A Elements Behavioral Health Guide to Drug Rehab
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When it comes to teen alcohol and drug use, it seems like there’s always a new method that young people are finding to get high – chugging cough medicine, sniffing glue, snorting bath salts or mixing old medications found in the family medicine cabinet. While it’s normal to be curious, one poor decision can change a person’s life forever.

That’s why authorities and health officials are concerned about a dangerous new trend: smoking alcohol. Because the lungs have such a large surface area, alcohol is absorbed at a much quicker rate when it is inhaled using vaporizers, i.e.: dry ice and bicycle pumps connected to old plastic bottles.

Breathalyzer Comparison

Dangers of Inhaling Alcohol?

According to Dwayne Baird, spokesperson for the Utah Department of Public Safety, one reason individuals may choose to inhale alcohol is because they believe it won’t show up on a breathalyzer. But Baird says that anyone who understands how the test works knows that a breathalyzer assesses the blood alcohol content and inhaling alcohol actually leads to a higher concentration.

Another reason that people choose to smoke alcohol instead of drink it is that inhaling directly into the lungs delivers a quicker, more intense high. Under normal circumstances, alcohol would be consumed then pass through the body’s stomach and liver where it takes time to metabolize. Dr. Barbara Crouch, Executive Director for Utah Poison Control, equates the practice to binge drinking – when too much alcohol is consumed too quickly, the body has a difficult time successfully processing all of it.

Baird says that the Department of Public Safety still runs across more cases of normal alcohol consumption than it does inhalation methods, but with information able to spread rapidly through social media sites, its popularity with teens could spike quickly.

Scary Results

The body has normal ways of signaling that it has had too much alcohol. When someone drinks to excess, the body responds by causing a person to vomit. That doesn’t happen when alcohol is inhaled. Instead, it passes straight through the lungs into the bloodstream and up to the brain. The problem with that, says Baird, is that it’s difficult for a person to tell when they’ve reached their limit.

Young people in particular tend to regard themselves as invincible and often don’t consider the consequences of their actions or how such consequences might impact their future. But inadvertent alcohol poisoning is a real and even bigger threat when inhaling than drinking alcohol.

Teens being treated for substance addiction may soon have a new tool to combat their drug problem. A new study finds that outcomes are improved for cocaine addiction treatment when the drug Topamax is included as part of the strategy for recovery.

Treating cocaine addiction can be challenging. Teens that begin using cocaine can become addicted quickly, and when treatment is sought and completed, relapse can be common. Teens often enter into a cycle of recovery and relapse with cocaine addiction.

Addiction to Alcohol

It is common for teens addicted to cocaine to also be addicted to alcohol. Abuse and addiction of both substances can make treatment complicated. For some, the traditional route of cognitive behavioral therapy is not an effective strategy for recovery to be a permanent state.

Topamax, a drug often prescribed for the purposes of treating epilepsy and, in more recent cases, weight loss, has been shown to help those attempting recovery from cocaine and alcohol addiction.

The Study

Drug May Help Teens Overcome Cocaine Addiction

The research team from the University of Pennsylvania School of Medicine used a double-blind, placebo-controlled design to test the effectiveness of topiramate in treating addiction, particularly in cases where cocaine addiction is complicated with a dependence on alcohol.

Previous studies have proven the effectiveness of topiramate in treating alcohol addiction. Other studies have shown that it can help prevent relapse in those who have received treatment for cocaine addiction. However, this is the first study to explore its application in treatment for a combined addiction to cocaine and alcohol.

The study’s results are critical because those who struggle with cocaine addiction commonly also struggle with alcohol dependence. Targeting the addictions as a unit may be an effective strategy to make recovery more successful.

The study was conducted over a 13-week period that included 170 individuals who met criteria for alcohol and cocaine addiction. The trial produced mixed results.

The Results

The researchers discovered that the drug was effective at reducing the cravings for alcohol, but actual drinking did not decrease. It was not found to impact cocaine cravings.

