Reasons for Relapse and Avoiding Them

August 18, 2016 by  
Filed under Treatment and Recovery News

Comments

Businessman wearing blue shirt drunk at desk on white backgroundRelapse (i.e., going back to using after abstaining for a length of time) happens to many people on their road to recovery and, if it does, is not a sign of failure. The National Drug Association reports the relapse rate for drug addiction to be 40 to 60 percent. People relapse and then try again. But being aware of these three signs can help you be mindful and avoid your own triggers before relapse happens.

1. Old Playgrounds and Playmates

This is a big one to put on your priority list. Even those who have been sober for years are subject to relapse if they choose to play in old playgrounds with old playmates. For those of you who are unfamiliar with the term often used in AA and NA, this refers to people and places you have used with or at. It’s easy for others to say if he or she is sober to obviously avoid the crack house, but it’s not always that simple. It may mean leaving behind your best friend of 20 years. It may mean breaking up with the love of your life, if they are actively using. Changing your surroundings is a vital part of your sobriety.

2. The Pink Cloud

If you have already gotten sober, congratulations. I’m sure everyone has heard of “the pink cloud” or, more bluntly, your new drug-free beginning. The first few weeks and even months of sobriety is so exciting, new and refreshing. The feeling of getting clean successfully is quite overwhelming, in a good way, but can also be something to remain wary of. Overconfidence may be something to watch out for, as those who are overconfident can overstep their boundaries, fall back into old practices and relapse more rapidly than they ever thought. When referring to the pink cloud, it is associated with those who think they can hang out in old places or around drug or alcohol use and assume that they themselves will not use. It may sound unreal but let me tell you from experienceit is real. It’s okay to stay away from people or places because you think you might use. There is no shame in being honest with yourself.

3. Emotional and Physical Triggers

A trigger is simplistically described as something that can set you off. It may be a person, place, thing that reminds you or even drives you to use drugs or alcohol. It can be anything from seeing someone you used to get high or drunk with to even the feeling you get when listening to a song you enjoyed while using. Recognizing your triggers is a key part in your recovery, although they aren’t always easy to spot in the beginning. Some people have to immediately experience their trigger to know that they are dangerously close to a relapse. If you have attempted to get clean several times before, you may already have a general idea of what sets you off to relapse. Unfortunately for myself, that was the only way I discovered my triggers to begin with; relapsing because of them, over and over again.

Other causes for relapse can sometimes be identified as H.A.L.T hungry, angry, lonely or tired. Those feelings or states of mind are also closely associated with reasons of relapse and are extremely important to stay mindful of. Ridding the chaos in your life is a big change for many addicts but getting bored may also lead you to a relapse, so keep your interests peaked and engaged. Do not forget that addiction is a disease, just like diabetes or cancer. We take steps every day to avoid consequences caused by our disease even if they may not always be laid out in front of you.

 

Cassandra Huerta is a freelance writer who lives in an extremely small Michigan town and lives life one day at a time. She enjoys regularly entertaining her six-month-old daughter and can thank her wonderful fiance and coffee for all of her work.

New Fingerprint Test Can Determine Cocaine Use

July 22, 2016 by  
Filed under Health, Treatment and Recovery News

Comments

 

Mass spectrometry analysis is a method of analysis that can measure specific types of chemicals in a sample. Researchers in the Netherlands and the United Kingdom used different types of mass spectrometry analyses to analyze the fingerprints of people who attended drug treatment programs [1]. They compared the fingerprints of the individuals to saliva tests in order to determine how the saliva tests and the mass spectrometry analysis tests were related.

When a person uses cocaine, they excrete traces of the chemicals benzoylecgonine and methylegonine as they metabolize the drug. Both of these chemicals show up in saliva tests and in other bodily fluid tests and, if present, indicate that a person has used cocaine because excreting these metabolites is impossible for someone who hasn’t used. However, previous tests that use fingerprint analysis and employ similar methods could only determine whether the person had touched cocaine—they’re unable to determine if the person had actually taken the drug internally. In this study the researchers were able to use an additional technique known as Desorption Electrospray Ionization to determine if these two particular chemicals that are metabolites of cocaine, benzoylecgonine and methylegonine were present in the fingerprint residue of individuals. If these chemicals are present, it would be certain that the person providing the fingerprint has used cocaine because they can only be present when the body metabolizes cocaine. The findings indicated that for people who had used cocaine these two chemicals are present in their fingerprint residue.

This type of test has some pretty interesting implications. For example, drug testing is used mainly by the courts, probation departments, prisons, law-enforcement, etc. Traditional drug testing methods that use a person’s urine, saliva or other bodily fluids are often limited by the need for special training, specific storage and disposal methods, off-site analysis of samples, can be vulnerable to tampering, and can be potentially hazardous to individuals doing the testing. This particular technique circumvents all of these issues. In addition, fingerprint analysis is much more difficult, if impossible, to fake.

