Saving lives made easy – Treating opiate overdose with intranasal naloxone

October 24th, 2011

Contributing 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)

Posted in:  Education, For addicts, For others, Opiates, prevention, Tips, Treatment Tags: addiction, addiction help, death, heroin, naloxone, opiate, opiate overdose, opioid, overdose, prevention, substance abuse

A3 Academy: Low-cost but high-value addiction help!

September 26th, 2011

The A3 Academy will be taking place again this upcoming Tursday- September 29th, 2011 – In West Los Angeles (2001 Barrington Ave., Suite 204)

The topic for this week – This week we will have a process group so come ready to share with everyone in a safe, supportive environment!

Cost - The cost for the class is $30.

Who should come to the A3 Academy?

The A3 Academy is specifically formulated to fill the void between doing nothing about addiction and formal addiction treatment.

If you’re wondering whether you’re addicted or if know for sure you are but aren’t sure what to do about it, the A3 Academy is for you. If a loved one close to you is suffering with addiction and you don’t know what to do about it and want to talk, learn about options, or just listen to others, the A3 Academy can offer you the addiction help you need. If you’re an addiction professional who wants to learn more about the newest advances in addiction research, come to the A3 Academy. If you’re an addict in recovery post-treatment and just want an informal place for your recovery booster-shot, come to us.

Dr. Jaffe is going to use the A3 Academy to offer addiction help of all kinds – educational groups, informational sessions, process groups, life planning, mindfulness, nutrition, expert consultation with leading addiction experts from the Los Angeles area and beyond. If it has to do with addiction, we’ll probably cover it.

And Dr. Jaffe is a great speaker – if you’ve never attended one of his lectures, you’ll be sure to enjoy these as he gets to let loose with his knowledge, experience, and passion!

Addiction education is one of the main keys to improving addiction treatment, reducing addiction stigma, and helping those unsure about their own issues around addiction.

For tickets – go HERE or email us at academy@allaboutaddiction.com.

 

We’re looking forward to seeing you!

The A3 team!

Watch the A3 Academy Class right here:

Posted in:  Education Tags: A3, a3 academy, academy, addiction, addiction help, Los Angeles

Parenting advice – What’s important when it comes to teens, alcohol, and drugs

July 8th, 2011

Parents often ask us what they can do to prevent their children or teens from becoming alcoholics, drug addicts, criminals, and the likes. I’ve been all of these and more, and so I’d like to share my insight with you now that I’ve made it over to the other side:

You can’t prevent anything – but you can educate, inform, prepare, and support.

My family breaths success; it also breeds its. My father was a star athlete who turned into a star doctor and a star family man. He also never drank alcohol and couldn’t care less about drugs. My mother was a beauty queen who always helped me get the best grades in school, even if it meant that she ended up doing my art projects for me and keeping me up all night so I’d finish my work. I’m not sure if it was my perception or my parents’ actual wish, but I always felt like unless I saved the world, I would end up a nobody. Drinking enough alcohol to black-out and consuming every drug on earth was never supposed to be on my menu.

A recent article I read in a monthly psychology magazine (see my post on it here) talked about this sense of perfectionism in our culture and its effect on teen depression, anxiety, and alcohol and drug abuse. Did you know that these are highest among more affluent teens?

Advice #1 – Shooting for good performance is important, but focusing on it as a sole measure of success can lead to trouble.

I got gifts for grades, and the best gifts came only with the best grades. Anything short of perfect was pretty much frowned upon and considered “less than my best.” It became impossible for me to actually enjoy anything but the school subjects I excelled in (math, physics, chemistry). It wasn’t until I graduated from college and did some of my own exploration that I learned to appreciate art, English, and history as worthwhile pursuits. It’s a well-know fact in developmental psychology that you don’t reward behaviors that are supposed to be appreciated in their own right. If you do reward them do so with small gifts, nothing large. Big gifts take away the perception that the activity itself brought about enjoyment.

Advice #2 – Parenting requires consistency and openness, but leave the preaching for church.

This constant need for perfectionism also lead to the repression of many issues in my family.

My parents fought often when I was a kid, screaming loud enough for me to take my sister away often and go play. We never talked about the fights so I never managed to learn about conflict, relationships, or resolution. We never talked about my stealing either, whether I was stealing from my family (mainly my father’s porn) or from the neighborhood toy store. The one time I got caught, my father sternly told me to return my new toy and to never be caught stealing again. I began stealing away from my neighborhood; it would be years before he’d hear about me stealing again. It probably would have been better to sit down and talk about what just happened.

Later on, when my mother would find my weed in my room, she would hide it so that my dad won’t find it because he would get mad. We call that enabling. When I was caught stealing at my work, my father didn’t want to tell my mom, so as not to upset her, so he never brought it up again. We call that denial. Neither of these work since they don’t teach a child anything except how to hide things properly and that even responsible adults lie.