However, the study participants that were taking topiramate were more likely to remain in treatment and avoid cocaine use during the last three weeks of the trial when compared to participants who were taking a placebo.

The researchers also found that participants taking topiramate were more likely to benefit from the drug if they reported more severe withdrawal symptoms. Those who indicated a high level of restless behavior, agitation and depressed mood were more likely to report benefiting from topiramate.

Counseling and the Drug

First author of the paper, Kyle M. Kampman, M.D., professor of psychiatry and medical director at the Charles O’Brien Center for Addiction Treatment, explains that while counseling is the first choice for addiction, there are some patients who are not responsive to this strategy.

The results of the study indicate that for those who have a particularly treatment-resistant addiction, the addition of a topiramate treatment in addition to cognitive behavioral therapy may result in better outcomes.

The study’s findings add to a growing body of research that supports the use of topiramate to aid in treating addiction. A previous study conducted in 2005 provided evidence that addicts treated with the drug were able to abstain from cocaine use for three weeks or longer.

The researchers note that the failure of topiramate to reduce alcohol use was puzzling, but may be explained by the severity level of that particular group of participants. The effects may be more visible when an individual has a habit of drinking heavily.

The Test Subjects

The study’s findings were the result of a trial conducted among a group of addicts who had an average age of 45 years and which was largely composed of African-American males. The groups of men examined using the drug of treatment and a placebo were similar in terms of sociodemographic variables or drug and alcohol use.

The findings of the study were published in a recent issue of the journal Drug and Alcohol Dependence.

Drug addiction can affect a wide array of people, but it’s mostly the celebrities who are struggling with substance abuse that we hear about, such as Amy Winehouse and Corey Haim. What are the reasons for all this drug abuse in Hollywood?

First you begin with the basic understanding that addiction is a serious issue, one that doesn’t discriminate and can affect anyone. Toss in celebrity-status, wealth, along with high expectations, and you see how drug abuse can take hold: the euphoric high provides temporary relief; a connection is made in one’s mind; and that connection becomes a crutch whenever moments of extreme stress or depression come up.

Inner Drive to Get Well

Celebrity Substance Abuse May Have Impact on Teens

Celebrities and drug addiction go hand in hand so often that the stigma appears to be fading, and since there seemingly aren’t penalties for using drugs in their professional lives there’s less motivation to get treatment. For all addicts, an intense passion and drive to get well is needed to build back the sober life they were once living.

This is all a backdrop for a teenager today struggling with substance abuse. Celebrities are constantly in the spotlight, their images and details of their lives flashed everywhere, saturating a teen’s mind, with the lifestyles of these celebrities having a huge impact. If a teen going down the path of addiction idolizes someone who is out partying with nothing to lose, they might not think about the consequences that can come from a life of drug addiction.

Teen’s Similarities to Celebrities

It’s not often that the other side of the story is reported to teens. Celebrities are people too and might have some of the very same insecurities, desires and needs as their teenage fans. Everyone has a lot to lose if they go down the road of substance abuse, and it’s a hard path to come back from.

Along the lines of Dr. Drew Pinsky’s writings, celebrities appear to be genetically wired to be vulnerable to addiction because of their drive to be successful entertainers. Perhaps this is why they seek the high that comes with being in the spotlight, and then seek the artificial high that comes from drugs. It’s important to be aware of what your teen is experiencing and perhaps discover the root of their desire to get involved in these various, dangerous activities.

Cocaine addiction is one of the toughest illnesses to treat.  Although scientists do not yet understand the entire mechanism of addiction, it is believed that the brain’s pleasure center plays a major role in the disease. Pleasure center cells appear in the prefrontal cortex and have long been thought to be responsible for impulse control. In fact, it is believed that a low level of activity in the prefrontal cortex is one characteristic of an addict.