At the current time this technology is not available for practical use; however, the researchers believe that in the future law-enforcement agencies and other interested in agencies could have a number of portable fingerprint drug tests available to them. These fingerprint analysis techniques would be able to specifically determine if an individual had used cocaine and also are infallible in their ability to identify that the sample comes from that particular person because everyone has a unique fingerprint.

References

[1] Bailey, M. J., Bradshaw, R., Francese, S., Salter, T. L., Costa, C., Ismail, M., … & de Puit, M. (2015). Rapid detection of cocaine, benzoylecgonine and methylecgonine in fingerprints using surface mass spectrometry. Analyst.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

Marijuana Contact Buzz: Myth or Not?

June 16, 2016 by  
Filed under Health, Treatment and Recovery News

Comments

MJ_ContactHigh_PhotoHaving been involved in the treatment of substance abusers and also an active participant in substance abuse groups, I’ve has witnessed several individuals who tested positive for cannabis but claimed they did not use the drug. Most often these individuals swear that they were with someone who was smoking marijuana and that is why they tested positive. Typically, people will test positive for THC, the active ingredient in marijuana, for up to 30 days following using it. In my personal interactions with these individuals, it seemed that their employers and the court system did not consider this to be a viable excuse, and quickly consider anyone who tests positive for cannabis to have used it at some time in the past. However, recent research may indicate that this attitude needs to be re-examined.

Testing Positive for THC

In one study researchers exposed non-marijuana users who were drug-free to secondhand marijuana smoke in a sealed chamber for one hour. The potency of the marijuana cigarettes was varied from low (5.3% THC) to rather high (11.3% THC). No ventilation was available in the room in two of the conditions (5.3% and 11.3%). In a third condition ventilation was employed in the room (11.3%).

The non-smokers tested positive for rather small levels of marijuana concentrations in their blood and urine. Interestingly, there was an effect for room ventilation such that in the condition with the better ventilation the concentration of THC in the blood was markedly decreased. Moreover there was also a dose effect such that individuals who were exposed to secondhand marijuana smoke with higher levels of THC were more likely to test positive [1].

Feeling the Buzz

In a second study, individuals in the high potency condition were subjected to physiological, behavioral or cognitive measures, and self-report measures of their experience. As stated above, exposure to cannabis smoke in poorly ventilated conditions produced detectable amounts of THC in the blood and urine of these individuals. Moreover, the individuals in the poorly ventilated room condition self-reported sedative effects of secondhand smoke as well as produced and impaired performance on a cognitive task of one’s ability to think quickly, react quickly, and make decisions. These effects were not seen in the ventilated room condition [2].

The Bottom Line

The researchers suggest that secondhand marijuana smoke exposure does produce detectable levels of THC in the blood and urine of individuals when there is little or very poor ventilation. Moreover, there is both subjective and objective evidence to suggest that secondhand exposure to cannabis smoke in such conditions can produce what most refer to as a “contact buzz.” However, the conditions under which this occurred in the studies were only positive for extremely poor ventilated areas.

Of course, much more research would be needed to actually determine the parameters regarding exactly how much secondhand exposure produces detectable results. The researchers in these studies concluded that objective measures like blood and urine tests coming up positive as a result of secondhand exposure to marijuana smoke in the real world are probably very rare.

References

[1] Cone, E. J., Bigelow, G. E., Herrmann, E. S., Mitchell, J. M., LoDico, C., Flegel, R., & Vandrey, R. (2014). Non-Smoker Exposure to Secondhand Cannabis Smoke. I. Urine Screening and Confirmation Results. Journal of analytical toxicology, bku116.

[2] Herrmann, E. S., Cone, E. J., Mitchell, J. M., Bigelow, G. E., LoDico, C., Flegel, R., & Vandrey, R. (2015). Non-Smoker Exposure to Secondhand Cannabis Smoke II: Effect of Room Ventilation on the Physiological, Subjective, and Behavioral/Cognitive Effects. Drug and Alcohol Dependence.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

STUDY: The “Love Drug” Oxytocin May Keep You Sober

May 5, 2016 by  
Filed under Treatment and Recovery News

Comments

98468Oxytocin is a hormone that is produced by the hypothalamus in the brain and then secreted by the posterior pituitary gland. Oxytocin is a neuromodulator, which means that it is a substance that is released by one neuron in the brain that can affect populations of neurons. It is known that oxytocin is produced in large amounts during acts of sex as well as other acts of intimacy such as cuddling, holding hands, gazing into a loved one’s eyes, and even giving birth and nursing young children. Oxytocin interacts with the reward system in the human brain in much the same way that drugs such as alcohol and cocaine do [1]. Thus, many brain researchers think that the reason why human beings like to touch each other is because these behaviors lead to higher levels of oxytocin in the brain. But, can this hormone have an effect drug use?

