Wednesday, November 28, 2007
~ " Against the assault of laughter nothing can stand " ~ A little humor can go a long way! When you're at your wits end and don't thinkYou can handle one more thing, Take a few minutes out to search For the humor amidst your choas. If you can't find the humor yourself,Pop in your favorite funny movie, visit online joke sites, think of a humorousSituation you've been in. Find something that works for you and use it.Not only is humor good for the soul but it has many health benefits,as well. To name a few of the health benefits of laughing, it can lower your blood pressureAnd reduce your stress hormone level. So, go ahead SMILE, LAUGH you'llBe glad you did! Click on the links below to visit a page I’ve created containingSome of my favorite jokes and quotes!
Tuesday, November 27, 2007
Busting - for those of us aware of the term, it is our worst nightmare. "Busting" means that after a period of abstinence, we use or drink again.
It is a heartbreaking experience for us, and extremely disappointing for all our loved ones. Not only that, but "busting" can be a matter of life and death - it is a very serious situation. To those reading this article who do not have the disease of addiction, "busting" must seem like insanity and stupidity. You are perfectly correct. And even though we know this, relapse rates are high. The mental hooks that the disease thrusts into us with are very strong and buried deep. We are so smart that we fool ourselves into thinking that we can socially drink/use again. Sometimes, we just couldn't give a damn about being responsible for our illness, it does get tiring. Or we just want to taste the oblivion for one last time. For some of us, it will be our last time - we will die, and perhaps take others with us.
The circumstances leading to busting vary, but the bottom line is that it isn't usually an accident - it is by design. We place ourselves into dangerous frames of mind or into situations that we know aren't healthy for us. For a recovering addict, any human emotion experienced in its extreme state i.e. anger, loneliness, depression, self pity or even euphoria is like playing Russian Roulette. It is very important for us to keep a tight rein on our emotions.
Have I ever busted? Yes, two years after I had accepted my illness. I remember the lead up to it well. I was trying to get my business off the ground and working 3 different jobs to finance it.
Mistake one - overworking.
I was experiencing trouble with one of my employers and was getting pretty wound up over it.
Mistake two - inappropriate anger and frustration
Sleep was becoming an interference to my activities
Mistake three - not sleeping
Due to the intensity of my emotions, I was grieving for the oblivion that drugs and drink used to provide me.
Mistake four - "stinking thinking"
I was working a couple of jobs where alcohol and other drugs were easily obtained.
Mistake five - bad environment considering the other circumstances - constant temptation
I wasn't having much contact with other recovering addicts
Mistake six - I had cut myself off from my support networks
I thought I had "earned" one day's respite from the illness....I'd just have a few drinks to unwind. After all, it was the Christmas season. (!?!?)
Mistake seven, the fatal one - Insanity - I fooled myself. I conveniently "forgot" that I was powerless over these substances and there was no way I could control my intake.
The end result was that I drank and dropped a few tranquilizers. 2 years of hard work was lost in under 24 hours. The next morning when I awoke (or more to the point, regained consciousness), I was in withdrawals. Even after years of abstinence, you return to where you left off. I knew what was going to happen next, so I rang the hospital and begged for detox. I spent the next five days there sweating, shaking and hallucinating. I put my various jobs, myself and others risk through my irresponsible actions. All for the privilege of experiencing oblivion. Insanity and stupidity.
I was once again a very lucky man. They say that God looks after drunks and fools. Seeing that I fall into both categories, I must have got special attention! The hospital looked after me well. I was actually working there as a Ward Clerk at the time of my bust. All employers stuck by me and I was able to return to work 2 weeks later. It was a shameful experience (small town), but I learnt a great deal from it. I hope never to tempt fate like that again.
Looking back on it now, and reading the above lead-up it is all too clear to me why it happened. No accident; I set myself up nicely to fail. Why? I guess I'll never really know. While life was tough at the time, it was nowhere near as bad as it had been during the "dark days". I hadn't really recognized my own limitations, so pride was also an issue. I discovered the hard way that the parasite within (I have published another article on the "parasite" concept) was a great deal more powerful than what I thought - even though I had been taught better than that.
In speaking with a number of addicts over the years, I have discovered one common point in all the "busting" stories. We "forget" that we have no control over the substances that threatened to destroy us. It's like a rather bizarre allergy. The allergic reaction is all the negative things that we do as practicing addicts. Yet, like moths to a flame, we are drawn back to it - knowing deep down that we will be burnt.