The method used to treat cocaine addiction has traditionally been a combination of abstinence and psychotherapy or behavioral therapy. Given how strong cocaine addiction can be, however, many people do not stay in recovery permanently. In fact, it can take several cycles of drug rehab to finally be free of the relentless cravings. By this point, many cocaine addicts have suffered from the consequences of prolonged addiction such as organ damage, social issues, family problems, financial disaster and job loss.

Prefrontal Cortex Activity and Cocaine Addiction

Can Magnets Fight Cocaine AddictionThere is new hope for people suffering from cocaine addiction and it comes in the form of a potential cure, not just remission. Researchers at the National Institutes of Health (NIH) and the University of California at San Francisco have been able to eradicate cocaine addiction in rats by focusing beams of laser light into their brain matter.

The scientists used genetic engineering to place rhodopsins (proteins that react to light) directly into the rats’ brain cells at the prefrontal cortex. When light is introduced, those particular cells will fire. The rats were then administered enough cocaine to develop a bona fide addiction, the hallmark of which is engaging in behavior that will result in the administration of more cocaine.

Using fiber optic cabling implanted in the tiny brains, the researchers were able to direct laser beams onto the brain cells that contained the rhodopsins. Once these prefrontal cortex neurons were activated, the subject immediately stopped all cocaine-seeking behavior. When the light was extinguished, the rats resumed behavior associated with addiction.

Although this is great news for those engaged in addiction research, the practical implications are less clear. At issue is the ability to activate prefrontal cortex neurons in human beings on a continuous basis without affecting activities of daily life. Although it is certainly possible to carry out surgical experiments similar to those undertaken by the NIH, invasive brain surgery is not something we would consider as a long-term treatment method.

Transcranial Magnetic Stimulation for Cocaine Addiction

Thankfully, scientists are already researching ways to activate prefrontal cortex neurons in cocaine addicts’ brains without using a scalpel. Transcranial magnetic stimulation (TMS) involves using a magnetic field on top of the scalp to influence behavior of the cells below the skull. This non-invasive and completely pain free process uses a coil to focus the magnetic field onto particular areas and patients experience nothing more serious than the feeling of being tapped on the head. In order to activate the cells, a high-frequency pulse is used.

The NIH plans to begin human trials of the treatment soon and hopes to show that TMS can activate prefrontal cortex neurons as effectively as the laser-light method. It remains unclear whether the relief achieved will be only temporary and, thus, require indefinite treatments. In any event, TMS may provide craving relief long enough to allow more traditional methods of cocaine addiction treatment to take hold.

Britain’s Daily Mail recently ran an article from the mother of a 12-year-old who told how her daughter’s friends are experimenting with marijuana and being expelled from school.  Once confined to older teens and young adults, smoking marijuana is now more common among teens and pre-teens.
Pre and young teens thinking that smoking weed is no big deal
From states in the U.S. deciding to legalize marijuana to movie stars and rock stars being photographed using it, the message sounding loud and clear to youngsters is that smoking marijuana has no repercussions.  The Daily Mail article recounted the stories of several pre-teens who had been either expelled from their private schools or who were using the drug off-campus to avoid expulsion.  The obvious point was that young children were getting their hands on marijuana and seemed to have no worries about the consequences.

The British newspaper article did not hesitate to point fingers at singers like Lil Wayne and the late Amy Winehouse among others – stars who make no bones about using marijuana.  Public icons, especially music icons, are influential for young teens and pre-teens.  Their cavalier attitude and, in some cases, promotion of marijuana use, has more impact than many parents might like.

At Risk

The article also reported on studies in the Commonwealth that have found that when a teen uses marijuana s/he becomes more at risk than alcoholics for developing mental illness.  Teens who use pot also tend to have more problems with relationships and have a tougher time finding steady employment.  These facts are lost on the pre-teen and early teenager who only knows that they want to be like the superstars they see on TV and splashed across online tabloids.