Oxytocin and Drug Use

It is well-known that even in a small or moderate amounts, alcohol has a profound effect on motor impairment (e.g., staggering walk, lack of coordination, etc.). The effects of alcohol are linked to how alcohol affects GABA neurotransmitters, the major inhibitory neurotransmitter of the brain [1]. Researchers in Australia decided to look at the effects of giving oxytocin to rodents who were also given alcohol [2]. When the researchers were able to introduce oxytocin directly into the brains of rodents who had been given moderate levels of alcohol the rodents did not display the types of coordination difficulties and other motor difficulties commonly seen during intoxication. Rodents given the same doses of alcohol without the oxytocin were seriously impaired.

The researchers hypothesized based on their findings that giving oxytocin to humans would most likely leave a person’s thinking and speech patterns less impaired after they drink alcohol. There have been no empirical studies that have looked at how the hormone affects motor impairment in humans who drink, but the researchers report that that will be their next order of investigation.

A Solution to Drunkenness?

Before you get really excited about these findings there are couple of things that you should understand.

First, giving the rodents oxytocin after alcohol reduced their issues with motor control; however, this does not reduce one’s blood alcohol level. So if a method to use the hormone were developed for humans, it would not keep people from getting drunk nor could someone using the hormone drink significantly more than they can normally tolerate.

Secondly, oxytocin is known to reduce alcohol consumption and craving for alcohol in both humans and animals [1]. The reason for this is that the hormone works on the same aspects of the reward system in the brain that alcohol and other drugs affect. In the experiment, the rats were infused with alcohol and with the hormone. If a drug or medication were to be developed for humans, its use would also reduce alcohol consumption in individuals and directly reduce alcohol cravings in individuals trying to achieve sobriety. The goal of this type of research is to develop a clinical use for oxytocin for treating alcohol and drug abuse and not to allow people with addictions to indulge in their destructive behaviors. Thus, these findings are not going to lead to people drinking more if a drug is developed for humans based on this research.

Other Implications

Interestingly, there is plenty of research indicating that many individuals with substance abuse problems begin to recover on their own once they get in a serious relationship, have children, or have some other significant event in their life that they embrace [3]. However, we can all point to instances where drug use ruined a relationship, led to neglect of children, ruined a career, etc. It may very well be that there are subjective differences in the way that we feel things that may be based on experience and on our physical makeup that drive how such things as relationship status affect addiction. At this time, it is impossible to determine if increased levels of oxytocin in the brain as a result of life changes such as getting in a relationship or giving birth may have assisted in recovery for some people, but that certainly is a possibility. Thus, perhaps love is the drug that can keep you sober after all.

References

1. Hatfield, R. C. (2013). The everything guide to the human brain. Avon, MA: Adams.

2. Bowen, M. T., Peters, S. T., Absalom, N., Chebib, M., Neumann, I. D., & McGregor, I. S. (2015). Oxytocin prevents ethanol actions at δ subunit-containing GABA A receptors and attenuates ethanol-induced motor impairment in rats. Proceedings of the National Academy of Sciences, 112(10), 3104-3109.

3. Heyman, G. M. (2009). Addiction: A disorder of choice. Harvard University Press.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

Medications to Curb Drinking Behaviors

Comments

103036The medical response to treating most conditions, even psychiatric conditions, is to prescribe some form of medication. Can medication effectively treat alcoholism? An important study in the Journal of the American Medical Association looked at the current evidence.

Let’s start with a quick primer on research methods.

Meta-Analysis

In statistics we refer to the term “power” as the ability to detect a significant effect when one is there. Certain types of different research approaches have more power than others. One particularly powerful approach in research methodology is a technique known as meta-analysis. Meta-analysis combines the effects of many studies to determine if the phenomenon being studied is indeed effective. For example, meta-analytic studies have been done in order to determine if medications like antidepressants or vaccines are effective, if different types of psychotherapy are effective at treating depression, etc. The basic idea behind meta-analysis is very quite simple. Being able to draw on the results of multiple studies would have more statistical power than just the results of a single study. So if meta-analytic studies suggest that a certain technique is effective in treating something, this is stronger evidence than the results of single studies.

Number Needed to Treat (NNT)

A particular statistic that comes out of epidemiology is called number needed to treat (NNT). The NNT basically represents the number of individuals that must receive the treatment in order for one person to be effectively treated by it. For example if the NNT is five, then five people need to get the treatment before one is successfully treated by it. If the NNT is one that means that everyone who gets the treatment is successfully treated (this almost never happens). The higher the NNT the less effective the treatment (or drug) is.

The Deal with Medications and Alcoholism

Alcohol use disorders are among the most common forms of addiction and treatment for alcoholism is difficult and often considered to be a lifelong process (Hatfield, 2013). Even with the development of many different types of medications to assist in the treatment of addiction less than 10% of the patients with alcohol use disorders receive medications to help them reduce their alcohol consumption. The results of a recent study may help increase the use of medications in assisting to treat people who suffer from alcohol use disorders.

A meta – analytic study recently reported in the Journal of the American Medical Association included 122 randomized controlled trials and one other study that all were at least 12 weeks long to determine the effectiveness of several medications in treating alcohol use disorders (Jonas, Amick, Feltner, et al., 2014). Randomized controlled trials are the gold standard in research because the methodology used allows for the researcher to determine if the treatment actually caused the particular outcome, whereas other types of studies cannot determine cause-and-effect relations (see Hatfield, 2013 for a complete review of research methods).

