Simply Sober Won’t Do – From Crystal Meth Addict to Scholar

August 29th, 2010

This is a “reprint” of an article I recently wrote for a NY publication called Spotlight On Recovery:

For an addict, the prospect of no longer using whatever it is that gets them through each day is daunting. There’s a comfort in knowing what life is going to look like even if all it entails is dragging yourself out of bed, taking a drink, smoke, or hit of crystal meth, and going on with a day focused only on managing the disaster. The dark cloud that surrounds us is obscured by our drug of choice; it’s what makes the days tolerable.

The first step of recovery – Addiction treatment sets the table

Some of us are sent into treatment by family members or jurists, while others recognize the problem themselves and decide to take the first step into addiction treatment on their own. However we get there, getting into addiction treatment is only the first step; often it’s not even the one that gets us clean. Whether you recover by yourself or with help, whether you got it done your first time or your twelfth, if you’ve managed to stop using, you’ve come up against the ultimate challenge: What now?!

For me, the most difficult aspect of steering my life in the right direction was simply learning how to live. True, I’d been doing it for 24 years by that day, but my life involved constant escape, discomfort, and boredom. When I stopped smoking crystal meth, getting over the fatigue, hunger, and even my non-existent libido (all part of my withdrawal) was easy when compared with the simple challenge of what to do every day.

You see, I smoked crystal meth for 5 years (and before that came alcohol, weed, cocaine, and a slew of other drugs). I smoked meth when I was in a good mood, when I was upset, when I was bored, sad, tired, or alert. With the one common denominator in my life now gone, I wasn’t even sure how to simply pass the time. True, rehab had groups, it had meetings, and it gave me an opportunity to discover myself. But, while all those were helpful, for me, it was the time in between all those that was a challenge.

Learning to live without drugs – Finding purpose in recovery

My inability to fill my time with anything other than thoughts of using got me tossed out of my first rehab. Going back to work in my studio, I couldn’t help but look for some left behind treasures; I found a bag of meth, filled a pipe, and threw out three months of sobriety without a second thought.

My second attempt at getting sober was more successful, not only because I’d learned from my mistake. I’d made mistakes before but never learned a thing. The difference was that this place made us all do chores. They made us work. They made us recognize, and then follow through, on what it meant to be a normal, functioning, member of society. As I got a better and better grasp on life as a non-user, I realized that for me, simply staying sober was never going to cut it.

I’m a doer. I need to get things accomplished in order to feel satisfied. When it came to my drug life, I got things done by becoming a pretty successful drug dealer as well as a less successful, but working, musician. Now, I needed to find another channel for my energy, one that didn’t center around filling a meth pipe.

12-Step meetings did the trick for a little while. Having a place to go where I didn’t have to be ashamed of my past made it easier for me to get adjusted to sober life. Still, within months, I was getting restless again, and for me, that’s a sign of trouble. I was looking for something to do that would pose a challenge, giving me something else to focus on than the gap left in my life.

My purpose – To learn about addiction and help others

I’d always been good at school. Even in the throws of my crystal-meth addiction, I managed to perform well enough in class. That was the reason for my looking into academics as my healthy way out. I mulled over the possibilities with my parents. I was a pre-med student in college and thought about medical school. My dad, a physician himself, wasn’t excited about the idea. Understandably, he wasn’t quite ready to believe that I could follow through on such a challenge. I hadn’t done anything to give him a reason to believe yet.

I decided to start more gradually, and applied for a Master’s program in psychology at a state school in California. Psychology was my undergraduate major, which made the application a little bit easier, but getting myself ready for a life I’d left so far behind was scary.

No matter how dark, there’s a charm in the aimless nature of drug addiction; the focus is simple, the goals, close at hand, and the reward, immediate. What I was embarking on now was some nebulous, long term contest that could end up any which way. I wasn’t sure I was ready for the uncertainty. Still, within minutes of sitting down in that first summer class, I knew I’d made the right decision.

Now that I was sober, I liked the daily routines I’d run away from so many years before. When class was finished every day, I was happy to dive into the work, proving to myself that I could do well here again, that I could reach my goal of getting a Master’s degree after more than 5 years as a daily crystal-meth user-dealer. I did well in that program and started looking into psychology research about addiction. I’d slowly moved away from the rooms of AA, and looking into the psychology of addiction allowed me to stay close to the reasons why I was taking this new path. It also allowed me to work with others who’d had similar experiences to my own without focusing on the past as much as AA meetings did.

