
What are the symptoms of marijuana abuse and addiction?
Much like alcohol, marijuana is a recreation drug used for the euphoric high it produces in the user. Users describe a wide range of emotional reactions including:
- Peace and a sense of well being.
- Confidence.
- Relaxation and a release from stress and tension.
- Giddiness and happiness.
All well and good, but like any artificially induced emotional state, it comes at a price.
When the effect wears off, there is the resulting crash. While it does not carry the baggage of the alcohol induced hangover, the empty feeling after coming off of marijuana use is one of the reasons many give for wanting to quit.
While under the influence of marijuana, your judgment and reactions are impaired, as well as your ability to make rational decisions.
While it can (and is) argued that occasional marijuana use causes not more harm than social drinking of alcohol, this drug does have significant effects on several centers of the brain controlling speech, memory and cognition. Long term use can produce symptoms including:
- Loss of ambition and focus.
- Difficulty remembering facts and events clearly.
- Emotional issues, including depression.
- Anxiety and even paranoia.
- Obsession with and obsessive need for the drug.
The point is, people get to the point where they want to give it up. Their life is not what they want it to be, and marijuana use is one of the reasons why. They want to know how to quit marijuana.
Fortunately, since marijuana does not contain any physically addictive compounds like nicotine and caffeine, you don’t have to go through the direct physical withdrawal symptoms.
However, the secondary addictive effects are still a difficult hurdle to face.
Once you quit, the centers of your brain that are accustomed to processing the mood changing elements in marijuana can react with chemical changes of their own. These can produce anxiety, obsessive thoughts about marijuana and a strong desire to continue your habit.
This can be difficult, but far from impossible.
Some tips on how to quit marijuana:
- First, admit that you have an addiction. This first step is common to all behavioral change programs. People with alcohol, gambling, eating and shopping issues all had to confess, at least to themselves, that they have a problem. Without this first step, the rest of the plan will almost surely fail.
- Admit to someone else that you have an addiction. Man has been described as the only rational animal, but it is often more accurate to say he is a ‘rationalizing animal’. Our highly adaptive natures which have allowed us to conquer and thrive in hostile and uncooperative environments can also work against us, making us think that what is bad for us is really not so bad.
- By sharing your load with someone you trust, you can get regular doses of ‘reality checks’ that can remind you of why you wanted to quit in the first place.
- Change your lifestyle. Recovering alcoholics stop going to bars, gamblers with problems stop going to Vegas, and you will need to avoid the places (and people) associated with marijuana use.
- Get some exercise. Not only will it improve your general health, it will it use up time during the day that could otherwise be spent using marijuana. In addition, exercise produces it’s own chemical changes in the brain and body which can substitute for those you are missing. It also reduces the stress that contributed to marijuana use in the first place.
- Get involved. Keep your mind active. Read, write, take classes, expand your horizons.
- Keep a journal. Record your feelings about why you want to quit and what you want to be when you are done. Re-read your entries from time to time to keep up your resolve.
- If you have a faith based or spiritual outlook, do not ignore it. Many of the organizations dedicated to changing negative behavior consider the help of a higher power or the spiritual aspect of your being to be essential to ultimate success.
Marijuana is addictive, it can limit your potential, increase your risks for a number of psychiatric disorders, and there is a withdrawal syndrome associated with the drug.
Marijuana today is not what it was even a couple of decades ago, and parents may be underestimating the threat that marijuana poses to today’s teens.
The potency of marijuana has increased many-fold in the last couple of decades alone, and it is as much as 6 times as strong as the marijuana of the 60′s and 70′s. With increased potency unfortunately comes an increased risk for social and health problems and addiction, and with addiction, the inevitable need to detox off of the drug.
Addictions professionals now recognize marijuana as an addictive drug, and there is a documented syndrome of withdrawal symptoms that occur when marijuana addicts try to break free from their habit. The intensity of these marijuana withdrawal symptoms may not be as great as with drugs like heroin, and they may not be as dangerous as a detox off of alcohol; but they are real, they are unpleasant, and they do pose a threat to recovery.