Most of the studies in the meta-analysis looked at the medications naltrexone (common brand names Revia or Depade) or acamprosate (brand name Campral). Both of these medications block neurotransmitter systems that are associated with the development of cravings and are believed to be able to reduce the urge to drink in people that take these medications.

According to the meta-analytic findings by Jonas et al. the NNT for oral naltrexone for return to any drinking at all was 20 and for a return to heavy drinking patterns was 12. The NNT for the return to any drinking at all for treatment with acamprosate was 12. There were no significant differences found between the use of the two medications (the researchers could not find any statistical evidence to establish the superiority of either medication compared to the other). As a comparison, meta-analytic studies using psychotherapy typically find an NNT of between 7 – 10 for psychotherapy and alcohol use disorder (e.g., Riper, Andersson, Hunter et al., 2014); however, psychotherapy has the added benefit of concurrently treating things like depression, anxiety, etc. whereas these medications are unable to do that.

Most of the readers of these articles are probably more familiar with the medication disulfiram (brand name Antabuse) for treating alcoholism. Disulfiram does not affect the urge to drink but instead results in the person developing a noxious reaction if they drink alcohol while on the medication. This results in the person getting very sick and hopefully will dissuade them from using alcohol in the future. The research on the effectiveness of disulfiram has never been positive because people taking this medication still get urges to drink and can often simply stop taking the medication for 48 hours before drinking with no ill effects at all (Jonas et al., 2014; Hatfield, 2013).

Thus, based on the current research findings it appears that these medications can be extremely helpful in treating alcoholism; however, it appears that combinations of medications, psychotherapy, group therapies such as AA, and other factors such as social support are needed to bolster treatment effectiveness.

Do you think that the use of medications has a place in treating addictive behaviors such as alcohol use disorder? Why or why not?

References

Hatfield, R. C. (2013). The everything guide to the human brain. Avon, MA: Adams.

Jonas, D. E., Amick, H. R., Feltner, C., Bobashev, G., Thomas, K., Wines, R. & Garbutt, J. C. (2014). Pharmacotherapy for Adults with Alcohol Use Disorders in Outpatient Settings: A Systematic Review and Meta-Analysis. JAMA, 311(18), 1889-1900.

Riper, H., Andersson, G., Hunter, S. B., Wit, J., Berking, M., & Cuijpers, P. (2014). Treatment of Comorbid Alcohol Use Disorders and Depression with Cognitive Behavioural Therapy and Motivational interviewing: A meta-analysis. Addiction, 109(3), 394-406.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

 

Treating Mental Health and Addiction: Our Flawed Approach

April 14, 2016 by  
Filed under People and Culture, Treatment and Recovery News

Comments

146217Although substance abuse is generally left for the medical field to discuss, there are multiple faces of the issue, arguably the most important being the political and social spheres. Substance abuse is one of the leading callouses that has left America with the biggest prison population in the world. Instead of having accessible or inexpensive treatment centers, it is decently difficult if not impossible for an individual without medical insurance to receive treatment.

“For most people with addictions, there are many mental health problems that need attention. And for many people with mental health problems, substance misuse problems accompany and complicate the care of their mental health problems,” says Eric Collins, physician-in-chief at Siler Hill Hospital in new Canna, Conn.

These issues must be discussed in the public and political forums because legislation is the only way to establish a willful angle at tackling the greater issue. Incarceration may be looked at as an easy solution to getting substance abusers off the streets, but it costs tax payers a great deal of money and has been shown to be a vicious cycle of repeat offenders traveling in and out of prison multiple times for the rest of their lives.

Aside from the criminal aspects of substance abuse there is also the matter of 8.9 million American’s suffering from both mental illness and substance abuse issues. Of this figure, only 7.4 percent will be treated for both conditions and more than half will not receive any treatment at all according to a report from the National Alliance for Mental Illness.

According to Ron Manderscheid, executive director of the National Association of County Behavioral Health and Developmental Disability Directors, two-thirds of all people who suffer from substance abuse also have a mental illness. Their abusive habits combined with an impaired mental state make for a dangerous formula that puts the public at risk in terms of safety and also hits their pocket books in the form of incarceration tax dollars. To add a concrete figure to the notion of taxes, it roughly costs $70,000 per year per inmate, which is almost double what the nation spends per K-12 student.

The superseding point appears to be that mental illness, substance abuse, prisons and the public are all cemented to one another whether they like it or not. There is no easy way to say that this is a personal problem due to the large social impacts that are at stake. In recent years mental health has begun to be put on the forefront of American policy due in part to a large amount of shootings in which the accused were found to be suffering from various mental illnesses. It is only when the public sees what mental illness can cause that they become aware of how serious the problem really is. Moreover, when their children or loved ones could be affected by someone who has not received treatment for mental illness or substance abuse the matter becomes personal and is finally taken seriously.