The other common cause for busting is being "dry" instead of clean and sober. In alcoholic terms, a dry drunk is someone who has ceased drinking but has done nothing to rectify the deep seated behavioral and emotional patterns which are the results of years of self abuse. The dry drunk may seem stable and happy on the surface, but tends to harbor deep resentment towards their lot in life.
This is why it is so important to go into recovery for yourself, not for your wife, children or friends. Recovery is a selfish process, but down the track other people will benefit from your recovery if you have the right initial motivation. If you do stop using/drinking purely for the sake of others, you will more than likely start feeling resentment towards them - and bust when the frustration builds up. Sober is more than cessation and sobriety is a life long study. There are no days off.
Before you get to the busting stage, become aware of patterns in your own behavior that may lead to the flashpoint situation. Avoid them or remove them. But please remember, if you ever do "bust", it does not mean that you can never be sober. Swallow your pride and ask for help - if you are lucky enough to be still able to.............some of us are made silent forever.
The parasite within likes to win and will wait patiently for decades until the time is right........I remember one recovering alcoholic saying that every morning when he wakes up, he envisions a vulture sitting at the end of his bed.....waiting. He then makes his daily affirmation not to drink. It's a pretty strong mental image, one that I choose not to use, but I could understand where he was coming from.
"I am the secret,
I am the sin,
I am the guilty,
I am the thorn within"
The Thorn Within - Metallica - Load
Copyright information.... This article is free for reproduction but must be reproduced in its entirety along with the authors' name and web site link. This copyright statement must be also be included. (c) 2001 - 2007 Michael Bloch, World Wide Addiction.com,. All rights reserved.
Copyright (c) 2001 - 2007 Taming the Beast - email@example.com
Monday, November 26, 2007
About SMART Recovery.
Every "system" for achieving sobriety focuses at first on tools to reduce cravings. SMART especially focuses on disputing the beliefs you may have that increase your urges, and on recognizing the triggers that start drinking behavior.
People often are already taken medicine for specific problems, and wonder how that fits in here. Medication that helps with the physiological part of drinking (e.g., Naltrexone) may be useful in conjunction with the behavioral changes, and prescriptions for anxiety, etc., may reduce the symptoms of suddenly quitting. Prolonged heavy drinkers should discuss quitting with a doctor.
In discussing 'reasons' for drinking people usually mention situational and self-esteem issues. The tools to deal with them are right here. Situational issues are practical--planning for urges, and figuring out ways to dispute them, or planning for events or social situations where drinking is likely and having a strategy in hand. It can be as simple as rehearsing your answers, role-playing, or getting a little deeper into why you're so anxious about what you think other people are going to think or say. That anxiety is often based on irrational beliefs which you can dispute.
You may be discussing self-esteem issues with a counselor (hopefully one familiar with REBT principles). The only thing I'd add from a SMART perspective is to read about the concept of Unconditional Self Acceptance (USA) and to avoid framing your drinking behavior in terms of morality or strength of character. You don't drink because you're weak, or lacking in virtue. It is a compulsive behavior. We act based on our beliefs, and beliefs that lead to unhealthy behavior can be changed.
If you make a commitment to sobriety, plan for urges and practice ways to deal with them, and make the simple changes in your life that help you avoid alcohol--you are likely to succeed. For most people the first step is to do a cost-benefit analysis (CBA) about their drinking and the associated behavior.
Most people can get a pretty long list of costs (and we can help you with that!). But there must be some perceived benefits as well, and those are what are worth exploring to start finding the underlying beliefs that can be disputed. "Alcohol makes me more fun at parties." Really? Follow the belief through to its logical conclusion: "I can't have fun unless I drink." Then think of ways that you CAN have fun, and you're on your way to disputing that belief, and dealing with the next social event where you might feel the urge to drink.
Take some time on this, because these beliefs really get to the core of your drinking behavior. Don't get side-tracked and use this to put off the act of quitting! That may take a separate plan and some reinforcement from friends, family, meetings, or folks here at the forum board.
Once you've identified some of the beliefs that you use to give yourself permission to drink, you can start fitting them into specific situations by doing ABC's. A stressful event at work makes you really want to have a glass of wine as soon as you get home.
