Naltrexone the addiction cure?

January 23rd, 2012

CNN released a news article a little while back titled “With anti-addiction pill, ‘no urge, no craving‘” that seems to suggest that a cure for addiction has been found. As usual, news reporting on these sort of topics revolves around a kernel of truth, with nice window dressing an a serving of embellishment.

While naltrexone, and topiramate, have been shown to improve outcomes in addiction treatment, they have by no means revealed anything that would warrant giving them the title “anti-addiction pills.”

Indeed, there are now a few different preparations of Naltrexone, including a long acting version called Vivitrol that while relatively expensive, has been shown to be relatively effective at cutting relapse rates for both alcoholics AND heroin (or opiate addicts). Note the difference though here between my language and that used by CNN; Naltrexone has been shown to reduce relapse rates, not eliminate them, and current research seems to show that it is most effective only for specific groups of alcoholics who have a specific type of Mu opioid receptor.

As the article points out, a combination of therapies, including behavioral therapies, medications, and social-support, are still the best option when it comes to addiction treatment.

We’re a long way off from finding anything that can be considered a cure for addiction, no matter what some treatment centers like to claim, but these pills should help us stem the tide while we keep looking…

Posted in:  Education, Medications, Opinions, Treatment Tags: addiction, addiction cure, addiction pill, alcoholics, anti addiction, CNN, cure, cure addiction, heroin, mu, naltrexone, news, opiate, opioid receptor, pill, relapse rates, topiramate, treatment, vivitrol

More money more problems? Rich teens and drugs

September 7th, 2011

Teens raised in affluent homes display the highest rates of depression, anxiety, and drug abuse according to a recent article in Monitor on Psychology, the APA‘s monthly magazine.

One of our recent posts dealt with some of the issues unique to teens and drugs. In addition to the issues we’d already mentioned, the article named a number of reasons for the high prevalence of mental-health issues among affluent teens. Among them were an increasingly narcissistic society, overbearing parents, and an common attitude of perfectionism.

Each of these reasons are likely contributors to the prevalence of mental health and drug abuse issues among upper-middle-class (and above) teens. Still, as far as I’m concerned, the main take home message of the article is this:

Money truly doesn’t buy happiness – Rich teens and drug use.

While drug abuse research often focuses on the lower socioeconomic strata these recent findings indicate that being financially stable offers little in the way of protection from some of the most common psychological difficulties.

Thankfully, the researchers cited in the article gave some simple advice to parents:

• Give children clear responsibilities to help around the house.
• Take part in community service (to unite the family and reduce narcissism).
• Reduce TV watching (especially of reality TV shows that glorify celebrity and excess).
• Monitor internet use.
• Stop obsessing about perfect grades and focus instead on the joy of learning for its own sake.

I couldn’t agree more with these recommendations. Having taught a number of classes myself, I have witnessed the ridiculous inflation in students’ expectations of top grades. I think it’s time we turned attention back to the family and reintroduce some of the basic skills that many addicts find themselves learning much too late… Often in recovery.

Posted in:  Alcohol, Cocaine, Drugs, Education, For others, Marijuana, Meth, Opiates, Opinions, Prescription, Tips Tags: abuse, affluent, anxiety, celebrity, challenge, class, depression, grades, internet, middle, money, monitor, narcissis, perfectionism, responsibilities, rich, skill, substance, teens and drugs, television, tv, upper

Family Addiction – A Tough Nut to Crack

August 3rd, 2011

Guest author – Lisa Fredriksen from breakingthecycles.com:

I was 49 years old when one of my loved ones entered a residential alcohol treatment program and I found myself plunged into a whole other world – a world that included terms and concepts like codependency, adult children of alcoholics, 12-step programs, co-addictions, dual diagnosis and the role a family member has in the denial that protects a loved one’s drinking. The family addiction world was a world I found confusing and overwhelming as I learned just how many of my loved ones had an alcohol problem and what that had meant in my life.

True to my nature, I began my quest for deeper understanding in the same way I’d approached my six other published nonfiction books and numerous articles. I immersed myself in research, intent on learning as much as I could about the subject – in this case alcoholism and treatment programs – and then all of the other issues that emerged as I tried to understand why a loved one drinks too much and why someone like myself puts up with it for so long. I started attending Al- Anon meetings, doubled my individual therapy sessions and attended family-help group sessions at the treatment center, as well.

My book, If You Loved Me, You’d Stop! What You Really Need To Know When A Loved One Drinks Too Much, and my blog, www.breakingthecycles.com, are the culmination and continuation of my discoveries. I hope that by sharing what I have learned, others – whether a parent, friend, sibling, spouse or child – will find the tools they need to live their lives.

