Krokodil Drug Use in US

March 20, 2015 by  
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Krokodil comes from Russia, where there is a severe shortage of heroin. The war in Afghanistan, amongst other factors in decreasing production of opium in that country (the world’s largest producer of opium poppies) is directly attributed to the creation of this drug.

The drug is made from codeine tablets with lighter fluid or paint thinner, and is a highly toxic substance. Injection of the drug increases the rapid effects. An active ingredient in codeine medication is Desomorphine, which is 8-10 times more potent and addictive than morphine. Desomorphine also acts much faster than morphine. These factors account for the widespread use of the drug, despite its horrific side effects.

The other ingredients that create its toxic and flesh-rotting effects are red phosphorous and high quantities of gasoline, paint thinner or other solvents.

What Does It Do?

Named Krokodil, the Russian name for crocodile, this drug destroys human flesh from inside the body. Named for the green scales covering human skin, it eats away at the site of the injection, causing unsightly wounds to appear, along with the horrible skin affliction.

Flesh is dissolved from the inside of the body, usually eating from the bones outward, exposing the bones and leaving little or no flesh. Users can seldom be saved from death, except in cases where surgical intervention is done and use is discontinued. Amputation of damaged limbs is often the only way to save the life of the user, in order to remove the rapidly rotting flesh. Most users who continue to use the drug die within two years of first use.

Blood diseases are also another outcome of use of Krokodil. As blood vessels are destroyed by the drug, it enters the bloodstream and causes damage in various ways and can travel throughout the body to infest sites other than where the injection takes place. This rapidly increases its damaging effects.

Why are Addicts Using Krokodil?

Costs are low for this drug. Because of the shortage of heroin in certain European and Russian markets, as mentioned above, this drug presents addicts with a cheaper and more readily available alternative.

Another reason for using Krokodil is its faster assimilation into the body. Desomorphine is much more rapidly synthesized, making it virtually untraceable by methods used to test for drugs. Those who are likely to be randomly drug screened may turn to Krokodil because it is more difficult to detect with standard test methods.

What is the Popularity?

Numbers of cases found in the United States are low. This is believed to be due to the low cost and high grade heroin that is readily available in the US. This heroin comes from neighboring Mexico, where opium production has increased rapidly since the early 2000s.

There are thought to be only 3-4 cases of Krokodil in the US and one of those was an American teen who was diagnosed in Mexico, although she reportedly used the drug in the US before traveling there.

While reports vary widely on the number of Russian and European addicts who have been diagnosed with Krokodil use and outbreaks are reportedly dwindling, it was once believed to have been affecting upwards of 100,000 people. The numbers are hard to confirm, due to conflicting reports. Part of the reason is the Russian silence regarding treatment of addicts and the various diseases killing them. Reports are silenced and altered by their media, and medical statistics are unconfirmed.

Resources:

CritCom. The Quietest Casualties: Russian Public Health Policies Cause Patient Deaths in Crimea. Retrieved online from: http://councilforeuropeanstudies.org/critcom/the-quietest-casualties-russian-public-health-policies-cause-patient-deaths-in-crimea/

Doheny, Kathleen. (9/30/2013). WebMD.com. Krokodil Drug FAQ. Deadly Drug May Have Entered the US.Retrieved online from: http://www.webmd.com/mental-health/news/20130930/krokodil-drug-faq

Ehrenfreund, Max. (10/07/2013). Washington Post. Homemade Heroin First Developed in Russia may have come to the US. Retrieved online from: http://www.washingtonpost.com/national/health-science/homemade-heroin-first-developed-in-russia-may-have-come-to-the-united-states/2013/10/07

Newser. Teen’s Lesions Linked to Cheap Heroin Substitute. Retrieved online from: http://www.newser.com/story/180158/teens-lesions-linked-to-cheap-heroine-substitute.html

Time. The Curse of the Crocodile: Russia’s Deadly Designer Drug. Retrieved online from: http://content.time.com/time/world/article/0,8599,2078355,00.html

 

Preventing Relapses by Embracing Prolapses

March 6, 2015 by  
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Girl-DepressedWe all make mistakes and miss the mark at times. If we allow a single lapse to cause us to move backwards, relapse begins and can take over our lives. If we learn something from the lapse and it helps us to grow, we can instead experience a prolapse.