In Great Britain, one out of every eight arrests for dealing marijuana involves a child.  Kids are smoking it.  Kids are selling it.  Kids don’t think marijuana is anything to stay away from.  The facts, of course, are far different but evidently we aren’t getting the message through.  There is too much confusion between what is being portrayed and what is being said.

The truth is that early marijuana use can increase the likelihood of later addictions.  Teens who use marijuana run a greater risk of depression.  One out of every 10 marijuana users will experience severe effects such as anxiety, paranoia and hallucinations.  No one can say who will be in the 10 percent.

One of the researchers in Australia who investigated the outcomes for teens who decide to smoke marijuana said use of cannabis can negatively affect teens for years.

You would be forgiven for thinking that the prescription drug epidemic affects only the users themselves. Abusing medicines such as Vicodin and OxyContin—opiate drugs with chemical similarities to heroin—puts the users at significant risk, killing more Americans than heroin and cocaine combined in 2008; but using when you’re pregnant presents a whole new class of risks. Babies of opiate-using mothers can be born in withdrawal, their systems shocked by the abrupt withdrawal of substances, and research has revealed that this is happening more and more frequently in the United States. In fact, three times as many babies were born with neonatal abstinence syndrome (NAS) in 2009 than in 2000, reflecting the rapid rise in the prescription drug problem.

The Study

Lead researcher Dr. Stephen Patrick had noticed an increase in the number of babies with NAS at CS Mott Children’s Hospital at the University of Michigan, and set out to determine whether the numbers were also increasing across the country. The researchers looked at discharge records from 2000, 2003, 2006 and 2009 from a database of patients that covers 44 states and over 4,100 hospitals. When the researchers determined which of the births were associated with opiate use, they revealed some shocking statistics about the extent of the problem.

Number of Babies Born Addicted to Opiates Has Tripled

They found that the number of pregnant women abusing opiate medicines when the baby was being delivered was five times higher in 2009 than in 2000. In addition, the researchers found that the rates of illicit drug use during pregnancy were 16.2 percent of teens and 7.4 percent of adults. Generally speaking—and somewhat obviously—any drug use during pregnancy poses some risk to the infant since they’re getting small doses of anything the mother takes.

As you might expect with the increase in numbers of opiate-using mothers, the number of babies born with NAS has also increased significantly. The rate almost tripled over the experimental period, from 1.20 per 1,000 births up to 3.39 in 2009. This has a disturbing parallel with the numbers of overdose deaths from prescription painkillers since the 1990s, which has also increased three-fold. The problem can’t exist in a vacuum—related issues, like babies born with NAS, are bound to increase as well.

What Is NAS?

NAS is a condition that occurs when the baby becomes addicted to drugs along with the mother when it’s in the womb. It isn’t just opiate drugs that can lead to it: marijuana, benzodiazepines, cocaine, amphetamines and the use other substances can also result in NAS. The symptoms include excessive or high-pitched crying, fever, irritability, tremors, sweating, sleep problems and sneezing or a stuffy nose.

The researchers also found that the babies born with NAS were over three times more likely to have respiratory problems and over twice as likely to have a low birth weight. Interestingly, they were also notably more likely to be covered by Medicaid, meaning that the issues were more common in low-income families.

Better Treatment or Prevention?

The researchers also looked at the average length of stay for the newborns with NAS, which they noted hasn’t decreased over the last decade. From their perspective, this represents an area in need of improvement for physicians. Since state Medicaid programs bear much of the brunt of the problem, there is a lot of motivation to improve care for opiate-addicted pregnant women. The researchers argue that since there are no standardized clinical guidelines for treatment of NAS, it is possible to improve care for the babies themselves, possibly using a combination of an opiate and another medicine such as clonidine, but breastfeeding can also help.

The other suggestion is to enroll opiate-addicted mothers in methadone programs or provide them with drugs such as buprenorphine, which is often used in cases of opiate addiction. If these interventions were successful, the numbers of babies born with NAS would decrease, rather than just the amount of time they have to spend in treatment as a result of it.