For many of us, that glass of wine gradually became an automatic part of getting home, so it's become engrained behavior--this is a good way of looking at why it did. Many parts of your day now revolve around that behavior, from how and where you shop to the haste with which you do errands and travel. You may have been drinking for so long that you no longer are reacting to a specific event, so you can generalize instead: "I drink because it helps me relax after dealing with my stressful job."
That event is the A, or activating event. C is the condition in which you find yourself: anxious, upset, angry. It is hard to talk yourself out of emotional conditions, but they often lead us to drink--episodically for some, daily for others. There is a belief (B) that leads from the activating event to the condition. If you can dispute that (D), you can avoid the trigger, defeat the urge, and get to an effective (E) new condition.
Not every situation lends itself to an elegant ABC. The point is to recognize the beliefs, and dispute them specifically, repeatedly, and out loud if necessary! SMART meetings focus on recognizing those beliefs and disputing them. If your problem is frequent anger, for example, recognize the underlying causes of anger, explain to yourself why the frustration is based, for example, on unrealistic assumptions or a misplaced sense of unfairness. "Don't think poisonous thoughts," is one of my mantras to head off anger.
Developing simple sayings or techniques can help when you feel the start of a mood that, from your experience, is likely to lead to one of those conditions. Nip it in the bud. If it is "self-downing" and feeling inadequate to the many tasks at hand, learn to recognize "awfulizing"--adding up everything that is going wrong and telling yourself how awful everything is. "Oh, stop awfulizing," has worked for me.
Changing your daily pattern of behavior is often the key to starting sobriety. You've spent many years developing a set of actions, from when and where you put the bottle into your shopping cart right up to the little rituals that go along with drinking. Going on a diet, starting exercise, taking up a hobby you'd put aside years ago...whatever works to change the routine and fill the time you spent drinking.
Avoiding lapses involves daily reinforcement of your commitment to abstinence. Just coming to this board each day is an example of a simple thing you can do to keep your new belief fresh. Recognizing the weekly and monthly cycles that you have followed, perhaps unconsciously, in the past can help you avoid triggers. These may be work-related, hormonal (yours or those of someone around you...), or even seasonal.
Keeping your CBA handy and updating it periodically, or having a journal in which you record where you've been, where you are, and where you want to be in the near and mid-range future--these written records of your progress can be very helpful in times of stress. And if you post them here, they benefit untold numbers of others, each at a different place in their sobriety, for a long time to come.
So...thanks for posting!
Copied with permission from Don S at the The Sober Village
Saturday, November 24, 2007
Rehabilitation of substance abuse strictly relies upon individualism. “Text book cases” and generalized treatments proved inadequate. Everyone is an individual with a different life. Likewise, addiction begins and affects each person differently. Successful treatments first address the pain of each person’s unique experiences; then, they continue by restoring the individuality inevitably lost by addiction. The desperation of feeding addiction usually dulls a person’s unique personality and interests. As healing takes effect, people regain the very identity that made them individuals in the first place.
Dramatic advancements have greatly improved treatment programs/centers. Today, quality rehabilitation centers provide caring, individualized, and holistic treatment. However, memories of past rehabilitation centers and the continuation of outdated programs deter many from a better life. Incorrect treatments of the past proved not only ineffective but also detrimental. An awareness of past programs will assist in the identification of an ideal center.
For the majority of the nineteenth century addiction and its treatment was extremely misinterpreted. Largely influenced by Prohibition movements and religiously fueled treatment programs, ideas of addiction as a moral weakness continued until the 1970s. The first modern treatment facility was developed in Cleveland in the late 30’s/early 40’s. When the American Medical Association called addiction a “disease” in 1955, the still existing “medical model” to treatment developed. While “moral model” advocates locked addicts away to prevent the feared debasement of society, proponents of the “medical model” institutionalized people to be “cured.” However, “medication” merely numbed addiction and destroyed an individuals’ identity. An atmosphere of hopelessness and intimidation permeated prison-like quarters. Abusive and unsanitary conditions were common. While these methods failed to treat addiction, they merely intensified the damage that addiction had initiated.