Most of us are familiar with the concept of a relapse from what we know about addictions. Someone who is addicted to a drug stops using the drug and then at some point starts using again. Often the person is more enslaved to the drug than they were before. This cycle is common in drug addiction, but it can also apply to any habit we attempt to change. The disorganized person fails to put away a day’s worth of mail and suddenly finds a month’s worth of mail scattered across the dining room table. The successful dieter eats cake at a birthday party and suddenly finds cake has become a daily indulgence. What if every lapse did not turn into a relapse? What if a lapse became an opportunity to grow and become stronger? This is the idea behind a prolapse.

A lapse turns into a prolapse when one is able to identify the triggers contributing to the lapse, increase outside support and create a viable plan for moving forward. The first of these three steps—identifying the triggers to the lapse—is a key step that’s often overlooked but all three steps are an important part of the process.

Discovering Your Triggers

Triggers can include events or circumstances, emotional or hormonal changes, anniversaries and the like. Triggers vary significantly from person to person and monitoring how someone else is triggered may help increase understanding of the concept—but it will not necessarily help one gain personal insight. Consider, for example, three former gamblers. The first ex-gambler played the lottery for the excitement. She is triggered when the jackpot gets over $100 million dollars. The second ex-gambler enjoyed going to the casino with friends. He is triggered when feeling lonely. The final former gambler enjoyed a wide range of gambling and gravitates to whatever is closest if she is short on cash. For her, being low on funds is a trigger. Each gambler had a different set of triggers for the same behavior. In each case, identifying the trigger for the unwanted behavior starts with understanding why the unwanted behavior started in the first place.

Once we understand why unwanted behaviors surface, we can then start looking for patterns. A smoker may notice that they lapse and have a cigarette right after work. Ending the work day is therefore a trigger. A former gossiper may notice they lapse when a certain person is in the office. That person’s presence then is a trigger. Finding patterns may mean taking a look back to when the habit was commonplace even though that may be a painful process.

Increasing Outside Support

Support can come from many different directions. Involving friends and family in the process is a great first step. This could include asking them to be mindful of what they bring into your presence, asking them to hold you accountable or helping you get to other resources. Many times the people who are closest to you know you best and also how to help. Other times friends and family are too emotionally involved to provide true support or have needs of their own to take care of. You may have to look elsewhere.

Outside support could alternatively include professional assistance. For serious or dangerous lapses, that could mean the assistance of a mental health or substance abuse professional. For other situations that could mean hiring a life coach or accountability coach. A dieter with frequent lapses may want to turn to a weight loss program with an accountability component such as Weight Watchers. Asking for professional help is not a sign of weakness. Rather, it demonstrates true courage.

Outside support may also come from setting up systems to slow or delay the negative behavior. For example, someone who struggles with overspending on their credit cards could freeze their cards in a block of ice, call the card company and request the card be placed on hold for a period of time, or cancel their cards altogether. It can be very valuable to take some time to consider what creative intervention sparked by a person, computer or circumstance may slow down impulsive behaviors.

Creating a Plan

Understanding triggers and finding support may help one feel good, but without a plan for moving forward, the first two steps will likely be ineffective. In the addictions field this plan is formally referred to as a relapse prevention plan. It should just as easily be called a prolapse plan. Such plans can be applied to any behavior we are trying to overcome – not just addictions.

A great plan begins with an acknowledgement of triggers and a list of how to reach identified supporters. The next major part of the plan is what can be done when the triggers have risen. This is a detailed list of realistic actions that can be taken during times of temptation. For the overeater it could mean drinking a bottle of water. The disorganized may plan for 10 minutes of uninterrupted cleaning. The lonely ex-gambler may call a sponsor or have coffee with a friend. These small steps are what make the prolapse come to life.

If Another Lapse Occurs

Lapses happen. When they do, start the prolapse process immediately. Identify the triggers. Write them down. If you are not able to identify a trigger, talk with a supporter for suggestions. Revisit your list of outside supporters. How can your support system be modified to be more effective? Finally, revisit your plan while keeping what you have learned in mind. Tweak the plan as needed and move forward.

Cyndy Adeniyi is a counselor and founder of Out of the Woods Life Coaching. She enjoys hiking, Zumba, and flea markets in her spare time. She lives with her husband and two children in Maryland.

