A Look at the Cumulative Effects of Anti-Depressant and Anti-Anxiety Medications on People With Addiction

May 25, 2017 by  
Filed under Health

Comments

The dangers lie in belief that this is an open and shut situation for anyone, especially when it comes to the neurological damage caused by addiction, the fact that many addicts have self-medicated underlying mental health issues, and the difficulty of diagnosis for early recovery.

Of course there is a plethora of material touting the use of antidepressants. Anyone who suffers the crippling effects of depression, whether it is long-term, chronic depression or a shorter-term, situational depression can testify that medication can be a God-sent assistant in navigating daily life. For some, it allows functioning in a world that appeared sinister and overwhelming to accommodate.

However, the challenges for those who are in early stages of recovery from addiction to substances that alter their brain function for months or years are in appropriately being diagnosed for said mental health issues.

What are the Challenges of Diagnosing Addicts?

Alcohol, some benzos (Benzodiazepines), Opiates, and Central Nervous System (CNS)-Depressant medications may cause long-term damage to the synapse responses in the addict’s brain over long periods of abuse. How and when those functions are returned to homeostasis is questionable. Diagnosing these addicts as depressed may be tricky, if not impossible, during the early stages of recovery.

Many addicts have lied to their providers when asked about alcohol and drug use. An addict using these substances is going to present symptoms that are being created by the drug, not the addict’s natural mental state.

Addicts who have been abusing stimulant medications over a period of time may present with symptoms of depression when newly eliminating these drugs from their system. They feel depressed, because their continual state of hyper-alertness, caused by the drugs they were abusing, is missing. This may go on for up to a year after they stop drug use. Treating these symptoms with medication may not be the best way for them to stabilize and return to homeostasis.

For that purpose, it is important to question the use of medications during this period, as well as to determine a shorter period of use of medications, due to the changing brain chemistry of the addict overall.

What are the specific issues of use of antidepressants?

For anyone facing the question of whether or not use of antidepressants is their best bet, there are several pieces of information to consider. There are many articles and much information about the side effects of various antidepressant medications, which will not be addressed in this article. These should be weighed by the person who is considering medication.

They may need to try more than one medication before the appropriate fit is found for their personal use. It is highly recommended by doctors and pharmacists that the patient work closely with their physician to find the appropriate medication, dose and term of treatment. Staying on top of your use of medication requires a team effort. DO NOT ATTEMPT TO STOP USE OF MEDICATION WITHOUT MEDICAL SUPERVISION.

Any and all use of medications during the taking of anti-depressant medication needs to be consulted with a physician to determine best course of action. MAKE SURE YOUR DOCTOR KNOWS ABOUT ALL MEDICINE, EVEN OVER-THE-COUNTER VITAMINS OR SUPPLEMENTS BEING TAKEN.

Why is this a personal decision?

In March, 2010, a report made by Dr. Charles Raison, a psychiatrist at Emory University Medical School for CNN spoke of cataracts being caused in long-term use of medications used for treatment of depression. In addressing this finding, Dr. Raison stated his opinion that few long-term studies had been conducted to find long-term effects of medications because there are so many variables in patients. Another reason is that there is no baseline for “normal” in the human brain or one established for all of the factors that may lead to the “causal” nature of depression, much less the lifestyle variables and conditions for each patient.

Given these factors, it is important to remember that not everyone:

(a) Is appropriately diagnosed,

(b) Is willing to make lifestyle changes that will enhance recovery options,

(c) Is suffering the same levels of depression,

(d) Has the same state of homeostasis in their brain chemistry,

(e) Understands what depression feels like,

(f) Recognizes the responsibility they have to work through their issues to recover.

These are all roadblocks that must be understood, recognized and navigated when treating depression. If the condition exists in co-occurrence with addiction, the challenges are multiplied.

What is known about side effects with long-term use?

Research has indicated several things that need to be recognized with side effects of anti-depressant medication.

  • Weight gain: Over any period of time, health issues surrounding body weight gain are many. These must be addressed with use of anti-depressants, because new health risks may occur.
  • Some types may cause heart problems such as arrhythmia and palpitations.
  • Drug interactions that can be fatal, especially when combined long-term.
  • Most medications are designed to be used only by those who maintain abstinence from other drugs. Addicts in relapse create additional risks for adverse effects of these medications.
  • Loss of effectiveness. After months or years, the brain becomes less responsive to the medication, a condition known as tolerance. This can cause a return of depressed symptoms, as well as the need for an increased dose or change to another type of medication for treatment.
  • Nausea and other digestive problems seen with use of anti-depressants can become chronic and cause additional digestive conditions when medication is used over years.
  • Recognized sexual difficulties seen with anti-depressant medication can lead to relationship difficulties, and may require the use of other medications; thereby increasing risk of harmful drug interactions. In a long-term sense, these may also create permanent breaches in relationships between sexual partners.
  • Sluggishness and lack of energy caused by medication may create trouble for those with depression, because they are using medication to offset some of these symptoms, which may persist or worsen with use of anti-depressant medication.
  • Sleep pattern disruptions are another source of trouble. Many depressed patients report trouble with sleep on anti-depressant medication. This causes further sluggishness and lack of energy, thus exacerbating the problem.
  • Medications may have some opposite effects, such as agitation, nervousness, twitching and involuntary muscle movement. Long-term use may worsen or create greater frequency of these problems.
  • Headaches have been reported after initial use of anti-depressant medication, and may continue or develop into chronic, episodic events in long-term use of medications.

