The 18^th century British philosopher and statesman Edmund Burke once famously declared: “Those who don’t know history are destined to repeat it.” In the years since, Burke’s quote has been repeated often in slightly different forms by a variety of public figures, which is a testament to how much truth the sentiment behind it contains.

This statement could undoubtedly be applied quite aptly to the ongoing War on Drugs. Over the past several decades United States law enforcement agencies have spent over $1 trillion persecuting this war, and during that time hundreds of millions of tons of illegal drugs have been seized and destroyed here and around the world. And yet, much to the chagrin of those responsible for the continuation of this military-style anti-drug campaign, there is no evidence to suggest that any drug pipelines have been permanently closed off or that the flow of illegal substances has been reduced in any meaningful way as a result of this approach. In fact, the international drug trade appears to be more profitable and efficient than ever before.

Effects Of Drugs On The Black Market

The Sept.  30 edition of the online medical journal BMJ Open includes a report from a multi-national team of researchers who studied and analyzed international drug surveillance databases in order to identify long-term trends in the illegal drug trade. They discovered that despite the stalwart anti-drug efforts of law enforcement, officers and administrators from across the globe, over the last 20 plus years the cocaine, heroin and marijuana available on the international black market has gotten both stronger and less expensive.

In the United States, from 1990 to 2007 the potency of these three substances rose by 60 percent, 11 percent and 160 percent respectively, and yet the street price of these three popular illegal drugs actually fell by 80 percent over the same time period when adjusted for inflation. The increased strength of such drugs is a testament to the fact that demand for illegal substances has remained high enough to spur constant innovation in production methods, while their steadily dropping price shows that supplies are bountiful and that users of cocaine, heroin or marijuana are still very much operating in a buyer’s market.

War On Drugs And Illegal Drug Use

Contrary to hype and popular opinion, the War on Drugs was never designed to stop the trade of illegal substances entirely. Instead, its goal has been to disrupt supply chains just enough to drive prices up and make dangerous intoxicants unaffordable to many who might be tempted to experiment with them. But even this modest goal has proven elusive, and few if any honest observers still believe that ramped up law enforcement strategies will ever reduce illegal drug consumption or prevent millions of users from plunging headfirst into the dark canyon of substance abuse and addiction.

At the present time, the global black market drug trade generates about $350 billion in tax-free profits annually. In the U.S. alone, there are approximately 22 million illegal drug users above the age of 12, and while the majority could not accurately be classified as addicts, those who do become dependent on substances like cocaine, heroin and methamphetamine usually have no difficulty in obtaining the supplies they need to quench their addictive thirsts. And with drugs becoming stronger and cheaper, we may start seeing greater percentages of casual drug aficionados eventually succumbing to addiction, since these individuals will be able to afford greater quantities of illegal substances even as the high they are getting from what they are using intensifies.

Drug Popularity, Reputation And Availability

It is true that the rates of usage of drugs such as cocaine, angel dust and heroin have generally been declining over the years. However, it would be a mistake to assume that the drug war has been successful just because certain drugs have now gone out of style. Once a drug starts to get a bad reputation, its use will usually decline. But as some drugs become less popular, other illegal substances will inevitably flood the market to fill the void, and, as a result, the whole cycle of casual use, abuse, addiction and disillusionment just keeps repeating itself with no apparent end in sight.

What Can Help Drug Addiction?

We can only speculate about what might finally make the merry-go-round of drug dependency stop spinning—expanded availability of treatment, more drug courts, innovative educational campaigns, greater social awareness, a reduction in the rates of poverty and unemployment, community outreach programs, or some combination of all of the above. It seems clear, however, that more interdiction, indictment and incarceration will not make the decisive difference.

The “Just Say No” campaigns were mocked in their day and seem hopelessly quaint now. Trying to shame people into avoiding drugs has not worked any better than treating drug use as a crime. But in the end, illegal drug use will only decline precipitously if enough people decide the risk of addiction is too great to flaunt. So in a sense, it really is about just saying no, and being able to recognize the critically important reasons it is logical to do so. Cheaper and stronger means extreme danger, and consequently a refusal to get involved with drugs in the first place is the smartest decision one can make.