The Rising Epidemic of Heroin Addiction

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SONY DSCWhen people think about heroin, they often think back to the junkies of the 1960s and 1970s; sunken-eyed, skinny and unwashed young men and women who represented the poorer class of our social structure, stealing to support their habit and mostly living in dirty ghetto rooms with other junkies.

Today we see a whole new paradigm with heroin use and abuse. Most of those who abuse heroin now are professional or para-professional men and women who started using much later in life. They are doctors, nurses, police, clergy—those with high levels of education and living in nicer suburbs where addiction was not previously believed to travel in such high numbers. Again, these addicts most often speak of their addiction as having begun with prescription pain medications. Often, they first became addicted to pain medication that proved too difficult, illegal or expensive to maintain.

Why Heroin?

Heroin in today’s market is less expensive than ever before and more abundant in availability. One source reported that prescription pain pills sell on the street for approximately $1.00 per milligram. The cost for a 30-milligram pill would therefore be $30.00. This is far more than heroin costs, which would be somewhere between $10.00 and $25.00 a single use. The heroin available in most public settings today is of much higher quality than the black tar heroin of the 1960s and 1970s, since it is being refined more efficiently by producers before reaching the open market.

The United States is the world’s largest consumer of pain medication, buying 80% of the medication produced. Overdose of prescription pain medication is the highest cause of accidental death in this country, with death occurring every 19 minutes nationwide. Overdose from heroin use is rising sharply over the period of the last ten years; often observed with higher incidence in celebrity overdose cases in recent years.

The Center for Disease Control (CDC), reports that while overdose deaths from cocaine and prescription opiate medications have remained consistent in the period between 2011 and 2013, deaths from heroin overdose have doubled in number during that time.

A National Concern

Treatment professionals are seeing a steady increase in rates of admissions for addiction treatment regarding heroin, as well as prescribed opiates. In Denver, rates increased nearly one full percentage point between 2011 and 2012. In Vermont, the governor spent his entire ‘State of the State’ address in January, 2014 talking about the rising rates of heroin addiction, calling it a public health crisis. Cases there of heroin trafficking increased 135 percent between 2012 and 2013. From 2000 to 2013, the rate of heroin addiction treatment increased over 250 percent.

Most of the heroin coming in to the U.S. is coming from drug cartels in Mexico. Mexican heroin has decreased dramatically in cost for several reasons. Farmers who once grew acres of marijuana have switched to fields of heroin poppies. This is primarily due to the higher prices paid for the same volume of product. Drug cartels will pay the high price for tar produced by opium poppies and risk the dangerous transport of tar from mountain villages where they grow faster than crops that cannot be sold at the same high price.

Resources:

Typical Opioid User Has Changed. Real Time Recovery. Retrieved from http://realtimerecovery.net/typical-opioid-user-changed/

Edelsten, Josh. (August 2014). Vermont Quits War on Drugs to Treat Heroin Abuse as Health Issue.BloombergBusiness. Retrieved from http://www.bloomberg.com/news/articles/2014-08-22/vermont-quits-war-on-drugs-to-treat-heroin-abuse-as-health-issue

O’Reilly, Andrew. (February 5, 2015). Gang warfare on streets of Chicago fueled by Sinaloa Cartel heroin.Fox News. Retrieved from http://latino.foxnews.com/latino/news/2015/02/05/gang-warfare-on-streets-chicago-fueled-by-sinaloa-cartel-heroin/

Stevenson, Mark. (February 3, 2015). Mexican Cartels Expand Offerings to Feed America’s Growing Heroin Addiction. Huffington Post.  Retrieved from http://www.huffingtonpost.com/2015/02/03/mexico-heroin-trade-us_n_6601296.html

Torres, Kevin. (January 7, 2015). Heroin Cheaper than Pain Killers. Denver News. Retrieved from http://www.9news.com/story/news/health/2015/01/03/heroin-prescription-drug-overdoses-colorado/21238183/

Weathers, Helen & Carmen Bruegmann. Heroin Britain.Daily Mail Online. Retrieved from http://www.dailymail.co.uk/news/article-105112/Heroin-Britain.html

Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

Reasons for Relapse and Avoiding Them

February 20, 2015 by  
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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 experience—it 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.

Are E-cigarettes the Lesser of Two Evils?

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iStock_000044677596_Large (1)E-cigarettes are electronic devices that have come into popular use after being initially created to replace cigarettes and/or wean smokers off dangerous chemical effects of nicotine. They have several names but the terms most often used to describe these devices for vaping are “vapes” or vaporizers.

