Prescription drug abuse and how Can Am interventions can help.

 

  • In 2010, approximately 7.0 million persons were current users of psychotherapeutic drugs taken nonmedically (2.7 percent of the U.S. population), an estimate similar to that in 2009. This class of drugs is broadly described as those targeting the central nervous system, including drugs used to treat psychiatric disorders (NSDUH, 2010). The medications most commonly abused are:
    • Pain relievers – 5.1 million
    • Tranquilizers – 2.2 million
    • Stimulants – 1.1 million
    • Sedatives – 0.4 million
  • Among adolescents, prescription and over-the-counter medications account for most of the commonly abused illicit drugs by high school seniors (see chart).
    • Nearly 1 in 12 high school seniors reported nonmedical use of Vicodin; 1 in 20 reported abuse of OxyContin.
    • When asked how prescription narcotics were obtained for nonmedical use, 70% of 12th graders said they were given to them by a friend or relative (MTF 2011). The number obtaining them over the internet was negligible.
  • Among those who abuse prescription drugs, high rates of other risky behaviors, including abuse of other drugs and alcohol, have also been reported.

What is driving this high prevalence?

Multiple factors are likely at work:

  • Misperceptions about their safety. Because these medications are prescribed by doctors, many assume that they are safe to take under any circumstances. This is not the case. Prescription drugs act directly or indirectly on the same brain systems affected by illicit drugs. Using a medication other than as prescribed can potentially lead to a variety of adverse health effects, including overdose and addiction.
  • Increasing environmental availability. Between 1991 and 2010, prescriptions for stimulants increased from 5 million to nearly 45 million and for opioid analgesics from about 75.5 million to 209.5 million.
  • Varied motivations for their abuse. Underlying reasons include: to get high; to counter anxiety, pain, or sleep problems; or to enhance cognition. Whatever the motivation, prescription drug abuse comes with serious risks.
Unintentional Drug Overdose Deaths by Major Type of Drug, United States 1999-2008

Risks of commonly abused prescription drugs

  • Opioids (used to treat pain):
    • Addiction. Prescription opioids act on the same receptors as heroin and can be highly addictive. People who abuse them sometimes alter the route of administration (e.g., snorting or injecting) to intensify the effect; some even report moving from prescription opioids to heroin. NSDUH estimates about 1.9 million people in the U.S. meet abuse or dependence criteria for prescription opioids.
    • Overdose. Abuse of opioids, alone or with alcohol or other drugs, can depress respiration and lead to death. Unintentional overdose deaths involving prescription opioids have quadrupled since 1999 and now outnumber those from heroin and cocaine combined.
    • Heightened HIV risk. Injecting opioids increases the risk of HIV and other infectious diseases through use of unsterile or shared equipment. Noninjection drug use can also increase these risks through drug-altered judgment and decisionmaking.
  • CNS Depressants (used to treat anxiety and sleep problems):
    • Addiction and dangerous withdrawal symptoms. These drugs are addictive and, in chronic users or abusers, discontinuing them absent a physician’s guidance can bring about severe withdrawal symptoms, including seizures that can be life-threatening.
    • Overdose. High doses can cause severe respiratory depression. This risk increases when CNS depressants are combined with other medications or alcohol.
  • Stimulants (used to treat ADHD and narcolepsy):
    • Addiction and other health consequences. These include psychosis, seizures, and cardiovascular complications.

Treatments for Prescription Drug Abuse

Available options for effectively treating addiction to prescription drugs depend on the medication being abused. Approaches to treating pain reliever addiction are drawn from research on treating heroin addiction, and include medications combined with behavioral counseling. A recent large-scale clinical trial supported by NIDA showed that Suboxone (buprenorphine + naloxone), prescribed in primary care settings, helped about half of participants reduce their pain reliever abuse during extended Suboxone treatment. Another promising approach includes longacting formulations of medications, such as Vivitrol, a depot formulation of the opioid receptor blocker naltrexone, recently approved by the FDA to treat opioid addiction. With effects that last for weeks instead of hours or days, long-acting formulations stand to aid in treatment retention and abstinence.

Although no medications yet exist to treat addiction to CNS depressants or to prescription stimulants, behavioral therapies proven effective in treating other drug addictions may be used. NIDA is also supporting multiple studies to identify promising medications for stimulant addiction.

NIDA Supported Research on Prescription Drug Abuse

NIDA’s multipronged strategy to reverse prescription drug abuse trends complements and expands our already robust portfolio of basic, preclinical, and clinical research and educational and outreach initiatives. NIDA-supported researchers are conducting large-scale epidemiological studies investigating the patterns and sources of nonmedical use of prescription medications in high school and college students. Results suggest that prevention efforts should include a focus on the motivations behind the abuse, which often have an age and gender bias.