There is no easy or simple way to combat each of these problems seeing as they form a complex network of victims, society and politicians. In 1998 Supplemental Security Income disallowed for substance abuse to be classified as being a disability. This in turn stopped Medicaid checks from going out and thus substance abusers without insurance could not afford to receive help. President Obama has sought to change this trend by introducing the Affordable Care Act, which hopefully will allow for those with mental illnesses and substance abuse problems to get the treatment they need at an affordable rate.

What remains unknown is how many in the mental illness and substance abuse category actually seek out help on their own accord. 24 million Americans suffer with substance abuse problems but only an estimated 2.5 million Americans go into rehabilitation centers every year. The general population cannot help those who don’t want to be helped, so it is quite possible that mandatory rehab stints should be implemented instead of sending criminal offenders to prison. Some of the responsibility must be placed on those who actually have the affliction, though this isn’t to say that it is their fault, just more their duty to society to try to get better.

Incarceration is currently the sham remedy in dealing with this demographic but by no means is it a solution; merely a Band-Aid hiding the fact that there is serious turmoil going on. A clear point must be made that whether or not the majority of Americans suffer from mental illness and substance abuse they are affected in one way or another by its byproducts. Society is only as great as it ‘lowest’ members and so to simply condemn them with bars instead of recovery is a chilling reality that must be curved by legislation and public sentiment. As stated earlier there is no easy fix but each faction of society must push forward together in order to come up with more cost efficient and effective solutions.


Chad Arias has a B.A. in journalism and is a contributor for the Latino Post and Opposing Views. In his free time, Arias writes poetry, short stories and is currently working on a novel detailing his experiences with substance abuse. He is most interested on the philosophical and psychological aspects of the subject.

Using the Placebo Effect as Addiction Treatment

March 3, 2016 by  
Filed under Health, Treatment and Recovery News

Comments

A placebo effect occurs when some form of ineffectual treatment (in research studies a placebo) is actually effective in reducing or treating the symptoms of a particular disease or other type of disorder. Placebo effects are typically strongest in situations where it is the subjective viewpoint of the person that plays an important role in the interpretation and severity of their symptoms, feelings and/or attitudes [1]. Placebo effects have been highly researched and a recent study demonstrated how the power of belief, an important component of the placebo effect, affects the areas of the brain that are considered to be activated during addictive behaviors [2].

The researchers set out to determine if smokers’ beliefs about nicotine would have a positive effect based on their expectations. The researchers performed a true experiment where one group of smokers were told that the cigarettes that they smoked were nicotine free, whereas the other group of smokers were told that the cigarettes they were smoking contained nicotine. In fact, both groups of the participants were actually smoking standard nicotine-containing cigarettes. Following smoking the cigarettes all of the participants underwent functional magnetic resonance imaging of their brains (fMRI). Interestingly, the participants who believed that they had smoked cigarettes with nicotine demonstrated much higher brain activity in their brain reward-learning pathways compared to those who believed that their cigarettes contain no nicotine, even though both groups smoked regular cigarettes [2].

The researchers believe that these findings may be useful in developing new treatments for addiction that manage the person’s belief system. This type of research is actually not new and other studies have similar type findings regarding how a person’s beliefs influence the brains of individuals with other addictions such as cocaine, alcohol, etc. [see #3 for a discussion]. Moreover, older research has even indicated that some individuals who were told they are drinking alcoholic beverages when in fact no alcohol was in them began to display symptoms of drunkenness [1]. Thus, a person’s beliefs can influence both their addictive behavior and their recovery. This type of research often stirs a debate that giving addicts placebos can be a treatment option.

Placebos as Treatments: Yes or No?

This writer has written quite a bit on the effects of placebos and how placebos stimulate the central nervous system [1]. Interestingly, while the aforementioned studies do not propose using placebos as treatments for anything, a common conclusion made by many is something to the effect of”Well, if placebos work like treatments for many conditions and placebos are basically safe because they are inert, then why don’t counselors and medical professionals give placebos as treatments?”In fact, this writer has had to debate this potential type of practice with certain uninformed medical professionals and several previous studies have indicated that some medical professionals and clinicians believe that it is ethical and advisable to administer placebos as treatments when no other alternative exists. However, this belief is not true.

While working on a person’s belief system is a fundamental component of any form of therapy including therapy for treating addiction, formally using a placebo as a treatment is unethical. First of all, the American Medical Association and the American Psychological Association consider the use of placebos as treatments unethical unless the person receiving the placebo is fully informed concerning what a placebo is and of its use and then after being fully informed agrees to receive the placebo in place of an actual treatment [4]. Most people upon learning about what placebos are would not pay a physician or other medical professional to treat them with one. Thus, the use of placebos is only justified in research such as clinical trials where the participants are informed that they might be getting a placebo instead of the treatment but are not told which one they are really getting.