But research shows us that preaching is not a good parenting technique so stay open and talk about struggles without being hypocritical and trying to teach lessons that are obviously forced. Kids and teens pick up on that very quickly but they’re ready to learn from their parents.

Advice #3 – Don’t let your sense of pride, or your ego, prevent you from dealing with real issues with your children. Parenting requires you to be the adult in the relationship with your children even when things don’t go your way.

By the time my parents were forced to confront reality, things in my life had spiraled way out of control. They received a call from my LA lawyer telling them that their son had been arrested for some pretty serious drug dealing. My bail was set at $750,000 and I was facing 18 years in prison. That’s pretty difficult to ignore.

Ironically, my arrest, court case, and the year I spent in jail brought my family closer together than we had even been during my teen years or my later drug addiction phase. Having to actually confront many of our issues allowed us to bring some actual intimacy into the family I had run away from so many years before. The important thing was that my parents didn’t pull out the “we told you so” card but rather helped me confront my demons and treat them. It was the best parenting I’d received in my life and it worked.

My parents did the best they could. I know that. Still, I can’t help to wonder if worrying a little less about how things “should be” and a bit more about the reality of parenting their deviant son may have prevented the latter part of this story. Then again, there’s no guarantee of that either. That’s the most important parenting advice I can give when it comes to teens and drugs…

Posted in:  Education, For others, Tips Tags: addiction, addiction help, Alcohol, best, best grades, caught stealing, drug abuse, Drugs, family, help, important, parenting, parenting advice, stealing, teen addiction, teen drug use, teens and drugs

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

May 14th, 2011

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. Read the rest of this entry »

Posted in:  Addiction Stories, Drugs, Opiates Tags: addiction help, addiction stories, dope, drug withdrawal, finder, heroin, heroin addiction, heroin addiction stories, hydrocodone, hydrocodone withdrawal, methadone, methadone treatment, OC, opiate addiction, opiate addiction stories, opiate withdrawal, oxy, oxycodone, oxycodone addiction stories, oxycontin, oxycontin addiction, oxycontin addiction stories, rehab, rehab-finder, suboxone, suboxone treatment, time

Don’t walk this road alone – Tips for those still struggling

February 14th, 2011

Trying to quit an addiction can be challenging for many reasons. One of the biggest problems, especially at first, is the faulty learning that has taken place while using (or engaging in addictive behavior). For this reason, finding a long term residential addiction treatment option is ideal for people with severe and long addiction problems. And yet, for many, this solution is simply impractical.

If you can’t remove yourself from your everyday life for long enough to change your now addictive patterns, make sure to enlist the help of others around you.

Be honest with people who are close to you and are not using (at least not abusively) and ask them if they’d be willing to act as de-facto chaperons (or sober buddies). I’ve talked about it on here before, but if you’re anything like me, your addiction permeates your life. Make sure that you have planned activities that fill up your free time with those who are willing to help you. Read my treatment-related posts for specific ideas on things to fill up your time with (exercise, reading, gardening, etc.).

While you may have forgotten what going to the movies when not stoned feels like, trust me, it all comes back in time. Just make sure you have someone there to help you along the way in the beginning…

Like so much else, the biggest first step is asking for that help. Once that’s done, so much of the rest gets easier!

Posted in:  Education, For addicts, Tips Tags: addiction, addiction help, help, learning, rehab, residential, stoned, treatment, using

Physical addiction or psychological addiction – Is there a real difference?

July 20th, 2010

This is another one of the basic questions I get regarding addiction.

It seems that people think about physical addiction and psychological addiction as somehow separate processes. I think this distinction makes no sense. Even if people really meant what they were saying, the brain is undoubtedly part of the body, and therefore, psychological addictions are also physical.

The “Physical Addiction” Vs. “Psychological Addiction” truth

What people are really referring to when they make this comparison is the distinction between physical withdrawal symptoms and the addictive process in the brain. There’s no doubt that some substances, like alcohol, opiates, and the likes, leave long term users with horrible withdrawal symptoms that are terrible to watch, and even worse to go through. In fact, early addiction theories asserted that it was this horrible withdrawal syndrome that made people go back to drugs. This was called the Tolerance-withdrawal addiction theory.

The Tolerance-withdrawal addiction theory fell apart when addictions to substances that didn’t display such withdrawal effects became obvious (like cocaine addiction), and when getting people through the difficult withdrawal proved insufficient to cure their addiction (naltrexone was thought to be the magic cure once upon a time).

In one of my previous posts about marijuana addiction, a reader suggested that since marijuana does not produce horrible withdrawal symptoms, it can not be physically addictive. While withdrawal from marijuana, cocaine, methamphetamine, nicotine, and numerous other drugs does not result in the stereotypical “opiate-withdrawal-flu-like-syndrome,” there is no doubt that real withdrawal from these substances exists for long term users and it sucks: Fatigue, depression, anxiety, sleep disturbances, and trouble eating are only some of the symptoms that tend to show up.

