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Showing posts with label substance abuse. Show all posts
Showing posts with label substance abuse. Show all posts

Sunday, January 5, 2014

Addiction isn't just about Willpower.

By Lauran Neergaard
AP Medical Writer
WASHINGTON — Addiction isn't just about willpower. It's a chronic brain disease, says a new definition aimed at helping families and their doctors better understand the challenges of treating it.
"Addiction is about a lot more than people behaving badly," says Dr. Michael M. Miller of the American Society for Addiction Medicine.
That's true whether it involves drugs and alcohol or gambling and compulsive eating, the doctors group said Monday. And like other chronic conditions such as heart disease or diabetes, treating addiction and preventing relapse is a long-term endeavor, the specialists concluded.
Addiction generally is described by its behavioral symptoms — the highs, the cravings, and the things people will do to achieve one and avoid the other. The new definition doesn't disagree with the standard guide for diagnosis based on those symptoms.
But two decades of neuroscience have uncovered how addiction hijacks different parts of the brain, to explain what prompts those behaviors and why they can be so hard to overcome. The society's policy statement, published on its Web site, isn't a new direction as much as part of an effort to translate those findings to primary care doctors and the general public.
"The behavioral problem is a result of brain dysfunction," agrees Dr. Nora Volkow, director of the National Institute on Drug Abuse.
She welcomed the statement as a way to help her own agency's work to spur more primary care physicians to screen their patients for signs of addiction. NIDA estimates that 23 million Americans need treatment for substance abuse but only about 2 million get that help. Trying to add compassion to the brain findings, NIDA even has made readings from Eugene O'Neill's "Long Day's Journey into Night" a part of meetings where primary care doctors learn about addiction.
Then there's the frustration of relapses, which doctors and families alike need to know are common for a chronic disease, Volkow says.
"You have family members that say, `OK, you've been to a detox program, how come you're taking drugs?'" she says. "The pathology in the brain persists for years after you've stopped taking the drug."
Just what does happen in the brain? It's a complex interplay of emotional, cognitive and behavioral networks.
Genetics plays a role, meaning some people are more vulnerable to an addiction if they, say, experiment with drugs as a teenager or wind up on potent prescription painkillers after an injury.
Age does, too. The frontal cortex helps put the brakes on unhealthy behaviors, Volkow explains. It's where the brain's reasoning side connects to emotion-related areas. It's among the last neural regions to mature, one reason that it's harder for a teenager to withstand peer pressure to experiment with drugs.
Even if you're not biologically vulnerable to begin with, perhaps you try alcohol or drugs to cope with a stressful or painful environment, Volkow says. Whatever the reason, the brain's reward system can change as a chemical named dopamine conditions it to rituals and routines that are linked to getting something you've found pleasurable, whether it's a pack of cigarettes or a few drinks or even overeating. When someone's truly addicted, that warped system keeps them going back even after the brain gets so used to the high that it's no longer pleasurable.
Make no mistake: Patients still must choose to fight back and treat an addiction, stresses Miller, medical director of the Herrington Recovery Center at Rogers Memorial Hospital in Oconomowoc, Wis.
But understanding some of the brain reactions at the root of the problem will "hopefully reduce some of the shame about some of these issues, hopefully reduce stigma," he says.
And while most of the neuroscience centers on drug and alcohol addiction, the society notes that it's possible to become addicted to gambling, sex or food although there's no good data on how often that happens. It's time for better study to find out, Miller says.
Meanwhile, Volkow says intriguing research is under way to use those brain findings to develop better treatments — not just to temporarily block an addict's high but to strengthen the underlying brain circuitry to fend off relapse.
Topping Miller's wish list: Learning why some people find recovery easier and faster than others, and "what does brain healing look like."