The reader might ask themselves why using placebos is unethical. The reasons are quite simple. First, placebos are demonstrated through empirical evidence to have no real affects on the conditions that they are given for. If a clinician offers a placebo as a treatment without explaining to the patient that what they are getting is an inactive treatment this results in the use of deception and dishonesty by the clinical professional, especially if the placebo is used in the guise and effective treatment. Such a practice violates the ethical notion that clinicians must be frank and forthcoming regarding the types of treatments that they use with their patients.

Secondly, it is dishonest and unethical to charge someone for a treatment that the clinician knows is not established as being effective. Would you really pay a doctor to give you a placebo like a sugar pill after they told you that the pill had no real treatment benefit? Now you might say “What if the treatment provider does not charge me and gives me the placebo?” But think about that for a second. Do you really need to see a doctor or treatment provider to get a sugar pill? Does that even make sense? Why not just go take some sugar for your addiction or other ailment yourself (of course this won’t work because you don’t believe that it will). A big part of the placebo effect is the belief that one is receiving treatment.

Third, there is no way to predict whether a placebo will actually be effective with someone. Placebo effects vary widely with much more variation than actual treatment effects and are primarily effective when the complaint or symptom is subjective and subject to a person’s emotional state [1]. For instance, placebos have virtually no effect in helping people with physical diseases such as people who have cancerous tumors of their brain eliminate or shrink the tumor; however, placebos might help in lessening their pain (pain is a very subjective experience that is moderated by one’s emotions and there is no way to actually objectively measure a person’s pain; 1). Thus, placebo effects are often not strongly observed in research studies for diseases or conditions where the symptoms and their progression can be physically and/or objectively measured.

Finally, there is quite a difference between using or changing a person’s belief system in order to help them in recovery compared to administering placebos under the guise of offering a real treatment to an individual. Thus, the specific use of placebos by trained and licensed clinicians as actual treatments is both unethical and illegal; however, due to the nature of just being treated any individual in treatment may experience some level of placebo effects. What this means is that for many of the treatments that you use for problems that have a highly subjective component to them such as pain, your mood, and even your approach to recovery from addiction there is both a treatment effect and a potential placebo effect working in tandem. What qualifies many of these as actual clinical treatments is their ability to provide demonstrable benefits beyond the effects observed with placebos alone. Interestingly many of the alternative treatments you see advertised for many common ailments and conditions have a large placebo effect and little to no treatment effect.

Would you be willing to pay for treatment if you knew it was a placebo?

References

[1] Hatfield, R. C. (2013). The everything guide to the human brain. Avon, MA: Adams.

[2] Gu, X., Lohrenz, T., Salas, R., Baldwin, P. R., Soltani, A., Kirk, U., … & Montague, P. R. (2015). Belief about nicotine selectively modulates value and reward prediction error signals in smokers. Proceedings of the National Academy of Sciences, 112(8), 2539-2534.

[3] Volkow, N. D., & Baler, R. (2015). Beliefs modulate the effects of drugs on the human brain. Proceedings of the National Academy of Sciences, 112(8), 2301-2302.

[4] http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion8083.page?


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

Treating Mental Health Disorders and Addiction: Our Flawed Approach

February 18, 2016 by  
Filed under Health, Treatment and Recovery News

Comments

Although substance abuse is generally left for the medical field to discuss, the issue has multiple faces, arguably the most important being the political and social spheres. Substance abuse is one of the leading callouses that has left America with the biggest prison population in the world. Instead of having accessible or inexpensive treatment centers, it is decently difficult–if not impossible–for an individual without medical insurance to receive treatment.

“For most people with addictions, there are many mental health problems that need attention. And for many people with mental health problems, substance misuse problems accompany and complicate the care of their mental health problems,” says Eric Collins, physician-in-chief at Siler Hill Hospital in new Canna, Connecticut.

These issues must be discussed in the public and political forums because legislation is the only way to establish a willful angle at tackling the greater issue. Incarceration may be looked at as an easy solution to getting substance abusers off the streets, but it costs tax payers a great deal of money and has been shown to be a vicious cycle of repeat offenders traveling in and out of prison multiple times for the rest of their lives.

Aside from the criminal aspects of substance abuse there is also the matter of 8.9 million Americans suffering from both mental illness and substance abuse issues. Of this figure, only 7.4 percent will be treated for both conditions and more than half will not receive any treatment at all according to a report from the National Alliance for Mental Illness.

According to Ron Manderscheid, executive director of the National Association of County Behavioral Health and Developmental Disability Directors, two-thirds of all people who suffer from substance abuse also have mental illnesses. Their abusive habits combined with an impaired mental state make for a dangerous formula that puts the public at risk in terms of safety and also hits their pocket books in the form of incarceration tax dollars. To add a concrete figure to the notion of taxes, it roughly costs $70,000 per year per inmate, which is almost double what the nation spends per K-12 student.

The superseding point appears to be that mental illness, substance abuse, prisons and the public are all cemented to one another whether they like it or not. There is no easy way to say that this is a personal problem due to the large social impacts that are at stake. In recent years, mental health has begun to be put on the forefront of American policy due in part to a large amount of shootings in which the accused were found to be suffering from various mental illnesses. It is only when the public sees what mental illness can cause that they become aware of how serious the problem really is. Moreover, when their children or loved ones could be affected by someone who has not received treatment for mental illness or substance abuse the matter becomes personal and is finally taken seriously.