Initially only marketed and sold on the internet, the first e-cigarettes were sold without legislation by the agencies who monitor and control tobacco products. As they became more popular, agencies who manufacture tobacco products began to step into this arena as well. Advertising increased and use became more widespread.

Today, entire stores are devoted to the practice of inhaling vapors through the mechanisms being developed and constantly upgraded as “e-cigarettes.” There are many models, styles and combinations of flavors to choose from. There are customized vapors as well as holders, allowing for a wide variety of experiences with “vapes.”

What We Know About Them

At the beginning of the conversation about vaporizing, there was little risk seen with the devices or the manner of delivery for the product. Concern with the chemicals used for the vapors in e-cigarettes, however, has risen since their early inception. This is due to the fact that some of the problematic effects of the chemicals are seen at higher temperatures. These temperatures were not possible with the early types sold. Today, there is a much higher temperature that’s possible in vaping.

This chemical, propylene glycol, a common component in e-cigarettes, is known to cause eye and lung irritation. It carries a warning from the manufacturer, Dow Chemical Company, against inhalation. Additionally, the toxic formation of carbonyls is even higher than that produced from tobacco products. This is the danger seen at higher temperatures that can be achieved with newer models of e-cigarettes.

Some of the carbonyls shown to be formed are formaldehyde, acetaldehyde, acetone and butanol. Added to this risk are the flavorings added to the vapor liquids to make them taste like flavors ranging from bubble gum to rum. While they are listed as safe ingredients for consumption in food substances, vaporizing these compounds with propylene glycol may produce far different results.

While research is ongoing, there is no definitive information about e-cigarettes that raises alarms at this time. However, there are several factors that bring up the conversation about regulating them in ways similar to tobacco products.

Arguments for Regulation

First of all, there is no age requirement for buying e-cigarettes which makes them widely popular with adolescents and pre-teens. Since there are recognized health risks possible, it would seem that this makes a good argument for regulation of sale for use of this product.

Many manufacturers are targeting this specific population for marketing purposes. Even if the use of “vapes” is as innocuous as they argue, the habit of smoking these may increase chances for addiction, which may raise the possibility of moving from this product to tobacco use in the young.

Additionally, many users have already created ways to use other substances with e-cigarettes. Allowing minors to use them increases the possible risk of moving into use of substances that can be masked by “vaping.”

Until specific health benefits can be recognized over the use of tobacco, one argument for regulation remains consistent: age requirements should be legislated.

Health Risks

Again, research has shown little consistent data with e-cigarette use. Comparison is drawn between a known danger, tobacco product use, and that of vapors. This is similar to stating that it is safer to shoot someone in the foot than to shoot them in the head. Or to say that use of strychnine is more favorable than use of arsenic or vice-versa. When something as dangerous and addictive as nicotine in tobacco products is compared to a less dangerous practice, there is considerable risk involved either way.

There is some evidence that health risks are present with use of vapors. There is also some evidence that secondary exposure to vapors is harmful. At any time, there is little benefit for human consumption of chemical compounds such as those produced by or used in either product.

Until the exact extent of danger of these products is known, perhaps the burden of proof should be on the manufacturers of the products to show a benefit of their use. Why smoke at all? What possible benefit can be found for developing a taste for vapors of chemical compounds?

Why Use E-Cigarettes?

The most common reason people use e-cigarettes is to help themselves stop smoking tobacco products. Many former smokers remain steadfast in their support of vaporizing as a means of substitution of tobacco. However, thousands, if not millions, of former smokers have shown that there is no need for this product to stop smoking tobacco products. That argument simply does not hold together.

Sources:

Environmental Health Perspectives: National Institute of Environmental Health Sciences: National Institute of Health. “Vaping and Health: What Do We Know about E-Cigarettes?” Retrieved online from: http://ehp.niehs.nih.gov/122-a244/

Oxford Journals. “Carbonyl Compounds in Electronic Cigarette Vapors—Effects of Nicotine Solvent and Battery Output Voltage.” Retrieved online from: http://ntr.oxfordjournals.org/content/early/2014/05/14/ntr.ntu078.full

 

Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

Why a DUI Was the Best Thing that Ever Happened to Me

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Drunk DrivingAnyone who has had a few drinks and gets behind the wheel of a motor vehicle is an idiot. Yet, many drinkers do just that. Fortunately for everyone on the road, many of them don’t get into an accident. Unfortunately for the drunk drivers, most will not get arrested. However, drunk driving arrest can be the all-important wakeup call a person needs, especially for the driver who habitually drives drunk.