Saturday, January 4, 2014

Top Ten Warning Signs of Drug Problems in Teenagers



Ten warning signs include:

1. Drop in grades
2. Change in friends
3. Isolating more
4. Paraphernalia found
5. Stopping or decrease in activities
6 More emotional outbursts
7. Change in appearance or hygiene
8. More secretive/avoidant behaviors
9. Change in sleep patterns
10. More defiant

If you see these behaviors, it does not mean your child is using drugs. They are just warning signs and also be more reflective of other issues he or she is going through.

Q & A About Marijuana: Talking to Your Teens About Drugs

ll information is provided by the National Institute on Drug Abuse and the National Institutes of Health



Following a troubling increase in marijuana abuse in the 1900s among U.S.  teens,recent finding have shown more encouraging trends. For example, part-year use has fallen significantly among students in the 8th, 10th, and 12th grades since 2001:it has dropped by 24% among 8th-graders,23% among 10th-graders,and 15% among 12th-graders.Perceived risk of harm from smoking marijuana regularly remained stable for all three grades from 2005-2006 and perceived availability of marijuana fell significantly among 10th-graders , from 72.6% in 2005 to 70.7% in 2006. Even with these encouraging trends,marijuana is still the illegal drug most often abused in the United States. Its continued high prevalence rate,particularly among teens, indicates that we still have a long way to go. In addition, because many parents of present-day teens used marijuana when they were in college, they often find it difficult to talk about marijuana with their children and to set strict ground rules against it. This conversation must begin early, as marijuana use today often starts at a young age-with more potent forms of the drug now available to these children and adolescents. Parents need to recognize that marijuana use is a serious threat, and they need to tell their children not to use it. 


Q: What is marijuana? Are there different kinds?
A: Marijuana is a green, brown, or gray mixture of dried shredded leaves, stems, seeds and flowers of the hemp plant. It is the most often used illegal drug in the United States. Cannabis is a term that refers to marijuana and other drugs made from the same plant. Strong forms of cannabis include sinsemilla, hashish and hash oil. All forms of cannabis are mind-altering drugs; they all contain THC (delta-9-tetrahyfrocannabinol), the main active chemical in marijuana. They also contain more than 400 other chemicals. 

Q: What are the current slang terms for marijuana?
A: There are many different names for marijuana. Slang terms for drugs change quickly and they vary from on part of the country to another. Terms from years ago, such as pot, herb, grass, week, Mary Jane and reefer are still used. You might also hear names like Aunt Mary, skunk, boom, gangster, kif, or ganja. There are also street name for different strains or "brands" of marijuana such as "Texas tea," "Maui wowie," and "chronic." 

Q: How is Marijuana used?
A: Most users roll loose marijuana into a cigarette called a joint or smoke it in a pipe or a water pipe, sometimes referred to as a bong. Some users mix marijuana into foods or use it to brew tea. Another method is to slice open a cigar and replace the tobacco with marijuana, making what's called a blunt. Joints or blunts sometimes include other substances as well, including crack cocaine called "primos" or "woolies." Joints and blunts sometimes are dipped in PCP and are called "happy sticks," "wicky sticks," "love boat," "dust," "wets," or "tical."

Q: How many people smoke marijuana? At what age do children generally start?
A: A recent government study tells us that marijuana is the most frequently used illegal drug in the U.S. Nearly 98 million Americans over the age of 12 have tried marijuana at least once. Over 14 million had used the drug in the month before the survey.  The Monitoring the Future Survey, which is conducted yearly, included students from 8th, 10th, and 12th grades. In 2006, the survey found that 15.7% of 8th-graders have tried marijuana at least once, and among 10th-graders, 14.2%  were "current" users (in the past month). Among 12th-graders, 42.3% have tried marijuana at least once and about 18% were current users. Other researchers have found that the use of marijuana and other drugs usually peaks in the late teens and early twenties, then declines in late years.