As a “social model” view of addiction developed, community-based programs slowly appeared across the country. Medication became eliminated from treatment programs. No longer viewed as a chemical ailment, addiction became attributed to environmental causes. Finally factors such as family issues and peer pressure were brought to attention. The civil rights movement outlawed abuse, and caring approaches developed. Since negative surroundings were believed to be the cause of addiction, treatment focused on providing positive social settings to bring counteracting effects. Programs became group focused. The actual concept of rehabilitation centers appeared, and out-patient programs developed. Nevertheless, this sole focus on group therapy also proved unable to meet specific needs. The individual still became lost amidst “treatment.” Opportunities to talk about past experiences increased, but counseling and self-exploration remained largely reserved to group sessions. While conditions were no longer dangerous, irrelevant and intimidating activities, such as the cleaning toilets, remained. Although a more humane version of the “medical model” and group-focused “social model” exist today, they still fail to accomplish complete treatment. Permanent recovery is never assured.
In 1985 New York became one of the first to combine addiction and mental illness into one treatment. More and more instances of joined treatments appeared in the 1990s. Now in the twenty-first century, although both the “medical” and “social” models of substance treatment still continue, so does evolution. Modernized facilities provide people with unmatchable, long-lasting effects. Grounded in the most up-to-date research, progressive programs stay directly aligned with practices of good health. Past treatments have helped some. But as the combined approach of individualized and holistic methodologies galvanizes the concept of rehabilitation, treatment is not only more effective than ever, but everyone can also achieve outstanding success. Taking California Drug and Alcohol Treatment by storm, evolution has empowered rehabilitation to new frontiers. Wellness can now thrive in all aspects of life.
Finally, rehabilitation not only recognizes, but also places full attention on patient individuality. While medicine and community may be utilized, programs now use a wide variety of approaches to achieve ideal individualized treatment plans. Beginning with the process of detox, psychiatrists, neuropharmacologists, and nurses provide one-to-one twenty-four-hour assistance. Addiction causes the body to rely upon poison. Highly skilled professionals stand ready for both the effects of substance withdrawal and arising individual complications. As detox enables the body to return to normal functioning, attentive individualized care makes this necessary time as short and painless as possible.
After drug detox frees the body of its dependency, the mind is ready to start its healing journey. Individualized and holistic methods are critical. Programs based on team counseling offer numerous one-on-one sessions from a variety of counselors and constantly revised personal therapy programs. As psychotherapy and hypnotherapy enable the crucial awareness of behaviors and repressed memories, a wide variety of specialized therapies enable further individualized care. Services include marriage/family, spiritual, life purpose, nutritional, image, yoga, and music/art therapy. No longer forced to share personal matters in a group setting, people also benefit from this array of therapy services. With holistic programs, catered to the individual, treatment becomes an unquestionable reality.
Weaving all components of life into recovery, the complete healing of a person’s entire existence can be achieved. During the period of intensive counseling, physical attention furthers the simultaneous mind and body rehabilitation process. Physical training, massage/bodywork, and acupuncture treatment prove extremely effective. While hypnotherapy also works to reduce anxiety, the lulling effects of a luxurious and an outdoor setting rejuvenate the spirit. Eventually, this holistic individualized approach reconnects the body and mind into harmonious wholeness.
Finally treatment is able to eliminate the devastating effects of alcohol and drug abuse, and the everyday concerns of prescription drug addition no longer have to remain part of daily life. The historical development of treatment has come a long way. Recovery does not have to bring further complications or merely touch surface issues. Treatment has the ability to eradicate problems at their source and restore each person’s individual existence to complete health. It is about time.
Tuesday, November 20, 2007
Finding appropriate treatment does not have to be as complicated as it may seem. Substance abuse is a highly individualized experience. The ever-growing number of treatment centers actually makes it possible to pick the best option for the personal situation of the addict in question. Although research is essential, it does not have to be overwhelming. When the different elements of drug treatment are evaluated on their own merits, unfit drug rehab centers can be easily eliminated. The important factor is to locate a program that provides not only comprehensive, but also individual care and service. By concentrating on a specific person’s wants and needs, a little research can successfully find ideal treatment with lasting benefits.
Separate the “needs” from the “wants” when researching drug rehab centers. Maybe a local outpatient drug treatment program seems most hassle-free? Maybe the cheapest rehab seems more desirable? Keep in mind that the goal is not just to stop substance addiction, but to eradicate it permanently. Focusing on this ultimate goal will greatly guide the research process. Remember that quality addiction treatment does usually cost more, and complete healing often requires extensive treatment and a longer length of stay. Nonetheless, the expense and time are worth it. Meaningful addiction treatment requires proper care and should not to be taken lightly.