NIDA is also leading efforts to develop pain medications with diminished abuse potential, such as those that bypass the reward system of the brain. This is particularly important in light of returning veteran and growing elderly populations. To that end, NIDA is supporting research to better understand how to effectively treat people with chronic pain, which may predispose someone to become addicted to prescription pain relievers, and what can be done to prevent it among those at risk.

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Expressions of …

Expressions of the Pain & Grief of losses for families in Connecticut.

“Tears of a Broken Heart”

 

I sit in disbelief as the story unfolds.
I hear voices with no words to express the pain.
I want to give, but search for the strength.
A thought of a mother giving birth with such joy….

 

The innocent of a young child crying…
A child life is gone. Forever…. was taken without a choice…
My heart is heavy with no words to express.
The realness of my child death becomes a nightmare.

 

The sadness is real, fears of loss takes over my spirit.
The emptiness, loneliness becomes my world.
How this can be, I cry in anger…..
My heat is broken…….my little one is gone forever….

Writer – Patti Pike

Dangerous Times for the Newly Sober

 

The holidays (Thanksgiving, Christmas, and New Year’s) can be a time of great joy and celebration, or a time of great pain, sorrow and depression.  These can be particularly dangerous times for people who are in recovery, especially those in early recovery.
Drinking and using substances were ways that we celebrated the joy, or medicated the pain.  What the holidays mean to us and how we participate in them might help us to remain clean and sober.

An Essential Part of Recovery

Thanksgiving has its roots in the end of the growing season, where people would gather what they grew and take stock of their harvest.  In the United States, we think about the Indians and early settlers, sharing their food with each other.
Thanksgiving is usually a time when we get together with family and friends, to share our food and company with each other.  This is not any different than what we learn in recovery.  We take stock of what we have and are grateful for it.  Remember,  “A grateful heart will never drink.” We then share what we have with others.  This is an essential part of recovery.

Celebrate Life!

Christmas seems to be the combination of a number of beliefs and rituals adopted from many people.  However, most people, at least of Christian beliefs, celebrate the birth of Jesus Christ.  He was someone who wrestled with his spirituality and humanity.  Sound familiar?
    When we were drinking or drugging, we were moving quickly towards death and were engaged in destruction.  Christmas can be a celebration of life and creation instead.  We celebrate life, a birth, on Christmas. We can learn the rewards of embracing our spirituality and humanity.

Letting Go of the Past

New Year’s is a letting go of the past year and embracing the new one.  It is depicted, sometimes in a comical way, as Father Time handing the baton of a new year to a young baby.  In a way, isn’t this what recovery is?  Our old addicted life handing the reigns over to our new recovering self?  A common practice around this time is New Year’s resolutions.
Of course, most of these are broken in a short period of time.  However, for alcoholics and addicts, to break our resolution to remain clean and sober is to die.  And that is the good news.  We usually live a life of destruction until that happens.  Let’s make that resolution to remain clean and sober, and to do what is necessary to achieve that.

Stages of Grief

1. SHOCK & DENIAL- You will probably react to learning of the loss with numbed disbelief. You may  deny the reality of the loss at some level, in order to avoid the pain. Shock  provides emotional protection from being overwhelmed all at once. This may last  for weeks. 2. PAIN & GUILT- As the shock wears off, it is replaced with the suffering of unbelievable pain.  Although excruciating and almost unbearable, it is important that you experience  the pain fully, and not hide it, avoid it or escape from it with alcohol or  drugs.

You may have guilty feelings or remorse over things you did or didn’t do  with your loved one. Life feels chaotic and scary during this phase.
3. ANGER & BARGAINING- Frustration gives way to anger, and you may lash out and lay unwarranted blame  for the death on someone else. Please try to control this, as permanent damage  to your relationships may result. This is a time for the release of bottled up  emotion.

You may rail against fate, questioning “Why me?” You may also try to  bargain in vain with the powers that be for a way out of your despair (“I will  never drink again if you just bring him back”)
4. “DEPRESSION”, REFLECTION, LONELINESS- Just when your friends may think you should be getting on with your life, a long  period of sad reflection will likely overtake you. This is a normal stage of  grief, so do not be “talked out of it” by well-meaning outsiders. Encouragement from others is not helpful to you during this stage of grieving.

