Tuesday, April 29, 2008

The Cold Hard Truth About 'Speed' And 'Ice', Australian Medical Association

The Australian Medical Association claimed methamphetamine users were being put in the too-hard basket - with the peak medical body calling for an overhaul of how the health system deals with this very difficult drug problem.

AMA National President, Dr Rosanna Capolingua, released the AMA Position Statement on Methamphetamine at a press conference at the Royal Perth Hospital, saying methamphetamine users who were often aggressive or in a psychotic state were ending up in emergency wards or in police custody.

Dr Capolingua said emergency department staffs were increasingly being placed in harm's way when it came to methamphetamine users.

"Methamphetamine use is an urgent and pressing health problem that is creating a serious safety issue for health care staff," she said.

The AMA is calling for all emergency departments to have a specialist drugs liaison officer to engage and support methamphetamine and other drug users.

Dr Capolingua said using methamphetamines may produce an initial sense of wellbeing and euphoria but dependence on this harmful drug can lead to methamphetamine-induced psychosis. Three in 10 users will experience psychotic episodes with paranoia and hallucinations.

"Methamphetamine should never be referred to as a recreational, soft or party drug. It's a harmful drug at the community and individual level. More than three-quarters of dependent users suffer serious mental health problems such as agitation, aggression, depression and anxiety," Dr Capolingua said.

A recent Western Australian study found that amphetamine-related presentations accounted for 1.2 per cent of emergency department cases.

Dr Capolingua said many agitated or psychotic users brought into emergency wards were often drunk as well - increasing the risk of aggression towards staff and creating clinical management challenges.

"Symptoms usually last two or three hours but users often need to be hospitalised for their own protection and the safety of others. A third require sedation and intensive treatment which obviously takes up considerable hospital resources," she said.

Further research is also needed into methamphetamine-related problems in emergency departments, best practice in treatment, and what services are required to avoid hospital admission or police custody if a patient is not psychotic. The AMA believes low-intensity, supervised hostel-type accommodation may be suitable.

The AMA is also calling for:

- A renewed, comprehensive and sustained public education program on the social and health consequences of methamphetamine use;

- A sustained investment in GP training on how to engage drug users for lifestyle change; and

- More generic programs, such as Life Skills, which are aimed at young people.

The AMA Position Statement can be found here.


Around three per cent of Australians over the age of 14 use the harmful drug at least once a year.

There are approximately 73,000 dependent methamphetamine users in Australia compared to the 45,000 regular heroin users.

Methamphetamine is a stimulant drug available in various forms:

- Powder or 'speed' is usually of relatively low purity and can be snorted, injected or taken orally;

- Methamphetamine base, a damp oily substance, is of higher purity and typically injected; and

- Crystalline methamphetamine, colloquially known as 'crystal' or 'ice' is methamphetamine in its purest form. Ice is usually smoked or injected.

Pseudoephedrine, available from pharmacies as a symptomatic treatment for the common cold, is the usual base for the illicit manufacture of methamphetamines.

Australian Medical Association

Monday, April 28, 2008

Prescription Pain Killers Are Involved In More Drug Overdose Deaths Than Either Cocaine Or Heroin In U.S.

Trends analysis of drug poisoning deaths has helped explain a national epidemic of overdose deaths in the USA that began in the 1990s, concludes Leonard Paulozzi and colleagues at the Centers for Disease Control and Prevention in Atlanta, USA. The contribution of prescription pain killers to the epidemic has only become clear recently. This research is published this week in the journal, Pharmacoepidemiology and Drug Safety.

Drugs called "opioids" are frequently prescribed to relieve pain, but if abused they can kill. Over the past 15 years, sales of opioid pain killers, including oxycodone, hydrocodone, methadone and fentanyl, have increased, and deaths from these drugs have increased in parallel.

In 2002, over 16,000 people died in the USA as a result of drug overdoses, with most deaths related to opioids, heroin, and cocaine. Opioids surpassed both cocaine and heroin in extent of involvement in these drug overdoses between 1999 and 2002.

The situation appears to be accelerating. Between 1979 and 1990 the rate of deaths attributed to unintentional drug poisoning increased by an average of 5.3% each year. Between 1990 and 2002, the rate increased by 18.1% per year. The contribution played by opioids is also increasing. Between 1999 and 2002 the number of overdose death certificates that mention poisoning by opioid pain killers went up by 91.2%. While the pain killer category showed the greatest increase, death certificates pointing a finger of blame at heroin and cocaine also increased by 12.4% and 22.8% respectively.

In an accompanying 'comment' article, David Joranson and Aaron Gilson of the University of Wisconsin School of Medicine and Public Health Comprehensive Cancer Centre; Pain & Policy Studies Group, of Madison, Wisconsin. They caution against increasing unwarranted fears of using opioid analgesics in pain management, noting that much of the abuse of opioid analgesics is by recreational and street users and individuals with psychiatric conditions rather than pain patients.