Specific conditions recognized by long-term use

One of the things seen to be occurring over long-term use of anti-depressants is seen through a group of published papers in Minnesota. They were specifically looking for an answer to the question of whether medications worsen the condition of depression over the course of long-term use. This was a concern first addressed in the late 1960s and early 70s.

A term called “chronification” of depression was coined to address the condition being recognized by an Italian psychiatrist by the name of Giovanni Fava. In a description of how anti-depressants work on the brain, he spoke to the mechanism that was created when the brain developed what he called “oppositional tolerance”.

As the brain seeks stability when being medicated and brain function is altered, it may begin to overcompensate for the medication’s interference, thus creating a worsening of the brain malfunction that creates the condition to begin with.

The human body and brain will always seek to maintain homeostasis. In battling the introduction of medication, the brain may create a counter-balance effect in response. Numerous scientists have explored this theory over the course of the ensuing 40-50 years.

Treating depression that was NOT labeled major depressive illness, or those who had symptoms that were other than a chronic type of depression actually created brain responses to medication-intervention that simulated depression. This is caused by the oppositional forces of medication, even after it is discontinued in those persons who had initial success with the medication. After an initial stabilizing effect, continuing the use of the medication may create what one doctor termed “prodepressant effect”. This doctor is El-Mallakh, a physician who began his research shortly after reading about “oppositional tolerance”. The effect takes place often in those who relapse and stop use of their medication, those who suffer from anxiety, panic disorder or those with no symptoms who take the medication after being mis-diagnosed or who have acted as “controls” during trial drug tests. While they may not have presented with symptoms of acute depression of a major type, they develop these symptoms after use of an anti-depressant medication. Some of these symptoms may last for long periods after discontinuing medication and may not be completely reversible.

How is this important to addicts?

Recognizing serious depressive disorders is challenging for those in early recovery, due to the many factors involved in their brain and body conditions during that time. For that purpose, it is imperative to determine appropriate treatment and to alter the treatment to fit the newfound stability of the patient.

Because symptoms may mimic depression and other mental illness diagnoses, it is important to monitor how medications are affecting these patients. For that reason, most doctors continue to recommend counseling or therapy, along with medication in order to shorten the time of use of medication if possible.

Working closely with mental and physical health providers will ensure that appropriate care is provided for those who suffer from depression. Medications for treatment of depression are most effective when used for short periods of time. They may become ineffective when not needed by the person taking them.

Another danger of long-term use of anti-depressant medications is seen when tolerance is created. Patients are then much more likely to relapse into depressed states. This danger escalates with potency of the prescribed dose, along with the length of use. Also important to note are the side effects when withdrawing from the medication; which also increase incrementally, depending on dosage and length of time the patient has used the drug.

Dr. Peter Breggin, a psychiatrist educated at Harvard, summarizes Dr. El-Mallakh’s body of research in an article whose main focus is finding the balance each patient must come to when considering treatment for depression. His pivotal message is: that when viewing the preponderance of evidence showing the side effects that, for many patients outweigh any benefits; it becomes increasingly important to understand and explore all possible options before prescribing or taking medication of this type.


References:

[1] CNN.com. Ask the Expert: What are antidepressants’ long-term effects? Retrieved online from: http://www.cnn.com/2010/HEALTH/expert.q.a/03/16/antidepressants.long.term.effects/index.html

[2] Web MD.com. How Long Should You Take Antidepressants? Retrieved online from: http://www.webmd.com/depression/features/antidepressants

[3] Psychology Today. Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria

New research on why antidepressants may worsen long-term outcomes. Retrieved online from: https://www.psychologytoday.com/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria

[4] Harvard Health Publications: Harvard Medical School. What are the real risks of antidepressants? Retrieved online from: http://www.health.harvard.edu/mind-and-mood/what_are_the_real_risks_of_antidepressants

[5] Huffington Post: Healthy Living. New Research: Antidepressants Can Cause Long-Term Depression. Retrieved online from: http://www.huffingtonpost.com/dr-peter-breggin/antidepressants-long-term-depression_b_1077185.html

Long-Term Effects of Anti-Depressants on Addicts

February 15, 2017 by  
Filed under Health, Treatment and Recovery News

Comments

Since the 1980s, diagnosing and treatment for depression has come to be a big part of recovery for millions of addicts. The controversy surrounding medication for depression and when and how it is determined necessary has created an ongoing conversation that can, from time to time, be addressed with fresh information.

The cumulative, long-term effects

The dangers lie in belief that this is an open and shut situation for anyone, especially when it comes to the neurological damage caused by addiction, the fact that many addicts have self-medicated underlying mental health issues, and the difficulty of diagnosis for early recovery.

Of course there is a plethora of material touting the use of antidepressants. Anyone who suffers the crippling effects of depression, whether it is long-term, chronic depression or a shorter-term, situational depression can testify that medication can be a God-sent assistant in navigating daily life. For some, it allows functioning in a world that appeared sinister and overwhelming to accommodate.

However, the challenges for those who are in early stages of recovery from addiction to substances that alter their brain function for months or years are in appropriately being diagnosed for said mental health issues.

What are the Challenges of Diagnosing Addicts?

Alcohol, some benzo (Benzodiazepines), Opiates, and Central Nervous System (CNS)-Depressant medications may cause long-term damage to the synapse responses in the addict’s brain over long periods of abuse. How and when those functions are returned to homeostasis is questionable. Diagnosing these addicts as depressed may be tricky, if not impossible, during the early stages of recovery.