What are the symptoms of marijuana withdrawal?
Marijuana withdrawal symptoms can include insomnia, irritability, aggression, nausea, a lack of appetite, headaches and very strong cravings for the drug. So strong are the cravings and so uncomfortable are the withdrawal symptoms that many people cannot get past the initial few days of intense withdrawal, and use marijuana again if only to make the symptoms of withdrawal go away.
Marijuana abuse and addiction is the number one reason for a teen entry into drug treatment or drug rehab, and so potent is today’s pot that many thousands of kids have developed addictions strong enough to require residential treatment, and untold more thousands have developed as yet untreated addictions.
Heavy marijuana use brings an increased risk of present and future psychiatric problems, including depression, anxiety and psychosis, is linked to certain cancers, is linked to developmental delays, and is strongly and negatively linked to academic performance.
How to beat an addiction to marijuana
The reality is that an occasional joint is very unlikely to do much damage, and many people can use marijuana recreationally at this occasional level. But when recreational use becomes regular abuse, and possibly addiction, the detrimental impacts of marijuana on quality of life and potential become very evident.
Many thousands of kids (and adults) need drug treatment each year for assistance bettering an addiction to marijuana, if someone you love is having difficulty reducing their usage or quitting altogether, there are programs and therapies available, and these can be very helpful for anyone committed to quitting.
It is not unusual for anyone to need professional help when dealing with an addiction, and with marijuana addiction as with any dependency, it is unlikely to go away on its own; and the sooner it’s dealt with, the better the ultimate prognosis.
Darvocet® (propoxyphene/acetaminophen), a pain medicine, is specifically approved to treat mild to moderate pain. It comes in tablet form and is typically taken every four hours as needed for pain. There are three different types of Darvocet, including:
- Darvocet-N 50
- Darvocet-N 100
- Darvocet A500.
The medication contains two active ingredients. Propoxyphene is classified as a mild, centrally-acting, narcotic pain reliever. “Centrally-acting” means that it works in the central nervous system (the brain and spinal cord). Propoxyphene is chemically related to methadone. The other active ingredient in Darvocet is acetaminophen, a pain reliever and fever reducer commonly found in non-prescription medications such as Tylenol®. Adding acetaminophen to propoxyphene increases the effectiveness for relieving pain and also provides fever-reducing effects.
Most people appear to tolerate Darvocet well. As with any medication, however, side effects are possible. Some of the most common side effects that have been reported with Darvocet include vomiting, dizziness, nausea, and drowsiness.
The formal term for painkillers is analgesics, a word derived from the Greek words an (without) and algia (pain). The three most commonly used types of pain medicine today are the nonsteroidal anti-inflammatory drugs (NSAIDs), the paracetamol based drugs and the opioid drugs.
The nonsteroidal anti-inflammatory drug (NSAIDs) group contains a wide range of different painkillers. Examples of commonly known NSAID painkillers are Aspirin, Diclofenac and Ibuprofen. NSAID pain killers do not only alleviate pain; they will also lower fever and decrease inflammations. They are called non-steroidal in order to discern them from the steroids, since the steroids are also used for their anti-inflammatory capacity. Aspirin was discovered in 1829 when salicylic acid was chemically isolated for the first time, but willow bark containing salicylic acid has been used as a pain killer long before the 19th century. A lot of NSAIDs are available over-the-counter but this does not mean that they are harmless. When misused, even comparatively weak NSAIDs can have severe side effects, including bleeding ulcers and photosensitivity. NSAIDs are generally not recommended during pregnancy.