The Lucky Incident

I was one of those “fortunate” few who did get arrested. It wasn’t pretty. Luckily, no one else was hurt, although I did suffer a few broken ribs. But believe me, it could have been much worse. I was driving with my fourteen-year-old daughter in the car and the guilt I suffered from my transgression was unbearable. I could not face the legal consequences of my actions alone so I hired a lawyer who was an old acquaintance to see me through the ordeal. Whether he got me a lesser penalty or not was besides the point. He helped me when I needed his help.

The court suspended my driver’s license except for limited trips to and from work and court-ordered meetings. They also charged me a fine and sentenced me to attend a government-sponsored program to educate me on the terrible consequences of driving under the influence. In California, such programs are referred to as “drunk school” and include group therapy sessions as well as instructive lectures and videos on the subject. Attendance at a number of Alcoholics Anonymous meetings is also mandated by law. The court orders often allow the miscreant to eventually regain driving privileges and will remove the probationary status common to all those convicted of driving under the influence of intoxicating substances.

A Learning Experience

Drunk school was highly enlightening. While all my classmates were not alcoholics, many of them were, and some were in denial of their own alcoholism. A few of them did not even know what alcoholism was. I vividly recall one of my peers telling us in group that she often closed the bar after consuming as many beers as possible and then slept in her car in the parking lot if she passed out before she could drive home. She honestly did not see this as a problem with alcohol. She thought this was what everybody did–so what? Though no one judged anyone in our sessions, I hope she came to understand that this was unhealthy behavior. We were all in it together and most of us came out of it with greater insight into our own and our fellow classmates’ issues with alcohol.

On a not-so-positive note, the required Alcoholics Anonymous (AA) meetings were something else. I signed up for the meetings closest to home. These took place in a local church community room and were very well attended. The regular attendees were well aware that any newcomers were probably there because the court had ordered their attendance. While this was undoubtedly true of most new members at the time, the second-class treatment we received did not encourage attendance beyond our obligatory limits.

I introduced myself according to the usual AA protocol by giving my name, after which I stated “and I am an alcoholic.” The regular membership neither listened nor responded. They just went on with their meeting that leaned heavily on praising a higher being. Since I am not a religious person and being that I felt ignored and proselytized, I never attended another AA meeting after satisfying my legal obligation. I do understand though that there are hundreds of thousands of AA meetings that take place throughout the country every day and that each one is different. I, for one, just choose not to take part in them.

The Positive Takeaways

My DUI happened almost thirty years ago and I never got behind a wheel after imbibing in alcohol—and never will. I began to look at alcohol in an entirely different light after talking freely, often with my colleagues in group therapy. We helped each other get through a rough patch in our lives. Their help will always stay with me. I hope they can say the same about the help I tried to provide.

I also learned not to waste any time on twelve-step programs and to channel my energy instead in other directions. What works for some is no guarantee that it will work for everyone. This shouldn’t stop anyone who needs help to search long and hard for the treatment that works best for them. Don’t wait for a DUI arrest to begin this very important search.

 

Tess Chedsey is a retired systems analyst, life-long alcoholic and native of Los Angeles, California. She now resides in a small town in Oregon where the Columbia River meets the Pacific Ocean–a setting not unlike some of the more luxurious rehabilitation ”resorts.” She has been writing articles for over ten years for numerous websites on a wide variety of topics, including addiction. Besides writing, Tess has a passion for world travel and animals.

The Growing Cases of Real Nurse Jackies

December 26, 2014 by  
Filed under Treatment and Recovery News

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Nurse JackieThe incidence of nurses who are addicted to either alcohol or drugs is an increasing problem in the healthcare industry. While the numbers climb and more treatment interventions are offered, there are numerous reasons attributed to this increase. Here are 4 reasons that stand out in this growing trend:

1. Stress

The most-often stated reason for the increase in addiction within the nursing population is high levels of stress that nurses have to deal with. As the healthcare community becomes more focused on treating higher numbers of patients at lower costs, budget cuts and increased numbers of patients, the workload for nurses also increase. Due to their ability to provide most of the care necessary for patient treatment at lower costs than physicians, they are essentially the go-to providers of healthcare. Nurses are affected by increasing amounts of responsibility for patient care as well as rising stress levels.