Many addicts have lied to their providers when asked about alcohol and drug use. An addict using these substances is going to present symptoms that are being created by the drug, not the addict’s natural mental state.

Addicts who have been abusing stimulant medications over a period of time may present with symptoms of depression when newly eliminating these drugs from their system. They feel depressed, because their continual state of hyper-alertness, caused by the drugs they were abusing, is missing. This may go on for up to a year after they stop drug use. Treating these symptoms with medication may not be the best way for them to stabilize and return to homeostasis.

For that purpose, it is important to question the use of medications during this period, as well as to determine a shorter period of use of medications, due to the changing brain chemistry of the addict overall.

What are the specific issues of use of antidepressants?

For anyone facing the question of whether or not use of antidepressants is their best bet, there are several pieces of information to consider. There are many articles and much information about the side effects of various antidepressant medications, which will not be addressed in this article. These should be weighed by the person who is considering medication.

They may need to try more than one medication before the appropriate fit is found for their personal use. It is highly recommended by doctors and pharmacists that the patient work closely with their physician to find the appropriate medication, dose and term of treatment. Staying on top of your use of medication requires a team effort. DO NOT ATTEMPT TO STOP USE OF MEDICATION WITHOUT MEDICAL SUPERVISION.

Any and all use of medications during the taking of anti-depressant medication needs to be consulted with a physician to determine best course of action. MAKE SURE YOUR DOCTOR KNOWS ABOUT ALL MEDICINE, EVEN OVER-THE-COUNTER VITAMINS OR SUPPLEMENTS BEING TAKEN.

Why is this a personal decision?

In March, 2010, a report made by Dr. Charles Raison, a psychiatrist at Emory University Medical School for CNN spoke of cataracts being caused in long-term use of medications used for treatment of depression. In addressing this finding, Dr. Raison stated his opinion that few long-term studies had been conducted to find long-term effects of medications because there are so many variables in patients. Another reason is that there is no baseline for “normal” in the human brain or one established for all of the factors that may lead to the “causal” nature of depression, much less the lifestyle variables and conditions for each patient.

Given these factors, it is important to remember that not everyone:

(a) Is appropriately diagnosed,

(b) Is willing to make lifestyle changes that will enhance recovery options,

(c) Is suffering the same levels of depression,

(d) Has the same state of homeostasis in their brain chemistry,

(e) Understands what depression feels like,

(f) Recognizes the responsibility they have to work through their issues to recover.

These are all roadblocks that must be understood, recognized and navigated when treating depression. If the condition exists in co-occurrence with addiction, the challenges are multiplied.

What is known about side effects with long-term use?

Research has indicated several things that need to be recognized with side effects of anti-depressant medication.

  • Weight gain: Over any period of time, health issues surrounding body weight gain are many. These must be addressed with use of anti-depressants, because new health risks may occur.
  • Some types may cause heart problems such as arrhythmia and palpitations.
  • Drug interactions that can be fatal, especially when combined long-term.
  • Most medications are designed to be used only by those who maintain abstinence from other drugs. Addicts in relapse create additional risks for adverse effects of these medications.
  • Loss of effectiveness. After months or years, the brain becomes less responsive to the medication, a condition known as tolerance. This can cause a return of depressed symptoms, as well as the need for an increased dose or change to another type of medication for treatment.
  • Nausea and other digestive problems seen with use of anti-depressants can become chronic and cause additional digestive conditions when medication is used over years.
  • Recognized sexual difficulties seen with anti-depressant medication can lead to relationship difficulties, and may require the use of other medications; thereby increasing risk of harmful drug interactions. In a long-term sense, these may also create permanent breaches in relationships between sexual partners.
  • Sluggishness and lack of energy caused by medication may create trouble for those with depression, because they are using medication to offset some of these symptoms, which may persist or worsen with use of anti-depressant medication.
  • Sleep pattern disruptions are another source of trouble. Many depressed patients report trouble with sleep on anti-depressant medication. This causes further sluggishness and lack of energy, thus exacerbating the problem.
  • Medications may have some opposite effects, such as agitation, nervousness, twitching and involuntary muscle movement. Long-term use may worsen or create greater frequency of these problems.
  • Headaches have been reported after initial use of anti-depressant medication, and may continue or develop into chronic, episodic events in long-term use of medications.

Specific conditions recognized by long-term use

One of the things seen to be occurring over long-term use of anti-depressants is seen through a group of published papers in Minnesota. They were specifically looking for an answer to the question of whether medications worsen the condition of depression over the course of long-term use. This was a concern first addressed in the late 1960s and early 70s.

A term called “chronification” of depression was coined to address the condition being recognized by an Italian psychiatrist by the name of Giovanni Fava. In a description of how anti-depressants work on the brain, he spoke to the mechanism that was created when the brain developed what he called “oppositional tolerance”.

As the brain seeks stability when being medicated and brain function is altered, it may begin to overcompensate for the medication’s interference, thus creating a worsening of the brain malfunction that creates the condition to begin with.

The human body and brain will always seek to maintain homeostasis. In battling the introduction of medication, the brain may create a counter-balance effect in response. Numerous scientists have explored this theory over the course of the ensuing 40-50 years.