Read More Captivating Drug News

Cannabis is the umbrella term for the mind-altering products marijuana, hashish and hashish oil, which come from the cannabis group of plant species. All of these products create substantial risks for physical dependence and addiction when used regularly for relatively extended amounts of time. Cannabis use also comes with a known risk for psychosis and certain other mental health problems. In a study published in August 2013 in the journal Addiction, a team of Dutch researchers looked at the relative risks for mental illness in dependent/addicted marijuana users and users unaffected by dependence/addiction. The researchers concluded that the mental illness risks in these populations differ in substantial ways.

What Exactly Is Cannabis?

Marijuana comes from dried, non-concentrated parts of Cannabis plants such as the leaves, stems and flowers. Hashish and hashish oil, on the other hand, come from the purposeful concentration of these plant parts. All three of these cannabis-based products contain the same active ingredient, known informally as THC and formally as tetrahydrocannabinol. THC triggers changes in brain function that create the classic effects of cannabis intoxication, including altered thinking and sensory perception, a rise in pleasurable feelings, appetite increases, reduced clarity in several major areas of consciousness, and a reduced ability to move the body’s muscles in an efficient, controlled manner.

Marijuana’s Dependence And Addiction

Despite its reputation as a relatively harmless, “natural” substance, THC can make substantial alterations in a person’s long-term brain function when used repeatedly or habitually over time. These changes in function can eventually make the brain “see” the presence of THC as a chemical norm rather than a rare or occasional event. When this situation arises, the affected individual has what’s known as a physical dependence on the effects of cannabis/THC. By itself, physical dependence on a substance does not necessarily constitute a dangerous or harmful situation. However, when combined with persistent drug-seeking behaviors and other disruptive or dysfunctional actions, dependence establishes the necessary groundwork for the onset of a drug addiction.

Mental Health Risks Of Marijuana Use

While under the temporary influence of cannabis products, users commonly experience short-term symptoms that closely approximate psychosis, an altered mental state (classically associated with schizophrenia and schizophrenia-related illnesses) that primarily features delusional thought processes and/or some sort of sensory hallucination. In some cases, regular users develop a more extended form of psychosis that continues as long as a pattern of cannabis intake continues. In addition, current evidence strongly indicates that habitual cannabis users have increased long-term chances of developing diagnosable cases of schizophrenia or depression that continue to exert their effects even when a pattern of cannabis intake stops.

In the study published in Addiction, researchers from the University of Amsterdam and the Netherlands Institute of Mental Health and Addiction sought to determine if people physically dependent on cannabis have higher risks for developing mental health issues than cannabis users unaffected by dependence. They made this determination by tracking the mental health diagnoses of 252 young adults affected by cannabis dependence, as well as the diagnoses of 269 young adult, non-dependent cannabis users. For comparison’s sake, they also tracked the mental health diagnoses of over 1,000 non-cannabis-using young adults. The researchers did not attempt to differentiate issues of cannabis dependence from issues of cannabis addiction.

Effects On Mental Illness In Dependent vs. Non-Dependent Marijuana Users

After reviewing the gathered data, the researchers found that both dependent and non-dependent cannabis users have a higher rate of mental illness than people who don’t use cannabis at all. They also found that dependent and non-dependent cannabis users are similar in most ways and share comparable patterns of general cannabis use, patterns of other forms of substance use and histories of problematic or traumatic childhoods. While dependent cannabis users have a higher overall rate of mental illness than non-dependent users, non-dependent users have higher rates than dependent users for illnesses called externalizing disorders, which include attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder and conduct disorder. Conversely, dependent users have particularly high rates for illnesses called internalizing disorders, which include mood disorders (depressive and bipolar illness) and a range of conditions referred to together as anxiety disorders.

Most of the difference in the mental illness rates between dependent and non-dependent cannabis users disappeared when the authors of the study published in Addiction took certain secondary factors into account, including the use of other substances and the presence of traumatic or problematic childhoods. However, even with these adjustments, dependent users still have higher illness rates than non-dependent users. Except for the spike in their rates for ADHD, oppositional defiant disorder and conduct disorder, non-dependent cannabis users have mental health profiles that closely resemble the profiles found among people who don’t use cannabis.

