Global Commission on Drug Policy: Legalization, decriminalization, and the war on drugs

June 7th, 2011

A commission made up of some big names, though not really any names of addiction or drug researchers I noticed, just released a report that’s making a lot of noise throughout every news channel including NPR (see here, and here for stories) and others (see CNN). They want the debate about the current state of drug regulation expanded, and since I’ve written on the issue before, I figured it’s time for another stab at this. Read the rest of this entry »

Posted in:  Education, Opinions Tags: abstinence, Alcohol, cigarettes, CNN, commission, commission on drug policy, criminal, criminalization drugs, decriminalization, drug, drug use, Drugs, harm reduction, hope, legalization, NPR, offenders, prison, replacement medication, report, Richard Branson, should we legalize drugs?, smoking, stigmatization, stimga, syringe, treatment, War on Drugs

Two Million Dollars a piece – The cost of drug use and violence

May 25th, 2011

The average cost to society of a lifelong criminal = About $2 million

I’ll get into more of this in later posts (I already talked about the cost of addiction prevention versus treatment versus enforcement), but if that cost of drug use and violence doesn’t cry out for a better application of money to prevention and addiction treatment, I don’t know what does.

At that cost, even if a treatment method costs $10k per client, it only needs to work for 1 out of 200 people to break even, and benefit society while doing so. In reality, our success rates are much higher than .5% (1/200) and closer to 15%-25%. When you take into account the fact that average cost of a month in addiction treatment (residential, outpatient treatment is much cheaper) is indeed about $7000-$10,000, it seems silly not to avoid the cost of crime by greatly reducing drug use, and hence criminal behavior.

NIDA, the government’s top agency for drug and alcohol abuse research recommends three months of treatment, but even then, success rates as low as 2% would leave us with a profit by providing treatment. Screw it, even a whole year of treatment would save us money if it succeeded but I can tell you that funding for that kind of addiction treatment length is almost non-existent, especially when compared to the actual need.

So with success rates about 20 to 30 times higher than our break-even point, we would literally benefit, and I’m talking financially, from helping people with treatment as expensive as $100,000 or more (as long as it worked). One of the things I’ve learned in all my work has been that while some individuals are actually interested in helping people, yes, even if they’ve been dirty drug addicts who have commited crimes, almost everyone cares about money. So forget for a second about all the social justice arguments to be made for helping addicts and think about the cost savings to our society… It makes sense.

True, true, not all drug users who would enter treatment would become lifelong offender, but if you’re still keeping tabs, even if only 1/20 or so do, we’re more than breaking even here. In fact, with our prison populations exploding as more and more drug users enter the system, I bet we’re in for some real savings.

Citation:

Dodge, K. A. (2008) Framing public policy and prevention of chronic violence in American youths. America Psychologist, 63, 573-590.

Posted in:  Education, Opinions, Treatment Tags: addiction, average cost, cost, criminal, drug, drug use, enforcement, helping, helping people, million, money, policy, prevention, success rates, treatment, violence

Brain damage and changes due to drug use – Video

May 23rd, 2011

Posted in:  Education, Links Tags: brain damage, Dr. Jaffe, drug, drug use, neurotoxic, question, use

Body image and medicalization: Socially relevant behavioral “addictions” beyond drug use

May 21st, 2011

We know that addiction can go beyond drug use, but are we becoming addicted to making our bodies perfect?

I put “addiction” in parentheses here because I think it’s important to distinguish substance-related addictions from behavioral ones. There’s no doubt that people’s behavior can become compulsive in the same way addicts become compulsive about using, but I’ve seen no evidence that behavioral addictions interfere with brain function in the way that cocaine, methamphetamine, and opiates alter actual brain mechanisms.

Still, this recent trend of obsessive plastic surgery is a dual-headed “addiction”, one that is both physical and social.  In many ways, people are now able to change aspects of their being that were once thought unalterable including their own physical appearances. To gain social acceptance, if you have money, you now have new tools!

This may also play a big role for those who are love addicted, at least if they have money… Read the rest of this entry »

Posted in:  Education, Opinions, Prescription, Tips Tags: addiction, antisocial, behavioral addictions, body image, celebrity, death, drug use, hollywood, hormones, love addicted, love addiction, love addicts, medical procedures, medicalization, medication, michael jackson, michael jackson's death, my addiction, people, perfectionism, pill, plastic surgery, prescription, relationship addiction, sex addiction, social, society, surgery

Sometimes it just takes blind faith – Depression and drug use

April 19th, 2011

I don’t normally like sharing this kind of stuff, but I think that if the point of the blog is be truthful, I need to cover all bases. When it comes to depression and drug use, I have personal experience with the connection.

When depression hits – Drug use and self-medication

I don’t always wake up ready to take on the day.

I know that what I’m doing is important, and I know that if I keep going I’ll be successful. Still, sometimes I wake up and feel like there’s really no point; like getting out of bed is useless and that I’m doomed to be nothing. Read the rest of this entry »

Posted in:  Addiction Stories, For addicts, Opinions Tags: belief, depression, drink, drug, drug use, faith, feeling, help, help depression, hope, isolation, know, pain, weed

Early drug use problems: Kids, inhalants, and huffing.

April 6th, 2011

22.9 million Americans report trying inhalants at least once in their lives.

When it comes to drug use problems, inhalants are often the first drugs that kids decide to experiment with. The habit is often called huffing. While use of alcohol, tobacco, marijuana, cocaine, ecstasy, and other drugs peaks around the 12th grade, inhalant use peaks in the 8th grade. A study conducted by the National Institute on Drug Abuse found that 17.3% of 8th graders have abused inhalants before.

Why does kids’ drug-use start with inhalants so early in life?