Treating depression that was NOT labeled major depressive illness, or those who had symptoms that were other than a chronic type of depression actually created brain responses to medication-intervention that simulated depression. This is caused by the oppositional forces of medication, even after it is discontinued in those persons who had initial success with the medication. After an initial stabilizing effect, continuing the use of the medication may create what one doctor termed “pro-depressant effect”. This doctor is El-Mallakh, a physician who began his research shortly after reading about “oppositional tolerance”. The effect takes place often in those who relapse and stop use of their medication, those who suffer from anxiety, panic disorder or those with no symptoms who take the medication after being misdiagnosed or who have acted as “controls” during trial drug tests. While they may not have presented with symptoms of acute depression of a major type, they develop these symptoms after use of an anti-depressant medication. Some of these symptoms may last for long periods after discontinuing medication and may not be completely reversible.

How is this important to addicts?

Recognizing serious depressive disorders is challenging for those in early recovery, due to the many factors involved in their brain and body conditions during that time. For that purpose, it is imperative to determine appropriate treatment and to alter the treatment to fit the newfound stability of the patient.

Because symptoms may mimic depression and other mental illness diagnoses, it is important to monitor how medications are affecting these patients. For that reason, most doctors continue to recommend counseling or therapy, along with medication in order to shorten the time of use of medication if possible.

Working closely with mental and physical health providers will ensure that appropriate care is provided for those who suffer from depression. Medications for treatment of depression are most effective when used for short periods of time. They may become ineffective when not needed by the person taking them.

Another danger of long-term use of anti-depressant medications is seen when tolerance is created. Patients are then much more likely to relapse into depressed states. This danger escalates with potency of the prescribed dose, along with the length of use. Also important to note are the side effects when withdrawing from the medication; which also increase incrementally, depending on dosage and length of time the patient has used the drug.

Dr. Peter Breggin, a psychiatrist educated at Harvard, summarizes Dr. El-Mallakh’s body of research in an article whose main focus is finding the balance each patient must come to when considering treatment for depression. His pivotal message is: that when viewing the preponderance of evidence showing the side effects that, for many patients outweigh any benefits; it becomes increasingly important to understand and explore all possible options before prescribing or taking medication of this type.

 

References:

1-CNN.com. Ask the Expert: What are antidepressants’ long-term effects? Retrieved online from: http://www.cnn.com/2010/HEALTH/expert.q.a/03/16/antidepressants.long.term.effects/index.html

2-Web MD.com. How Long Should You Take Antidepressants? Retrieved online from: http://www.webmd.com/depression/features/antidepressants

3-Psychology Today. Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria

New research on why antidepressants may worsen long-term outcomes. Retrieved online from: https://www.psychologytoday.com/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria

4-Harvard Health Publications: Harvard Medical School. What are the real risks of antidepressants? Retrieved online from: http://www.health.harvard.edu/mind-and-mood/what_are_the_real_risks_of_antidepressants

5-Huffington Post: Healthy Living. New Research: Antidepressants Can Cause Long-Term Depression. Retrieved online from: http://www.huffingtonpost.com/dr-peter-breggin/antidepressants-long-term-depression_b_1077185.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.

 

Legislation Aims to Curb Drug Abuse Among Seniors

September 17, 2015 by  
Filed under Laws and Legalization, Politics and Government

Comments

A shot of a senior asian man taking a medicine

Opioid pain medication addiction is now considered an epidemic as the number of those who are addicted quadrupled in the past two decades. The highest age group plagued with this addiction are senior citizens. Sherrod Brown (D-OH) is set to introduce a new bill for bipartisan legislation that aims to tackle prescription drug abuse among seniors. With approximately 170,000 people receiving Medicare benefits impacted by this epidemic, the bill can save an enormous amount of taxpayer funds.

Putting an End to Multiple Prescriptions

Use of multiple doctors and pharmacies is one way that drug seekers can obtain multiple prescriptions and the drugs they need to fuel their addiction. The new bill would limit the use of doctors to one and the use of pharmacies filling their prescriptions to one. This eliminates what addicted patients have access to. The practice of “doctor-shopping” and “pharmacy hopping” would be stopped by this limitation.

Better use of Medicare funds will allow these funds to serve more patients, thus ensuring funding availability for those in future generations.

Better Foothold on Medication Costs

Increases in costs of Medicare-approved drugs have created a huge loss of revenues being filtered into the Medicare system, over a period of many years. The current problem is exponentially increased due to the sheer numbers of those reaching Medicare age in the Baby Boomers generation. These are people born between the years 1946 to 1964; whose ages today are from 51 to 69. This age group is raising costs of Medicare-provided services through the roof, with little or no end in sight.

Controlling costs of medication has become a national concern over the last 10 years, especially as these seniors reach age 65 and the Medicare system is hit with such high numbers of applicants and their medical expenses.

Increasing numbers of seniors with addiction to pain medication creates a severe hit on the funds allocated for Medicare treatment, threatening losses in the billions of dollars to these programs.

Cost-cutting measures have been established across the country as each state has implemented programs to offset the losses. This current proposal is another way to address the issue.

Keeping the Medicare System Alert

Looking for those who are guilty of seeing multiple doctors, who are filling more than one prescription for their addictive medications is a big part of the bill. These measures are similar to those already in place for Medicaid and private insurance programs nationwide.

Anyone with a propensity toward abusing prescription pain medications would be singled out of the plan for inclusion into a drug-diversion type of treatment program. They would be allowed to determine a preferred provider for prescribing their required medications and filling prescriptions. Limitations would be placed on how much and how often these could be refilled. Controls and monitors would be exercised in this person’s use of medications.