Desomorphine, also known by the Russian nickname Krokodil or the English language equivalent Crocodile, is a synthetic substance based on the opioid narcotic drug morphine. This drug, outlawed in America, has much stronger chemical effects than morphine and produces severe side effects in long-term users that can include tissue destruction, limb loss or death. Desomorphine users commonly take a homemade form of the drug that contains one or more additional toxic substances. Until recently, desomorphine abuse was not known to affect any segment of the U.S. population. However, in September 2013, the country’s first identified cases of this abuse allegedly occurred in Phoenix, Arizona.

Desomorphine Basics

Morphine is an opioid substance taken directly from the sap of a plant called Papaver somniferum (commonly referred to as the opium poppy). Like all other natural and synthetic opioids, it achieves powerful, potentially addicting drug effects by accessing key portions of the brain and creating intense spikes in pleasure levels, as well as a reduced ability to feel pain. Desomorphine was invented in a laboratory setting in the 1930s by changing morphine molecules’ natural chemical structure. Compared to morphine, it produces roughly 10 times the level of effect at any given dose. This drug effect comes on rapidly and also fades away in a relatively short amount of time.

Even in its most chemically pure form, desomorphine is capable of producing significant damage when used repeatedly over time. The most common side effect of chronic use—a form of blood vessel and soft tissue damage that results in green, scaly skin—gives the drug its nickname, Krokodil (Crocodile). If left untreated, desomorphine-related vessel and tissue damage can ultimately result in tissue death (gangrene) or a clot- and inflammation-based ailment called thrombophlebitis. People with these conditions can lose their affected limbs to amputation or even die. Doctors can potentially combat the active drug effects of desomorphine with the anti-narcotic medication naloxone or other treatments used to address heroin addiction. However, there is no specific, fully developed treatment for the drug. In addition to dealing with the brain effects of desomorphine addiction, doctors commonly need to address the severe physical injuries associated with the drug’s use.

Desomorphine Abuse

Today, desomorphine abuse doesn’t typically involve batches of the drug made in a laboratory. Instead, most users make an injectable form of the drug themselves by boiling tablets of another opioid narcotic, called codeine, then combining the resulting liquid with any one of a number of additional toxic additives, including gasoline, red phosphorus, hydrochloric acid or paint thinner. Together, these substances can produce a level of blood vessel and tissue damage far above that associated with pure desomorphine, and users can develop large pockets of rotting flesh or even lose their flesh all the way down to the bone. Current evidence indicates that chronic users of “bootleg” Krokodil commonly die within a period of two or three years.

International Patterns of Krokodil Usage

The first known cases of bootleg Krokodil abuse occurred among heroin users in Russia in 2003. These users were looking for a cheaper alternative to the normally available narcotics in their country. According to current estimates, roughly 1 million people in Russia and another million people in other European regions use the drug. However, these estimates are likely quite imprecise, and no one really knows how many people in Europe or other areas across the globe take some form of Krokodil. In the U.S., desomorphine belongs to a highly restricted class of substances called Schedule I substances. All drugs with this federal classification are illegal, present a strong potential for the onset of abuse and/or addiction, and have no accepted usefulness in medical treatment. Still, some amount of pharmaceutical-grade desomorphine likely enters the U.S. through illegal Internet sales or other unlawful avenues. Americans also have access to the materials required to make bootleg desomorphine.

First Krokodil Cases In The U.S.

In September 2013, a poison control center in Phoenix, Arizona, reported two cases of Krokodil abuse among local residents. The directors of this facility believe that the cases in question are related, a situation that indicates that use of the drug is not widespread. However, since they represent the first nationally reported incidences of Krokodil abuse in the U.S., the two cases are naturally garnering significant amounts of scrutiny and media attention. As of now, no one can truly say what course the use of homemade desomorphine will take among American IV drug abusers in the years and decades to come.

Read More About The Zombie Drug Finding It’s Way To The U.S.

Addiction is a complicated disease. For those of us who have never had an addiction, it can be easy to wonder why addicts can’t seem to make the decision to stop using and then do it. There are complicated brain chemical pathways that are affected by drugs and alcohol that lead to addiction and that make it almost impossible to stop using. Modern research has uncovered much of the role of the brain in addiction, but more recently has found that the immune system is also important.