Joranson and Gilson also point to the large quantity of opioid analgesics stolen from pharmacies every year, saying that "overdose deaths involving prescription medications do not necessarily mean they were prescribed. It is also crucial to know that most overdose deaths involve several drugs and these data cannot attribute the cause to a particular drug."

In a second commentary, Scott Fishman, Professor of Anaesthesiology and Pain Medicine at University of California, Davis concludes that drug abuse and under treated pain are both public health crises, but the solution to one need not undermine the other. "The least we can do is make sure that the casualties of the war on drugs are not suffering patients who legitimately deserve relief," he says.

Adapted from materials provided by John Wiley & Sons, Inc..

Friday, April 25, 2008

Old Habits

After decades of drug addiction, Adriane Allen believes she has finally grown too old to smoke crack. At 57, she has chest pains, has lost most of her teeth and has trouble moving her arms. Lately, she worries about how her grandchildren will remember her when she is gone.

"I definitely do not want them mourning me as an addict, that I died as an addict," said Ms. Allen, shaking her head, covered with gray hair and fidgeting uncontrollably during an interview at a New York City needle-exchange center.

"You get tired of being tired," she continued. "They say that is a drug addict's saying, but it is true, you do get tired of being tired. I am tired of walking around in a daze. I am tired of walking around with sunglasses on. Blocking out real life. I am ready to face my demons and just say I don't want it anymore."

As the first of the baby boomers approach 60, addiction treatment centers are bracing for a growing population of older drug addicts. Many aging users, veterans of the counterculture 60's, started using drugs as teenagers and have progressed to harder substances and addiction, while others turned to illicit drugs, abuse of prescription medications or increased alcohol intake later in life, with the loss of jobs or spouses.

Since, traditionally, substance-abuse- treatment programs and research have focused on teenagers and young adults, doctors, social workers, therapists and researchers say that new approaches need to be developed for the ballooning number of boomer addicts.

"In treatment of people 55 and older, we are starting to see much more cocaine addiction, which we never saw before," said Frederic C. Blow, an associate professor in the University of Michigan's psychiatry department, who has developed policy recommendations for the federal Substance Abuse and Mental Health Services Administration. "In fact, in some treatment programs, we are starting to see more problems related to stimulant abuse: cocaine, crack and marijuana use."

The federal government's 2004 survey of substance abuse, released in September, estimated that more than three million adults 50 and older had used marijuana, hashish, cocaine or crack, heroin, hallucinogens or inhalants or had misused prescription drugs during the previous year. That number could more than double by 2020, said Joseph C. Gfroerer, director of the substance abuse agency's population surveys.

Willard L. Mays, a delegate to the White House Conference on Aging and a member of the executive committee of the National Coalition on Mental Health and Aging, said, "There are not enough geriatric specialists to handle this increased number of people who need services."

Their medical problems can be overwhelming. Long-term heroin use can hasten the decline in immunity that comes with age. Prolonged cocaine use can lead to erosion of the nasal passages, arrhythmia and other cardiovascular problems. The slower metabolism, lower body mass and decrease in an enzyme called alcohol dehydrogenase that accompany aging drive down the alcohol tolerance of older adults, contributing to liver disease and making them susceptible to falls. Older patients may already have diabetes, arthritis or hypertension, meaning that they need to be stabilized before they can start treatment for their addiction.

At the methadone maintenance treatment program at Beth Israel Medical Center, doses sometimes need to be adjusted for older patients who are more likely to be on several prescription drugs, said the medical director, Dr. Randy Seewald.

Older patients can also present practical treatment problems. Those with mobility problems might have trouble getting to treatment centers. They often need treatment literature printed in large type, or help in unscrewing the caps of methadone bottles, because of arthritis. Therapy must be tailored to address regret over wasted youth and lost spouses.

Substance abuse also often goes undetected - and therefore untreated - for long periods in older adults who are isolated. "When people are retired and do not have professional obligations and the children have left home, then our red flags are not raised quite as effectively," said Petros Levounis, director of the Addiction Institute of New York.

Even when an older person's drug or drinking problem is noticed, people are sometimes loath to interfere and deprive parents or other loved ones of a remaining pleasure, said Julie E. Jensen, a researcher with the Washington Institute, an academic institution that advises the public health system in Tacoma.

Some who had been casual drug users in their youth returned to the substances later in life because of loneliness, the death of a spouse or a loss of purpose after retirement. "They will go back to what satisfied them years ago," said Carolyn M. Drennan, director of nursing at the Beth Israel methadone program.

Moses Henderson, 57, said he started sniffing heroin to cope with depression after his wife died in 2001. He has hypertension, a bad heart and diabetes, but is now in treatment. "I don't think my wife would want me dead," he said, adding that if he uses drugs again, "I will not make it."