I performed so well in the program that I started looking into further schooling, eying the outstanding program at UCLA, my alma mater. The UCLA psychology graduate program is the best in the country and one of the best in the world. Feeling a bit like a novice climber taking on Everest, I set my sights high and went for it. I gathered recommendations; I made phone calls, set up interviews, and worked my full court press. After working tirelessly for more than six months, the good news came in. I was ecstatic. Then I was scared. Quickly, I realized that for me, challenge is food. I need to feel like I’m working toward something to quiet the restlessness in my head.

I know now, having researched addiction for the past 9 years, that addicts have personalities that make them search out challenges, make them need a rush, that leave them unable to sit still. For some of us, it manifests as Attention Deficit problems, but even for the others, for whom the challenge doesn’t quite reach clinical levels, the underlying restlessness is still a constant factor.

In our past lives, that restlessness left us searching for a way to pass the time. Drugs did that reasonably well for me while filling my life with distractions that moved me away from everything that was important. In my new life, I made sure that the challenges were worthwhile; I got involved in sports, rechanneling my need for achievement not only into school, but into fitness as well.

It has taken me years to balance my life, and the struggle is ongoing. I still have classmates, as well as my wife, reminding me sometime that I need time off once in a while to smell the roses. They’re right, and I try, but for me, staying busy is the rose. Without my endless work, I’m afraid I’d lose my grip.

So no matter how long ago it was that you seemed to have lost your passion, if you want to make life without drugs worthwhile, it’s crucial that you find it again now. Simply being clean of drugs is not the end-all. In fact, being drug free merely offers us the means to rediscover the life we left behind.

Posted in:  Addiction Stories, Drugs, For addicts, Tips Tags: addiction, challenge, crystal meth, life, meth, PhD, Sex, teaching, treatment, weed

About Addiction: Basics, Smoking and drugs

May 31st, 2010

Whether you are interested in addiction as a whole or specific drugs, we have it all here.  Read on for some interesting breaking news and informative articles.

Addiction Basics

Addiction in Recovery: Alcohol and drugs are not the only addictions looming over US college students heads. This article reveals that cut off from the Internet, social media, cell phones and devices like iPods and TVs, students experience agitation, aggression, slight depression and a sudden overabundance of time.

PRLog: Some basic addiction statistics.  In 2001 almost thirty percent of kids between the ages of twelve and seventeen reported using drugs.

Smoking

Medical News Today: This article discusses a study which found that Arizona’s smoking ban reduced hospital visits.  Since the 2007 state law took effect, admissions for ailments related to secondhand smoke have declined by as much as 33 percent.

Health Today: A new study found that Americans could suffer 18,000 fewer attacks per year, save millions in health costs if all states banned smoking in restaurants, offices and other public spaces nationwide.

Medical News Today: The medical marijuana boom is always a prevalent topic. According to this article, fourteen states in the US plus the District of Columbia have passed laws intended to give certain ill people legal access to medical marijuana.

Other Drugs

Harm Reduction Journal: This is about a case study examining the closure of a large urban fixed site needle exchange in Canada. The article concludes that closing the fixed site needle exchange had an adverse effect on already vulnerable clients and reduced access to effective comprehensive harm reduction services.

AP News Break: The investment and crackdown of drug war in Mexico have failed to halt drug-related violence, which has killed 23,000 Mexicans in the past three years, or the availability of drugs in the U.S. marketplace, the world’s biggest. Obama said Tuesday that he would send as many as 1,200 National Guard troops back to the US- Mexico boarder to help battle illegal immigration and drug smuggling.

Science Daily: Researchers at Harvard-affiliated McLean Hospital have produced the first evidence that the opioid blocker extended-release injectable naltrexone (XR-NTX) is able to reduce the brain’s response to cues that may cause alcoholics to relapse.

Posted in:  Education Tags: addiction, alcoholic, artificial sweeteners, college, college drinking, Drugs, hospital, internet, marijuana, mexico, naltrexone, secondhand smoke, smoking, tobacco, weed

Helping Addicts with medications for cravings

May 16th, 2010

If we could make it so drug addicts could stop craving the substances that have brought them to their knees, would relapse rates drop and addiction-treatment success rates soar? I sure hope so!

Medications that stop cravings?

I’ve already written about a study by the renowned addiction researcher Barry Everitt showing that medications could be used in treatment to help addicts who are struggling with strong cravings and the effect of triggers (see it here). Still, in that study the researchers used a drug that blocked pretty much all memory formation and my original idea had to do with using a very common drug, one being used every day for hypertension, and more recently, in the treatment of PTSD.

Well, a study recently completed revealed that indeed, propranolol, a common beta-blocker, may be useful in greatly reducing the amount of time needed to overcome the sometimes crippling effect of triggers on behavior.