Paracetamol is also known as acetaminophen. Both words are derived from the chemical name for this painkilling compound: N-acetyl-para-aminophenol and para-acetyl-amino-phenol. Two examples of commonly known brand names under which Paracetamol is marketed are Tylenol and Panadol. Painkillers containing Paracetamol will relieve pain and decrease a fever, but unlike the NSAID painkillers they have no anti-inflammatory properties. One of the advantages of Paracetamol compared to NSAIDs is that Paracetamol painkillers will not affect the blood’s ability to clot. Nor will they damage the kidney or lining of the stomach as long as you stay within the recommended limits and never use too much Paracetamol. High doses of Paracetamol will however be damaging to a wide range of bodily functions. Paracetamol should never be combined with alcohol since the liver will be overloaded with the burden of breaking down both alcohol and Paracetamol, which makes the risk of Paracetamol poisoning higher. If you are healthy, well-nourished and do not drink alcohol, a single 10 gram dose of Paracetamol can cause significant liver damage.
Opioid drugs are very potent painkillers but will come with a sever side effects, even in low concentrations. Morphine is one of the most commonly used opioids in pain killing drugs. An example of a morphine based painkiller is Tramal. Pethidine is another pain killing opiate and can be found in medications such as Alodan and Demerol. Morphine will act directly on the central nervous system and can relieve even sever pains, such as post surgery pains and cancer pains. Morphine is addictive and it is important that it is used with caution. The addiction can be physical as well as physiological. The side effects are also both physical and psychological. Among the physical side effects are constipation and an inhibition of the cough reflex. Psychological side effects include euphoria as well as nightmares, and drowsiness can come hand in hand with insomnia. Morphine was isolated from opium in 1803 by Friedrich Serturner, a German pharmacist. He named it morphium after the Greek god of dreams, Morpheus. Serturner soon discovered its usefulness as a painkiller, but morphine didn’t grow really popular until the hypodermic needle was invented in 1853.
What would you think if your child received advice to “tune in, turn on, and drop out”? Would you think it was Timothy Leary, Ken Kesey and the ‘Merry Pranksters’ Haight-Asbury Bay hippies era revisited?
What would you think if your child’s attention span issues were being treated by well-intentioned district psychologists with a known hallucinogen from a mushroom called psilocybin?
Think again, because that’s almost the case in many American schools, as the pharmacy kit-bag opens further with speculative treatment therapies for teen attention deficit disorder. Wide spread medication of American kids and adults is based on use of amphetamines and stimulants, which in recent clinical research are shown to mimic some of the hallucinogenic properties of mushroom psilocybin.
Over 6 million Americans each day receive behavior modifying medications like Ritalin for alleged attention deficit disorder. Perhaps no wider spreading trend, beyond over-budgeted and under-performing schools themselves, should cause parents to wonder than the medicating of teenagers in the pursuit of “normative standards”.
Straight Talk On Attention Disorder In Young People. Asking whether teens have attention span issues is like asking whether the Pope is Catholic? Of course they do…but it’s a matter of degree when comparing “Jody can’t concentrate on her class work” to increasingly obtuse and theoretical concepts of the “normative standard” for teens.
Here’s the current list of “usual suspect” symptoms to look for if you think your child may have attention deficit disorder. He’ll be fidgety, squirmy, evidencing low concentration, bored, unable to complete assignments, forgets what was taught in class.
Psychiatric Meds – Anti Depression And Anti Anxiety… Once you “prime the pump” and commence use of neural-blockers you’re playing in a complex arena. 4 million miles of nerve fibers are imbedded within your brain’s neural architecture of over 10 billion cells. Is it any wonder that “psychiatric theory” comes unstuck in the “reality” of this complexity and the necessary uniqueness of each person?
Stimulants And Amphetamines – Major Chemical Interventions. Remarkably, a clinically observed “over-active” child showing alleged attention deficit hyperactivity disorder receives mood-altering powerful stimulants from the class known as methylphenidates under brand names including Ritalin and Concerta. Now to the stimulants add another potion from the class of legally approved amphetamines under labels such as Dexedrine or Adderall.
