Following up on the benefits of detox medication in long term drug treatment, it is important to understand the risks involved in using medication as a recovery mechanism. Detox medications are employed in opiate addiction recovery specifically due to the extreme physical dependency that opiate drug use causes. With prolonged usage, the brain starts to rely on the drugs to function and produce endorphins (good feeling hormones). Nerve cells will degenerate, leading to intense physical pain upon discontinued use. The cardiopulmonary and central nervous system are at risk for permanent damage during withdrawals, and death is also a possibility during the detoxification process. Withdrawal frequently includes sweating, shaking, headache, drug craving, nausea, vomiting, abdominal cramping, diarrhea, inability to sleep, confusion, agitation, depression, anxiety, and other behavioral changes.

Detox medications work to alleviate the onset of painful withdrawals and ease the brain off the abused opiates. As mentioned in the previous post, Suboxone is an opiate addiction treatment intended to support long-term drug recovery. Methadone is also a powerful addiction therapy drug for users of heroin, Oxycontin and other types of opioids, but is tightly regulated by the FDA due to its abusive properties. Suboxone is the only opiate addiction therapy drug that can be prescribed by a physician, and is a treatment method for addicts who seek addiction maintenance and relief from anxiety-inducing opioid cravings. However, abuse of Suboxone and other detox medications like Methadone is a risk factor that may derail the recovery process.

Methadone is only administered through clinics, but Suboxone was created to divert the abusive dangers inherent in Methadone. Both detox medications have the potential for abuse because they are classified as opioids and can produce sensations of euphoria, analgesia and sedation like other opiates, though to a lesser degree. The medications also don’t impair cognitive or motor skills like their addictive counterparts, and work by blocking the effects of more potent opiates on brain receptors, thus disabling the user’s ability to get high. Suboxone has a "ceiling effect" that prevents increased pleasurable effects in the patient, and actually produces uncomfortable, withdrawal-like symptoms upon excessive intake.

Relapse for opiate addiction is very common, making treatment difficult in the long term. Studies show that on average addicts will stop and start detox 10-25 times in their lifetime relapsing back to opiate use each and every time. But recovery is possible, especially with the right combination of treatment methods.

“At addiction centers, longer treatment programs are proving key to ending the relapse-rehab cycle” was the headline for a recent Los Angeles Times news article. Relapse is often the bane of rehabilitation. We often hear about celebrities or witness people in our own communities who are released from 30 day rehab programs only to return several months later. While it’s true that relapse is quite often part of the recovery process, studies are showing that the risk of relapsing occurs less often in people who have received long-term treatment.

The article cites two distinct studies conducted by the National Institute on Drug Abuse and one UCLA study focusing on teens. In all of these studies, the research shows relapse rates are higher for people who received short-term treatment. It’s reported that people who received treatment for 90 days or longer were less likely to revert to their previous abusive habits. Some other interesting points:

-  “Treatment programs of 28 or 30 days are still common. But this template was never based on medical evidence, says Dr. David Lewis”

- “Brain scans of recovering addicts support the idea that changes are still taking place three months or more after treatment. Chronic drug use damages the brain, such as reducing the number of dopamine receptors, chemical pathways that allow for normal brain functioning. Changes in the brain during recovery correlate to clearer thinking and more honesty on the part of the patient” - Dr. Harry Haroutunian.

The issue of jail was also brought up. After release from imprisonment many addicts return to drugs and/or alcohol. This supports the idea that it isn’t just abstinence that helps people recover. To successfully change a person’s lifestyle, they need time to “learn to handle stress, develop ways to cope with environmental cues that could trigger drug use and improve relationships that are needed to sustain recovery.”

An addict’s acknowledgment of the need for help is a major first step in a path towards recovery. Knowing which treatment method to pursue can be just as influential of a decision in the process of overcoming addiction. The withdrawal effects of substances vary, and the severity and duration of detox is often the deciding factor in one’s recovery route.

Health Day News recently reported that extended therapy combined with detox medications have shown to produce noticeable results for opioid addiction in young adults. Detox medications buprenorphine (Suboxone) and naloxone relieve withdrawal symptoms and prevent the physical effects of injected opioids, and have proven more successful in treating addiction when administered over an extended period as compared to short-term treatment programs. The study compared 12 week and  2 week-long treatment programs with the defined drugs, and found that extended treatment patients reported less use of opioids, cocaine and marijuana, less injecting, and less need for additional addiction treatment after 12 weeks. The researchers also found that patients in the long-term program tested positive for opioid use in urine tests more times in weeks four and eight, than at week 12.

This information demonstrates the benefits of prolonged use of detox medications in transforming deep-rooted lifestyle habits. Medication coupled with continuous counseling aids addicts in reaching their long-term goals. Although the administration of such detox medications is controversial due to the risk of dependence, this report reinstates the necessity of viewing addiction recovery as a lifelong process that can’t be wiped clean of the body instantaneously. When considering treatment methods, addicts shouldn’t follow a method that they consider a quick fix; rather, look at treatment as an ever-evolving self-healing process that requires patience and constant care.