High stress also exists in the healthcare field due to the life-and-death nature of most facilities and service providers. This can lead to high burnout for nurses and doctors alike. When coupled with the increasing patient loads they are being required to carry, it is not surprising that more and more addiction is being recognized in this professional realm.

2. Accessibility

The second most frequent reason for high incidence of addiction in this field is the widespread knowledge of and access to narcotics of all types. Long hours and heavy stress loads at work may not allow nurses to relax without chemical use. While many have learned good coping skills that allow them to de-stress at the end of their shifts, many nurses may not utilize stress management methods that require more effort. Tired and feeling the effects of operating at high levels of cortisol and adrenaline for many hours, it is far easier to look for relief in a drink or a sedative medication.

Given the social focus of drugs in our culture and its powerful use in medicine today, drugs are seen as the “magic” fix to nearly every problem. This focus has a huge impact on our entire population and nurses are inundated with this message at every turn.

Having ready access to stimulant drugs when they need to work a longer shift or when they need to relax after working at high levels of stress for many hours and the day-to-day stresses of life apart from the job can explain the use of drugs in the nursing field to cope with life.

3. Emotional Trauma

Some of the other reasons for drug use in nurses and other healthcare professionals can be the high rates of serious injury, trauma experienced from death and disease in their patients, and the emotional nature of working with families of these patients. Many emotional factors exist in the day-to-day treatment of these conditions; factors that take a toll on even the most well-balanced of people. Add this emotional factor to the high numbers of patients being treated by nurses today, and it begins to make sense that they experience more than most of us can tolerate.

4. Drug Types and Predispositions

The types of drugs most frequently abused also plays another factor. The high potential for addiction to relaxants, sedatives, pain relief medication and stimulant drugs is a big part of the picture. They quickly develop dependence in all users. Coupled with tendency towards escape from emotional and physical stress, users are likely to become not only dependent on the drugs but addicted.

Then there are also people who are likely to develop addictions, those who have heritable and behavioral tendencies which are recognized to be the precursors to the disease of addiction. Not all users who become addicted to drugs and alcohol have the disease of addiction but those who have both the disease and the addiction face double likelihood for problems.

What We’re Doing

Today, over 40 states have specific professional treatment for addicted nurses. Along with Boards established to work with nurses in treatment to oversee their education and recovery processes, various states have moved to address this growing concern and retain as many nurses in viable medical professions as possible.

High recidivism is recognized as a danger for this population. However, many nurses operate in the hospitals, healthcare providers’ offices, clinics and other settings without return to addictive practices. This retraining and recovery for addicted nurses is a field of expertise for many in the treatment and mental healthcare fields.

High levels of training in stress management and coping skills is a large part of this field. Learning to deal with the emotional imbalances of heavy workloads and life-and-death situations that make up this work is important for the ongoing maintenance of a return to working as a nurse.

Some nurses will change their field of practice to one that is less stress-inducing. Others may find a support-group approach to stress reduction in their place of business, incorporating others in recovery or attending 12-Step meetings on lunch breaks or daily after or before their daily shift. Still others find a practice of stress reduction they can participate in during their work shift.

Many forms of stress-management exist for addicts, whatever their profession. Finding relief in alcohol or drugs can be replaced with healthier diet, exercise and many types of stress reduction practices.

Sources:

AddictionBlog.org. Addiction Treatment for Nurses.Retrieved online from: http://addictionblog.org/FAQ/special-populations/addiction-treatment-for-nurses/.

NursingCenter.com. Addiction: An Occupational Hazard in Nursing. Maher-Brisen, Patricia. From AJN, American Journal of Nursing, August 2007, Volume 107 Number 8, Pages 78-79. Retrieved online from: http://www.nursingcenter.com/lnc/journalarticle

Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

Are There Degrees of Alcoholism?

December 19, 2014 by  
Filed under Treatment and Recovery News

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alcoholismThere remains controversy over whether alcoholism is a disease or a moral flaw. There is enough evidence among medical professionals and literature to prove to me that it is a disease. Like all diseases, the severity of the disease of alcoholism varies between individuals and runs in families, much like cancer or hemophilia.