Upon entering a treatment center, detox is the first step in the drug rehabilitation process. Before a person can begin to heal psychologically and emotionally, physical dependency of the substance must be stopped. Killing brain cells and sometimes even DNA, drug addiction and alcohol dependencies unnaturally causes the body to rely on harmful substances. As time continues, the body progressively requires larger amounts of the drug to feel “normal.” Hence, because detox interrupts bodily functioning, the body often reacts, and sometimes very painfully—even possibly harmfully. Many addictive substances of abuse are linked to specific withdrawal symptoms. However, while the jitters of Valium withdrawal can turn into a seizure, and while the convulsions of alcohol withdrawal can turn into a heart attack, round-the-clock professionals must also be ready to handle any additional complications that might arise. Health providers should always include nurses and a doctor who can subscribe medications. Detox medications are often needed to alleviate addiction withdrawal symptoms and counteract any other developing medical problems. Under the care of trained specialists, drug detox becomes a safe and brief process.
One-on-One Addiction Treatment
After detox destroys physical dependency of the harmful substance, true addiction rehabilitation can begin. Careful and extensive counseling is needed to ensure that sobriety continues indefinitely. When looking for a drug rehab, individual/group dynamics and counseling arrangements should always be a priority. Although group activities do offer excellent community-bonds for the healing process, groups should be kept limited in number. Individual attention ensures that no one is “lost in the crowd,” and everyone receives the care they need and deserve. Regular and private counseling sessions are imperative. Drug addiction is a deeply personal problem with very personal roots. Lasting addiction treatment makes the underlying causes of substance abuse paramount in the healing process. Exploring past and present experiences, people need both the full attention of a professional and the confidential and secure setting of a one-to-one environment. The potential for healing in therapy also greatly increases when specialists’ efforts are combined. Together, small-group centers, individualized therapy, and team counseling create the intensive individualized treatment needed for a long, addiction-free life.
The Union of Body, Mind, and Spirit
Holistic addiction treatment is another key component to permanent healing. A complex and individual body, mind, and spirit interdependence constructs every person. In today’s society it is difficult to keep the three harmonized with each other. However, drug addiction turns the body’s regular stress into utter violence. Physically, cells are killed and nutrients are drained. As the substance becomes of dominant importance, the body/mind/spirit connection dramatically severs, and the person’s unique individuality becomes lost. Old interests and other identity components slowly deteriorate. Drug Rehab centers that create individualized and holistic addiction treatment not only attend to the many needs of the addict or alcoholic, but also uniquely mold comprehensive programs to fit each specific individual.
Author: Abhilash Patel
Saturday, November 17, 2007
Many people abuse alcohol on the occasional wedding or night out, this is not considered alcoholism. You can consume alcohol without abusing alcohol or you can abuse alcohol without being addicted to alcohol.
Alcoholism is the prolonged and continued abuse to alcohol. This typically includes an addiction to alcohol. The use of the alcohol continues despite any negative consequences of the consumption. Money, lost work time or jobs, lost friends, lost self respect, and the loss of health mean nothing to an individual in the grip of alcoholism.
Many alcoholics deny having a problem with alcohol or even other drug addictions. If you have a family member or a loved one in denial you may have to stage an intervention. There are many sources available on the internet, you local doctor, or local drug rehab centers that you can get intervention and treatment information from. If you know someone addicted to alcohol and any other drug getting informed and involved maybe that persons only hope of a positive outcome of the addiction. Addiction usually ends in one of three ways treatment, jail, or death.
Friday, November 16, 2007
I am currently a psychotherapist at the Holistic Addiction Treatment Program in North Miami Beach, Florida. In addition to a variety of counseling and consulting responsibilities, I also conduct goal-setting sessions with all of the inpatient and outpatient clients admitted to the Holistic residential programs. Twice a week I encourage and coach each client to participate fully in an exercise of learning and putting into practice the technology of well-formed outcome. Participating in the goal setting exercises allows for clients to learn the technology of setting well formed goals and also to begin learning about the internal constraints and barriers that stop them from achieving their goals.
