Friday, June 27, 2008

State policies have a significant impact on the services performed by substance abuse treatment programs, and could play a key role in efforts to expand the use of research-based "comprehensive" treatment approaches, reports a study in the June issue of the Journal of Substance Abuse Treatment (JSAT).

"The states are uniquely positioned to institute specific policy proscriptions emanating from scientific research in the substance abuse treatment arena, indicating that a comprehensive approach…[is] associated with positive treatment outcomes and reduced recidivism," according to the researchers, led by Jamie F. Chriqui, Ph.D., M.H.S., of University of Illinois at Chicago.

Dr. Chriqui and colleagues gathered data on state policy requirements regarding outpatient substance abuse treatment programs. They focused on state-authorized programs, which make up the vast majority of drug and alcohol abuse programs in the United States. The study included data on more than 9,000 drug treatment programs nationwide.

Nearly all of the programs were in a state with policies requiring some type of assessment for substance abuse treatment programs. However, most were in states that did not mandate the use of comprehensive diagnostic criteria, such as those published by the American Society for Addiction Medicine.

Most programs were in states requiring some type of group and individual counseling or therapy, but not family counseling or therapy. Studies have found that family counseling is an important part of successful substance abuse treatment. Few programs were in states requiring specific types of medical tests. For example, only six percent of programs were required to perform drug or alcohol testing/screening. Most programs were not in states requiring testing for diseases related to substance abuse, such as hepatitis and sexually transmitted diseases, including HIV. Less than 30 percent of programs were in states requiring relapse-prevention services. Just over 40 percent were required to provide aftercare counseling services.

When the researchers looked at what services the programs actually provided, there was a closer correspondence to research recommendations. Almost all programs performed diagnostic assessment and group and individual therapy, although rates of family counseling were lower. Nearly all programs performed urine screening for drugs and alcohol, but most did not test for substance-abuse related diseases. Most programs did provide relapse-prevention and aftercare services.

When other factors were taken into account, programs in states requiring more comprehensive services were more likely to offer those services. "The results…indicate that state policy requirements governing outpatient substance abuse treatment may have significant public health implications," the researchers write.

In recent years, major federal and other national organizations have urged the states to play a more active role in ensuring access to proven and effective treatments for substance abuse. A growing body of research shows that comprehensive treatment programs, including all of the components evaluated in this study, yield the best outcomes.

State policies could play a central role in improving the quality of substance abuse treatment programs, the new results suggest. Simply doing research on the most effective treatment approaches is not enough - strategies are also needed to ensure that the research-proven approaches find their way into actual treatment practice. "It is crucial for health services researchers to work with policy makers to incorporate best treatment practices into state policy and regulations," Dr. Chriqui and colleagues conclude.

Article adapted by Medical News Today from original press release.

Tuesday, June 24, 2008

When Will It Be Time To Take Action On Alcohol?

The Australian Drug Foundation (ADF) expressed disappointment that the Report from the Inquiry into the Alcohol Toll Reduction Bill from the Senate Community Affairs Committee (SCAC) recommended the Bill not be passed.

"The Committee expressed particular concern about the loophole that allows alcohol to be advertised on daytime TV via sponsorship of sport, and results in children being exposed to mass alcohol promotions. Yet it fails to recommend the loophole be closed. It is a missed opportunity" said Mr Rogerson, 'this must be a priority for the National Binge Drinking Strategy'. 'It is imperative the Ministerial Council on Drug Strategy moves quickly on this, as well as the other key agendas identified - supporting responsible service of alcohol, addressing secondary supply of alcohol to minors, reducing the alcohol content in products and the need for health warnings.'

The ADF agrees with the Committee's view that labels of alcohol products need to provide nutritional information so consumers can make an informed choice. However the ADF is disappointed the Committee didn't take the next step in recommending health warnings on alcohol products.

"Alcohol kills 3400 Australians every year and a warning on the label would remind drinkers when they buy and consume the product that they need to exercise care"

The ADF agrees that the labelling and packaging of alcohol products needs to be included within the alcohol advertising code. "The alcohol industry promised to do that but it has failed to keep its promise. Too many labels and packages are designed to appeal to young people and promote unsafe drinking" said Mr Rogerson.

'What we'd really like to see now is the bull taken by the horns and these anomalies addressed sooner rather than later'

The ADF commended Family First's Senator Steven Fielding for his efforts in introducing the Bill and further highlighting alcohol misuse as a national problem, and thanked Senator Rachel Siewert for her dissenting report.

Australian Drug Foundation

Friday, June 20, 2008

Addiction? How do you know?