Unlike Mr. Henderson, who is in a residential program, Margaret Baldwin, 65, lives in a homeless shelter. Two years ago, she fell down the stairs while drunk and broke her hip. That was the last straw, after 23 years of alcohol abuse and drinking a pint of gin every day. "I had no company," she said. "The only thing that entertained me was the bottle."

Then there are longtime addicts like Ms. Allen. She said she went from a puff of marijuana at a party in the 60's to "skin-popping" heroin and smoking crack over the years.

Sometimes, "I found myself asleep on the train," she said, "because I would be so high."

"I would like, nod out," she said, at the Lower East Side Harm Reduction Center. "When I wake up, I am like in the Bronx or Coney Island. Now that I am older I won't do that when I get high. I make sure I get to a friend's house."

Ms. Allen said she had used cocaine five days a week. She agreed to be interviewed because she thought her story would help younger addicts quit.

While some addicts, like Ms. Allen, are unemployed and homeless, others hold down jobs and lead middle class lives. Take Gwendolyn Jennings-Hill, a 55-year-old grandmother who says she was a functional addict. She used to cook up marble-size pellets of cocaine at home in Hampton, Va., then smoke it quickly, so her daughter would not catch her.

"I fell in love with crack," said Ms. Jennings-Hill, who is in Odyssey House's ElderCare program in Harlem. "I used marijuana and then I progressed to drinking, then sniffing cocaine and freebasing. The 60's was a time when people started coming out of Vietnam. There was the hippie generation. I was connected to that age and that era."

This year, encouraged by her family, Ms. Jennings-Hill sought to end what she called the thrill and insanity of addiction. "I did not go to crack houses," she said. "I was one of the, I guess, fortunate addicts that had a house, had food, had money."

Ms. Jennings-Hill's teacher's salary was enough to support a habit that cost about $3,000 a month. Others use Social Security payments or rent space in their apartments as crack houses.

In contrast to younger addicts, older substance abusers thrive on treatment that features personal accounts, counselors say. They dress up for group sessions, and hesitate to speak openly in mixed-age groups.

At Odyssey House, a dozen residents aged 54 to 75 sat in a circle recently and told stories of broken marriages and estranged children. Some were trying to overcome heroin and crack habits while dealing with hypertension, diabetes, cardiac problems and sleep apnea.

"I been drugging for the past 55 years," Pedro Rosa, 66, said reflectively, looking at the floor and leaning on his cane, his tattooed arms protruding from his shirtsleeves.

Several in the group let out murmurs of agreement, like the sounds listeners make when they not only know the story but have also lived it.

"I was a very angry man when I was in the street," Mr. Rosa said. "But now I am too old to continue the life I was living."

Source: nytimes.com

Tuesday, April 22, 2008

Addiction and the Family

Addiction: Harm to the User and the Family

A drug addiction or alcohol addiction of a family member not only affects the said member per se but also has a serious effect on the people around the user, most especially the loved ones. It is but normal to be ignorant of how to deal with your loved ones who are into alcoholism, substance abuse, drug abuse, etc. It will also be hard to understand why the member of the family resorted to those addictions. Most of the time, the loved ones would have a hard time telling the person to the face that he/she needs to be brought to the treatment center or undergo rehabilitation.

The life of a user is not the only thing that is ruined as soon as addiction has been developed---the life of the family may also be destroyed as they are either hurt physically and emotionally by the user. Drugs or alcohol may be likened to a director who calls out how the actors and actresses (the users) should act, and most of the time, the actions are negative and destructive. The behavior of the user not only results to self destruction but also negatively affects the actions, feelings and thoughts of the people around the user, most especially the family.

Life for the person’s (the one who does substance abuse or is a slave to alcoholism) family will never be normal. This is because users behave in the manner that will most of the time hurt their family. The change in the user’s behavior, e.g. from being a meek child, has become a violent child, often cause the family members to have difficulty in adapting, thus resulting to their own emotional and psychological problems. Now, even the family members are being controlled by the user’s addiction. The most common feelings that family members would experience would be guilt, sometimes blaming themselves for the user’s dependency on drugs, disappointment, fear of whatever the user might do, and a lot more.

The best resort of family members would be to first learn all there is to know about substance abuse as well as alcoholism. As soon as they have an understanding of those subjects, they will be able to start helping the users as well as themselves on the way to recovery. Family members can do their research through the Internet with a lot of online resources available such as sober forums, the Sober Sources network, etc. They also need to learn first how it works in rehabilitation and treatment centers before making a decision of letting the user undergo rehabilitation.