How this trigger to cravings study worked

The researchers trained rats to take cocaine, and after they were well trained, allowed them to press a lever for a light that had previously been associated with the drug. This is a common method to test the way animals react to triggers that have been associated with the drug. Even though the animals are no longer getting any cocaine when the light goes on, the fact that it had been previously associated with the drug makes the animals press the lever, like an addict triggered by something they’ve associated with their drug use.

The animals that were given propranolol immediately after every session took half as long to stop pressing for the drug-associated light. It took multiple administrations of propranolol (seven to be exact), but the effect was clear. The next step is to see if the same effect can be observed in people.

Helping addicts transition to outpatient substance abuse treatment

I’ve been claiming for the past few years that if we look in the right places, we can find many ways to help struggling addicts who are having a hard time quitting using currently available methods. I think that the notion that sticking to the “best method we have right now” is unwise given the fact that science has progressed quite a bit in the past 20-30 years. I agree, and am thankful, that the system works for some, but there’s no question that many still have trouble recovering from addictions that devastate their own lives and the lives of many close to them. I think these medications can offer some serious help.

The thing is, that if we could seriously reduce the impact of cravings on relapse rates, it’s possible that addicts would be ready to move from residential to outpatient substance abuse treatment  more quickly. Indeed, the main reason for keeping people in residential treatment is the thinking that they’re not ready to be in the world given the influence of triggers. My guess is that this is true for some addicts, but if we could provide an intervention, like propranolol, that would significantly reduce the influence of triggers, outpatient substance abuse treatment, which is a cheaper option, will be useful for many more. This would mean more people in treatment that truly works for them for less money. Sounds good to me.

Citation:

Ashley N. Fricks-Gleason & John F. Marshall (2008). Post-retrieval ß-adrenergic receptor blockade: Effects on extinction and reconsolidation of cocaine-cue memories. Memory & Learning, 15, 643-648

Posted in:  Medications, Treatment Tags: addiction, cocaine, Drugs, medication, methamphetamine, outpatient substance abuse treatment, propranolol, PTSD, rats, substance abuse treatment, treatment, weed

Drugs and Pregnancy Part II: Cigarettes and Weed

March 29th, 2010

We’ve already covered the issue of drinking alcohol while pregnant. Now it’s time for smoking.

When a pregnant mother smokes cigarettes, nicotine and carbon monoxide pass across the placental barrier. This disrupts the normal transfer of oxygen and nutrients to the developing fetus, harming its development.

Smoking in pregnancy

It’s been estimated that nearly 1 in 10 American women smoke cigarettes while pregnant (1). This is an alarming statistic considering that studies have repeatedly shown maternal smoking to be associated with adverse birth outcomes such as low birth weight (LBW), miscarriage, and infant mortality.

LBW infants are the result of a preterm birth, intrauterine growth retardation, or both. Nearly twice as many infants born to smokers have a low birth weight when compared to infants of nonsmokers (1), putting them at risk for cerebral palsy, mental retardation, and learning problems. Smoking during pregnancy has also been linked to respiratory disease and sudden infant death syndrome (2).

The effect of maternal smoking on the fetus depends on when it occurs. As we’d reported with drinking, smoking does the most harm during the early stages of pregnancy and the least during the later stages of pregnancy.

What about marijuana?

Studies of marijuana use during pregnancy provide some inconsistent results. Some studies link maternal marijuana use to growth retardation, preterm birth, decreased head circumference, and learning disabilities (3). One study concluded that marijuana has no adverse effects on children up to the age of 3, but after age 3, children who are exposed to cannabis in-utero are more likely to demonstrate attention deficit, hyperactivity, delinquent behavior, and decreased reasoning ability (4). Other studies find absolutely no association between marijuana and adverse birth outcomes.

The truth is, we don’t really know what marijuana use during pregnancy does to an infant, partially because researchers face two unique problems when studying maternal marijuana use:

1) Social stigma against drug use during pregnancy is likely causing women nationwide to under report their marijuana use.

2) Marijuana users are more likely to be using alcohol, cigarettes, and other illicit drugs. It is well known that poly-drug use during pregnancy greatly increases the chance of adverse birth outcomes (5).

So, smoking cigarettes and weed apparently does not consistently cause the same harm that drinking causes. However, the harm brought about by smoking seems to depend less on the amount smoked and more on the combination of substances used and its timing.

Keep on the lookout for more posts on drug use during pregnancy!