During this time, you finally realize the true  magnitude of your loss, and it depresses you. You may isolate yourself on  purpose, reflect on things you did with your lost one, and focus on memories of  the past. You may sense feelings of emptiness or despair.
7 Stages of Grief… 5. THE UPWARD TURN- As you start to adjust to life without your dear one, your life becomes a little  calmer and more organized. Your physical symptoms lessen, and your “depression”  begins to lift slightly.
6. RECONSTRUCTION & WORKING THROUGH- As you become more functional, your mind starts working again, and you will find  yourself seeking realistic solutions to problems posed by life without your  loved one. You will start to work on practical and financial problems and  reconstructing yourself and your life without him or her.
7. ACCEPTANCE & HOPE- During this, the last of the seven stages in  this grief model, you learn to  accept and deal with the reality of your situation. Acceptance does not  necessarily mean instant happiness. Given the pain and turmoil you have  experienced, you can never return to the carefree, untroubled YOU that existed  before this tragedy. But you will find a way forward.

7 stages of grief…

You will start to look forward and actually plan  things for the future. Eventually, you will be able to think about your lost  loved one without pain; sadness, yes, but the wrenching pain will be gone. You  will once again anticipate some good times to come, and yes, even find joy again  in the experience of living.

Help a loved one overcome addiction

Intervention: Help a loved one overcome addiction

An intervention can motivate someone to seek help for alcoholism, drug abuse, eating disorders or other addictive behaviors. Discover when to hold one and how to make it successful.

By Mayo Clinic staff

It can be challenging to help a loved one struggling with alcoholism, drug problems, an eating disorder or other destructive behavior. Sometimes a direct, heart-to-heart conversation can start the road to recovery. But when it comes to addiction, a more focused approach is often needed. You may need to join forces with others and take action through a formal intervention.

People who struggle with addictive behaviors are often in denial about their situation or are unwilling to seek treatment. Often they don’t recognize the negative effects their behavior has on themselves and others. An intervention presents your loved one a structured opportunity to make changes before things get even worse.

What is an intervention?

An intervention is a carefully planned process involving family and friends and sometimes colleagues, clergy members or others who care about a person struggling with addiction. During the intervention, these people gather together to confront the person about the consequences of addiction and ask him or her to accept treatment. The intervention:

  • Provides specific examples of destructive behaviors and their impact on the addicted person and loved ones
  • Offers a prearranged treatment plan with clear steps, goals and guidelines
  • Spells out what each person will do if a loved one refuses to accept treatment

Who might benefit from an intervention?

An intervention can help people who struggle with addictive behaviors but who are in denial about their situation or who have been unwilling to accept treatment. Some examples of behaviors that may warrant an intervention include:

  • Alcoholism
  • Prescription drug abuse
  • Abuse of street drugs
  • Eating disorders
  • Compulsive gambling

People with addiction often don’t see the negative effects their behavior has on them and others. It’s important not to wait until they “want help.” Instead, think of an intervention as giving your loved one a clear opportunity to make changes before things get really bad

 

http://www.mayoclinic.com/health/intervention/MH00127

treatment outcomes for adolescents

The study, part of NIDA’s ongoing Drug Abuse Treatment Outcome Studies for Adolescents (DATOS-A), analyzed data from 23 community-based adolescent treatment programs that addressed peer relationships, educational concerns, and family issues such as parent-child relationships and parental substance abuse. Successful elements of adult treatment programs, such as participation in group therapy and participation in a 12-step program, were also included in treatment plans.

“The results of this study are particularly impressive in light of the fact that the adolescents had multiple problems,” says Dr. Christine Grella of the University of California, Los Angeles (UCLA), Drug Abuse Research Center, one of the study’s investigators. “Although this is also typical of many adults in treatment, timely resolution of these problems is even more critical for adolescents. These young people are in the process of developing values, making lifestyle decisions, and preparing to assume adult roles and responsibilities, such as family and work; whereas when many adults enter treatment, they have completed this process.”

Treatment Programs Varied

Dr. Yih-Ing Hser, also of UCLA, led the research team that evaluated the treatment outcomes for 1,167 adolescents, age 11 to 18, who were admitted to one of the treatment programs between 1993 and 1995. The treatment centers, located in Pittsburgh, Pennsylvania; Minneapolis, Minnesota; Chicago, Illinois; and Portland, Oregon, included eight residential programs, nine outpatient drug-free programs, and six short-term inpatient programs.

The 418 adolescents in the residential treatment programs received education, individual and group counseling, and interventions to develop social responsibility. The 292 adolescents in the outpatient drug-free programs received education, skills training, and individual and group counseling. The 467 adolescents in short-term inpatient programs received counseling and a 12-step program. Family therapy was strongly emphasized, and adolescents in these programs were referred to continued outpatient treatment. The average length of treatment for adolescents in the residential, outpatient drug-free, and short-term inpatient programs was 5 months, 1.6 months, and 18 days, respectively.