I remember walking into my doctors office shortly after detoxing to 'fess up that I had alcohol/drug problems. I held a great respect for my doctor (I couldn't get pills out of him) and he had repaired a great deal of damage I had done to my body during the previous years, including some rather nasty duodenal ulcers when I was the ripe old age of 22. Stress caused them, or so I convinced myself was the case. The fact that I was vomiting blood incessantly, in pain 24 hours a day and still drinking never struck me as being somewhat stupid.... I didn't really care anyway.... I ended up basically living on antacid... should have bought shares!

I was nervous about telling my doctor what I was. He was well known in the town to refuse to keep tobacco smokers as patients... he thought it was a waste of time. Based on that (and my sensitivity at the time) I was sure that he would call me every name under the sun and curse me out of his office, hurling unspeakable medical instruments at me as I retreated.

When I told him what had happened and what I had done about it, he extended his hand and shook mine. You could have knocked me over with a feather. He then started speaking about what he knew of addiction, and surprised me with his depth of knowledge. He believed in the disease concept, knew the importance of not prescribing mood altering medications to recovering addicts and was very supportive.

I asked him "you know so much about it, why didn't you ever bail me up on the subject?" His response: "Was there any point?".

And that is the point of this article.

It's true.. we can't be told. Denial is our greatest ally in our downhill run. It shields us and allows us to find alternative scapegoats for our situation. "If only this, if only that, blah blah blah...things would be different". Even when we get "this and that", things don't change... the illness is progressive and does not respond to a change in our finances, environment or relationships - it must be dealt with directly.

For most of us, we have to lose everything... material and emotional before the denial is also lost - many of us are brought to our knees. I used to take a lot of pride in my appearance, but by the end of my "career" I had even stopped bothering to wash myself or even brush my hair. It didn't seem to matter.

We just don't seem to get it, but I do believe that subconsciously we know damned well what is causing our lives to be chaotic.

So how do you tell if you are alcoholic/addicted?

Are you ready to take a good look at yourself? If not, don't bother reading any further... go back to your bottle or your bong and find what temporary happiness you can in that. If you can really face yourself, I assure you that the future will hold a happiness that you have not experienced for a long time, perhaps ever.... but I warn you, it is damned hard work... for the term of your natural life.

I guess I could write reams and reams of quizzes and symptoms (I sat through many of them), but for the person questioning themselves as to whether they are an addict; it boils down to this:

-If you spend most of your straight time thinking about the substance of choice, to the point that it distracts you from other things, that is a strong indicator that you have the obsessive aspect of addiction.

-If you maneuvre events around things that may get in the way of using or drinking. That much mental energy dedicated to something so destructive is definitely not what I would consider a "good life".

-If you use/drink and it causes problems in your life, be they financial, physical, emotional or spiritual, and you continue to use or drink.

-If your behaviour while you are under the influence is totally out of character, negatively affects others and you have blank spots (called blackouts) - this signifies a lack of control over the substance and also indicates the beginnings of frontal lobe brain damage.

-If you need to use/drink more in order to achieve the same sensations, you are developing a tolerance to it. Your body is growing used to the substance, which is never a good sign.

That's it, 5 points. Simple things for complicated people. Now, I could pretty it up and make it fuzzy around the edges by making the statement that if you experience the above you may have an alcohol/drug problem. But that wouldn't sit right with me.

Whether you accept it or not, you are addicted and in big trouble.. end of story.

How does that hit you? Do you feel angry or threatened by what I just stated? Maybe you are thinking "what right does this person have to make this statement?". You are of course correct, I have no right - but you don't have to read this. Is our old friend Denial paying a visit, tying your stomach into knots? Then I have made my point.

That's all that addiction is - a physical compulsion couple with a mental obsession. Very strong, very dangerous... and more often than not, fatal. If a loved one confronts us head on with the accusation of being a drunk or addict, we usually have a instantaneous, very defensive response. Some of us become aggressive and I know of cases where people have killed others when confronted. Never underestimate the power of the disease or the grip it has upon you.

To people who don't understand this disease, I guess their reaction is "just stop". They are pretty fortunate to obviously not have an addictive bone in their body - it is so hard to try and relay to someone the gnawing feelings which remain long after the hell of withdrawal is over. It is very tiring, and that is why so many of us relapse. But the gnawing does taper off to a point that it just becomes a part of lifes other aches and pains & the positives far outweigh the negatives. My other articles explore avenues of assistance in the battle against substance addiction.

I guess the other way to self diagnose is to think about this: If you are seriously questioning yourself as to whether you have a problem, then you probably have one ........... "normal" people usually don't have to ask themselves these things .........

Please do something about it, before the "Parasite" takes a firmer grip... I guarantee you it won't get any easier the longer you put it off. Like pregnancy, you can't ignore it and hope it will go away.