Citations:

1. Martin, J. A., Hamilton, B. E., Sutton, P. D., et al., (2003). Births: Final data for 2005, National Vital Statistics Reports, 56(6)

2. Difranza, J. R., Aligne, C.A., & Weitzman, M., (2004). Prenatal and postnatal environmental tobacco smoke exposure and children’s health, Pediatrics, 113, pg 1007-1015

3. Hatch, E. E., & Bracken, M.B., (1986) Effect of marijuana use in pregnancy on fetal growth, American Journal of Epidemiology, 124, pg 986-993.

4. Huizink, A. C., Mulder, E. J. H., (2006). Maternal smoking, drinking, or cannabis use during pregnancy and neurobehavioral and cognitive functioning in human offspring, Neuroscience and Biobehavioral Reviews, 30, pg 24-41

5. Hall W., and Solowij, N., (1998). Adverse effects of cannabis. The Lancet, 352, pg 1611-1616

Posted in:  Education, Marijuana Tags: cigarettes, fetus, joint, marijuana, nicotine, polydrug, pregnancy, smoking, weed

The benefits of marijuana: Things are far from all bad for weed

March 23rd, 2010

Marijuana can certainly be beneficial.

It’s true that essentially every drug has some abuse liability. However, somewhere in the vicinity of 85% of those who try any given drug will never develop abuse or addiction problems (yes there are probably variations based on specific drugs, but that’s a good estimate).  As we all know, marijuana is a drug that receives a lot of attention and drives intense debate when it comes to its benefits and harms.  While most of the posts on my site focus on the other 15%, there is, and continues to be, evidence for the benefits of marijuana and other drugs that directly activate cannabinoid receptors.

Some of the shown benefits of marijuana

THC, the active ingredient in cannabis, is known to cause sedation, euphoria, decrease in pain sensitivity, as well as memory and attention impairments.  But there are some aspects of the cannabinoid receptors that have been shown to be effective in AIDS, glaucoma and cancer treatments.

Stimulation of cannabinoid receptors causes an increase in appetite and therefore helps with the wasting syndrome often seen as a side effect in AIDS treatments or those with eating disorders. Since THC activation decreases intra-ocular pressure, another area in which marijuana has been proven to be effective is in the treatment of glaucoma.  THC’s anti-emetic (or anti-vomiting) properties also make it a very useful tool for combating the side effects of cancer treatments.

Still, the activation of cannabinoid receptors is not synonymous with smoking weed. In fact, there are a number of other possible ways to consume THC and other cannabinoid-receptor activators. Also, THC is a potent immune suppressing agent, so in someone who already has a compromised immune system, such as AIDS patients, marijuana and other THC compounds could increase the risk of infection.

Future promise for the use of THC in medicine

There is some evidence that of the 2 major THC receptors (CB1 and CB2), one is associated with the immuno-suppression that occurs after chronic usage and the other is associated with the the more beneficial aspects we’d discussed. In the future, we may be able to produce a compound that activate only the behavioral effects and could therefore be used more safely for AIDS patients. Marijuana lovers will say that we should leave things as they are, but I’m all for less immuno-suppression with my cancer therapy.

Again, just because activation of THC receptors can provide the above benefits does not necessarily mean one should smoke marijuana. As usual, the benefits and risks have to be considered and one has to reach an educated, informed, conclusion. Still, there’s little doubt that in some situations, the use of marijuana, or other THC activators is not only prudent, but indeed recommended.

Co-authored by: Jamie Felzer

Posted in:  Drugs, Education, Marijuana, Medications, Prescription, Treatment Tags: AIDS, cancer, glaucoma, HIV, marijuana, prescription drug use, prescription drugs, prescription medication, smoking weed, THC, weed

Weeding out your significant other? The effect of marijuana on relationships

March 12th, 2010

contributing co-author: Gacia Tachejian

Being young involves quite a bit of exciting change. There’s the end of high-school, the start of college and some measure of independence, and a whole slew of new experiences.

A recent study conducted by Judith Brooks at NYU School of Medicine has revealed that one of those experiences, smoking marijuana (weed) may be associated with more relationship conflict later in life. What’s amazing about this study is that the drug use here occurred earlier in life for most of the 534 participants, while the relationship trouble was assessed around their mid- to late-twenties.

Could other factors explain this finding?!

Now you may be thinking to yourself that there are a whole lot of other aspects of a person’s life that can affect their relationship quality and their probability of smoking weed in adolescence. You’d be right, but here’s what the researchers in this study ruled out as possible confounds (the scientific name for variables that obscure findings):

• Relationship with parents
• Aggressive tendencies
• adjustment difficulty
• gender
• education

Even after controlling for all of these things, smoking marijuana as a teen still predicted having less harmonious relationships later on in life.