On Monday afternoon I enroll the clients into setting a goal that they will complete or accomplish by Friday morning. The coaching is to make the goal simple and attainable. On Friday morning I conduct another session to process their progress towards completing their chosen goal. The processing of what stops them or how they achieved their goal can be very powerful. Powerful breakthroughs can appear for clients in this process. During the same session on Friday morning I encourage clients to set another goal to be worked on and completed over the weekend and by Monday afternoon. On Monday afternoon the client’s progress from the weekend is processed and the goal setting exercise starts over again. The repetition of this exercise will allow the client to utilize the technology of setting effective, well formed goals in his or her recovery program and also learn about how he she sabotages himself in the process.
The goal setting exercise is initially about answering three questions:
1. What goal I am committed to achieving by Friday morning?
2. What I will need to do everyday to achieve my chosen recovery goal by Friday.
3. Who will I talk with and have to hold me accountable for my commitment?
Question one is about the planning stage. The planning stage is about creating a goal or a well-formed outcome, that which a person will go about achieving. The conversation about well-formed outcome is primarily from the field of Neuro Linguistic Programming. In order to create a well formed outcome there are certain criteria that need to be met. If these seven criteria are met the goal or outcome is well formed. Many people do not achieve the goals that they set for themselves because they are not well formed.
The seven criteria for setting effective goals are taught as apart of the sessions that I conduct. There are seven criteria for creating a well-formed outcome:
1. Is your chosen goal specific?
2. Is your goal within your personal control?
3. Do you have with it takes to achieve your goal?
4. How will you know when you have achieved your goal?
5. Is your goal expressed positively?
6. Is your goal at the right level?
7. What else in your life might be affected by your goal?
Question Two is about doing, about determining the actions that will be necessary for the person to achieve the goal that they created in question one. Part of the rules for taking on the exercise is that the client’s goal has to be such that it will require the person to do something everyday to achieve it. The goal cannot be completed in one day or even two. In addition, there has to be a specific time and place that the client must declare to do this part of the exercise. For example, to complete his or her goal of reading 20 pages from the NA text, the client will have to read five pages each evening from 6 to 7 pm in his bedroom.
Retrieved November 16, 2007 from http://www.enhancedhealing.com
Wednesday, November 14, 2007
How do I know I have a problem?
Ask yourself the following questions to find out if you have a problem with alcohol. If you answer “yes” to any one of them, you may have a drinking problem.
- Do you sometimes drink more than you mean to?
- Have you tried to cut back on your drinking and failed?
- Do you black-out (have trouble remembering things that happened) while drinking?
- Have your problems at school, work or with your relationships gotten worse since you started drinking?
- Do you keep drinking even though you know it's causing problems?
- Do you drink when you feel stressed?
- Do you drink alone?
- Can you drink much more now than you used to be able to?
- Do you ever feel uncomfortable when you haven't had a drink?
- Do you drink even when it's important to stay sober?
How can I stop drinking?Help is here!
Tuesday, November 13, 2007
Time Magazine July 2007
(2 of 4)
Of course, not everyone becomes an addict. That's because we have other, more analytical regions that can evaluate consequences and override mere pleasure seeking. Brain imaging is showing exactly how that happens. Paulus, for example, looked at methamphetamine addicts enrolled in a VA hospital's intensive four-week rehabilitation program. Those who were more likely to relapse in the first year after completing the program were also less able to complete tasks involving cognitive skills and less able to adjust to new rules quickly. This suggested that those patients might also be less adept at using analytical areas of the brain while performing decision-making tasks. Sure enough, brain scans showed that there were reduced levels of activation in the prefrontal cortex, where rational thought can override impulsive behavior. It's impossible to say if the drugs might have damaged these abilities in the relapsers--an effect rather than a cause of the chemical abuse--but the fact that the cognitive deficit existed in only some of the meth users suggests that there was something innate that was unique to them. To his surprise, Paulus found that 80% to 90% of the time, he could accurately predict who would relapse within a year simply by examining the scans.
Marketers already seem to know a lot about how we think, but what if they could actually watch our ...
Another area of focus for researchers involves the brain's reward system, powered largely by the neurotransmitter dopamine. Investigators are looking specifically at the family of dopamine receptors that populate nerve cells and bind to the compound. The hope is that if you can dampen the effect of the brain chemical that carries the pleasurable signal, you can loosen the drug's hold.