And... how much do you want to lose while waiting? Denial may cost you your job, your house, your loved's their lives too that you are affecting.

Good luck to you in your struggle...fight it.. it's worth it. I can honestly say that I have more to live for in my life now than I would have ever dared dream, none of it was possible the way I was before.

Michael Bloch

Friday, June 13, 2008

Why Making Amends With Others Is Critical In The Addiction Recovery Process

Step nine of the 12 step program begins the process of the addict re-connecting with fellow human beings through the process of amends. After completing step 8 of the 12 step recovery program, the addict has a list of all the people and institutions he or she owe amends to. Amends can be made in person, through the mail, or by telephone.

By living the self-centered life of an addict, those in recovery can begin to see the havoc they have caused in the lives of those who care about them the most. Addicts have a tendency to manipulate their friends and family and have often treated them with disregard for their well-being in order to meet their selfish needs.

In step nine, the addict must face those that they have wronged and make amends for the harm they have caused. The recovering addict must pay back debts owed to people and institutions. The goal of step nine is to take direct and personal action to right the wrongs.

Mark Houston, founder of the Mark Houston Recovery Center talks about his personal revelations with Step 9

"My personal experiences with Step 9 were profound and life changing I did not realize prior to the process of making amends that I had disconnected from people through my alcoholism and drug addiction. I was an island unto myself and I was the only one on the island."

"As I made face to face amends with family members - particularly my parents - I began to experience a greater sense of ease and comfort within myself. I was able to accept the people in my life just as they are with no desire to change them. I owed a lot of money and as I began to pay the money back I began to earn more money at my job. I learned through this process that everything is connected. When one area of my life improved because of making amends, every area of my life became undeniably more rewarding."

We Don't Control the Outcome

The role of the addict in Step 9 is to make amends with each person, institution, and entity on the list created during step eight. There is no guarantee that those who receive apologies and amends will forgive. We do not control the outcome. We do not control the thoughts and intentions of others. We only offer the amends and accept what transpires.

The Role of Step 9 in the Recovery Process

By taking a series of actions to re-create in a positive way all the destruction created while being unconscious during addiction, the addict begins living with the positive effects of their new creations. Through amends, the recovering addict can finally begin consciously creating their own lives.
Author: Mark Houston

Wednesday, June 4, 2008

ScienceDaily (May 15, 2008) — Researchers from the Howard Florey Institute in Melbourne have identified a factor that may contribute towards the development of heroin addiction by manipulating the adenosine A2A receptor, which plays a major role in the brain's 'reward pathway'.

Using mice specifically bred without the adenosine A2A receptor, Prof Andrew Lawrence and his team showed that these mice had a reduced desire to self-administer morphine; heroin is converted to morphine in the body. The mice also self-administered less morphine compared to control littermates, but did not develop tolerance to specific behavioural effects of morphine.

The researchers also found that the mice did not develop a conditioned place preference for the drug, indicating that drug-context associations are mediated in part by this receptor. In human terms, this equates to the associative memory of the environment where the drug is used.

Collectively, these findings strongly suggest that the adenosine A2A receptor is involved in regulating the reinforcing and motivational properties of opiates.

Prof Lawrence said this was the first study to show that the adenosine A2A receptor was implicated in self-motivation to take opiates such as heroin.

"This receptor clearly plays a major role in opiate use and therefore abuse, as the mice were simply not interested in taking morphine despite it being freely available," he said.

"Although the drug-taking effects and behaviours of these mice were diminished, they still relapsed into drug-seeking after a period of withdrawal.

"This indicates that the adenosine A2A receptor has a role in the 'getting high' aspects of addiction, but not in the adaptations that contribute to relapse after going 'cold turkey'."

"The results from this study reinforce that addiction is a highly complex brain disorder that will require a multi-pronged approach to treat.

"Australia has over 50,000 heroin users. There are effective medical treatments available, such as methadone, buprenorphine and suboxone, as well as psychological interventions, but a better understanding of how heroin affects the brain could lead to improvements and broadening of these treatment options.

"Drugs alone will not be the answer -- successful treatment of drug addiction will require a combination of drugs and psychotherapy," Prof Lawrence said.

"Drugs alone will not be the answer -- successful treatment of drug addiction will require a combination of drugs and attention to social and psychological factors," Prof Lawrence said.

A number of major pharmaceutical companies are developing drugs that block the adenosine A2A receptor, so Prof Lawrence's research provides even more evidence that this receptor is an important target for treating drug addiction.

Prof Lawrence said that drugs affecting the adenosine A2A receptor show preclinical promise to treat alcohol addiction.