Learning about counseling treatment options will also be a good idea as the user will be needing all the support that he or she could get. As soon as the user has attained sobriety, lapses could be avoided through the mutual support groups as well as self-help resources that gives support continuously for the users to live a drug free life with consistency. These groups support the addict in making lifestyle changes, such as establishing new, drug-free friends and activities, necessary to maintaining abstinence. There are also communities that will help the family members and the loved ones cope from the effects of having an addict within the family.

Monday, April 21, 2008

Medicare Plans Affected by Rising Drug Costs

Employers and patients in corporate health plans are not the only ones affected by the soaring prices of specialty drugs. Enrollees in Medicare drug plans are also feeling the pressure.

Many leading pharmacy benefit managers and drug insurers that oversee employer plans also offer coverage through the Medicare Part D drug insurance program, and so are profiting from federal spending on specialty drugs and from Medicare patients’ own high out-of-pocket co-payments.

Driven in part by specialty drugs, the prices of medicines heavily used by the elderly have risen more than 24 percent since June 2006, two senior health economists at Harvard reported in January in the policy journal Health Affairs.

In that article the economists, Richard G. Frank and Joseph E. Newhouse, said single-source unique drugs have the potential to present “important new pressures on the federal budget.”

Many Part D plans segregate specialty drugs in a special tier, where a Medicare enrollee pays 25 to 33 percent of the price, according to Jack Hoadley, a research professor at Georgetown University. At that rate, patients quickly reach the $5,726 cap on out-of-pocket spending, after which the patient pays only 5 percent. From that point, the drug plan sponsor pays 15 percent, while Medicare pays 80 percent of the cost.

The trend, the Frank-Newhouse article said, bodes ill for “the worrisome future financial health of Medicare.”


Saturday, April 19, 2008

Treatment Centers

Most addicted people need help to find a way to live clean, sober lives. Treatment Centers, therapists and specialists are often the last stop in the vicious cycle that is substance addiction. When alcoholism and drug addiction become part of your daily life - be it yourself, a friend or a family member - opportunities for happiness, life, prosperity and peace of mind can vanish in the blink of an eye.

Many individuals will not seek treatment for various reasons. It has been our experience that 'active' addicts and alcoholics, as well as people afflicted with different addictions or conditions, can sometimes lose the ability to reason. A therapist or specialist for a specific illness or addiction issue, or a full-fledged residential treatment center can and will help. You, or your loved one, can find it here at
Treatment Centers.com

Wednesday, April 16, 2008

Middle Age Drinking Linked to Alzheimer's

Researchers found an apparent link between heavy drinking or heavy smoking by people in their 40s and the development of Alzheimer's disease decades later, Health Day News reported April 16.

One study of people 60 and older diagnosed with possible or probable Alzheimer's found earlier onset for the disease for heavy drinkers -- 4.8 years earlier for those who had consumed more than two drinks a day -- and for heavy smokers -- 2.3 years earlier for those who had smoked a pack of cigarettes or more a day.

"The current thinking is that the pathology of Alzheimer's disease builds up over many years before clinical symptoms are manifest," said Dr. Ranjan Duara, director of the Mount Sinai Medical Center Wien Center for Alzheimer's Disease in Miami Beach. "People who start with a good cognitive reserve, who remain active mentally, are able to compensate for the pathology of the brain for a much longer period of time."

Duara noted that both smoking and drinking can damage the brain. However, while it is agreed that any amount of smoking is bad, Duara said there remains "a bit of controversy" about heavy drinking and Alzheimer's, especially what amount of alcohol, if any, is safe.

"I suggest that more than two drinks a day is probably not a good idea," Duara said. "No one has shown that one or two a day is not as good as three or four a day in protecting" general health.

Rachel Whitmer, a research scientist with the Kaiser Permanente division of research in Oakland believes "... people need to be thinking about their risk factors for Alzheimer's disease even in their 40s. What is good for your heart is also good for your brain."

The research was presented at the American Academy of Neurology's annual meeting in Chicago.

Thursday, April 10, 2008

Addiction Interventions

Drug and alcoholism intervention is an attempt by family members and friends to help a chemically dependent person get help for his or her addiction. The purpose of an addiction intervention is to help the substance abuser see the physical and mental destruction their addiction creates. Interventions are usually successful and often enable the abuser to move on to successful drug and alcohol treatment programs.1

As with all addictions, drug and alcohol abusers are usually the last to admit there is a problem. Or, the abuser may realize there is a problem but just cannot seem to seek help. Family, friends and careers also suffer and can be destroyed by the abuser’s addiction. Jay notes, one out of 3 people is living with or related to someone with an alcohol or other drug problem. Intervention is the most effective technique families can use to help a loved one suffering from chemical dependency - alcoholism or other drug addiction. It is also the most ignored. But just as CPR is often the first, life saving step in helping a heart attack victim, intervention is the most powerful step that a family can take to initiate the recovery process.2 By taking action, families and friends can get help for their loved one and help for themselves as they cope. According to Addiction Intervention Resources, 92 percent of those intervened on go to treatment and have the opportunity to change their lives.