The Immune System And The Brain

Your body’s immune system is a complex network of different types of cells that are dedicated to protecting you from foreign invaders that cause sickness. Many of those immune cells live in the brain. These are called glial cells and they work alongside your neurons, or brain cells. The brain cells and immune cells that work together to regulate the responses of the immune system are called collectively, the neuroimmune system. This system keeps the brain healthy and mediates communication between the immune system and the central nervous system.

Addiction’s Effects On The Neuroimmune System

Parts of the neuroimmune system are activated by various factors. Stress is one factor, which is why the feeling of being stressed can actually make you physically sick. Alcohol and drugs also trigger responses in the neuroimmune system. The responses can lead to disrupted decision making. This helps to explain why addicts make choices about using even when doing so is bad for them.

The response of the neuroimmune system to drugs and alcohol also changes a person’s affect and causes feelings of depression. Again, these feelings are characteristic of addiction. Researchers have even found that people with certain genetic variations in their neuroimmune system are more likely than others to succumb to addiction.

Innovative Addiction Treatments

With the increased understanding of how the immune system in the brain impacts addiction, researchers are able to come up with new treatments for this devastating disease. One such possible treatment may help addicts who use opioids like heroin and prescription painkillers. Studies have found that morphine, an opioid drug, binds to a certain immune system receptor that changes the dopamine pathway in the brain.

Dopamine is the brain chemical that is released when we feel something pleasurable. Drugs release huge floods of dopamine, which plays a role in developing addictions. The researchers hope that if they can block the immune receptor with a medication, they can stop the release of dopamine when someone uses an opioid. With no pleasurable sensation, there would be no addiction.

Methamphetamine is another seriously addictive drug that can be just as hard to quit as opioids. Research has shown how the drug negatively impacts the immune system of the user, so new studies have focused on targeting the immune system for treatment medications. A drug being developed for a variety of immune diseases may also help meth addicts. The drug reduces the immune response in the brain, which could help meth addicts feel better. One major hurdle to quitting is that the users feel awful when they give up meth. With the new medication, they may feel better, and less inclined to going back to using.

Other researchers have tackled cocaine addiction by working with the immune system. The new treatment is actually a vaccine. The researchers who developed it created a vaccine that would target cocaine and treat it as if it were an invader like a virus or bacterium. After being injected with the vaccine, mice in laboratory experiments showed an immune response that tackled any cocaine in the body. The result was that the mice did not get a high from cocaine. If the vaccine works in human trials, it could help addicts stop using. If they get no high, there will be no reason to use the drug.

The exciting field of addiction and the immune system is coming up with new information about the disease of addiction every day. With this new knowledge, researchers are able to create treatments that are medically- and evidence-based that may truly help people recover from addiction.

The e-cigarette is a modern invention and an alternative to tobacco cigarettes. They were designed to allow people to smoke and to get nicotine into the bloodstream without inhaling all of the toxins found in tobacco. E-cigarettes may be helping people to quit smoking, and because they do not produce actual smoke, they may also allow people to get their nicotine without affecting the people around them.

On the surface, it seems that e-cigarettes are a great invention that can help people. Unfortunately, there are downsides to these fake cigarettes, not least of which is the fact that they can be used to smoke illegal drugs, like marijuana. Because of the way they work, someone can smoke pot using an e-cigarette without being detected.

The E-Cigarette Revolution

An e-cigarette is different from a traditional cigarette in that it does not use tobacco. Instead, it uses batteries and a liquid solution of nicotine. The battery heats and vaporizes the solution so that the user inhales and exhales vapors, rather than smoke. Because nicotine is the only ingredient, the user is also not inhaling all of the additives in tobacco that are so harmful, such as tar, acetone and arsenic.

Although nicotine is still a drug, and one that is harmful and addictive, smoking an e-cigarette is much less dangerous than smoking tobacco cigarettes. It is also less harmful to others around the smoker because there is no secondhand smoke. Without the offensive fumes, it may be possible for people to smoke using e-cigarettes in areas that are normally restricted to smokers.

For the above reasons, e-cigarettes are set to become big sellers in the U.S. and elsewhere. Some experts are even predicting that they will start to outsell real cigarettes within a decade. E-cigarettes are already big business in Europe. The European Parliament recently rejected a proposal to regulate them as medical devices, which would have meant tight restrictions on sales.