All members of the team of doctors and providers within the Medicare system would be encouraged to remain watchful of patients in the system to determine possible problems with drug-seeking behaviors and possible dependency issues around the medications seen as problematic. They would also implement necessary interventions and recommendations for treatment of drug dependencies where needed.

Stopping Medication Abuse and Protecting Seniors Act

  • Preference for their provider and pharmacy use would be granted, unless that provider or pharmacy has been determined to contribute to abuse in the past.
  • The beneficiary will be notified when they have a change in status of benefits and a clinical review provided to determine which members require high doses of pain medication, keeping them out of the program as needed.
  • Determining clinical criteria for who is eligible and at-risk of abusing opioid pain medication.
  • Those who receive hospice care or long-term care in nursing homes will be determined eligible for exemption from this ruling.
  • Create guidelines for data sharing between providers, plans and contractors to decrease opportunities for abuse of the plan, as well as fraud and waste problems.
  • Address any areas of concern for prescription drug abuse aside from opioid pain medications.
  • Create procedural criteria for any member’s inclusion in the program and their appeal rights.

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 and recommends essay help online with professional writers wich have years of experience in this field and they can help you with any written work!. She also leads workshops and seminars on treatment of addictive disorders and stress reduction.

Feds Push States To Provide Medical Treatment for Heroin Addicts

September 10, 2015 by  
Filed under Treatment and Recovery News

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shutterstock_79301824Many treatment programs nationwide support abstinence for all forms of addiction treatment, but increasingly, the use of drugs such as Suboxone and Methadone is seen as more effective than the traditional model. So much so that recent block grants handed down from the federal government now included allotment for drug-enhanced treatment for heroin addiction

What is the Difference?

The new funds being provided through Substance Abuse and Mental Health Administration (SAMHSA) will provide funds for programs in those states which provide medication-assisted treatment protocols. While not required to do so, the push is on for the option to be made available in all facilities funded through the grants.

Medically Assisted Treatment (MAT) is a type of treatment that has created controversy for many years. It is based on the fact these drugs can be more highly addictive than heroin itself. Treatment is optimal when these drugs are used short-term and then decreased gradually to give addicts a bridge from addiction to becoming drug-free.

The Food and Drug Administration cites increasing reports of positive treatment outcomes in research performed using MAT. For many years, heroin addiction has seen low incidence of long-term abstinence using any previous models for treatment.

It is hoped that providing the option for MAT will increase recovery rates, along with inciting addicts to receive treatment in increasing numbers. Many treatment programs across the nation already provide MAT. Some of the funds are earmarked for those programs without the resources (usually medical staff) to accommodate the protocols; and give them additional help in upgrading this status.

Why is this happening now?

The recent increase in heroin use and addiction has created a treatment environment focused on providing optimal outcomes for heroin addicts seeking recovery from their addiction.

Along with the news from SAMHSA, drug spokesman, Michael Botticelli, announced that the federal government would fund only those drug courts in states with MAT-supported treatment protocols.

How do block grants work?

Federal block grants such as this are awarded to states, who then distribute the funds to Counties that request the funding through a grant application process. These counties then administer the funds within County facilities and also by disbursing them to agencies within their boundaries who compete for funds for operation. Most of these agencies operate on a non-profit basis, which allows them to qualify for federal grants.

Few of these agencies operate at a funding level that allows for medical staff. SAMHSA spokesperson, Anne Herron, who is the director of Division of Regional and National Policy, stated that most of the states had a positive response to the grant language. She did confirm, however, that each state has autonomy when deciding how funds were distributed.

As this indicates, the trend is moving toward MAT types of treatment, which may influence more of the funding received in the future.

Sources:

Huffington Post: Feds Now Pushing States Toward Medical Treatment For Heroin Addicts: Some federal grants will even require rehab centers to offer it. Retrieved online from: http://www.huffingtonpost.com/entry/heroin-addiction-treatment_55cd1855e4b055a6daafe67f

 

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.

The Dangers of Marijuana-Impaired Driving

September 2, 2015 by  
Filed under Laws and Legalization, People and Culture

Comments

iStock_000023889836_MediumA recent study regarding the effects of marijuana on driving performance showed dangerously impaired motor coordination. Those with a blood content of 13.1 micrograms/L of THC, which is close to the 0.08 legal limit for blood-alcohol content in many states, showed patterns of weaving outside their designated lanes in traffic. Tests were conducted in driving simulators to gain specific details of impaired driving ranges for those under the influence of marijuana, both alone and with combined influence of alcohol and marijuana.

Of particular interest were those tests which showed impaired results for both marijuana and alcohol, combined. The results were impactful because neither substance was at the designated range for impairment; even though tests concluded that impairment was recognized.

In essence, this means that lower doses of marijuana, when combined with lower doses of alcohol, have a cumulative effect that impairs the driving capabilities of the user, even though neither substance indicates in a range that is prohibited by law.

A dangerous level of alcohol and marijuana may not be considered problematic, when tested separately. Also found in the study were significant differences in content of THC, the psychoactive ingredient in marijuana, when tested using different methodology.

Blood tests for THC may not indicate the accurate level in a person’s body, due to the 2-4 hour time frame it takes to gather the specimen in most cases. A breath test, which can be gathered immediately at the scene may be more beneficial, time-wise, but is less accurate a measure of actual THC content in the driver’s blood. These variations in testing capability cause concern for police in determining impairment in drivers due to marijuana use.