Tuesday, April 8, 2008

Scientists Say Methadone-Like Treatment for Cocaine Addiction Possible

Cocaine addicts could be treated with less-addictive amphetamines, similar to using methadone to treat opiate addiction, ScienceDaily reported April 6.

Wake Forest University School of Medicine researchers reported at the recent annual meeting of the American Society of Pharmacology and Experimental Therapeutics that they had successfully lowered cocaine self-administration among research monkeys by giving the animals amphetamines. "This suggests the possibility of developing an amphetamine-like drug for treating cocaine addiction," said lead researcher Paul Czoty, Ph.D. "The research also demonstrates the usefulness for conducting studies in monkeys to test potential treatments."

In the animal study, cocaine use was reduced by 60 percent. No FDA-approved pharmacological treatment for cocaine addiction currently exists, Czoty noted. "While it's unlikely that amphetamine itself will turn out to be the best treatment, these drugs allow us to prove the concept of using a replacement drug to combat cocaine addiction," he said.

Sunday, April 6, 2008

Dreams, Conflicts, Priorities

By: LeeDavidhcz

If I give you the following 6F’s to re-arrange based on your order of priority, how would yours shape up? Here goes: fitness-finances-family-faith-future-friends. The order of your 6F’s determines if you are living a balanced life or not.

A lot depends on your value system. Your value system drives your priorities. It determines your definition of success and the role of money. We may not agree on definitions, but one thing is basic, if your doctors tell you that you will be dead in ten days, you will act different. This begs the question, “Do we have to approach our death bed before we get our priorities right?”

"No man on his deathbed ever said, 'I wish I'd spent more time at the office.'" Sen. Paul Tsongas

Do we have to look back in regret?

The foundation to our future is being laid in the present. The pursuit of any dream or goal has to be placed in context. Success has to be all round. Succeeding in one area and failing in others still amounts to failure overall. We cannot jeopardize our family life, spiritual life, health or relationships in pursuit of finances or goal. If we achieve our dreams, and look back to find our family gone, or end up in hospital or feel empty or suicidal, you begin to wonder whether it was worth the trouble.

In the heat of the pursuit of our dreams, it is easy to forget about our priorities and live our lives out of synch. It is an ongoing battle. There is a price to pay for our dreams, and we must be ready to pay the price. However, there is a limit to the price we have to pay. This depends on our priorities. Herein lie the conflicts in the pursuit of our dreams.

There are questions that others cannot answer for us. For a Christian, the priority system is pretty well spelt out: faith-family-friends-finances-fitness-future. Some may still have issues with this. In the final analysis, the decision is still up to us.

Ultimately, we have to make a conscious effort to make choices in consonance with our value system, and be ready to bear the consequences. We must not lose sight of the big picture. We need all the 6F’s intact as we breast the finish line. If we leave any one behind, we end up with a hollow victory.

If things are no longer at ease and you are experiencing any of these symptoms:

- tension in the home, the children avoid you and everyone snaps at each other
- lack of peace within, you feel hollow and empty inside
- you are always feeling tired, you wake up tired and go to bed tired
- you cannot remember the last time you exercised
- your friendships have become a distant memory

It may be time to shut down, take a deep breath and exhale. Something is wrong somewhere. If you look hard enough, you will find out where.

Sit back and take a second look at how you’ve been going about pursuing your dream. Admit to yourself that there is a better way. Go back to the basics, and begin again. It is possible to have the 6F’s right by you as you breast the finish line. Anything less is hollow, empty and not worth the trouble.

Article Source: http://article2008.com

Thursday, April 3, 2008

Who Controls You

Who Controls You?
How Rational Emotive Behaviour Therapy can help you change unwanted emotions and behaviours
By Wayne Froggatt

Copyright Notice: This document is copyright © to the author (1990-97). Single copies (which include this notice) may be made for therapeutic or training purposes. For permission to use it in any other way, please contact: Wayne Froggatt, PO Box 2292, Stortford Lodge, Hastings, New Zealand. (E-mail: waynefroggatt@rational.org.nz). Comments are welcomed. This document is located on the internet site: http://www.rational.org.nz Reprinted here with permission

Most people want to be happy. They would like to feel good, avoid pain, and achieve their goals. For many, though, happiness seems to be an elusive dream. In fact, it appears that we humans are much better at disturbing and defeating ourselves! Instead of feeling good, we are more likely to worry, feel guilty and get depressed. We put ourselves down and feel shy, hurt or self-pitying. We get jealous, angry, hostile and bitter or suffer anxiety, tension and panic.

On top of feeling bad, we often act in self-destructive ways. Some strive to be perfect in everything they do. Many mess up relationships. Others worry about disapproval and let people use them as doormats. Still others compulsively gamble, smoke and overspend - or abuse alcohol, drugs and food. Some even try to end it all.