There is no easy or simple way to combat each of these problems seeing as they form a complex network of victims, society and politicians. In 1998 Supplemental Security Income disallowed for substance abuse to be classified as being a disability. This in turn stopped Medicaid checks from going out and thus substance abusers without insurance could not afford to receive help. President Obama has sought to change this trend by introducing the Affordable Care Act, which hopefully will allow for those with mental illnesses and substance abuse problems to get the treatment they need at an affordable rate.

What remains unknown is how many in the mental illness and substance abuse category actually seek out help on their own accord. An estimated 24 million Americans suffer with substance abuse problems but only about 2.5 million go into rehabilitation centers every year. The general population cannot help those who don’t want to be helped, so it is quite possible that mandatory rehab stints should be implemented instead of sending criminal offenders to prison. Some of the responsibility must be placed on those who actually have the affliction, though this isn’t to say that it is their fault, just more their duty to society to try to get better.

Incarceration is currently the sham remedy in dealing with this demographic but by no means is it a solution; merely a Band-Aid hiding the fact that there is serious turmoil going on. A clear point must be made that whether or not the majority of Americans suffer from mental illness and substance abuse they are affected in one way or another by its byproducts. Society is only as great as it ‘lowest’ members and so to simply condemn them with bars instead of recovery is a chilling reality that must be curved by legislation and public sentiment. As stated earlier there is no easy fix but each faction of society must push forward together in order to come up with more cost efficient and effective solutions.


Chad Arias has a B.A. in journalism and is a contributor for the Latino Post and Opposing Views. In his free time, Arias writes poetry, short stories and is currently working on a novel detailing his experiences with substance abuse. He is most interested on the philosophical and psychological aspects of the subject.

Alternative Rehab Centers Increase in Popularity

January 28, 2016 by  
Filed under Treatment and Recovery News

Comments

Alcohol and drug rehab treatment centers are invaluable, as they are centers that welcome struggling addicts and help them get free from addiction. Millions of men and women have attended rehab with the hopes of facing the disease of addiction and getting started on a new life of recovery. Yes, rehabs can truly be life savers.

One thing that’s great about rehabs is that not everyone is the same and in fact, there are some alternative rehabs out there that offer a more non-traditional approach to treatment. Today let’s take a look at a few of them.

Holistic Rehab Centers

A holistic rehab center will focus on the whole person, including mind, body, and spirit. They oftentimes use alternative therapies and methods when doing so and many do so without the use of any medications. At a holistic treatment center, you will be able to focus on your mental, physical, and spiritual health.

Just as traditional rehabs focus on treating addiction via counseling and education, so do holistic centers. In addition to these, you may find activities and techniques such as:

  • Visualization techniques
  • Deep breathing techniques
  • Meditation
  • Yoga
  • Acupuncture
  • Massage therapy
  • Exercise programs
  • Reiki and other energy healing modules
  • Spiritual counseling
  • Nature therapy

At a holistic center, you will still get all of the great recovery treatments as the traditional centers offer, but you will also have the chance to try out some alternative therapies. Many people really like having the chance to sample such therapies to see what they like and what works for them.

Narconon Drug and Alcohol Rehab Program

At Narconon, you’ll find an alternative addiction program that has helped many addicts become free and happy. The first obvious difference between this center and the more traditional center is that at Narconon you will go through the withdrawal process receiving no medication. You will be given nutritional supplements and engage in gentle exercise that calms your mind and relaxes your body. You will also get to enjoy a sauna.

Along with this, you will be taught communication and life skills that will help you in your recovery. The center does not advocate the 12 Step program and fully believes that once you graduate, you will be able to navigate life sober and clean- although you are always free to attend 12 Step meetings at your leisure.

Alternative rehabs have been highly successful, as more and more people are turning to alternative health therapies for health and happiness. If you are seeking a treatment center, be sure to look into your options and be open to trying something different. Take your first step toward recovery and reach out for help today.


Dominica Applegate has a BS in Psychology, an MA in Counseling and has worked in the mental health field for 12 years before launching her own business as a writer. Specializing in addictions, relationships, codependency, fitness and health, Dominica’s work is ultimately about helping people remove blocks that keep them stuck, because everyone can really create a life that they love.

What Marijuana Does to the Casual Smoker

December 3, 2015 by  
Filed under Treatment and Recovery News

Comments

Smoky man

One can Google “the harmful effects of marijuana” and find a number of sites reporting marijuana smokers are at risk for lung cancer due the drug’s properties or that marijuana smokers smoke unfiltered cigarettes. This research is rightly criticized for having small sample sizes or other methodological problems. However, a large study followed 5115 men and women who were casual users of marijuana (average of one joint daily) for 20 years. Using a sophisticated analysis that accounted for tobacco use and other potential confounding variables the researchers were unable to find any association between casual marijuana use and impaired pulmonary functioning (Pletcher, Vittinghoff, Kalhan et al., 2102).