Another confounding implication is seen with those who are aware of how to control their peak blood levels by “titration”, which is a method for controlling inhalation while smoking marijuana. This method can alter the readings on breath tests for marijuana consumption by a driver. A range of 2.9% to 6.7% is seen in variations in drivers using this method. Alcohol consumption radically changed these peaks to a measure indicating severe impairment.

Drugged driving is a serious problem. While alcohol continues to be the deadliest cause of fatal driving accidents nationwide, drugged driving is growing in incidence.

The true measures for drugged driving accidents is skewed for many reasons:

  • Alcohol consumption is most easily recognized, usually causing suspicion by the smell of alcohol on the driver’s breath.
  • Alcohol screening is done most easily and frequently by police and other emergency service providers.
  • If a driver tests within a high range for alcohol consumption, no further testing is performed, thereby not including the statistic for drugged driving.
  • Testing for drugs involves breath, blood and urine sampling to cover all forms of possible drugged driving.

A nationwide study, done in 2010 on fatal crashes, determined that 36.9% of drivers had smoked marijuana. Given this high statistic, it is reasonable to state that impairment from marijuana use can be considered deadly.

 

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.

New Synthetic Drug ‘Flakka’ Triggers Crazed Behaviors

August 25, 2015 by  
Filed under Health, Treatment and Recovery News

Comments

Young man smokingFlorida seems to be the point of entry for “flakka,” a new drug reportedly coming primarily from China, India and Pakistan. The substance’s frightening effects has been seen to put a number of Florida residents in the headlines, emergency rooms and in the hands of local police.

In April 2015, flakka exploded in the media after causing erratic and delusional behavior. According to Florida police, it has similar effect as another recreational designer drug termed “bath salts.”

What is Flakka?

Flakkasometimes referred to as “gravel” due to its small crystal pebbles and foul odoris produced from cathinones, a naturally occurring amphetamine-like stimulant found in the khat plant. Much like the coca plant in South America, some cultures are known to chew on khat leaves to achieve euphoria.

The active ingredient found in flakka is alpha-PVP, which is a substance banned by the U.S. Drug Enforcement Agency (DEA) in 2014, although it continues to be found in vast amounts throughout parts of the U.S. Last year in Broward County, Florida, there were 200 cases filed against laboratories reportedly using alpha-PVP. Within the first three months of 2015, Florida officials reported having discovered more than 300 cases within state.

How does it affect the body?

Flakka affects the user’s central nervous system by stopping the re-uptake of the chemical compounds dopamine and norepinephrine. These two chemicals in the brain, known as the “pleasure chemicals,” then flood the brain causing a concentrated pleasure effect. This is similar to the brain’s reaction with other amphetamine drugs.

What are symptoms of flakka?

As the user increases the dose, which can be easily done as the amount of flakka needed to get high is both small and inexpensive, they begin to experience heart palpitations, shortness of breath, rapid heartbeat, increased excitability and a very intense sense of pleasurable euphoria. This is quickly lost, however, as their brain begins to produce hallucinations and delusions due to higher concentrations of dopamine and norepinephrine.

Most users experience a spike in body heat up to 106 degrees farenheit, explaining the tendency for them to take off clothing and run around naked, as seen with many recently reported incidents in Florida.

The user becomes very agitated and violent as their adrenaline soars, along with surges of super-human strength. Police report that some users require up to four officers to subdue and restrain them. Intense paranoia and hallucinations added to their intense violent reaction to the drug make these users frightening to deal with.

What are the dangers of flakka?

The most serious risk around use of flakka is that it takes only a tenth of a gram to have strong effect on the brain chemistry of the user. This amount currently costs only $4 to $5 on the streets. Due to this low cost and the small dose required, users will experiment with higher doses and begin to experience dangerous side effects.

As the dose increases, so does its effect on the user’s brain chemistry. This leads to a state known as “excited delirium.” Users become extremely agitated, highly excitable and delirious. This effect becomes longer lasting, the higher the dose.

High body temperatures, when sustained for any period of time, create the breakdown of internal muscle tissue, which are then released into the bloodstream, leading to kidney failure. Heart attack is also a common side effect of sustained, increased heart rate from use of flakka.

Some users also experience extended periods of psychosis, as a result of the drug. As with similar drugs, it is possible for permanent psychosis to occur, along with psychotic episodes that may be a long-term problem for users.

There is also no “build up” of effects with flakka. The user does not develop tolerance or the need to up their doses overtime to get the same high,nor does a user develop tolerance to higher doses. This makes it possible to reach an overdose at any point, from the first or 100th use.

Another dangerous factor with using flakka is the user’s ability to mask their drug use with vaping, or inhaling vapor through an e-cigarette or similar device. Virtually unknown to others, flakka is easy to mask in this fashion, making it easy to use in public. Flakka, however, can also be smoked, inhaled, snorted, injected or swallowed.

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.

Eight Drug Smugglers Killed By Firing Squad in Indonesia

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iStock_000015916460_LargeSimilar to the six people executed in January 2015, Indonesia has slayed eight more people via firing squad.

The April 29 execution of two members of Bali Nine, a group of heroin smugglers arrested in 2005, has led an Australian foreign diplomat in protest of the executions. Other Bali Nine members are currently being held in prison, but none are serving a death sentence.