Withdrawal – The real physical addiction

Withdrawal symptoms occur because the body is attempting to counteract the stoppage of drug ingestion. Just like tolerance builds as the body adjusts to chronic drug use, withdrawal occurs as the body reacts to its cessation.

As crystal meth increases the amount of dopamine present in the brain, the body reacts by producing less dopamine and getting rid of dopamine receptors. When a user stops putting meth in their body, the low production of dopamine must increase and additional receptors must be inserted. Like tolerance, the process of withdrawal, even past the initial, obvious, symptoms, is a long and complicated one. For crystal meth addicts, the initially low levels of dopamine result in what is known as anhedonia, or an almost complete lack of pleasure in anything. There’s no mystery as to why: Dopamine is one of the major “pleasure” neurotransmitters. No dopamine, no pleasure.

The process of addiction in the brain

So, if we’re going to try to dissect which drugs cause what effects on the body, it’s important that we understand the underlying causes for those effects and that we use the proper language. Withdrawal, tolerance, and addiction are different, though obviously related topics. Their interplay is key for understanding the addiction process, but their more subtle points can often be lost on those observing addicts unless they are well trained.

As I’d mentioned in earlier posts, our current best notions about addiction are that the process involves some obvious physical and psychological processes and some much more subtle effects on learning that are still being studied. A study I’m currently conducting is meant to test whether drugs interfere with some of the most basic learning processes that are meant to limit the amount of control that rewards have over behavior. Such fine distinctions are no doubt the result of the ways in which drugs alter the neurochemical reactions that take place in our brain. Such basic changes can not possibly be seen as any less important than physical withdrawal symptoms.

All in all, the only way to look at Addiction is as both a psychological addiction AND a physical addiction that are inextricably liked through our psyche’s presence in the brain, a physical part of the body. It may seem like a small thing, but this distinction makes many users feel as if their problem is less, or more, sever than that of other addicts. As far as I’m concerned, if you have a behavior that is making your life miserable and which you can’t seem to stop, it doesn’t matter if you’re throwing up during withdrawal or not. It’s an issue and you need help.

Posted in:  Education, For addicts, For others, Opinions, Tips Tags: addiction, addiction help, body, Brain, dopamine, drug withdrawal, horrible withdrawal, physical addiction, psychological addiction, tolerance, withdrawal, withdrawal symptoms

About Addiction: Smoking, Alcohol, Painkillers, Prescriptions

June 28th, 2010

This are new, interesting articles about addiction. Check out the links to the articles, and give us your feedback.

Smoking and related issues

Health Day: Smoking increases the risk of age-related macular degeneration, a disease that robs people of their sight.

Reuters: When cigarette smokers quit smoking, chronic stress levels may go down. This should give smokers reassurance that quitting will not deprive them of a valuable stress reliever.

Reuters: A nicotine mouth spray may help prevent cigarette cravings three times faster than nicotine lozenges or chewing gum. This might help smokers who are trying to quit smoking.

Cesar Fax: The percentage of national tobacco retailers selling to minors appears to have leveled off. The average national retailer violation rate decreased from 40.1% to 10.8%, and stabilized at 10.8%.

wcstv: Under a proposed deal reached by Governor David Paterson and Albany legislators, cigarette taxes would increase by $1.60 per pack. In New York City, the price of one pack of cigarettes would cost over $10 in many stores. The hope is that this huge price increase will help smokers quit smoking and reduce overall levels of smoking in New York.

About addiction to alcohol, painkillers, and prescription medication

Hazelden: Abuse of alcohol, painkillers, and prescription medication is rising dramatically among older people. Signs of alcohol abuse and drug addiction are different in older adults than in younger people.

Science Daily: Religiosity can moderate genetic effects on alcohol abuse during adolescence but not during early adulthood. The heritability of an alcohol abuse phenotype depends upon the social environment within which it is measured.

Medical News TODAY: Sleep problems can predict the onset of alcohol abuse in healthy adults and relapse in abstinent alcoholics. Puberty is related to sleep problems and later bedtimes, which are associated with alcohol abuse.

Health Day: Exercise may be an effective treatment option for alcoholism. In addition, alcoholism disrupts normal daily circadian rhythms, which can lead to disrupted sleep patterns.

About addiction and mental illness

KansasCity.com:  To study drug addiction and mental illness researchers, at the University of Missouri-Kansas City, have received a $1.8 million federal grant. One of the leading researchers states that conditions such as drug addiction and depression are major problems across the globe.

Posted in:  Education, Links Tags: addiction help, addiction research, Alcohol, alcohol abuse, alcoholism, amoking, cigarette, cigarettes, craving, Drug addiction, drug use, help quitting, mental health, mental illness, nicotine, painkiller, prescription medication, quit smoking, sleep, smoking, tax