Many kids start inhalant drug use by accident; they like the smell of glue, whiteout, or gasoline, take a long inhale, get high, and keep going. For others, inhalant use is introduced through friends.

Also, attaining drugs can be somewhat of a challenge when you are 13 years old. Inhalants solve this problem. Inhalants are found in a variety of household products including: spray paint, nail polish remover, whiteout, marker, gasoline, glue, keyboard cleaner, shoe polish, and aerosol sprays. These products are easy to buy and relatively inexpensive, even for young kids. They can often be found readily in the house, which also makes them easy to hide.

Inhalants, the brain, and organ damage

Inhalants can be breathed in directly or concentrated in a container such as a plastic bag or cloth and then inhaled. Most inhalants work by depressing the central nervous system. The chemicals are absorbed through the lungs and proceed into the bloodstream, where they quickly reach the brain and other organs. Inhalant intoxication looks very similar to being drunk: Slurred speech, bad coordination, euphoria, dizziness, and drowsiness are all common during inhalant drug use.

The inhalant high only lasts a few minutes, so people often use inhalants repeatedly for several hours. This can have some devastating long-term effects. Brain damage, nerve damage, and organ damage are all possible. Inhalant use can impair vision, hearing, and movement. Inhalant drug-use is also linked with a variety of mental disorders, including antisocial personality disorder and depression. In pregnant animals, inhalant use has been linked to low birth weight, skeletal abnormalities, and delayed development.

Most tragically, even a single session of inhalant use can cause heart failure and consequently, death. The National Inhalant Prevention Coalition reports 100 to 125 inhalant-related deaths per year. This is particularly sad considering the fact that many of these individuals are kids and haven’t even left middle school yet.

Dr. Jaffe talking about huffing and inhalant abuse on Fox News

Citations:

1. Seigial, J.T., Alvaro, E.M., Patel, N., Crano, W.D. (2009) “…you would probably want to do it. Cause that’s what made them popular.” Exploring Perceptions of Inhalant Utility Among Young Adolescent Nonusers and Occasional Users. Substance Use & Misuse. 44(597-615)
2. NIDA. Inhalant Abuse. 2005

Posted in:  Drugs, Education Tags: addiction research, adolescent substance abuse, drug abuse information, drug use, huffing, inhalant, inhalant drug, inhalant drug use, inhalant use, inhalants, kids, statistics drug addiction, use

Calling bullshit on addiction treatment bullies

March 6th, 2011

About three years ago, I was attending a national conference on public health (American Public Health Association) and presenting my posters on the relationship between drug use and violence, and sexually transmitted infections and injecting drugs. As I walked the aisles I ran into a woman who runs a Florida addiction “treatment” facility. We talked for a bit about my work, her facility, and then we shared some of our personal stories. Mine included meth addiction, jail, recovery, and now graduate school studying addictions. Everything was great until I mentioned that I now drink alcohol socially… “We’ll save a seat for you” she told me as she handed me her business card. Idiot.

Recovery bullies and addiction treatment

As soon as my version of recovery from addiction didn’t match her expectations, it was an immediate failure. Forget the 6 years I’d spent free from crystal meth use, the excellent graduate school career that was producing real results I was there to present. Forget the fact that my family, my bosses, and my girlfriend at the time thought I was doing amazingly well – As far as this woman was concerned it was her way, or her way. Well I call bullshit on that thinking once and for all.

Unfortunately for her, the research evidence, as well as the actual human evidence that I’ve seen, shows that recovery from addiction comes in many colors and flavors, like pretty much everything else in life. We’ve covered research on all about addiction before showing that the best evidence to date actually calls into question the idea that relapse is the necessary disaster so many paint it as. The fact that the majority of those who meet criteria for drug dependence at some point in their life actually recover on their won is also there, and although this does nothing to reduce the impact of addiction on all those who have an incredibly difficult time quitting, it’s there and can’t be ignored. Drug dependence is almost certainly not a one size problem and the solution is probably far from a one-size-fits-all, no matter how much you like your own solution.

So there’s cognitive behavioral therapy, peer support solutions (like SMART Recovery, Rational Recovery, Life Ring, 12 Step groups like Alcoholics Anonymous, and more), medication-supported recovery (like Suboxone, Methadone, Vivitrol and more), Motivational interviewing and other Motivational Enhancement techniques, as well as a whole host of psychotheraputic approaches that are more eclectic. No research we have to date indicates that any of these approaches is necessarily more effective than others, which means that they are all essentially equally effective. We’ve already talked about some combinations that work very well together, like PHP programs for physicians, but there is absolutely nothing to indicate that the 12-steps (for examples) are somehow superior to CBT, or Rational Recovery, when it comes to treating addiction.

If you get better, you’re a success in my book

When it comes down to it, whether this Florida 12-stepper likes it or not, I am still a social drinker and I still don’t believe that this nullifies any of my other achievements or my successful recovery. More importantly, it doesn’t nullify the success of millions of others, no matter how poorly it fits with some people’s notions. When a life gets overrun by drug use or another addiction, a successful outcome to me means recapturing a functional life that is no longer dictated by the pursuit of that addictive behavior. Anything more or less is a personal preference sort of thing. The problem with these idiots who will absolutely ignore success because it doesn’t conform to their expectations is that they drive people out of treatment and away from success and that is not okay. I’ll continue to call them out for their narrow mindedness and hopefully eventually, their voice will be far from the dominant one.

Posted in:  Education Tags: 12 step, addiction, Alcohol, alcoholics anonymous, CBT, crystal meth, drug, drug dependence, drug use, Drugs, graduate school, MI, motivational, motivational interviewing, public health, recovery, relapse