Ritalin Side Effects. It’s true that 70% or more of the “standard population” will respond favorably to Ritalin for attention deficit and hyperactivity disorder. However, that leaves a “big chunk of statistical change” or 20% or more of the same medicated population that runs the risk of becoming seriously and psychiatrically unglued by the experience.
* Hyper-Nervous Jitters. Physical manifestations of Ritalin abuse can include profound states of agitation and “jittery feeling”. Doctor’s response? Take another intervention drug or beta blocker blood pressure med…so you now have two powerful drugs interacting.
* Irritability And Relapse Depression. As powerful attention disorder meds wear off, people can experience anger, irritability and a form of ‘rebound’ short-term depression. Solution? Other drugs may be prescribed such as serotonin or the class of alpha agonist medications.
* Stomach And Digestive Disorders And Headaches. It’s a known fact that amphetamines and stimulants, including Ritalin, can cause appetite suppression. Solution? While avoiding Ritalin abuse, users may be asked to time their meds, in order to “wear off” just before meal times. Other Ritalin users experience stomach irritability that takes months to control, accordingly are instructed to “take your meds with your meals”.
* Sleeping Disorder. “Short” and “long” acting stimulants remain neural-blockers, not matter which way you look at it. Not surprisingly, the chemically induced stated of “controlled stimulation” carries some unwanted baggage, such as sleeping disorders. Reduced meds may be a partial solution.
* Increased Blood Pressure And Blood Glucose. Borderline diabetics may trigger adult onset diabetes due to elevated blood glucose. Similarly, these stimulants and amphetamines meds stimulate all sorts of metabolic activity, including blood pressure.
* Nervous Tics Exacerbated. If a patient normally exhibits the sort of patterned nervousness and “tics”, then these drugs will amplify these tics as well as the underlying attention span disorder complex.
Non Pharmaceutical Alternatives. Fortunately, families can now turn back into time, and begin selective use of various herbs like St. Thomas Wort, nature’s valium, rosemary, ginseng, centella asiatica as well as to an evolving class of exercise and visual programming aids that allegedly can actually train the ADD-HD person to create new neural pathways (think brain right and left hemispheres) to adjust for certain imbalances.
Some prescription drugs can become addictive, especially when they are used in a manner inconsistent with their labeling or for reasons they were not prescribed. Those include narcotic painkillers like OxyContin or Vicodin, sedatives and tranquilizers like Xanax or Valium, and stimulants like Dexedrine, Adderall or Ritalin.
Steroid abuse is also on the rise. Steroids are prescription drugs that are legally prescribed to treat a variety of medical conditions that cause loss of lean muscle mass, such as cancer and AIDS. Men consistently report higher rates of steroid use than women. In 2008, 2.5 percent of 12th grade males, versus 0.6 percent of 12th grade females, reported taking the drugs in the past year.
In 2000, about 43 percent of hospital emergency admissions for drug overdoses (nearly 500,000 people) happened because of misused prescription drugs. This type of drug abuse is increasing partially because of the availability of drugs, including online pharmacies that make it easier to get the drugs without a prescription, even for minors.
There may also be a perception, especially among younger people, that prescription drugs are safer than illegal street drugs. Most people don’t lock up their prescription medications, nor do they discard them when they are no longer needed for their intended use, making them vulnerable to theft or misuse.
Prescription drug abuse is generally the same between men and women, except among 12 to 17 year olds. In this age group, research conducted by the National Institute on Drug Abuse found that females are more likely to use psychotherapeutic drugs for non-medical purposes. Research has also shown that women in general are more likely to use narcotic pain relievers and tranquilizers for non-medical purposes.
The number of teens and young adults (ages 12 to 25) who were new abusers of prescription painkillers grew from 400,000 in the mid-’80s to 2 million in 2000, according to a study by the Substance Abuse and Mental Health Services Administration. New misusers of tranquilizers, which are normally used to treat anxiety or tension, increased nearly 50 percent between 1999 and 2000 alone.