Last week, our nation voted on several key propositions that are sure to have an effect on drug abuse across the country. Here is a recap on how voting went for some of the drug and alcohol propositions:

Massachusetts:  The people of Massachusetts voted to decriminalize marijuana usage for clinical purposes and for people in possession of small amounts. A $1,000 fine or mandatory drug awareness program will await offenders instead of jail time.

Michigan: Proposition 1 was supported by a large majority o f the population in the Great Lakes State, and it legalized medicinal marijuana use. In the area

California: Booze is now officially banned at the beaches in San Diego, despite strong opposition.  However, the Nonviolent Offender Rehabilitation Act failed to pass. Proposition 5 was defeated by about 20 percentage points.

While opinions on the propositions differ greatly amongst people across the state, the one thing everyone agrees upon is that it’s impossible to tell what the impact of these measures will be. It will be interesting to see how (or if) the local communities change. Will there be fewer addictions? Less crowding in jail? Fewer kids on drugs? Voters chose to support the initiatives that they believed would be best for our country and society. Only time will tell the story of how Democracy changed our drug policy and reformed lives.

Slang is a prevalent part of drug culture: It’s a form of self expression, method for discreet communication and way for drug users to project their mastery in the subject area. Street terms for drugs are often more relevant than medical terminology; words that don’t tend to roll off the tongue as smoothly, like diacetylmorphine and desoxyephedrine, aren’t popular among groups actually using the substances. Interpreting the way in which drug users converse may provide a better understanding of their lifestyles. The following is a condensed list of popular drugs and their corresponding slang terms, many of which come from the Indiana Prevention Resource Center:

Marijuana: Bammy, funk

Smoke marijuana: Blow a stick, blast a roach

Heroin: Dope, smack, skag
Inject heroin: Dip and dab       

Smoke heroin: Chase the tiger

Heroin and cocaine mixture: Speedball, Belushi

Cocaine: Candycaine, weasel dust

Addicted to cocaine: Flaky

Inhale cocaine: Blow blue

Crack cocaine: Cat’s pee, crackers

Crack: Apple jacks

Smoke crack: Blast

Methamphetamine: Crystal, crank, tweek

Injecting methamphetamine: Bangin’ it in

When kids and young adults are abusing drugs, it’s a challenge for parents to confront them about their problems. It’s much easier to deny the warning signs or to just wait for these young adults to seek out help; but, when kids are dying from drug overdoses, it’s reasonable for parents to worry and want to do more to prevent addiction from taking hold of their children.

In New Jersey and Ohio, a company called Sniff Dogs rents drug detection dogs to parents and employers to find any traces of illegal drugs like marijuana, cocaine, meth, heroin, and ecstasy. It’s one way for parents to find out if substances are present inside their home or if chemical residue from the drugs lingers on their child’s dirty laundry.

If the dogs find something or nothing at all, communication between the parent and child is priceless. Talking about drugs with kids or teens lays the foundation that they need to fend off the peer pressure or low self-esteem that can lead to drug abuse. If the child is already using or suffering from addiction, talking about the problem is the first step to getting help.

While drug sniffing dogs may be a discrete method for dealing with addiction at home for some families, it may not work well in all parent and child relationships. ABC News reported that some psychologists are highly critical of parents using drug dogs and other surveillance methods, because it implies a lack of trust on the parent’s behalf. Kids need to feel that they can go to their parents for help, but that is tough to accomplish without a mutual sense of trust and respect.

As a parent, would you consider using a service like this one to find out if your child is using drugs?

I have a close friend who drinks two or three glasses of wine most nights. When we go out she rarely abstains from drinking, but never is visibly intoxicated. I have another friend who doesn’t drink at all during the week; alcohol is meant for chugging and pounding — not casually enjoying. She gets drunk every weekend. Alcohol isn’t necessary to function, but she doesn’t seem to enjoy social gatherings unless she’s taken a few shots beforehand. Both of my friends appear to be somewhat dependent upon alcohol, but for very different reasons. Is one of the two more negatively affected by their alcohol use, and is one more clearly addicted? How do the weights vary regarding functional dependence and binge drinking? How can I tell if a friend is in need of help?

“Alcohol dependence,” according to the NIAAA, “is a condition characterized by impaired control over drinking, compulsive drinking, preoccupation with drinking, tolerance to alcohol, and/or withdrawal symptoms.” Alcohol abuse is the next step in problem drinking and is defined by failure to fulfill major role obligations, social problems and/or hazardous drinking situations. Work suffers, motivation is stalled, friendships are weak, and sleep is altered.

But negative effects as such are not always clear when surveying a friends’ life. Research shows that analyzing childhood behaviors leads to understanding how people become alcoholics. Environmental factors in adolescence can lead to developmental disorders that spark addiction. Genetics also play a role in drug and alcohol behaviors, but like environmental conditions, there is no single direct route to addiction. Studies have shown a link between low serotonin levels and binge drinking, as well as blunted stress responses and increased consumption of alcohol.