Given this premise, it is clear that some alcoholics are able to function normally, some are not. Some alcoholics can drink socially and never cross the line to private or public drunkenness. Some are able to manage their disease and some are not. This is not a choice, it is the degree to which the alcoholic suffers from the disease of alcoholism.

A Family Case Study of Alcoholism

A case study that illustrates the degrees of alcoholism can be found in my own family history. I’m sure it predates my maternal grandfather, but I have no knowledge of the family history before him. My grandfather enjoyed a good stiff drink on occasion. I do not really know the details of the onset or progression of his alcoholism. I do know that once the Great Depression hit, so did the severity and negative impacts of his disease. He died in his fifties after being hit by a car while jaywalking drunk.

My mother and two uncles drank moderately. My aunt was a teetotaler like my grandmother. I am an alcoholic. My brother, sister, and two cousins were alcoholics of varying degrees. My brother, who definitely suffered from at least a moderate degree of alcoholism, decided to stop drinking cold turkey when he was 31 years of age. He accomplished this task by first downing the last of a bottle of scotch he had on hand. He never woke up. He died of alcoholic poisoning.

My sister and cousin were so ravaged by severe alcoholism, there was no way they could be successfully treated. Both of them were in and out of rehab for years, with minimal or fleeting results. They were completely incapable of ceasing to drink. My sister died of alcoholism at age 41, my cousin at age 44. These two were the most extreme examples of the illness that I have thus far encountered. No one would choose the lives they led. The disease chose them with the full force of its fury. My other cousin underwent alcohol treatment only once and never drank again.

The Science of Medicine and Alcoholism

Alcoholics have been part of human history since the discovery of fermentation. It is a sad reflection on the field of medicine that so little attention has been paid to the disease of alcoholism by scientists working to discover the cure for so many other illnesses. Alcoholism is a disease that, according to Steven Reinberg, writing in the July 2, 2007 of The Washington Post, affects one-third of the United States’ population at some point in their lives. This number can be extended greatly by the inclusion of the affected family members and associates that are directly impacted by the alcoholic’s issues and behaviors in everyday life.

The sooner our society can overcome the argument that alcoholism is a moral weakness and put it in its rightful place as a disease with physiological underpinnings, the sooner relief will come to the many people afflicted with this terrible, sometimes fatal disease. Medical science needs to see alcoholism as a disease affecting millions. The medical and scientific communities need to proceed as they have always done in order to eliminate or lessen the impact of debilitating diseases through research. Such research is long overdue for the millions of people suffering from alcoholism – their own or their loved one’s.

Tess Chedsey is a retired systems analyst, life-long alcoholic and native of Los Angeles, California. She now resides in a small town in Oregon where the Columbia River meets the Pacific Ocean–a setting not unlike some of the more luxurious rehabilitation ”resorts.” She has been writing articles for over ten years for numerous websites on a wide variety of topics, including addiction. Besides writing, Tess has a passion for world travel and animals.

What Austin’s Doing to Fight Drunk Driving and What Other Cities Can Learn

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parking ticket on windshieldWhen a drunk driver plowed through a dense crowd of music lovers at the South by Southwest (SXSW) festival in March, horror rippled through the festival community and spread to the Austin community at large. When all was said and done, four people died because of that one drunk driver and many others sustained serious injuries. The road had been closed to vehicular traffic, but roadblocks and police officers didn’t stop the 21-year-old driver from steering toward the pedestrian crowd and accelerating. The tragedy cast a shadow over the remaining days of the festival and not just because of this one incident.

Culture Shock

The SXSW tragedy was a wake up call for many in the city of Austin, especially those in the music community. Known for being the “live music capital of the world,” Austin’s music clubs, many of which stand side by side, have live music performances most nights of the week. The drinks are cheap and drinking is a warmly embraced component of the live music scene in Austin. The biggest problem, aside from the addiction that can occur within a drinking-friendly subculture, is the lack of safe transportation options that can serve as an alternative to driving under the influence.

Like many midsize cities, Austin has taxi companies, pedicabs, and even a small train system. While none of these options are ideal yet for conveniently ferrying intoxicated individuals safely home, one of the bigger deterrents for those who drive into town to drink are the parking ticket fees for leaving a car downtown overnight. Many parking meter machines in town will allow drivers to buy time for the next day if they plan to leave their car after drinking. Since enforcement of parking meters doesn’t begin until 8 a.m. on weekdays and 11 a.m. on Saturdays, drivers might be able to get back to their cars the next morning before they receive a ticket. However, despite these accommodations, drivers who make the responsible choice and take another method of transportation home after drinking, often return to their cars to find hefty tickets waiting for them on their windshields.