Q: How can I tell if my child has been using marijuana?
A: there are some signs you might be able to see. If someone is high on marijuana, he or she might seem dizzy and have trouble walking, seem silly and giggly for no reason, have very red, bloodshot eyes and have a hard time remembering things that just happened. the user than can become very sleepy. Parents should look for withdrawal, depression, fatigue, carelessness with grooming, hostility and deteriorating relationships with family members and friends. Also, changes in academic performance, increased absenteeism or truancy, lost interest in sports or other favorite activities and chances in eating or sleeping habits could be related to drug use. In addition parents should be aware of signs of drugs and drug paraphernalia, including pipes and rolling papers, odor on clothes and in the bedroom, use of incense and other deodorizers, use of eye drops and clothing, posters, jewelry, etc. promoting drug use.

Q: why do young people use marijuana?
A: Children and young teen start using marijuana for many reasons. Curiosity and the desire to fit into a social group are common reasons. Certainly, youngsters who have already begun to smoke cigarettes and/or use alcohol are at high risk

Q:  Does using Marijuana lead to other drugs?
A: Long-term studies of high school students and their patterns of drug use show that very few young people use other drugs without trying marijuana, alcohol, or tobacco. Though few young people use cocaine, for example, the risk of doing so is much greater for youth who have tried marijuana than for those who have never tried it. Although research has not fully explained this association, growing evidence suggests a combination of biological, social, and psychological factors is involved.

Q: What are the effects of marijuana?
A: The effects of marijuana on each person depend on the type of cannabis and how much THC it contains, the way the drug is taken, the setting where the drug is used and the use of other drugs and/or alcohol. Some people feel nothing at all when they first try marijuana. Others may feel high (intoxicated and/or euphoric). It is common for marijuana users to become engrossed with ordinary sights, sounds or tastes and trivial events may seem extremely interesting or funny. Time seems to pass very slowly so minutes feel like hours. Sometime the drug causes users to feel thirsty and very hungry-an effect called "the munchies."

Q: What happens after a person smokes marijuana?
A: Within a few minutes of inhaling marijuana smoke, the user will likely feel, along with intoxication, a dry mouth, rapid heartbeat, some loss of coordination and balance, and a slower than normal reaction time. Blood vessels in the eye expand, so the user's eyes look red. For some people, marijuana raises blood pressure slightly and can double the normal heart rate. This effect can be greater when other drugs are mixed with marijuana, but users do not always know when that happens. as the immediate effects fade, usually after 2 to 3 hours, the user may become sleepy. 

Q: How long does marijuana stay in the user's body?
A: THC in marijuana is readily absorbed by fatty tissues in various organs. Generally, traces of THC can be detected by standard urine testing methods several days after a smoking session. In heavy, chronic users, however traces can sometime be detected for weeks after they have stopped using marijuana.

Q: can a user have a bad reaction?
A: Yes. Some users, especially those who are new to the drug or in a strange setting, may suffer acute anxiety and have paranoid thoughts. This is more likely to happen with high doses of THC.These scary feeling will fade as the drug's effects wear off. In rare cases, a user who has taken a very high dose of the drug can have severe psychotic symptoms and need emergency medical treatment. Other kinds of bad reactions can occur when marijuana is mixed with other drugs like PCP or cocaine.

Q: How is marijuana harmful?
A: marijuana can be harmful in a number of ways, through immediate effects and through damage to health over time. Marijuana hiders the user's short-term memory and he or she may have troubling handling complex  tasks. With the use of more potent varieties of marijuana, even simple tasks can be difficult. Because of the drug's effects on perceptions and reaction time, users could be involved in auto crashes. Drug users also may become involved in risky sexual behaviors, which could lead to the spread of HIV, the virus that causes AIDS. Under the influence of marijuana, students may find it hard to study and learn. Young athletes could find their performance is off, timing, movements and coordination are all affected by THC.