After serving almost a decade in prison, Andrew Chan and Myuran Sukumaran, who are Australian nationals alleged to be ringleaders of Bali Nine, were executed after being given a 72-hour notice. Australian authorities sought clemency for the two men, claiming they had been fully rehabilitated during their time in prison.

Further allegations towards Indonesia include the sentencing the two men to less than 20 years in prison atop a payment of $100,000. However, court official in Jakarta has denied the allegations stating that they were made too long after the trial to be considered.

One of the drug offenders executed by firing squad was a Brazilian man said to be suffering from paranoid schizophrenia. Documents were introduced during his trial that offer diagnostic evidence from more than 20 years ago, showing he has suffered from a history of bipolar disorder and schizophrenia. His execution violated the international humane treatment laws that prohibit those with mental illnesses from execution for their crimes. His prosecution and execution are also in violation of Indonesian laws governing the sentencing of the mentally ill. He was arrested in 2004 for attempting to smuggle cocaine into Jakarta in surfboards.

One member of the group slated to be executed for drug smuggling is a woman, Mary Jane Fiesta Veloso, from the Phillipines. She was given last-minute stay of execution when another Filipino woman came forward to testify that Veloso had been tricked into smuggling drugs she did not know were in her possession. It is reported that the woman was her employer and planted the drugs on Veloso, whose suitcase held heroin. Veloso is expected to testify in a new trial against the woman, who is being held in the Philippines on charges of human trafficking.

Four Nigerian men were also executed, namely: Martin Anderson, 50, who was arrested in Jakarta in 2003 with heroin; Jamiu Owolabi Abashin, 50, who had been arrested in 1998 for smuggling heroin and originally sentenced to life in prison, but was accelerated to death after prosecutors appealed his sentence; Sylvester Obiekwe  Nwolise, 49, who was arrested in 2003 when he landed in Jakarta Airport from Pakistan possessing heroin; and Okwudili Oyatanze, 45, who was arrested in 2001 in Jakarta Airport with heroin he smuggled from Pakistan.

The last man to be executed was Zainal Abidin bin Mahmud Badarudin, 50, from Indonesia. He was arrested at his home in 2000 with marijuana.

The executions are the response of President Joko Widodo to what he claims is a “national emergency” and to push forth his efforts to stop drug abuse and trafficking. He has rejected all appeals for clemency from international heads of state and declared that he is exercising Indonesia’s “sovereign right to exercise our laws.”

Allegations against Indonesia is that those being tried and convicted in the country for drug crimes are not given fair opportunity for interpreters and appropriate legal representation. There are currently at least 64 other drug convicts on death row at this time. All reported appeals for clemency on their behalf are being rejected.

“For those countries that exercise the death penalty, they have to make sure that the best mechanisms of the judicial system should be open to and exercised by the convicted person,” Haris Azhar, coordinator of the Indonesian human rights group called the Commission for Missing Persons and Victims of Violence, told New York Times in April. “This is not the case in Indonesia.”

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.

New Drug to Erase Drug-Associated Memories

August 13, 2015 by  
Filed under Health

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Impulse Control DisorderThe new drug Blebbistatin may be the next breakthrough in treating methamphetamine addiction. Clinical tests on animals show that a single injection of the drug has promising results in erasing the brain’s memories of drug use and response.

Why do we need Blebbistatin?

Treating the phenomenon known as “euphoric recall” in the mind of the addict is a problem grappled with by treatment professionals for decades. Once thought to be present only in the brains of cocaine addicts, this is the response (trigger) seen when the addicts think of using the drug or when a reminder of the drug is present to them. The overpowering memories triggered by these stimuli compel addicts to crave drugs again.

Some addicts can be triggered into relapse with the smell of something that reminds them of using. Much like the memory associations of Post-Traumatic Stress Disorder, an addict’s brain has made associations with smells like those from the sulphur on a match being lit, a part of the ritual of drug use that is quite small, but powerful in bringing up drug memories. Associated with the smell is the sensation (memory) of smoking the drug or heating it for injection.

Other associations are as simple as the sight of the drug, even a fleeting image on TV or in a movie; the sound of something related to the addict’s drug use, and many others that are stored deep in their memories. These associations often “hijack” the brain, meaning that they override other memories to stay prominent in the addict’s mind, long after they stop using the drug.

Associations with pleasurable sensations and experiences from their drug use make treating these addictions doubly difficult. The brain responses in addiction are permanent markers that can create relapse conditions for many years.

The only treatment thus far to address these specific areas is Cognitive-Behavioral Therapy and others similarly focused on changing the thinking patterns for the addict. The downside of this is the need for long-term treatment, which is seldom available to recovering addicts. Because the memories are persistent and deeply ingrained in the brain of the addict, most will not receive the intense treatment needed to permanently alter the mindset of drug use.

What does it do?

Blebbistatin is remarkable in its ability to target the actin in the brain, storing addiction memories and the dendrites that form these specific memories, without impacting actin in the rest of the body.

Earlier research showed that targeting actin, the protein in the brain that stores memory and its supportive structure, was crucial for destroying drug-related memories. Unfortunately, actin serves throughout the body, and nothing served to specifically target only those memories which were drug-related. In these current trials, Blebbistatin has shown itself to be effective in doing just that, without any side effects to other memory structure, after only a single injection.

Another challenge previously solved was that of having to inject the drug into the brain. Blebbistatin is being shown to be effective through an action of the nonmuscle myosin II, destroying memories related to drug use, along with the dendrite spines supporting that structure; even when injected into peripheral body parts, with test animals remaining free from other health risks. The animals show ability to create new memories, along with retaining memories stored prior to the treatments.