Limitations

All humor aside, this research is not saying that if you smoke weed you will definitely have a lower quality relationship later. What it does point out is that, on average, given a person with similar social skills, aggressive personality, and education, the one who smoked marijuana around their mid-teens is likely to have a less satisfying relationship.

UPDATE: Before you leave another angry comment about how wrong this article is to suggest that marijuana can cause any problems ever, please read my article on the difference between causality and association; this article is talking about an association, not causality.

Citation:

Brook, J. S., Pahl, K., and Cohen, P. (2008). Associations between marijuana use during emerging adulthood and aspects of significant other relationship in young adulthood. Journal of Child and Family Studies, Vol 17, pg. 1-12.

Posted in:  Education, Marijuana, Opinions Tags: addiction, adjustment, adolescent, aggression, association, causation, conflict, dope, drug use, education, gender, green, high-school, marijuana, medicine, pot, relationship, research, skunk, study, teen, teens, weed

Drug use isn’t the problem – Addiction and the question of legalization or decriminalization

December 1st, 2009

I don’t keep it a secret that I used to have a very serious drug problem. If you haven’t read it by now, my drug use started early on along with a whole bunch of high-school friends. They smoked weed, I wanted to fit in, and the rest is history.

But guess what? Most of them turned out fine.

Drug use versus addiction

Only about 3 of us ended up screwing up a major part of our lives because of our drug use. One friend died 8 years later from AIDS after finding out way too late about an HIV infection he got from shooting up heroin. Another dropped out of college and never made it back. I developed a massive habit that only grew bigger when I shifted from simply using drugs to selling them. Then I got arrested, served a year in jail and went to rehab. That sucked.

The thing is that I don’t think drugs were the source of our problem.

I’m pretty sure I’m going to get my own genetic code sequenced some time in the near future in order to certify this, but I think we all had way too much of the impulsive, rush-seeking in us to allow the rules of society to keep us down. If it wasn’t for the drugs, something else would have probably gotten us sooner or later. I know that, to date, my own love for speed (as in miles per hour) and motorcycles already got me in 3 pretty serious accidents.

What I know now is that once you start using drugs on a regular basis the issue of how you got there no longer matters. Your brain controls your behavior and when drugs control your brain, you’re out of luck without help.

Is the answer legalization or decriminalization?

I think legalization is a mistake. Making a drug legal gives the impression that the state sanctions its use. Heroin, cocaine, crystal meth, ecstasy, and yes, even marijuana cause problems for people. I think that sending any other message is dangerous.

It’s not a coincidence that most people with substance abuse problems in this country (about 15 million) are pure alcoholics. Want a guess at the second biggest group? The marijuana dependent group is about 5 million strong. The rest of the drugs pick up only a few millions in total. Any move towards the legalization of any new drugs will most likely increase their use and therefore the number of addicts.

Still, decriminalization could be the answer. I’ve been meaning to write a post about Portugal’s decriminalized system for a while and haven’t gotten around to it. The bottom line? People found with illegal drugs are given a ticket and sent before a committee. The more visits one has in front of the committee the more forceful the push towards treatment. Still, unless a drug user commits another crime aside from the  possession of drugs they aren’t sent to jail.

As it stand right now, 30%-40% of our prisoners are in for simple drug offenses. That means not only billions in wasted incarceration costs every year, but also billions and billions more useless dollars thrown away at future sentences, court costs, and more (health care, probation and on and on). As it stands now recidivism rates, especially within the addict population are at 70% or higher! Unless these people get treatment, they will go back to jail! It’s that simple. Really.

So what should we do?

Many people aren’t going to like my view point. Those of us in the addiction field are supposed to scream as loudly as possible that drug are bad and that their eradication should be a major goal of our system. I disagree. Sue me.

I think we need to put the money we’re putting into jailing drug addicts into treatment. Even if it saves no money in the present (it will) we’ll be seeing huge savings over time as less of these people go to jail, more of them earn wages and pay taxes, and less of them make wasteful use of other resources like emergency rooms and social services.

And guess what? It will make our society better. We’ll start taking care of our citizens instead of locking them up. We’ll be showing Americans that we believe they can overcome rather than telling them we’d rather see them rot in jail than help them. We’ll be cutting down the number of single parent households and along with them god only knows how many more seemingly endless problems.

That’s my story, an I’m sticking to it.

Posted in:  Education Tags: AIDS, college, drug problem, genetic, health care, heroin, high-school, HIV, illegal drugs, possession, recidivism, rehabs, selling drugs, shooting up, treatment, weed