The adolescents were interviewed when they began treatment and again 1 year after discharge by professional interviewers who were not employed by the treatment centers. Problem severity was determined at the initial interview according to a number of criteria. Dependence on drugs or alcohol was determined from standardized diagnostic measures. To validate self-reports of drug use, one-quarter of the participants were selected randomly to submit urine samples during the posttreatment interview.

Before treatment, 25 percent of the participants used three or more drugs, 36 percent were dependent on alcohol, 64 percent were dependent on marijuana, and 10 percent were dependent on cocaine. In addition to substance abuse problems, 63 percent were diagnosed with a mental disorder and 67 percent were criminally active.

 

In the year following treatment, more adolescents attended school and reported average or better-than-average grades.

 

Outcomes Overall

Research has indicated that in general the rate of drug and alcohol use tends to increase during adolescence. In the present study, however, improvements were observed in many of the areas evaluated, although some of the participants did not complete their treatment program. Comparing the year before treatment to the year after treatment, the adolescents showed significant declines in the use of marijuana and alcohol, which are considered to be the major drugs of abuse for this age group. Weekly or more frequent marijuana use dropped from 80 percent to 44 percent, and abstinence from any use of other illicit drugs increased from 52 percent to 58 percent. Heavy drinking decreased from 34 percent to 20 percent, and criminal activity decreased from 76 percent to 53 percent. Adolescents also reported fewer thoughts of suicide, lower hostility, and higher self-esteem. In the year following treatment, more adolescents attended school and reported average or better-than-average grades. Some exceptions to the general pattern of improvement were that overall, cocaine and hallucinogen use did not improve during the year after treatment.

Treatment Length and Outcomes

Previous research indicates that a minimum of 90 days of treatment for residential and outpatient drug-free programs and 21 days for short-term inpatient programs is predictive of positive outcomes for adults in treatment. Better treatment outcomes were reported among adolescents who met or exceeded these minimum lengths of treatment than for those who did not. Among the treatment participants, 58 percent of those in residential programs, 27 percent in outpatient drug-free programs, and 64 percent in short-term inpatient programs met or exceeded the minimum stay. In the year following treatment, those who met or exceeded the minimum treatment were 1.52 times more likely to abstain from drug and alcohol use and 1.2 times more likely to not be involved in criminal activity. In addition, these adolescents were 1.34 times more likely to have average or better-than-average grades.

This study confirms that community-based drug treatment programs designed for adolescents can reduce substance abuse and have a positive impact on many other aspects of their life, says Dr. Tom Hilton of NIDA’s Division of Epidemiology, Services and Prevention Research. These results justify new research to identify the key elements common to effective treatment programs for adolescents, he noted.

 

Co-dependency

 

Who Does Co-dependency Affect?

Co-dependency often affects a spouse, a parent, sibling, friend, or co-worker of a person afflicted with alcohol or drug dependence. Originally, co-dependent was a term used to describe partners in chemical dependency, persons living with, or in a relationship with an addicted person. Similar patterns have been seen in people in relationships with chronically or mentally ill individuals. Today, however, the term has broadened to describe any co-dependent person from any dysfunctional family.

 

Questionnaire To Identify Signs Of Co-dependency

This condition appears to run in different degrees, whereby the intensity of symptoms are on a spectrum of severity, as opposed to an all or nothing scale. Please note that only a qualified professional can make a diagnosis of co-dependency; not everyone experiencing these symptoms suffers from co-dependency.

1. Do you keep quiet to avoid arguments? 2. Are you always worried about others’ opinions of you? 3. Have you ever lived with someone with an alcohol or drug problem? 4. Have you ever lived with someone who hits or belittles you? 5. Are the opinions of others more important than your own? 6. Do you have difficulty adjusting to changes at work or home? 7. Do you feel rejected when significant others spend time with friends? 8. Do you doubt your ability to be who you want to be? 9. Are you uncomfortable expressing your true feelings to others? 10. Have you ever felt inadequate? 11. Do you feel like a “bad person” when you make a mistake? 12. Do you have difficulty taking compliments or gifts? 13. Do you feel humiliation when your child or spouse makes a mistake? 14. Do you think people in your life would go downhill without your constant efforts? 15. Do you frequently wish someone could help you get things done? 16. Do you have difficulty talking to people in authority, such as the police or your boss? 17. Are you confused about who you are or where you are going with your life? 18. Do you have trouble saying “no” when asked for help? 19. Do you have trouble asking for help? 20. Do you have so many things going at once that you can’t do justice to any of them?

If you identify with several of these symptoms; are dissatisfied with yourself or your relationships; you should consider seeking professional help. Arrange for a diagnostic evaluation with a licensed physician or psychologist experienced in treating co-dependency.