A Responsible Solution

To remedy this problem, the city of Austin is now allowing drivers who made the right choice to bring a receipt or ticket stub proving they took alternative transportation home to the Department of Transportation. The parking ticket fee will be waived if drivers bring in this proof. This is an approach many other cities could learn from – encouraging and giving incentives to drunk drivers to act responsibly will not only enhance the overall quality of life in any given city, but it will prevent serious injuries and fatalities, as well.

Of course, the city of Austin could still learn a few things from other cities on this topic. The buses and trains currently stop running before bars let out, leaving those who stay until last call short on options. The buses don’t run as often as they do in other cities and, for many people, the few stops on the train line are nowhere near where they need to be. Taxis and car services, although they exist in Austin, often have to be called rather than flagged down – especially if a potential patron is anywhere outside of the immediate downtown area. Nonetheless, the fee-forgiveness program is certainly a step in the right direction.

Kelly McClanahan has an MSW in clinical social work and a CATC IV in addictions counseling. She teaches meditation and mindfulness, specializing in addiction and trauma. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

How I Got through Opiate Withdrawals

October 30, 2014 by  
Filed under Treatment and Recovery News

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hand coming through pile of pillsWith every choice you make, we know there is either a consequence or a solution. As addicts, while many are still fighting for the willingness to get clean, there are those who are finally ready to take the plunge into sobriety but do not yet want to go through the symptoms of withdrawal. Unfortunately, symptoms that come along with quitting drugs are almost inevitable.

Alcohol withdrawals can kill you. Benzodiazepines, more commonly known as Xanax, can also kill you. Opiate withdrawals, interestingly enough, though it may feel like dying, will not kill you.

Why It’s Scary

Opiate withdrawal cannot kill you but the symptoms can seem like reason enough to keep using. When I first decided to get sober, I lasted about 5 hours opiate-free–long enough to get the sweaty chills. The second time, during my short stint in rehab, I was given Suboxone to help subside the physical symptoms of the withdrawal. Of course, there was a number of attempts in between then and when I actually got sober, but that doesn’t make it any less scary. I was well aware of what was going to happen to me if I chose to get sober, which was my very excuse for putting it off.

Symptoms and Medications

I’d like to paint the road to sobriety gold but that wouldn’t be realistic. The symptoms can come sporadically or all at once. Cold sweats, chills, vomiting, cramps, sneezing, a flu-like runny nose, diarrhea–those may be just the beginning. Seemingly worse, the nighttime drags on with restless legs, insomnia, cravings, dizziness and even depression. Though it seems crazy to “plan” to get sober, retrieving a prescription for Suboxone beforehand can ease some of the fear. Methadone is another way to assist with the withdrawal symptoms of opiates but long-term, high doses of methadone can lead you right back to square one.

Why I Went Cold Turkey

For some people, it almost sounds borderline insane to attempt going cold turkey. In my eyes, that was the only way I knew I was going to successfully quit. I had heard horror stories of people who had gotten sober using Methadone, only to have a lifelong sentence visiting the Methadone clinic. The withdrawals from long term Methadone use could be equally as scary as opiate withdrawals. As far as Suboxone was, in my opinion, the taste alone made me feel sick to my stomach. Going cold turkey was important to me because I knew I had to experience every aspect of withdrawals to remind myself what I never wanted to go through again. I knew if I used any medication to get through the withdrawals, it would leave the door open for me to relapse again. I knew that once I had felt every ache and pain, every inch of sickness, every restless night – I would know what it would feel like to repeat.

What to Do When It’s Over

Whether you go cold turkey or use medicine, I finally realized that withdrawal portion itself is actually the easy part. Making sure that you’re finding activities to occupy your time and ignoring cravings is another important part of the process. It may take a few days or even a week or two to get all the way through the aches and pains of the withdrawal symptoms but remind yourself that it is only temporary. It’s hard to recommend going cold turkey because the fear of withdrawals alone is overwhelming but not using medication can be helpful if you want to avoid further dependence on a prescription drug. However, with that said, do not feel discouraged if you do need medication – as long as you are free from opiates, you are one step further down the road than you were before.

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.

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