E-Cigarettes Being Used To Smoke Marijuana

Although e-cigarettes may have been created as healthier, alternative delivery devices for nicotine and to help smokers kick the habit, clever drug users have already crafted them for different uses. The cartridge of liquid nicotine solution that goes into an e-cigarette can easily be replaced by any liquid. Any substance can be vaporized and inhaled using one of these devices.

Most commonly, abusers are using a cartridge with a liquid solution of THC, the main psychoactive substance found in marijuana. With liquid THC in an e-cigarette, a person can get high and yet appear to be legally inhaling legal, nicotine vapors. The same property of e-cigarettes that allows users to smoke without offending those around them, allows for covert use of illicit drugs. The vapors produced by the e-cigarette are odorless. A person can get high without arousing suspicions.

Teens Smoking Marijuana With No Recognizable Odor

While an adult covertly smoking pot is a concern, a bigger one is the use of marijuana by teenagers. As the presence of e-cigarettes proliferates, teens are finding that they make an excellent vehicle for smoking pot. Smoking marijuana produces a characteristic odor that clings to clothes, hair and fingers. With e-cigarettes, a teen can inhale liquid THC, get high, and never give off the usual signs. Parents who are concerned that their teens may be using marijuana will have to be more vigilant and look for other signs of intoxication.

E-Cigarettes Targeting Young People?

Another concern regarding teens and e-cigarettes is that these new devices may be targeting young people. E-cigarettes can be sold with different types of nicotine cartridges with flavors like strawberry, peach and grape. They are also sold online, which makes it easier for kids to get a hold of them. If kids start using these devices at a young age, they may be more inclined to try other substances. In other words, e-cigarettes may become the new gateway drug. The problem has already begun, as statistics indicate that the number of middle and high school students using e-cigarettes is rising.

It seems that e-cigarettes have a place in our modern world. They allow adults to use a legal substance in a way that is less harmful than cigarettes. They also help those who want to quit the habit of smoking. On the other hand, e-cigarettes pose a big problem. Until we can figure out how regulate them fairly, or how to detect illegal drugs being used in e-cigarettes, parents and other adults should be aware of the possibility that they are being abused by teens.

Read About Smoking Marijuana And The Future Effects On Teens

“Mother’s little helper” has been around for decades. In 1966, The Rolling Stones released a hit song about the abuse of drugs, like Valium, by mothers looking to take the edge off a busy day. Now, some moms are using different substances to get through the day: prescription stimulants. Although they can provide a boost of much-desired energy, many women develop a drug addiction to these commonly prescribed “legitimate” medications.

Prescription stimulants are normally used to treat a range of medical conditions, including attention-deficit hyperactivity disorder (ADHD), narcolepsy, and depression. Common stimulant medications include Dexedrine (dextroamphetamine), Adderall (amphetamine and dextroamphetamine), Ritalin (methylphenidate), and Concerta (methylphenidate).

Legitimate Stimulant Use

Chemically, these drugs are similar to natural neurotransmitters within the brain, including norepinephrine and dopamine. When taken to treat a genuine medical condition, a physician will prescribe the medication at a low level and gradually increase it until the drug produces the desired effects. In addition, the stimulant typically comes in a capsule or tablet form that allows for the slow release of the medication into the body. This slow, steady rise in dopamine mimics the body’s natural production. When used as directed by a physician, ADHD medications and other prescription stimulants are not addictive and produce no high.

Stimulant Abuse And Emergency Room Visits

The effect is different when stimulants are abused, however. Instead of capsules or tablets generating a slow, steady rise of dopamine over time, the pills are crushed before being snorted or they are dissolved in water and then injected. This causes a dopamine rise so rapid that it disrupts the brain and produces feelings of euphoria.

Evidence suggests that drug addiction to stimulants is on the rise. For example, emergency room visits involving stimulant abuse skyrocketed between 2005 and 2010. Visits more than tripled for people over age 26 [1].

Why Mom’s Are Abusing Stimulants

The demands placed on mothers in this culture can feel overwhelming. From single moms to homeschooling moms to moms who work outside the home, many feel the pressure of being the master multitasker. Some mothers turn to stimulants in the belief they will help them focus better on their responsibilities or help them make it through a hectic day. It’s important to note that while these prescriptions can increase concentration in those with a medical need for them, there is no clinical evidence that abusing these drugs sharpens focus.