Q: How does marijuana affect driving?
A: Marijuana affects many skills required for safe driving: alertness, concentration, coordination, and reaction time. Marijuana use can make it difficult to judge distances and react to signals and sounds on the road. Studies have shown  that approximately 4-14% of drivers who sustained injury or died in traffic accidents tested positive for THC. In many cases, alcohol was detected as well. When users combine marijuana with alcohol, as they often do, hazards of driving can be more severe than with either drug alone. In a study conducted by the national Highway Traffic Safety Administration, a moderate dose of marijuana alone was shown to impair driving performance; however the effects of even a low dose of marijuana combined with alcohol were markedly greater than those of either drug alone. In one study conducted in Memphis, Tennessee, researchers found that 150 reckless drivers who were tested for drugs at the arrest scene, 33% tested positive for marijuana and 12% tested positive for both marijuana and cocaine. Data also show that whole smoking marijuana, people display the same lack of coordination on standard  "drunk driver" tests as do people who have had too much to drink.

Q: What are the long-tern effects of marijuana?
A: A group of scientists in California examined the health status of 450 daily smokers of marijuana, but not tobacco. They found that the marijuana smokers had more sick days and more doctor visits for respiratory problems and other types of illness than did a similar group who did not smoke either substance. Finding so far show that the regular use of marijuana may play a role in cancer and problems of the immune and respiratory systems. 

Cancer
It is hard to find out whether marijuana alone causes cancer, because many people who smoke marijuana also smoke cigarettes and use other drugs. Marijuana smoke contains some of the same cancer-causing compounds as tobacco, sometimes in higher concentrations. Studies show that someone who smokes five joints per day may be taking in as much cancer-causing chemicals as someone who smokes a full pack of cigarettes every day. Tobacco smoke and marijuana smoke may work together to change the tissues lining the respiratory tract. Marijuana smoking could contribute to early development of head and neck cancer in some people.

Immune system
It is not certain whether marijuana damages the immune system of people. But both animal and human studies have shown that marijuana impairs the ability of T-cells in the lungs' immune system to fight off some infections.

Lungs and airways
People who smoke marijuana regularly may develop many of the same breathing problems that tobacco users have, , such as a daily cough and phlegm production, more frequent chest colds, a heightened risk of lung infection, and a greater tendency toward obstructed airways. marijuana smokers usually inhale more deeply and hold their breath longer, which increases the lungs' exposure to toxic chemicals and irritants.

Q: What about pregnancy? Will smoking marijuana hurt the baby?
A: Doctors advise pregnant women not to use any drugs because they may harm the growing fetus. Although one animal study has linked marijuana to loss of the fetus very early in pregnancy, two studies in humans found no association between marijuana use and early pregnancy loss. More research is necessary to fully understand the effects of marijuana use on pregnancy outcome. Some scientific studies have found that babies born to women who used marijuana during pregnancy display altered responses to visual stimulation, increased tremors, and a high-pitched cry, which may indicate problems with nervous system development. During preschool and early school years, marijuana-exposed children have been reported to have more behavioral problems and difficulties with sustained attention and memory than non exposed children. Researchers are not certain whether any effects of maternal marijuana use during pregnancy persist as the child grows up; however, because some parts of the brain continue to develop into adolescence, it is also possible that certain kinds of problems will become more evident as the child matures.

Q: What happens if a nursing mother uses marijuana?
A: When a nursing mother uses marijuana, some of the THC is passed to the baby through breast milk. This is a matter for concern, because the THC in the mother's milk is much more concentrated than that in the mother's blood. One study has shown that the use of marijuana by a mother during the first month of breastfeeding can impair the infant's motor development. This work has not been replicated, although similar anecdotal reports exist. Further research is needed to determine whether THC transmitted in breast milk has harmful effects on development.