One particular group of dopamine receptors, for example, called D3, seems to multiply in the presence of cocaine, methamphetamine and nicotine, making it possible for more of the drug to enter and activate nerve cells. "Receptor density is thought to be an amplifier," says Frank Vocci, director of pharmacotherapies at NIDA. "[Chemically] blocking D3 interrupts an awful lot of the drugs' effects. It is probably the hottest target in modulating the reward system."
But just as there are two ways to stop a speeding car--by easing off the gas or hitting the brake pedal--there are two different possibilities for muting addiction. If dopamine receptors are the gas, the brain's own inhibitory systems act as the brakes. In addicts, this natural damping circuit, called GABA (gamma-aminobutyric acid), appears to be faulty. Without a proper chemical check on excitatory messages set off by drugs, the brain never appreciates that it's been satiated.
As it turns out, vigabatrin, an antiepilepsy treatment that is marketed in 60 countries (but not yet in the U.S.), is an effective GABA booster. In epileptics, vigabatrin suppresses overactivated motor neurons that cause muscles to contract and go into spasm. Hoping that enhancing GABA in the brains of addicts could help them control their drug cravings, two biotech companies in the U.S., Ovation Pharmaceuticals and Catalyst Pharmaceuticals, are studying the drug's effect on methamphetamine and cocaine use. So far, in animals, vigabatrin prevents the breakdown of GABA so that more of the inhibitory compound can be stored in whole form in nerve cells. That way, more of it could be released when those cells are activated by a hit from a drug. Says Vocci, optimistically: "If it works, it will probably work on all addictions."
Another fundamental target for addiction treatments is the stress network. Animal studies have long shown that stress can increase the desire for drugs. In rats trained to self-administer a substance, stressors such as a new environment, an unfamiliar cage mate or a change in daily routine push the animals to depend on the substance even more.
Among higher creatures like us, stress can also alter the way the brain thinks, particularly the way it contemplates the consequences of actions. Recall the last time you found yourself in a stressful situation--when you were scared, nervous or threatened. Your brain tuned out everything besides whatever it was that was frightening you--the familiar fight-or-flight mode. "The part of the prefrontal cortex that is involved in deliberative cognition is shut down by stress," says Vocci. "It's supposed to be, but it's even more inhibited in substance abusers." A less responsive prefrontal cortex sets up addicts to be more impulsive as well.
Hormones--of the male-female kind--may play a role in how people become addicted as well. Studies have shown, for instance, that women may be more vulnerable to cravings for nicotine during the latter part of the menstrual cycle, when the egg emerges from the follicle and the hormones progesterone and estrogen are released. "The reward systems of the brain have different sensitivities at different points in the cycle," notes Volkow. "There is way greater craving during the later phase."
That led researchers to wonder about other biological differences in the way men and women become addicted and, significantly, respond to treatments. Alcohol dependence is one very promising area. For years, researchers had documented the way female alcoholics tend to progress more rapidly to alcoholism than men. This telescoping effect, they now know, has a lot to do with the way women metabolize alcohol. Females are endowed with less alcohol dehydrogenase--the first enzyme in the stomach lining that starts to break down the ethanol in liquor--and less total body water than men. Together with estrogen, these factors have a net concentrating effect on the alcohol in the blood, giving women a more intense hit with each drink. The pleasure from that extreme high may be enough for some women to feel satisfied and therefore drink less. For others, the intense intoxication is so enjoyable that they try to duplicate the experience over and over.
But it's the brain, not the gut, that continues to get most of the attention, and one of the biggest reasons is technology. It was in 1985 that Volkow first began using PET scans to record trademark characteristics in the brains and nerve cells of chronic drug abusers, including blood flow, dopamine levels and glucose metabolism--a measure of how much energy is being used and where (and therefore a stand-in for figuring out which cells are at work). After the subjects had been abstinent a year, Volkow rescanned their brains and found that they had begun to return to their predrug state. Good news, certainly, but only as far as it goes.