How will it affect treatment?

Along with other treatment protocols, the use of Blebbistatin may reduce craving and euphoric recall to ease the recovering addict more comfortably and effectively into long-term, relapse-free abstinence.

These memories have caused countless addicts to relapse, many of them years after beginning recovery. Erasing the pleasurable memories stored in the brain is a giant step toward effective treatment that may allow them to focus more on recovery than their cognitions about their substance abuse.

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.

New Technology Tests Breath for Illegal Drugs

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iStock_000001996195_LargeFor many years, testing urine samples have been the primary method of checking for the presence of drugs and alcohol. However, this can be an invasive and challenging process, depending on circumstances. Urine samples can present problems such as the following:

  • Samples are easy to manipulate, those being tested can purchase drug and alcohol-free urine.
  • Samples may be easily tainted with other substances, such as water and/or other easy to obtain items,
  • The sample must be procured by witnessing the person creating the sample, often considered an invasion of privacy.
  • Results can be complicated by the presence of other medications and is not always accurate.
  • Samples are messy and may be mishandled easily.

The search for more accurate forms of testing has been ongoing. Blood tests are one option, but are lengthy to perform and require medical staff to obtain, as well as process. Expensive lab fees and long waiting periods for results are other reasons this method is less popular.

What is the new approach?

New technology being developed eliminates many of these factors. Analyzing the breath of the person being tested happens with a process called liquid chromatography-mass spectrometry. This is a highly sensitive method for detection of drugs in the system of the person being tested.

Basically, this technology captures small aerosol particles being exhaled and tests them for the presence of drugs. The device collects these particles and filters them for presence of drugs, such as amphetamines, methamphetamines, marijuana and cocaine.

How will it be applied?

Those most often impacted by the waiting period for testing of urine or blood are law enforcement officers and personnel. Others who will find this form of testing valuable and viable are employers who perform random testing, emergency room personnel who must act quickly in medical situations, treatment professionals who perform regular testing of participants, school officials who suspect drug use on campus, sporting officials who must perform random testing on athletes in competitions, and all those who need to save money on testing procedures as well as obtaining access to fast results of the testing.

What is the importance of testing?

Recent studies have shown that approximately 75 percent of those aged 18 and higher who use drugs, even only occasionally, are employed. They often use drugs while on the job and in the workplace, therefore making them a high risk group for workplace accidents and loss of productivity.

Using the percentage above, this translates to about 42,000 people per year who are coming to work high or getting high while in the workplace. This can lead to liability for the employer in many arenas. Is it any wonder that more employers are beginning to see the benefit of drug testing for their employees? It is estimated that approximately three quarters of the Fortune 500 companies now regularly perform drug tests.

Retraining costs and loss of productivity from employees who begin to lose work and eventually either quit or are laid off has created the trend toward pre-employment drug screens. It is estimated that 71% of employers now utilize this practice. Waiting times for blood and urine samples, along with high costs of lab and medical fees for this practice make the new technology very appealing for small to medium sized companies who currently do this type of testing.

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.

Hypertension Medication Finds New Use in Treating Opioid Addiction

July 30, 2015 by  
Filed under Health, Treatment and Recovery News

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New medicineThose in the early stages of opiate addiction treatment or anyone experiencing opioid withdrawal symptoms typically receive Buprenorphine.

Trade names for Buprenorphine are Cizdol, Suboxone, Subutex and Bunavail. Suboxone, which contains Naloxone, reportedly provides a safer alternative to Methadone treatment, which has been used for many years in treating heroin and various other opiate addictions. Methadone is known as a likely cause of respiratory depression among users when abused or mixed with other opiate drugs.

The combined effect of Suboxone with naloxone was designed to reduce pleasurable effects of crushing the pills for injection, although the creators of the drug report painful withdrawals when these drugs are injected.

A recent development in opioid recovery, however, has found a new blend of medications to also be effective in helping recovering opioid addicts stave off cravings.

What is Clonidine?

Researchers found that Buprenorphine, when combined with the drug Clonidine, shows positive and promising results in reducing cravings, even when symptoms of withdrawal were gone.

Clonidine is a medication frequently administered to regulate high blood pressure and treat attention deficit hyperactivity disorder (ADHD). It is a medication used to reduce hypertension as it relaxes the blood vessels, allowing blood to flow more freely. Other uses for the drug include reduction of menopausal symptoms and as an aid to smoking cessation.

Trials were conducted on 208 individuals undergoing outpatient treatment for opioid addiction, which used randomized double-blind techniques for control of a placebo versus the Clonidine recipients. Results showed a marked difference in the time that was seen in those who relapsed back to drug use.

Why is this Important?

Reduction of stress is an important factor in the treatment of addiction to pain medications and other opioid drugs, such as heroin. When stress is reduced, the craving for use of drugs is reduced as well.

Many years of research have been conducted to quell the high rate of recidivism and relapse with heroin and opium abuse and addiction. Today, the highest incidence of drug abuse is seen with pain medications. The high cost of pain medications typically lead those who are addicted to find relief through heroin, which has shown high rates of use and abuse due to its widespread production, availability and low cost.

Treatment protocols for reduction in use and abuse of opioid medications are a priority in the fight against addiction. The use of Clonidine provides another step in the battle faced with abuse and addiction to opioid drugs.

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.

 

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