In a study of students in Wisconsin and Minnesota, 34 percent of kids diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) said they had been approached to sell or trade their Ritalin or Adderall, two drugs commonly used to treat symptoms of ADHD.
The growing population of aging Baby Boomers are also prime candidates for prescription drug abuse, intentional or not, as are the elderly. Once someone begins taking a number of pills for things like managing blood pressure and cholesterol, it becomes easier to take narcotic pain killers, prescription sleep aids and other, more addictive drugs. It also increases the risk of negative and possibly fatal interactions between drugs, especially when they are not used as prescribed.
Alcohol Abuse
Alcohol abuse is more insidious than drug abuse. Since having a drink is socially sanctioned, there is no overt reminder that the behavior may lead to trouble down the road. With illicit drugs merely using the substance is a reminder because it is illegal. Having a cocktail at dinner, drinking a beer at a ballgame, and celebrating a wedding with champagne are all socially supported and even encouraged. One can receive accolades for being able to hold one’s liquor. Becoming “shit-faced” in college is a right of passage. There are many models of respected people enjoying alcohol. This is not true for other substances. Hence, it is easy to rationalize moving from the occasional beer, cocktail, or glass of wine to daily use.
It is easy to go from the meal enhancing drink to using alcohol to self-medicate for social inhibition, depression, loneliness, anxiety, and other discomforting affects. Because some people can develop a tolerance for higher levels of alcohol in their system, they may need higher doses in order to experience the same effects. One drink becomes two, two becomes three. Where one beer was good, for some people it can easily become three, four, or more during the week with a few extras on the weekend.
Unfortunately, most alcoholics are not aware that they are alcoholics until they get into some difficulty. And when there is some warning, they often deny it. Often the early signs are related to work performance, health problems, social problems, legal difficulties, financial problems, or marital difficulties.
Some people are born with a genetic and biochemical predisposition that leaves them more vulnerable to abusing alcohol. They do not receive a signal from their brain that they have had enough or too much. Rather than producing sleep, nausea or other obvious physiological effect, they develop a tolerance for large amounts of alcohol. In fact, with continued abuse they begin to crave the substance. In addition, these people find that the alcohol temporarily comforts them by reducing shyness, anxiety, depression, and inhibition. In a world where alcohol use is approved of and even encouraged, it becomes part of the culture.
Alcoholics do not want to think of themselves as not able to control their drinking. They want to keep up with and be part of their social group. Declining a drink in many situations is difficult for these people. It is not until they have developed a dependence that interferes with work, family life, and social life that they begin to recognize that they have a problem. But by then it is often too late. The physiological craving for alcohol becomes so great that giving it up does not seem like an option. The centers of the brain that regulate judgment have been so affected that it takes a crisis to motivate these individuals to seek treatment.
Signs of Abuse
The very nature of substance abuse is such that people do not want to admit that they have a problem. People around them do not want to admit that there is a problem, and healthcare practitioners tend to either overlook or fail to investigate the possible existence of substance abuse. Hence, the individual goes diagnosed and untreated. There are several areas in which signs of abuse may appear.
Problems in living: financial problems including poor financial decision-making; poor judgment; legal problems including traffic tickets (e.g., DUI) and accidents; occupational difficulties such as poor performance, absence, conflict; social problems such as inappropriate behavior, missed appointments, chronic lateness.
Physical effects: increased incidence of health problems, poor dietary changes, higher tolerance for substance causing increased quantity and frequency of use; experiencing withdrawal when not using; higher incidence of nausea, dizziness, vomiting; disrupted sleep pattern.
Psychological and behavior effects: emotional instability, e.g., irritability, impatience; difficulty in abstaining from use; using substances to regulate affect, i.e., to reduce social inhibition, relieve stress, reduce anxiety or depression; denial and defensiveness when substance use is suggested.