Relapse Versus Return to Use

USING EPISODE
A using episode (either drug or alcohol) could be defined as either a relapse or return to use.  For the individual, it is possible that at some point they may move from one to another.  What helps distinguish the difference is prior to the using episode is how would they categorize themselves(relapse or return to use), and how they view the using episode after the fact.  It is common for a person to start building up to a change in commitment about being abstinent. For example, a week prior to use they are committed to avoiding use.  However, through a series of events, they change their commitment and use.  There are some areas listed below to help distinguish where a person may currently be in regards to abstaining from drug and alcohol use.
RELAPSE
Thoughts: “ I don’t want to use,” “I want to stop” “ my use is a problem,”  
Behaviors: Making an active commitment to avoid use, conscious of using situations.   
Motivation: High.  Does not want to use.
Attitude after use: “ I was making an effort to stop and messed up, “ I did not anticipate problems.”
Emotions after use: Feel guilty
DECISION TO USE
Thoughts: “Using is no problem,” I want to cut back but not stop,” “it is okay to use every now and then,” “my use is not a problem.”
Behaviors: No changes from when first using, actions geared more toward hiding use then stopping use.
Motivation: Low.
Attitude after use: “I got caught,” “ No big deal.”
Emotions after use: Irritated. Awkward
When an using episode occurs, it is important to evaluate where you see yourself. If you view yourself presently as seeing the episode as a relapse, effort would need to be focused on relapse prevention.  If you see yourself in the decision to use column, effort would be used to reexamining the costs and benefits to use, including what brought you into therapy in the first place.    

Establishing Goals for Substance Abuse Treatment

Individuals who verbalize a commitment to abstaining from substance use or who enter therapy for drugs or alcohol, may not always be committed to the same goals for therapy as significant others who want him\her in treatment. I have worked in the chemical dependency field for over 25 years and believe it is important to understand someone’s motivation level when addressing this issue. A person may believe they could control or manage their drinking. Family members/significant others could be under the impression that goal is not realistic. Or a person may not believe their use is a problem and are entering treatment to appease others. This presents a conflict in treatment goals between client (person entering treatment) and others.
A therapist’s role is to help the client clarify goals in treatment. It is important to have mutually understood goals. If, as a therapist, I am presenting tools more consistent with someone who has a goal of complete abstinence, and this individual is not committed to stopping use all together, therapy will not be successful. The first step in the therapeutic process is endeavoring to be on the same page with the client. A helpful tool I use is the motivational wheel.
Once goals are established, we come up with tasks that will help meet these goals. If a person uses substances when his/her goals are abstinence we go over the motivational wheel again. We establish if the use was: a lapse (goal was abstinence but had a slip) or decision to use (goal was not to stop and decided to use). If it is determined to be a lapse, we examine goals and determine what areas may need further focus. Lapses are not uncommon in recovery and may actually help develop focus and commitment to stopping use. If the client made a decision to use, I will explore what may have changed from the initially stated goals.
Recovery is not a event, but a journey. Each person may carve their own individual
path. It may entail some slips or challenges along the way. For some it may take longer to reach this goal than others. What is essential in therapy is that goals in treatment are agreed upon, realistic, clear, and obtainable. If a person is not committed to stopping all together, my role will be to establish safe guidelines in exploring the costs to use and impact on one’s life.