The strange thing is, most of this pain is avoidable! We don't have to do it to ourselves. Humans can, believe it or not, learn how to choose how they feel and behave.

As you think, so you feel.

People feel disturbed not by things, but by the views they take of them.' Ancient words, from a first- century philosopher named Epictetus - but they are just as true now.

Events and circumstances do not cause your reactions. They result from what you tell yourself about the things that happen. Put simply, thoughts cause feelings and behaviours. Or, more precisely, events and circumstances serve to trigger thoughts, which then create reactions. These three processes are intertwined.

The past is significant. But only in so far as it leaves you with your current attitudes and beliefs. External events - whether in the past, present, or future - cannot influence the way you feel or behave until you become aware of and begin to think about them.

To fear something (or react in any other way), you have to be thinking about it. The cause is not the event - it's what you tell yourself about the event.

The ABC's of feelings & behaviours

American psychologist Albert Ellis, the originator of Rational Emotive Behaviour Therapy (REBT), was one of the first to systematically show how beliefs determine the way human beings feel and behave. Dr. Ellis developed the 'ABC' model to demonstrate this.

'A' refers to whatever started things off: a circumstance, event or experience - or just thinking about something which has happened. This triggers off thoughts ('B'), which in turn create a reaction - feelings and behaviours - ('C').

To see this in operation, let's meet Alan. A young man who had always tended to doubt himself, Alan imagined that other people did not like him, and that they were only friendly because they pitied him. One day, a friend passed him in the street without returning his greeting - to which Alan reacted negatively. Here is the event, Alan's beliefs, and his reaction, put into the ABC format:

A. What started things off:

Friend passed me in the street without speaking to me.

B. Beliefs about A.:

1. He's ignoring me. He doesn't like me.
2. I could end up without friends for ever.
3. That would be terrible.
4. For me to be happy and feel worthwhile, people must like me.
5. I'm unacceptable as a friend - so I must be worthless as a person.

C. Reaction:

Feelings: worthless, depressed. Behaviours: avoiding people generally.

Now, someone who thought differently about the same event would react in another way:

A. What started things off:

Friend passed me in the street without speaking to me.

B. Beliefs about A.:

1. He didn't ignore me deliberately. He may not have seen me.
2. He might have something on his mind.
3. I'd like to help if I can.

C. Reaction:

Feelings: Concerned.
Behaviours: Went to visit friend, to see how he is.

These examples show how different ways of viewing the same event can lead to different reactions. The same principle operates in reverse: when people react alike, it is because they are thinking in similar ways.

The rules we live by

What we tell ourselves in specific situations depends on the rules we hold. Everyone has a set of general 'rules'. Some will be rational, others will be self-defeating or irrational. Each person's set is different.

Mostly subconscious, these rules determine how we react to life. When an event triggers off a train of thought, what we consciously think depends on the general rules we subconsciously apply to the event.

Let us say that you hold the general rule: 'To be worthwhile, I must succeed at everything I do.' You happen to fail an examination; an event which, coupled with the underlying rule, leads you to the conclusion: 'I'm not worthwhile.'

Underlying rules are generalisations: one rule can apply to many situations. If you believe, for example:
'I can't stand discomfort and pain and must avoid them at all costs,' you might apply this to the dentist, to work, to relationships, and to life in general.

Why be concerned about your rules? While most will be valid and helpful, some will be self-defeating. Faulty rules will lead to faulty conclusions. Take the rule: 'If I am to feel OK about myself, others must like and approve of me.' Let us say that your boss tells you off. You may (rightly) think: 'He is angry with me' - but you may wrongly conclude: 'This proves I'm a failure.' And changing the situation (for instance, getting your boss to like you) would still leave the underlying rule untouched. It would then be there to bother you whenever some future event triggered it off.

Most self-defeating rules are a variation of one or other of the '12 Self-defeating Beliefs' listed at the end of this article. Take a look at this list now. Which ones do you identify with? Which are the ones that guide your reactions?

What are self-defeating beliefs?

To describe a belief as self-defeating, or irrational, is to say that:

l It distorts reality (it's a misinterpretation of what's happening); or it involves some illogical ways of evaluating yourself, others, and the world around you: awfulising, can't-stand-it-itis, demanding and people-rating;
l It blocks you from achieving your goals and purposes;
l It creates extreme emotions which persist, and which distress and immobilise; and
l It leads to behaviours that harm yourself, others, and your life in general.