Treatments
Interestingly, the research found that all people are not affected similarly by alcohol or drug abuse. For some the cognitive centers of the brain are more affected, for others the emotional centers are more affected. And for some both centers are affected. This has profound implications for treatment. One treatment does not fit all abusers. There is no magic bullet. In order to determine the best fit for any given individual, a complete psychological history and history of abuse and treatment must be taken. This places the individual into a context in order to decide what approach or approaches may be most beneficial.
Most treatment approaches agree that that the focus of treatment must be on the cessation of substance abuse. Even those experts who believe that it is possible for the alcoholic to learn to drink in moderation suggest that cessation for a period of time in the beginning of treatment is necessary in order for the patient and clinician to develop a clear picture of the role alcohol plays in the individual’s life. Most approaches, however, have abstinence as their goal, especially for those individuals who have a family and personal history of chronic abuse.
The following are some of the current treatment approaches for substance abuse:
Individual skill-based treatments: these approaches help clients interact more effectively with others without using alcohol or drugs. These approaches focus on coping and skills training to help clients quit or decrease abusing alcohol and drugs by teaching them strategies to address interpersonal, environmental and individual “skill deficits” that may provoke substance abuse.
Motivational Enhancement Treatments: this approach is based on a model that encourages patients to explore the consequences of drinking in a supportive, nonthreatening environment. One technique, called motivational interviewing, asks patients what about their alcohol or drug use causes them difficulties, enabling clients to examine their habits objectively. Once clients see how substance abuse or dependence affects their lives, they are motivated to change.
Cognitive Behavioral Treatment: CBT states that human behavior is learned through personal experience and cognitive thought patterns. Changing behavior requires learning how to think differently about situations and how to change dysfunctional behaviors that cause problems. Alcohol dependent people have learned to drink in response to specific situations. The treatment task is to identify the “alcohol triggers” and then apply techniques to develop new ways of thinking and new behavioral skills for coping with these triggers.
Environmental and relationship-based treatment: in this approach family members and significant others are taught coping skills and strategies to help influence their loved one’s drinking and motivation to change.
Behavioral marital and family treatment: this approach works with both the individual and the spouse or family to decrease or eliminate abusive drinking-related consequence.
Twelve-step programs: these inpatient or outpatient programs are based on the 12step model of Alcoholics Anonymous except that professionals lead them. Some professionals in private practice also use such a model, while other practitioners use AA to supplement and support the work being done by the patient in individual treatment.
Medications: Two medications disulfiram and naltrexone have been approved by the FDA for alcoholism with a third showing promise, acamprosate, which is pending approval. Naltrexone appears to be most effective with fewer side effects.
As mentioned previously, no one treatment is effective for all substance abusers. Several variables must be taken into account in order to find the treatment that is most effective for any given person. Such factors as duration of addiction, family history, degree of substance abuse, extent of disruption in the patient’s life, health, degree of motivation, to mention the most obvious, must be evaluated.
The first step in the treatment of substance abuse, after collecting a complete psychological, health, and substance abuse history, is to focus on harm reduction. If an individual is placing him or herself, or his or her family, in immediate danger, action must be taken to reduce the impending danger. Sometimes this may require inpatient treatment and sometimes it may involve the entire family. It requires developing a plan of action that can be implemented quickly. The focus during the early sessions is on changing the addictive behavior. In order for treatment to be effective, the individual must be sober. That is the first goal. Staying sober is the bulk of the work. Once sobriety has been achieved, treatment can focus on helping the patient restructure his or her thinking, behavior, lifestyle, and focus. Maintaining sobriety becomes a top priority especially in the early stages of treatment.
Frequently substance abusers have personality difficulties in addition to their addiction. Such concurrent psychological problems as depression, anxiety, social phobia, low self-esteem and other such personality issues, need to be addressed as well as the addiction. Alcoholics and drug abusers often use various substances as a form of self-medication to help them cope with these issues. In treatment, however, we first focus on the substance abuse and then work with the personality issues that may coexist. Sobriety or harm reduction is the immediate goal.