I share this information because I wish I had known it, that it had been openly and freely talked about, long before I’d spent decades grappling with my various loved ones’ drinking. I try keep my shares (including my book) very short and simple. I know, myself, that when I first started looking for information, I was frustrated with the variety and depth of the books and research on what I was striving to understand – excessive drinking (alcohol abuse), alcoholism, co-addictions, adult children of alcoholics, codependency, dual diagnosis, how to help the alcoholic stop drinking, how to heal the family, how to talk to your children, family in recovery – and the list went on and on.

For now, I’d like to leave you with my top key discoveries:

1. Alcoholism is one of the diseases of addiction – a chronic relapsing disease. Check out www.hbo.com/addiction for a wealth of information. It’s produced by HBO, NIAAA, NIDA and The Robert Wood Johnson Foundation.
2. To begin treating addiction, the substance of abuse must be stopped in its entirety in order to allow the structural and chemical changes in the brain to change and recover.

These first two discoveries freed me from my continued efforts to try control my loved ones’ drinking and thus stop my nagging, raging, deal-making and shaming – the behaviors I’d been using in order to “help” them stop [hence the title of my book, If You Loved Me, You'd Stop!...]. They also allowed me to respect the person but hate the disease and know that until that person came to grips with the power of addiction, they would/will continue to drink, no matter how hard they try to control their drinking.

3. Other family members need help, too, in order to change some of the behaviors they’ve adopted in order to survive but that are actually getting in the way of their living healthy, happy, fulfilling lives, regardless of whether their loved one stops drinking or not.
4. Alcoholism is a young person’s disease. Due to brain imaging technologies of the past fifteen years or so, neuroscientists have been studying how the brain develops. According to NIAAA, half of alcoholics were addicted by age 21 and two-thirds were addicted by age 25. Click here to better understand why.
5. Having a dual diagnoses (a mental illness, such as depression, bipolar, ADHD or PTSD) and an addiction (to alcohol or drugs) is common. Click here for information.

Posted in:  Drugs, Education, Opinions, Treatment Tags: 12 step, addiction, alcoholism, codependency, dual-diagnosis, family addiction, NIAAA, NIDA, residential, young

Shame on me – Stigma and addiction in treatment

July 12th, 2011

I keep hearing that back in the old days of addiction treatment, shame was the main motivating factor used by rehab counselors. Everyone admits that it proved to be a horrible motivator. It simply didn’t work! With all the advances in research into addiction, that must have changed, right?

I don’t think so. I see shame and stigma every time I hear an addict talk about their drug use. The shame is there in their eyes as they tell the stories of their trouble and the struggles of their recovery. Given the low rates of success in addiction treatment, the shame rests firmly in the inability to quit as well. A relapse is often seen as the ultimately shameful experience for an addict. The stigma of addicts as hopeless is rampant.

Still, we have evidence of genetic predisposition to drug abuse and addiction, we know of environmental factors that make it more likely that people will get hooked. The effect of many drugs on the brain make unsuspecting lab animals as likely to become addicted as any one of us and I’m pretty sure that shame doesn’t play a role in their process.

With all this evidence, why is the stigma of drug addicts still around? Why are they the only ones being blamed for their condition?

The evidence I cited isn’t that different from that known for cancer, yet we scarcely blame cancer patients for their disease. Even in the case of smokers who become ill, their is still sympathy for their suffering. So why are addicts different?

There are good addiction treatment options out there, as long as we don’t give up on the person and simply view their addiction as evidence of their weak character. Given the changes that long term drug use produces in the brain, it’s a miracle anyone recovers at all. We should be grateful for that.

Posted in:  Education, Opinions Tags: addiction, addiction treatment shame, addicts, cancer, drug, drug use, evidence, gene, predisposition, shame, stigma, success, treatment, Treatment, treatment shame

Is personal experience necessary for successful addiction treatment?

July 10th, 2011

In the “recovery” community, one often hears about how the best person to reach an addict is another addict in recovery. The question is whether personal experience with, and victory over, addiction is necessary for a counselor or therapist to be successful in providing successful addiction treatment?

I’ll spoil the surprise by telling you that I personally don’t believe such personal experience is necessary, and that is despite my own personal experience with addiction. I also think that spreading the notion that the above is true is counterproductive to addiction treatment as a field and that it creates an atmosphere whereby mental health professional are a little weary of getting involved in treating drug addicts.

Personal experience as a requirement for treatment in general?