Women also frequently use stimulants to lose weight. For example, Adderall can speed up metabolism and lower appetite, resulting in weight loss. However, it’s not a healthy or permanent weight loss solution. When a woman stops taking the drug, she typically gains the weight back – and sometimes even more.

Dangers Of Stimulant Abuse

Abusing any drug can have a serious impact on a mother’s emotional and physical well-being; however, stimulant abuse is particularly dangerous. When abused, these medications can trigger irregular heartbeat, heart failure, seizures, and dangerously high body temperatures. As mentioned earlier, stimulants also cause decreased appetite, which, in serious cases, can cause malnutrition. In addition, women addicted to high doses often experience episodes of paranoia or hostility. Instead of helping a mother meet the demands of a busy lifestyle, stimulants make it harder to handle normal responsibilities, including caring for children.

There is also added danger in the method some addicts use to get high. When the drug is dissolved in water, some insoluble fillers in the pill may not break down completely. While these solid pieces are small enough to be injected, they are also large enough to block small blood vessels, creating the risk for serious health complications.

Stimulants are also dangerous because they don’t mix well with other substances. The ER study mentioned above showed that 63% of visits involving stimulants included the use of alcohol, painkillers, sleep aids, or anti-anxiety medications [1]. The use of other drugs adds an additional layer of risk to stimulant drug addiction.

Stimulant Drug Addiction Treatment

If you’re addicted to or abusing stimulant prescription drugs, you need drug rehab treatment. Addicts experience psychological withdrawal from chronic stimulant abuse, so the first step will likely be a medically-monitored detox to wean your body from the drugs.

After detoxification, therapy begins. There are several therapies used to treat this addiction, and your rehab team will recommend one or more based on your situation. Cognitive-behavioral therapy (CBT) is often used to examine the negative thoughts, beliefs, behaviors, and emotions that contribute to addiction. Once you better understand how those contribute to your drug addiction, you’ll learn how to positively change those thinking patterns in order to cope in a healthier way. Although considered a short-term type of therapy, CBT involves a gradual process that takes time and effort in order to be effective.

Contingency management is another treatment that may be used for abuse of Adderall and other prescription stimulants. Sometimes called voucher-based reinforcement (VBR), the program provides tangible rewards for positive behaviors and staying drug free. For example, an addict who stays clean for a specified period of time, as verified through urine samples, may earn a voucher for food, movie tickets, or other goods and services that promote drug-free behavior. The value of the voucher starts low and increases the longer the addict stays clean.

Studies of contingency management show that it can reduce stimulant abuse when used as part of a comprehensive treatment strategy [2]. Additionally, one study suggests that, on its own, contingency management may be more effective at treating stimulant use than CBT alone [3].

Treatment for stimulant drug addiction will also likely include support groups. Often based on the 12-step program first developed by Alcoholics Anonymous (AA), self-help groups provide guidance and assistance to recovering addicts. You’ll be able to connect with others going through the same struggles, which may help reduce feelings of hopelessness or isolation. Meetings are free, and you can attend them for as long as needed to help you stay abstinent.

Drug addiction in mothers can lead to serious consequences for herself and her children. Contact a drug rehab treatment facility about getting help for stimulant abuse or addiction. With treatment, it’s possible to stop abusing drugs and start learning healthier ways to live life, no matter how hectic your life may be.

References:

[1] http://www.samhsa.gov/newsroom/advisories/1301241230.aspx

[2] http://www.ncbi.nlm.nih.gov/pubmed/23138961

[3] http://www.ncbi.nlm.nih.gov/pubmed/16445555

Choosing the right alcohol or drug rehab treatment strategy can be a challenge for someone still struggling with addiction. One of the most confusing aspects for many is simply figuring out which therapy does what. It’s critical information because it will guide you toward making the best decisions regarding treatment. This article will help you understand the treatment approach known as contingency management (CM) and how it helps addicts during recovery.

Contingency Management Basics

Contingency management is based on a simple principle: behavior that is rewarded is behavior more likely to be repeated in the future. It’s a principle we see all the time in everyday life. For example, a teen may earn an allowance for taking on extra chores, or a boss may award her employees with bonuses for excellent performance.