Clearly, prevention of NAS is a considerably better solution than merely determining a better way to treat babies suffering from it, but the problem impacts much more than pregnant women. The rates of prescription painkiller abuse across the U.S. are on the rise, so this research serves as yet another reason to address that problem.

Impulsive behavior, known more formally as impulsivity, is behavior that occurs spontaneously or with only minimal forethought or preparation. For a number of reasons, teenagers generally act impulsively more frequently than adults. Impulsivity in teens with attention-deficit hyperactivity disorder (ADHD) has been linked to increased risks for involvement in alcohol, drug and cigarette use. However, according to the results of a study published in 2012 in the journal Nature Neuroscience, the roots of the impulsive behavior found in teens with ADHD differ significantly from the roots of the impulsive behavior associated with teen substance use.

Teen Impulsivity Basics

The human brain relies on a specific region, called the frontal cortex, to perform and regulate such higher-level tasks as making judgments or decisions, gaining perspective on self-motivation and controlling fleeting or momentary urges. However, during adolescence,Teen ADHD, Impulsive Behavior and Substance Abuse the frontal cortex is not completely formed. This lack of brain development goes a long way toward explaining why teenagers tend to act impulsively, even when they receive information from adults that’s designed to offset impulsivity. The authors of another study, published in 2009 in the American Psychological Association’s American Psychologist, concluded that teens age 16 and older actually have enough brain development to reason in a manner similar to adults. However, teens in this age group still generally lack the emotional maturity to adequately or consistently control their impulsive behaviors.

Impulsivity and ADHD

Along with hyperactivity, impulsivity forms one of the two basic symptoms of ADHD. Impulsive urges in a teenager (or younger child or adult) affected by the disorder may manifest as a generally high level of impatience, a tendency to frequently interrupt others, an inability to wait patiently in different situations, a general lack of emotional restraint, a tendency to disregard unpleasant outcomes of one’s actions, or an inability to tailor one’s words appropriately for a given social situation. Some teens with ADHD have prominent symptoms of impulsivity and hyperactivity, while others have little or no problems with hyperactivity/impulsivity and instead have significant problems maintaining focus or attention.

Connections to Substance Use

In the past, researchers have clearly linked the presence of ADHD to increased risks for substance use in teenage populations. In the study, published in Nature Neuroscience, a multinational research team explored this link by periodically examining the brain function of 1,896 adolescents. These teens were all age 14 when the study began, and underwent brain scans at two-year intervals over the next four years. During these scans, all participants were asked to perform tasks that measured their level of self-control. The researchers also used medical histories to determine how many of the study’s participants had symptoms of ADHD. In addition, they periodically asked the participants about their level of involvement with alcohol, drug and cigarette use.

After reviewing their findings, the authors of the study concluded that the presence of ADHD itself does not reduce teenagers’ ability to control their impulsive urges. Similarly, they concluded that teens who use substances also don’t generally have a reduced ability to control their impulses. This does not mean that teens who have ADHD or use substances don’t act impulsively; it simply means that teens with these issues apparently don’t typically act impulsively any more often than teens unaffected by these issues. Critically, the authors of the study also concluded that when teens with ADHD do act impulsively, their behaviors are triggered by different brain pathways than the pathways that trigger impulsive participation in substance use. This finding suggests that the presence of ADHD-related impulsivity is not as likely to contribute to substance use risks as scientists once commonly believed.


Interestingly, the authors of the study in Nature Neuroscience also concluded that the brain pathways that contribute to impulsivity-related substance use kick into gear even when some teenagers use only minimal amounts of a given substance. This finding strongly suggests that substance use itself does not lead to increased impulsivity in adolescents. Instead, the reverse is likely true, with the preexisting effects of impulsivity contributing to increased participation in substance use. In real-world terms, this means that some teenagers may have longstanding or built-in impulsive tendencies that make them much more susceptible to substance use (and subsequent problems with substance abuse or addiction) than other teenagers who come from similar backgrounds, belong to similar peer groups and participate in similar sorts of daily activities.