Alcohol is a social substance, and the widespread perception of drinking as a societal norm impairs our ability to identify its negative impact on each others’ lives. Moreover, a clear prototype of an addict or abuser doesn’t exist. Although confusion is natural, even taking the time to consider your friends’ deep rooted problems is important, and an indicator of your desire to help and improve their lives. I don’t believe one of my friends is in worse shape than the other, but I will from now on consider their past and personal issues when trying to understand the role alcohol plays in their lives. 

On November 4th, the American public will not only decide who will be the next President of the United States, but they will determine the future of alcohol and drug use in numerous counties and states across the nation.

Alcohol seems to be emerging as a hot topic this election year. In San Diego, there is a measure to ban alcohol consumption at Pacific Beach. Drinking is banned at many public beach locations for safety reasons. Nevertheless, alcohol at the beach has long been a part of the culture in southern California, but unfortunately irresponsible drinking has led to unsafe situations, including a rough brawl during Labor Day weekend in 2007.

Ottawa County in Michigan currently prohibits the sale of wine and beer on Sundays. A measure to change the law to allow for alcohol sales on Sunday is on the ballot. The proposal is causing some controversy, not about whether alcohol should be sold or not, but because of the language involved. Voters who want to drink on Sundays have to vote ‘no’, while those who want to maintain the ban have to vote ‘yes.’ Texas also has several counties with alcohol-related propositions that would change how, when, or where alcohol is sold.

Marijuana is also on the ballot in Michigan, as well as in Massachusetts. Proposition 1 in Michigan is a medical marijuana legalization initiative that would allow for people suffering from serious illnesses, like cancer, to be in possession of pot for medical use only. The proposition in Massachusetts is quite different. The state is considering the decriminalization of marijuana in quantities of 1 ounce or less. Under the new law, those found in possession of marijuana are guilty of a criminal offense and must pay a $100 civil fine.

Drug abuse and alcoholism are serious issues that we’re grappling with as a nation through legislation. The only way to have a say in the future of drug and alcohol use is to go out and vote. Spread the word!

The media coverage of celebrity drug and alcohol use is unyielding, and the portrait painted of Hollywood’s drug culture by the entertainment press is not always accurate. Celebrity Rehab is a show in its second season created by addiction expert Dr. Drew Pinsky that demystifies the recovery process stars go through. Peering into the dark, complicated world of Rehab’s patients, viewers witness the struggle in overcoming addiction and dealing with painful personal issues that led to substance abuse. Pinsky determines to represent the reality of addiction — that celebrities who enter rehab aren’t simply checking into a center and avoiding drugs for a few weeks. It’s a lifelong process that requires constant attention.

One point of controversy over the show is the fact that the celebrities are paid to participate. Since most of the performers and public figures are out of work due to the control drugs and alcohol have had over their lives, it can be considered that they are participating in order to be granted re-entry into the spotlight. But Pinsky aims to dispel the idea that stars are pulling a publicity stunt when seeking help. He follows the practice of recent experiments paying addicts to stop using. MSNBC reported in 2006 about reward programs that incite users to stay clean. A study of 415 cocaine and methamphetamine users published in October 2005 in the Archives of General Psychiatry found that they stayed in treatment longer if they had a chance to win a prize. Some researchers believe that if rewarding sobriety shows positive feedback from addicts, why not use such methods?

I find Celebrity Rehab fascinating because it delves into the intimate experiences of addicts. The fact that they are celebrities only intrigues me because their public personality provides a point of reference. I watched Nikki McKibbin sing on the American Idol stage in front of thousands of adoring fans. Now I’m experiencing her crying about her addiction to cocaine and her mother’s death from a drug overdose. The show reiterates the one-dimensional nature of celebrity coverage, and that everyone has a story hiding beneath their persona.

Why is it that so many influential musicians, writers and artists are often associated with addiction? Throughout history, praised entertainers and creative forces have fallen victim to drugs and alcohol: American country singer Johnny Cash abused amphetamines; iconic French singer Edith Piaf was an alcoholic and eventually died of liver cancer; famous guitarist Jimmy Hendrix died of a mix of alcohol and barbiturates; American writer Jack Kerouac abused drugs and alcohol.

CNN reported recently that a link between mood disorders and creativity has shown in a number of psychology studies. Experts say that mental illness does not necessarily cause creativity, and vice versa, but a ruminating personality type may contribute to both mental health issues and art. Characteristics of this personality include hypersensitivity, constant contemplation and reflectiveness — a temperament found to be underlying in depression and bipolar disorder.

Although the studies do not link addiction with creativity, the high correlation between depression and substance abuse presents an indirect connection. For creative types who are mentally unstable and tend to overanalyze, drugs and alcohol can be a form of self-medication, a way to quiet the restless mind. Many singers who’ve experienced addiction, like Cash and Piaf, incorporate the dramatic highs and lows of their mental states into performances, pouring their emotionality and obsessive nature into lyrics.

People who are depressed may try to mute their inner demons with drugs, but art can be used as a therapeutic tool in recovery. In fact, many artists find that their work suffers when their minds are muddled by drugs and alcohol, stunting creative performance. To overcome addiction, some people need to rediscover their passion for art — a high that can’t be matched by any drug.