Although it can be used to treat alcohol abuse, CM is most commonly employed as to treat drug abuse and addiction. The therapy is also used by health professionals to help people overcome a range of challenges, including weight loss, exercise motivation, and cigarette smoking. Additionally, contingency management is sometimes utilized to increase the likelihood a patient will take medication as directed.

How Exactly Is CM Used In Substance Abuse Treatment?

During substance abuse treatment, CM reinforces positive, drug-free behavior with explicit, tangible rewards. One of the most common ways to use this reinforcement is to allow addicts to earn vouchers for goods and services, like movie tickets, retail goods, sports equipment, or electronics, after they’ve submitted a specified number of drug-free urine samples. In some programs, the reward has a fixed dollar amount, such as $25. Other treatment plan rewards may increase in value the longer the drug abuser stays clean.  For example, a voucher may hold a starting value of $10 and increase by $2 for each negative sample the addict provides. The goal is to encourage substance abusers to remain abstinent during outpatient treatment.

Why CM Promotes Healthy Behaviors In Addicts

In addition to promoting abstinence, CM can be used to promote other healthy behaviors in addicts. Addiction therapists may reward patients for attending a certain number of 12-step meetings or showing positive behaviors during drug rehab treatment. One program offered housing and behavioral treatment to homeless cocaine addicts in exchange for staying drug-free [1].

Another form of contingency management involves medication for methadone patients. Recovering addicts may be permitted to take methadone doses home if they increase positive behaviors or cease negative ones. A patient, for instance, could earn the right to take home one dose a week after submitting a specific number of drug-negative urine tests.

Contingency management can be an appropriate treatment for many addicts, however, it’s considered especially helpful for those in high-risk groups. For example, this drug rehab treatment has been used to reduce dangerous injection-related behaviors, which increase the risk of acquiring HIV and other bloodborne diseases [2]. CM has also been used successfully to treat pregnant women with addiction. One review of numerous studies concluded that contingency management was more effective at keeping pregnant women in drug treatment than motivational interviewing, another addiction therapy [3].

Effectiveness Of Contingency Management For Drug Abuse

Contingency management has proved to be an effective treatment for substance abuse disorders. One review of 47 studies found that incorporating it into treatment improved drug abstinence rates during recovery. However, it also suggested that contingency management may be more effective for those with opiate or cocaine addiction than for those with multiple drug addictions [4].

Research also suggests CM is useful for keeping addicts in outpatient therapy. Typically, many substance abuse patients miss scheduled appointments; one estimate puts the number as high as 60%. However, in one study, researchers gave addicts who attended scheduled group therapy the chance to draw from a prize bowl, which contained vouchers for prizes ranging from $1 to DVD players.  Recovering addicts were more likely to attend weekly sessions when reinforced with contingency management than when they were not [5]. Another study discovered that 84% of outpatient substance abusers receiving vouchers stayed in treatment over 8 weeks, while only 22% of non-voucher patients did so [6].

Contingency Management Drug Addiction Treatment Plan

Like many drug rehab treatment options, CM is not intended to be used as a sole therapy. It’s often used in conjunction with other addiction treatments. For example, cognitive-behavioral therapy (CBT) is one approach a therapist could pair with contingency management. During CBT, the alcoholic or drug addict will identify the negative behaviors and emotions that contribute to addiction.

The cost of contingency management can prevent some substance abuse clinics from using this therapy. Some evidence suggests that CM is not as effective when the value of the vouchers is too low [7]. The cost of vouchers attractive enough to change addiction behavior can quickly add up. In one study, addicts received vouchers worth more than $1,000 over the course of treatment [8].

Some experts have raised concerns that incentives, such as those that allow substance abusers the opportunity to draw a random prize from a bowl, increase the risk for pathological gambling. However, prize drawings in CM have not been shown to promote excessive gambling, according to the National Institute on Drug Abuse [9].

Critics Of Contingency Management For Drug Rehab Treatment

Contingency management is not without critics. Some opponents of this approach assert that contingency management amounts to bribing drug users to stay clean. Another concern of critics is that some addicts will deceive treatment professionals by providing clean urine samples that do not belong to them, thus collecting the incentive without meeting their own obligation to stay abstinent. Additionally, those against this approach argue that CM does not directly address underlying issues that contribute to substance abuse. However, it’s important to note that contingency management is often paired with other treatments developed to produce long-term behavioral changes.