“The take-home message is that impulsivity can be decomposed, broken down into different brain regions,” says Hugh Garavan, one of the study authors. “The functioning of one region is related to ADHD symptoms, while the functioning of other regions is related to drug use.”

Gangs are known for the physical and social threats they pose to rival gang members and their general communities. However, gang membership itself apparently poses a significant threat to mental health. According to the results of a study reported in 2013 by researchers from Queen Mary, University of London, gang members have substantially increased risks for developing harmful psychological symptoms or a diagnosable mental illness when compared to the at-large population.

Gang Membership Basics

Teenagers and people in the early stages of adulthood form the majority of gang members in the U.S., the American Academy of Child & Adolescent Psychiatry reports. However, increasingly, preteens and younger children also become involved in gang activity. While public perception commonly links the presence of gangs to large urban areas, these organized units also appear in smaller urban areas, isolated towns and rural regions. Known consequences of gang participation include increased chances of committing violence or being a target of violence, as well as heightened chances of substance abuse/addiction or incarceration, heightened chances of involvement in risky sexual activity and lowered chances of developing useful work skills or receiving useful academic training.

Gang Members Suffer Psychiatric Illness, Study Finds

The presence of certain mental health problems—including attention-deficit hyperactivity disorder (ADHD) and a conduct-related condition called oppositional defiant disorder—can increase a person’s chances of getting involved with a gang. Other known risk factors for joining a gang include living in an area populated by gangs, lack of appropriate adult supervision, exposure to music or other cultural influences that applaud gang participation, lack of work or educational opportunities, a violent home environment and a home environment or family background that includes gang members. A lack of self-esteem or role models also increases gang participation risks. Many individuals cite their gang affiliation as a “home” or stabilizing influence in their lives.

Mental Health Risks

In the study reported by Queen Mary, University of London, a team of British researchers examined the connections between gang involvement, violence and mental illness in a group of over 4,600 men between the ages of 18 and 34. Roughly 2 percent of these men identified themselves as current gang members, while slightly more than 27 percent identified themselves as recent perpetrators of physical assault or some other form of violent activity. The remaining 70.4 percent of the participants described themselves as being non-violent in the five-year period prior to the start of the study.

After reviewing their findings, the authors of the study concluded that both gang members and violent men not affiliated with gangs have significantly increased risks for developing a range of specific mental disorders or symptoms common to several different mental disorders. In the case of gang members, especially prominent illnesses include alcohol or drug addiction, antisocial personality disorder or some other personality disorder, and various types of anxiety disorder. Prominent symptoms common to a number of mental illnesses include hallucinations and/or delusions (also known as psychosis) and suicidal behaviors that culminate in a suicide attempt.

Significance and Considerations

The authors of the Queen Mary, University of London, study believe that they are the first researchers to assess gang members for mental health problems other than substance use disorders. They attributed the increased risks for anxiety disorders and psychosis in gang members to violence-oriented thinking, exposure to violence at the hands of others and fears about future violence exposure. In many cases, these problems manifest in the form of post-traumatic stress disorder (PTSD), a condition once viewed as an anxiety disorder in the U.S., but now classified along with several other illnesses as a trauma- and stressor-related disorder. The authors of the study attributed the rate of suicidal behavior and suicide attempts in gang members to both the psychological strain of mental illness and the impulsive nature of violent behavior, which can turn inward in some individuals.

Generally speaking, gang members and non-gang members who engage in violence are younger than non-violent men and also have a higher rate of unemployment. In the U.K., which has a socialized medical system, gang members also seek access to mental health services more often than non-violent men.  The authors of the study note that the men in the participating age range are typically gang “lifers;” they don’t know if the same problems with mental illness appear in short-term or younger gang members.

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