"Earlier this year we found that the adenosine A2A receptor interacts with the mGlu5 glutamate receptor found in the brain's reward pathway to regulate drug-seeking. "Consequently, a drug developed to target both these receptors could have an even better result in treating addiction," he added.

This research was recently accepted for publication in the journal Neuropsychopharmacology. This study is a collaboration between researchers from the

Howard Florey Institute, Victorian College of Pharmacy and the University of Melbourne.

Tuesday, June 3, 2008

Women And Alcohol, The Wrong Kind Of Fun

Many dates have turned to be a nightmare for many women due to excessive consumption of alcohol. Men may use alcohol as a 'date rape' drug to exploit women. Women and alcohol are inseparable since women are more prone to alcohol addiction. Once a woman gets used to the "high-feeling" of a beer, she wants to be in that excited state all the time so they end up drinking too much too often. Young women are more vulnerable since they are preyed by most men. Alcohol increases their chances of being raped or being sexually assaulted. Women who are more likely to be attacked are the ones who have exceeded the drinking threshold by far. Many people have the opinion that men use other drugs to assault women sexually but in many cases alcohol is the solo 'date-rape' drug.

The association between women and alcohol is real. This is because alcohol is confirmed to be a major contributor to women's vulnerability to sexual abuse and acquaintance rape in social situations. Other drugs are also used to spike drinks but their contribution to sexual assault is comparatively minimal. In some cases the recreational drugs found in drinks are consumed at will. Women's binge drinking put them in an excited state of mind and their valid consent to engage in sex is questionable. The capacity to give a well informed consent at these sky rocketing levels of alcohol consumption cannot be trusted. Alcohol impairs the thinking capacity of a woman and she can agree to anything unconsciously. Many women wake up to witness horrifying news of the night before. Alcohol loosens a woman's morals and demotes her level of integrity. Personal values are highly interfered with.

In many cases of alleged sexual assault alcohol is mostly involved. Matters are worsened by the fact that many people have a perception of alcohol as an aphrodisiac. There is an intimate relationship between sex, women and alcohol in our society. Alcohol is perceived to be courage in a bottle or as many people put it "liquid courage." No wonder men who are out to have sex with new partners always prefer meeting the new catch in a boozing joint. Much as alcohol puts people in a loosened, relaxed mood to 'have fun', it has a negative and complicated sexual consequences. To avoid being a victim to rape or any sexual assault, avoid mixing different alcoholic drinks in a single sitting. Take one type of a drink at a time and save others for another day. Another big contribution to vulnerability is tendency to mix substances such as recreational and medication drugs with alcohol. This should be avoided.

Much of the research carried out on the effects of alcohol tend to lean more on physiological rather than social aspects. This has played a major role in the existing poor awareness of long term social sexual effects in our culture. Women who are married to alcohol are observed to have major difficulties maintaining a long term and serious relationships. They are mostly depressed and live in social isolation when they are not drinking. When trying to understand the relationship between women and alcohol, do not generalize the study because the sexual effect of alcohol on women is different from its sexual effects on men. Expectancy sexual effects of alcohol lead to the aroused behavior in most cases. Physical effects are present since the person taking alcohol anticipated them. You can still have the same results of excitement if you learn some self improvement skills.

Francis K. Githinji Is A Online Dating Expert. His Latest Project Women And Alcohol Shows How The Power Of Online Dating Can Be Harnessed Internationally and With Great Success, Or You Could Post Your Valued Comments On His Blog At Women And Alcohol.

Article Source:

Sunday, June 1, 2008

Virtual Help for Alcoholics

A comfortable atmosphere, the crowd unwinding with a beer. It's not real, and it's not a video game. It's virtual reality therapy for alcoholics. Its aim is to mentally prepare them for situations that could trigger drinking.

Patrick Bordnick from the University of Houston says, "If we can have a virtual scenario, where we put that person in that bar, or in that social setting, and now have the therapist be able to teach you in real time. I think that will hold up when they are out in these realistic situations in the real world, that these skills should transfer from virtual reality to the real world."

Bordnick developed these virtual reality scenarios. In a study published in the journal "Addictive Behaviors," Bordnick found that alcohol dependent participants reported a greater urge to drink while viewing triggers like a bartender or a favorite cocktail, compared to viewing neutral scene. The study even included smells.

According to Bordnick, this was the first trial to use scent, so we have computer controlled scents, so when you walk by a shot of tequila on the bar, or a beer, you automatically smell beer.

Bordnick says that realism is critical to the next step --- seeing whether the scenarios can help addicts to learn coping skills.

Bordnick says, "We've demonstrated that virtual reality triggers for smoking, for cannabis, and now in this particular study, for alcohol, are real enough to get real world reactions." He says coping with those reactions virtually, could make the "real world" a lot less tempting for alcoholics.