Up in Smoke: The Medical Marijuana Debate

Containing over 400 chemicals, the cannabis plant is the source of marijuana, which has been labeled a Schedule 1 controlled substance since 1970. Once treated and dried, marijuana can be smoked (or even eaten!) to induce an altered mood, caused primarily by THC (delta 9 tetrhydrocannabinol). The terms "medical cannabis" and "medical marijuana" refer to the use of the chemicals in the cannabis plant and marijuana (such as THC) as a physician-recommended from of medicine or herbal therapy.
The potency of marijuana has increased over the years, with a 4% increase of THC presence in the drug from 20 years ago. Often taken as a recreational drug, marijuana has some adverse effects: short term memory loss, increased heart rate, weakening of the immune system, raised risk of lung infections, increased risk of lung cancer, decrease in perception and reaction time response (which is especially dangerous when driving), exacerbation of current mental health problems (or the creation of new ones), breathing problems, and addictive qualities (1).
The administration of medical marijuana is most frequently done through vaporizing or smoking dried buds, eating or drinking extracts, and taking capsules. Smoking has fielded the fewest positive outcomes (2).
Medicinal marijuana is a much-debated topic in the medical field, with no clear-cut agreement. Some research indicates that it could be effective for the relief of nausea and vomiting, stimulation of hunger in chemotherapy and AIDS patients, gastrointestinal illness, and lowered intralobular eye pressure (which has been effective for treating glaucoma).
Both pro and con sides of the medical marijuana debate present compelling arguments. It is important to remember that if the legalization of medicinal marijuana does occur, it should have no bearing on the legality of recreational use (which is a fear of many opponents of medical marijuana). As recently as May of 2011, the Illinois House of Representatives failed to pass medical marijuana legislation that came up for a vote. In fact, many legal medical drugs on the market are not only illegal, but also dangerous to use recreationally. Furthermore, there is a wide variety of marijuana with different potencies and additives (over 400 other chemicals), and street marijuana for medical use carries a greater risk than marijuana cultivated specifically for medicinal treatment.
Before an informed decision can be made, it would only be wise to undertake further research. Doctors have no guidelines or standards on when to use, how to administer, and the possible side effects of medicinal marijuana. With more research comes more knowledge, and with more knowledge comes the basis to train doctors to use medical marijuana effectively, and how to draw a distinct line between medical applications of marijuana and recreational use.
1. National Institute on Drug Abuse. Marijuana: Facts for Teens (http://www.drugabuse.gov/MarijBroch/MarijIntro.html). NIH Pub. No. 98-4037. Bethesda, MD. NIDA, NIH, DHHS. Revised March 2008. Retrieved June 2009.
2. Wikipedia

Tuesday, December 31, 2013

Understanding Hair Testing for Drug Analysis



Drug testing is used by courts, concerned parents, and places of employment to determine if an individual has been using drugs.  The two Drug testing methods most widely used are Hair Analysis and Urine Analysis.  Each test, although taken by different methods, determine if there are certain substances or metabolites in a person’s system as a result of using certain drugs.


In testing for hair, a sample of hair as close to the scalp as possible is gathered.  It should be around two inches long, with approximately 120 strands of hair needed for an accurate analysis.  The sample of hair would be rejected if not long enough or if it is contaminated with lice. Hair collected from a hair brush cannot be used. The hair collected from body parts other than the hair has not been determined to be reliable because the growth rate and rates of incorporation of drugs into the hair from other locations has not been studied as extensively as that of head hair.

This first method of testing is called Enzyme- Linked Immunosorbent Assay or ELISA.  Samples that test positive in the initial screening process are retested using a more intensive testing method.  This method is called gas chromatography/mass spectrometry/mass spectrometry or GC/MS/MS.  It is a more intensive testing method is used to ensure reliability of the test results.  It is more expensive method of testing and therefore is only used as means to confirm initial positive results.

The turnaround time (time results are known) is consistent with urinalysis.  Negative results should be known within twenty four hours of receipt and positive results are confirmed within forty eight-seventy two hours of receipt.  The drugs that are tested for include: Amphetamines (Amphetamine, Methamphetamine, Ecstasy, MDMA and MDA), Opiates (Codeine and Morphine), Cocaine (and Cocaine metabolites), Marijuana metabolite (THC), and PCP.

Hair tests are able to detect drug use from four days to ninety days.  When you compare it to urinalysis, hair tests are limited in being able to detect more recent use.  Urinalysis is able to determine substances as soon as twenty four hours (depending on the substance), while hair analysis is unable to detect for up to four days back (depending on hair growth).  If someone tests positive for substances, urinalysis would be better suited to monitor future substance usage as opposed to hair analysis.