The National Institute of Health (NIH, 2014) reports that there may be some mild irritation or respiratory distress and an increased risk of lung infection as a result of smoking marijuana, but as of yet there is no research tying marijuana into lung cancer. Chen, Chen, Braverman et al. (2008) made a case that marijuana smokers have a reduced risk of lung cancer due less tobacco use. So any link between decreased lung functioning and casual marijuana use appears not to be strong.

Marijuana and Cardiovascular Functioning

The NIH (2014) reports that smoking marijuana can increase one’s heart rate between 20 and 100% for up to three hours. This could increase the risk of heart attack in susceptible individuals.

In the most comprehensive research review to date regarding marijuana usage and cardiovascular health Thomas, Kloner, and Rezkalla (2014) presented a number of studies that link the use of marijuana to increased risk for heart attack, stroke, arteriosclerosis, and several other cardiovascular conditions. However, there is no designation as to the amount of marijuana being used by the subjects of these studies and even the authors of this review recommended more research to determine any causal mechanisms. Moreover, a risk factor is not a direct cause. Risk factors interact with other factors in order to increase the probability of a certain outcome; they themselves cannot be considered direct causes.

Neurological Issues

There is been quite a bit of research looking at how marijuana use alters the brain. The results of these studies are mixed. The first thing to understand is that any experience you have alters your brain. Your brain is being altered as you read this article. The dilemma is to try and understand if certain types of experiences alter the brain in a detrimental manner. The NIH (2014) reports that there are no studies that link casual marijuana use to altered brain functioning in adults; thus, research has focused on children and young adults.

Perhaps one of the most publicized of recent studies came from Gilman, Kuster, and Lee (2014) who performed neuroimaging studies on 20 young adults between the age of 18 and 25 who used marijuana at least once a week. Compared to a matched group of young adults the marijuana users were found to have abnormalities in the brain structures known as the amygdala (involved in emotional processing and memory) and the nucleus accumbens (involved in various aspects of reward behaviors and movement).

However, marijuana use in the study varied greatly with some of the participants smoking as many as 20 joints weekly. Secondly, there was much higher alcohol use among the marijuana group. Third, the researchers ran hundreds of statistical tests without controlling for the potential to find significant results due to chance. Finally, the study suffers from the correlation cannot infer causation issue. The study simply reports an association between variables; it cannot demonstrate that the presence of one variable causes the other. Thus, due to the small sample size and the other issues with this study, this type of study would have to be repeated over and over before any meaningful results could be gleaned.

Bottom Line

At this time, the research tying casual marijuana use with pulmonary issues and neurological issues is inconclusive. There is evidence to suggest that even casual use of marijuana may be a risk factor for cardiovascular issues; however, a risk factor is not necessarily a direct cause. The bottom line to take from these studies is that there does appear to be some potential risks with casual marijuana use; however, the research is not clear on the severity or types of physical health risks associated with casual use of marijuana.

References

Chen, A. L., Chen, T. J., Braverman, E. R., Acuri, V., Kerner, M., Varshavskiy, M., … & Blum, K. (2008). Hypothesizing that marijuana smokers are at a significantly lower risk of carcinogenicity relative to tobacco-non-marijuana smokers: evidenced based on statistical reevaluation of current literature. Journal of Psychoactive Drugs, 40(3), 263-272.

Gilman, J. M., Kuster, J. K., Lee, S., Lee, M. J., Kim, B. W., Makris, N., … & Breiter, H. C. (2014). Cannabis use is quantitatively associated with nucleus accumbens and amygdala abnormalities in young adult recreational users. The Journal of Neuroscience, 34(16), 5529-5538.

National Institute of Health (2014). Drug Facts: Marijuana. http://www.drugabuse.gov/publications/drugfacts/marijuana

Pletcher, M. J., Vittinghoff, E., Kalhan, R., Richman, J., Safford, M., Sidney, S., … & Kertesz, S. (2012). Association between marijuana exposure and pulmonary function over 20 years. Tama, 307(2), 173-181.

Thomas, G., Kloner, R. A., & Rezkalla, S. (2014). Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know. The American journal of cardiology, 113(1), 187-190.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

Next Page »

Need Help? View all Drug Treatment Centers and Drug Rehab Programs | Browse Top States: Arizona | California | Florida | New York | Texas
Alcohol And Marijuana Treatment Kick Club Drugs for Good Opiate and Prescription Abuse Recovery Top Crystal Meth Rehabs Cocaine Addiction Treatment
Kick Club Drugs for Good Opiate and Prescription Abuse Recovery Top Crystal Meth Rehabs Cocaine Addiction Treatment Alcohol And Marijuana Treatment
Opiate and Prescription Abuse Recovery Top Crystal Meth Rehabs Cocaine Addiction Treatment Alcohol And Marijuana Treatment Kick Club Drugs for Good
Want Help Beating an Addiction?