Imagine for a second that you had acne and needed to get a treatment for it, would you only seek out dermatologists who have had severe acne as teenagers themselves thinking they will be best able to assist you? What about if you were diagnosed with cancer or diabetes? I’m assuming most of you can see that requiring the ones treating us to have experience with the same issues we’re dealing with is a bit silly, at least in the physical health sense. We need clinicians that know what they’re doing, can diagnose problems quickly and accurately, and who are familiar with appropriate treatment options and keep up with the latest advancements. They don’t need to have personal-experience with the problem.

But what about mental health issues like depression, schizophrenia, or bipolar disorder, would having one of those require a therapist who suffers from the same disorder in order to truly provide tangible results? Should schizophrenics only be treated by schizophrenics? Here again I think that most people can see that experience is not necessary. It might be nice to have a therapist who sympathizes, but really, what we need is knowledge and ability, which often involved empathy, but not necessarily shared experience.

So what makes addiction so different and special?

There’s no doubt that addicts like to think of themselves as special. I would certainly place myself in that group and have personally heard countless addicts who are no longer using exclaim that once addict recover “we are a special and capable bunch.” All of this makes sense in the whole “in-group/out-group” mentality that is so familiar to everyone in psychology as an effect generally observable in the population. But my sense is that when it comes to treatment it can be a dangerous premise.

Think about it – There is no question that addicts are far less common than the general non-addicted population. This means that in essence, believing this dogma – that addicts are best treated by other addicts – leaves the field less open to outside influence that are no doubt able generate great insight into the addiction treatment field. We can feel as special as we want, but I hope that no one believes that addicts somehow have a monopoly on knowledge, expertise, ability, and empathy. We don’t, and thinking we do is at best narcissistic and at worst ignorant and stupid.

I work with dozens of researchers who have no first-hand knowledge of what smoking crack uncontrollably is like (and probably a handful who do) and I can tell you that each of them has had incredible insight into the problems of addiction. I can also tell you that I’ve met many addicts in recovery who think they have found the end-all-be-all answer to our collective problems simply because these things have worked for them. Experience as an addict does not equal insight into addiction treatment. Experience in recovery may give some insight, but thinking that it is necessary and sufficient for providing great treatment is… unwise.

I believe that we need to get better at measuring, identifying, and replicating good addiction treatment, not setting up barriers for clinicians interested in treating addicts based on their own personal experience. My guess is that as we do this we’ll find that some addicts are great at treating addiction and some are horrible and that the same goes for “normies.”

Posted in:  Education, Opinions Tags: addiction, addiction treatment field, addicts, experience, experience necessary, insight addiction, mental health, personal experience, professional, treatment

A word about animal research and animal rights

June 26th, 2011

Animal research is a controversial topic in some circles.

As some of you may know already, a UCLA group has recently banded together to counter-protest the fear-mongering tactics used by animal rights activists. Before UCLA Pro-Test became a reality, researchers on campus would hide away when on campus demonstration came our way. No more.

Dr. David Jentsch, who was one of my UCLA advisors, had his car burned and his work, and life, threatened by one of the more extreme, terrorist, animal-rights groups. I’m all for debate, but blowing up cars makes you lose your place at the table as far as I’m concerned.

So what are the animal-rights arguments?

Animal rights groups claim that animal research is simply sadistic and that it does not benefit us at all.

The notion that animal researchers enjoy hurting animals is so wrong as to be insulting. I’ve conducted animal research myself and know dozens of others who have. Not one of us enjoys hurting animals and we do our best to conduct everything in ways that minimize any discomfort to the animals. Additionally, government regulations regarding animal welfare in research are very strict and highly regulated. Research involving animals is always done while considering its necessity and weighing alternative options (like using cells, tissue, computer models, etc.).

The thought that animal research doesn’t benefit us is naive at best, but more likely purposefully misleading. Here’s a small, partial, list of advances that were made possible through animal research:

1. Penicillin (mice)
2. Insulin (dogs, mice, rabbits)
3. Anesthetics (rats, rabbits, dogs)
4. Polio Vaccine (mice, monkeys)
5. Heart transplants (dogs)
6. Meningitis Vaccine (mice)
7. Cervical Cancer Vaccine (rabbits, cancer)
8. Gene therapy for Muscular Dystrophy and Cystic Fibrosis (mice).
9. Techniques such as bypass surgery, joint replacement, carcinogen screening & blood transfusions have all been developed & improved using animals

Now if anyone wants to claim that none of the above have significantly improved, or indeed saved, human lives, I’m ready for the debate.

Posted in:  Opinions Tags: animal, Animal research, animal rights, animal rights groups, animals, counter protest, medicine, mice, penicillin, pro-test, protest, research, rights, rights group, terrorist, UCLA, UCLA protest, vaccine

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