Four ways to screw yourself up

There are four typical ways of thinking that will make you feel bad or behave in dysfunctional ways:

1. Awfulising: using words like 'awful', 'terrible', 'horrible', 'catastrophic' to describe something -
e.g. 'It would be terrible if …', 'It's the worst thing that could happen', 'That would be the end of the world'.
2. Cant-stand-it-itis: viewing an event or experience as unbearable - e.g. 'I can't stand it', 'It's absolutely unbearable', I'll die if I get rejected'.
3. Demanding: using 'shoulds' (moralising) or 'musts' (musturbating) - e.g. 'I should not have done that, 'I must not fail', 'I need to be loved', 'I have to have a drink'.
4. People-rating: labelling or rating your total self (or someone else's) - e.g. 'I'm stupid /hopeless /
useless /worthless.'

Rational thinking

Rational thinking presents a vivid contrast to its illogical opposite:

- It is based on reality - it emphasises seeing things as they really are, keeping their badness in perspective, tolerating frustration and discomfort, preferring rather than demanding, and self- acceptance;
- It helps you achieve your goals and purposes;
- It creates emotions you can handle; and
- It helps you behave in ways which promote your aims and survival.

We are not talking about so-called 'positive thinking'. Rational thinking is realistic thinking. It is concerned with facts - the real world - rather than subjective opinion or wishful thinking.

Realistic thinking leads to realistic emotions. Negative feelings aren't always bad for you. Neither are all positive feelings beneficial. Feeling happy when someone you love has died, for example, may hinder you from grieving properly. Or to be unconcerned in the face of real danger could put your survival at risk. Realistic thinking avoids exaggeration of both kinds - negative and positive.

The techniques of change

How does one actually set about achieving self-control and choice? The best place to start is by learning how to identify the thoughts and beliefs which cause your problems.

Next, learn how to apply this knowledge by analysing specific episodes where you feel and behave in the ways you would like to change. It is most effective to do this in writing at first, and later it will become easier to do it in your head. You connect whatever started things off, your reaction, and the thoughts which came in between. You then check out those thoughts and change the self-defeating ones. This method, called Rational Self-Analysis, uses the ABC approach described earlier, extended to include sections for setting a goal or new desired effect ('E'), disputing and changing beliefs ('D'), and, finally, further action to put those changes into practice ('F').

That final step is important. You will get there faster when you put into action what you have changed
in your mind. Let us say you decide to stop feeling guilty when you do something for yourself. The next step is to do it. Spend an hour a day reading a novel. Purchase some new clothes. Have coffee with a friend or a weekend away without the family. Do the things you would previously have regarded as 'undeserved'.

Overcoming obstacles

While change is possible, it is not easy - mainly because of a very human tendency known as 'low- discomfort tolerance'.

Most of us want to be physically and emotionally comfortable. But personal change means giving up some old habits of thinking and behaving and 'safe' ways of approaching life.

Whereas before you may have blamed others for your problems, now you start to take responsibility for yourself and what you want. You risk new ways of thinking and acting. You step out into the unknown. This could increase your stress and emotional pain - temporarily. In other words, you may well feel worse before you feel better.

Telling yourself that you 'can't stand it' could lead you to avoid change. You might decide to stick with the way things are, unpleasant though it is. You know you would be better off in the long run, but you choose to avoid the extra pain now.

Or you might look for a quick solution. Do you hope that somewhere there's a fancy therapy which will cure you straight away - without you having to do anything? I meet many people who try therapist after therapist, but never stay with one approach long enough to learn anything that will help. They still live in hope, though, and often get a brief boost from meeting new therapists or therapy groups.

As well as fearing discomfort, you may also worry that you 'won't be a real person'. You think that you will end up 'pretending' to feel and behave in new ways, and imagine yourself as false or phoney. Somehow, it seems, to choose how you feel seems 'less than human'.

You are, though, already choosing your reactions - even though you may not be fully aware of doing so. And using conscious choice is what sets humans apart from instinct-bound animals. It is also what makes you a unique person - different to every other. So give up the notion that it is false and machine- like to use your brain to avoid bad feelings. Getting depressed, worried, and desperate does not make you more human.

You might worry that learning self-control will make you cold and unemotional, with no feelings at all. This common fear is quite misguided. The opposite is true: if you learn how to handle strong feelings you will be less afraid of them. This will free you to experience a fuller range of emotions than before.

While self-improvement may be hard, it is achievable. The blocks I have described are all self-created. They're nothing more than beliefs - ideas you can change using practical techniques you can learn.

Rational thinking is not just academic theory. People from a wide range of social and educational backgrounds have already used it successfully. You will be able to as well.

It is true that human beings start life with a biological predisposition to irrational thinking, which they then add to by learning new and harmful ways of behaving and viewing life. But there is a positive side to human nature - we also have the ability to think about our beliefs and change the dysfunctional ones.

What about problems you can't sort out on your own? Some outside help may be a useful supplement to your self-help efforts. Whether or not you have such help, though, taking responsibility for your feelings and actions will be the key to success. You will also need some hard work and perseverance. But, happily, by learning how to identify and change self-defeating beliefs and attitudes, these things can be within your control - and happiness within your reach.