Monday, November 12, 2007
Thursday, Jul. 05, 2007 By MICHAEL D. LEMONICK
Back when I stopped drinking, such an experiment would have been unimaginable. At the time, the medical establishment had come to accept the idea that alcoholism was a disease rather than a moral failing; the American Medical Association (AMA) had said so in 1950. But while it had all the hallmarks of other diseases, including specific symptoms and a predictable course, leading to disability or even death, alcoholism was different. Its physical basis was a complete mystery--and since nobody forced alcoholics to drink, it was still seen, no matter what the AMA said, as somehow voluntary. Treatment consisted mostly of talk therapy, maybe some vitamins and usually a strong recommendation to join Alcoholics Anonymous. Although it's a totally nonprofessional organization, founded in 1935 by an ex-drunk and an active drinker, AA has managed to get millions of people off the bottle, using group support and a program of accumulated folk wisdom.
While AA is astonishingly effective for some people, it doesn't work for everyone; studies suggest it succeeds about 20% of the time, and other forms of treatment, including various types of behavioral therapy, do no better. The rate is much the same with drug addiction, which experts see as the same disorder triggered by a different chemical. "The sad part is that if you look at where addiction treatment was 10 years ago, it hasn't gotten much better," says Dr. Martin Paulus, a professor of psychiatry at the University of California at San Diego. "You have a better chance to do well after many types of cancer than you have of recovering from methamphetamine dependence."
That could all be about to change. During those same 10 years, researchers have made extraordinary progress in understanding the physical basis of addiction. They know now, for example, that the 20% success rate can shoot up to 40% if treatment is ongoing (very much the AA model, which is most effective when members continue to attend meetings long after their last drink). Armed with an array of increasingly sophisticated technology, including fMRIs and PET scans, investigators have begun to figure out exactly what goes wrong in the brain of an addict--which neurotransmitting chemicals are out of balance and what regions of the brain are affected. They are developing a more detailed understanding of how deeply and completely addiction can affect the brain, by hijacking memory-making processes and by exploiting emotions. Using that knowledge, they've begun to design new drugs that are showing promise in cutting off the craving that drives an addict irresistibly toward relapse--the greatest risk facing even the most dedicated abstainer.
"Addictions," says Joseph Frascella, director of the division of clinical neuroscience at the National Institute on Drug Abuse (NIDA), "are repetitive behaviors in the face of negative consequences, the desire to continue something you know is bad for you."
Addiction is such a harmful behavior, in fact, that evolution should have long ago weeded it out of the population: if it's hard to drive safely under the influence, imagine trying to run from a saber-toothed tiger or catch a squirrel for lunch. And yet, says Dr. Nora Volkow, director of NIDA and a pioneer in the use of imaging to understand addiction, "the use of drugs has been recorded since the beginning of civilization. Humans in my view will always want to experiment with things to make them feel good."
That's because drugs of abuse co-opt the very brain functions that allowed our distant ancestors to survive in a hostile world. Our minds are programmed to pay extra attention to what neurologists call salience--that is, special relevance. Threats, for example, are highly salient, which is why we instinctively try to get away from them. But so are food and sex because they help the individual and the species survive. Drugs of abuse capitalize on this ready-made programming. When exposed to drugs, our memory systems, reward circuits, decision-making skills and conditioning kick in--salience in overdrive--to create an all consuming pattern of uncontrollable craving. "Some people have a genetic predisposition to addiction," says Volkow. "But because it involves these basic brain functions, everyone will become an addict if sufficiently exposed to drugs or alcohol."
That can go for nonchemical addictions as well. Behaviors, from gambling to shopping to sex, may start out as habits but slide into addictions. Sometimes there might be a behavior-specific root of the problem. Volkow's research group, for example, has shown that pathologically obese people who are compulsive eaters exhibit hyperactivity in the areas of the brain that process food stimuli--including the mouth, lips and tongue. For them, activating these regions is like opening the floodgates to the pleasure center. Almost anything deeply enjoyable can turn into an addiction, though.
Saturday, November 3, 2007
re·source (rē'sôrs', -sōrs', -zôrs', -zōrs', rĭ-sôrs', -sōrs', -zôrs', -zōrs')
- Something that can be used for support or help: The local library is a valuable resource.
- An available supply that can be drawn on when needed. Often used in the plural.
- The ability to deal with a difficult or troublesome situation effectively; initiative: a person of resource.
- Means that can be used to cope with a difficult situation. Often used in the plural: needed all my intellectual resources for the exam.
- resources The total means available for economic and political development, such as mineral wealth, labor force, and armaments.
- resources The total means available to a company for increasing production or profit, including plant, labor, and raw material; assets.
- Such means considered individually.