Drug rehab treatment may be one of the most important decisions you’ll ever make. Speak with an addiction professional to learn if contingency management is the right choice for you.

References:

[1] http://www.sciencedirect.com/science/article/pii/S0376871600800083

[2] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271179/

[3] http://www.ncbi.nlm.nih.gov/pubmed/17943878

[4] http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2006.01581.x/abstract

[5] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2606605/

[6] http://psycnet.apa.org/journals/ccp/68/2/250/

[7] http://www.ncbi.nlm.nih.gov/pubmed/16445548

[8] http://ajp.psychiatryonline.org/article.aspx?articleID=174754

[9] http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-0

Statistics gathered by the Substance Abuse and Mental Health Services Administration, or SAMHSA, show a disturbing trend among older Americans. Members of the Baby Boom generation are using drugs and getting addicted to them in record numbers. Whether we can explain the trend or not, the fact remains that elder drug abuse presents some unique problems that require unique approaches for prevention and treatment.

The statistics from SAMHSA show that among older Americans in recent years, marijuana use has increased five-fold, cocaine use has quadrupled, heroin abuse has doubled, and abuse of prescription drugs has more than quadrupled. The survey from SAMHSA also records treatment for drug abuse and addiction and found increases in the numbers of Boomers getting help for alcohol abuse in combination with cocaine use, and for abusing prescription painkillers. Emergency room visits for painkiller abuse and overdoses increased greatly over the last decade.

Explanations And Complications Of Drug Abuse In Older Americans

At first glance, the statistics surrounding the use and abuse of drugs in older Americans seems surprising. However, it is important to understand that we are discussing a generation of people who came of age in the 1960s, a time of experimentation and rebellion against authority. In tracking the drug and alcohol behaviors of this generation over the years, finding that they now, in their older years, are still using drugs is not a surprise. It only seems shocking when compared with the generations that came before them.

Unfortunately, drug abuse is even more of a problem for a person in his 50s and 60s than it was when he was in his 20s. As we age, our metabolism slows. For an older person abusing drugs or drinking too much alcohol, the time it takes to metabolize and get out of his system is much longer. An older person using may be intoxicated for longer and, therefore, at risk for more accidents and injuries.

Another issue is that drug users in their 50s or 60s are more likely to have health problems than they did in their younger years. Drug or alcohol abuse may exacerbate these problems, or even interact badly with prescribed medications. Furthermore, the symptoms of these other health conditions may mask the usual signs of drug abuse or addiction.

Signs Of Drug Abuse

Drug abuse and addiction are serious problems at any age, but in older Americans they present greater risks and complications. It is important to be aware of the possibility of drug use and to look out for signs in loved ones. Because another health problem may cause symptoms that mask the physical signs of drug abuse, watch for changes in behavior as the sign of a problem. Mood swings that are unexplained could be a sign of addiction, drinking or drug abuse. Changes in personality are also troubling. When someone just doesn’t seem like himself anymore, there could be a problem with drug abuse.

Prescription abuse is a growing problem among all age groups, so look for signs that your older friend or family member is abusing them. This could mean that he is requesting more refills for painkillers, seeing several doctors to get more prescriptions, going to more than one pharmacy or in other ways is trying to get more of his medications than has been prescribed.

Getting Help For A Loved One Abusing Drugs Or Alcohol

If anyone you love or care about is abusing drugs or alcohol, it is important to help him seek treatment; with an older person, it is especially imperative. Drug abuse can cause even more problems for someone who is older and should be stopped in its tracks. Having the courage to confront your parent, spouse, or other loved one about your suspicions could just save his life.

Confrontation is never easy so be prepared. Bring one or two other people along, friends or family members your loved one trusts. Be ready with solutions so that you are not simply accusing, but helping. Do your research ahead of time and find facilities for treatment that are prepared to work with older patients. As the problem of drug abuse continues to rise in the older demographic, more treatment centers are focusing on the age group. You should be able to find treatment plans that will suit the specific needs of your loved one and that will help him feel comfortable while getting well.

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