From Self-defeat to Rational Living

12 Self-defeating Beliefs

1. I need love and approval from those significant to me - and I must avoid disapproval from any source.
2. To be worthwhile as a person I must achieve, succeed at what ever I do, and make no mistakes.
3. People should always do the right thing. When they behave obnoxiously, unfairly or selfishly, they must be blamed and punished.
4. Things must be the way I want them to be - otherwise life will be intolerable.
5. My unhappiness is caused by things outside my control - so there is little I can do to feel any better.
6. I must worry about things that could be dangerous, unpleasant or frightening - otherwise they might happen.
7. I can be happier by avoiding life's difficulties, unpleasantness, and responsibilities.
8. Everyone needs to depend on someone stronger than themselves.
9. Events in my past are the cause of my problems - and they continue to influence my feelings and behaviours now.
10. I should become upset when other people have problems and feel unhappy when they're sad.
11. I should not have to feel discomfort and pain - I
can't stand them and must avoid them at all costs.
12. Every problem should have an ideal solution, and it is intolerable when one can't be found.

12 Rational Beliefs

1. Love and approval are good things to have, and I'll seek them when I can. But they are not necessities - I can survive (even though uncomfortably) without them.
2. I'll always seek to achieve as much as I can - but unfailing success and competence is unrealistic. Better I just accept myself as a person, separate to my performance.
3. It's unfortunate that people sometimes do bad things. But humans are not yet perfect - and upsetting myself won't change that reality.
4. There is no law which says that things have to be the way I want. It's disappointing, but I can stand it
- especially if I avoid catastrophising.
5. Many external factors are outside my control. But it is my thoughts (not the externals) which cause my feelings. And I can learn to control my thoughts.
6. Worrying about things that might go wrong won't stop them happening. It will, though, ensure I get upset and disturbed right now!
7. Avoiding problems is only easier in the short term - putting things off can make them worse later on. It also gives me more time to worry about them!
8. Relying on someone else can lead to dependent behaviour. It is OK to seek help - as long as I learn to trust myself and my own judgement.
9. The past can't influence me now. My current beliefs cause my reactions. I may have learned
these beliefs in the past, but I can choose to analyse and change them in the present.
10. I can't change other people's problems and bad feelings by getting myself upset.
11. Why should I in particular not feel discomfort and pain? I don't like them, but I can stand it. Also, my life would be very restricted if I always avoided discomfort.
12. Problems usually have many possible solutions. It is better to stop waiting for the perfect one and get on with the best available. I can live with less than the ideal.

This article has adapted and summarised from the book Choose to be Happy: Your step-by-step guide By Wayne Froggatt, Published by HarperCollins New Zealand, Auckland, 1993.

Tuesday, April 1, 2008

Family Addiction Resource Groups

Family Addiction Recovery Resource Groups

There are millions of people whose lives are filled with chaos caused by the excessive drinking of someone close to them. Every day can be marked with distress, bitterness, sadness and fear as they keep watch of themselves versus the consequences of drinking.

There are sober forums, sober resources, face-to-face help on substance abuse and alcoholism offered online such as The Sober Village. The online support and services and live help are for codependents where they can opt for counseling, therapy, and treatment and rehab options.

Al-Anon: A worldwide fellowship of family groups who are relatives and friends of alcoholics with common experiences, strength and hope to solve the problem of alcoholism and addiction. They believe that there’s no better prescription than learning to face the problem until it loses the power to prevail in one’s life.

Alateen: Part of the Al-Anon fellowship for young people to share and discuss difficulties caused by their parents’ drinking habits. They learn ways to cope, support, encourage and help each other. They are taught to emotionally disjoin themselves from the problem while continuing to love the person, that they are not the cause, but they can only control themselves.

Nar-Anon: A worldwide non-professional fellowship of relatives and friends whose lives have been affected by a person’s addiction. It is a mutual support recovery program to share experiences and resolve their common problem. It is a religious organization, a treatment and counseling center conducted by professionals.

The diagnostic processes are adapted from AA, giving them a sense of well-being and opportunity to change and overcome the parlous situation.

1) The Twelve Steps: It is all about admission of the wrongs, searching one self’s moral inventory, restoration, making amends and believing in one authority, God; prayer, meditation and spiritual awakening and to live as He wills it.

2) The Twelve Traditions: It talks about one self’s common welfare with the purpose of helping families of addicts, not to divulge in any endorsement for money, to be self-supporting, to be responsible to those they serve, remain non-professional and anonymous with God at the center of their endeavor.

3) The Twelve Concepts of Service: Talks about responsible service, good leadership, the key to harmony, the right to be heard, spiritual foundations and delegation of authority.

Addiction resources and support for the family!