11 Jun 2014
Addiction is a complex disease of the brain that ties people to chemical substances and destroys lives if left untreated. Unlike many physical illnesses, healing from addiction has never been straightforward. Researchers have worked hard to understand this disease, and, as our understanding has evolved, we have come to learn that memory plays an important role in how addiction takes over the brain.
Addiction And The Brain
Your brain contains a reward system, which gives you a pleasurable feeling when you do or experience something positive. For instance, when you get a hug from someone you love, this reward system causes a chemical called dopamine to be released in your brain. Dopamine makes you feel good. Drugs act like a big switch that turns on a flood of dopamine—far more than is released during normal, pleasurable activities.
The powerful high experienced with drug use often leads to more drug use. Over time, your brain will respond by decreasing the number of receptors for dopamine. This means you need more of the drug to get any kind of pleasurable feeling and when you don’t get it, you feel terrible. This cycle of withdrawal, cravings and relief are centered in the brain and lead to addiction.
Addiction And Memory
As modern research is beginning to discover, the changes to the reward system are not enough to fully explain addiction. Addiction also involves memories. Every time a person takes a drug and gets a flood of dopamine, the brain makes a strong memory associated with that high. Often connected to this memory is what led the person to use the drug in the first place: an emotion, a stressful situation or another memory.
It turns out that these memories are the key to why drug addiction is so hard to overcome. Addicts quit over and over again, but relapse and come back to drug use because of memories. Even after years sober, an addict may have a memory of drug use triggered by an external factor. This could be a place where he used drugs in the past, or a person with whom he used, or even just the feeling of stress or fear that he long ago associated with drug use.
Memories are tied to learning, and addicts have learned when and in which situations to use drugs. This makes it very difficult not to relapse in the presence of these learned triggers.
Blocking Memories To Help Treat Addiction
With the knowledge of the role that memories play in addiction and relapse, experts are trying to develop treatments that block the memories that trigger drug or alcohol use. Researchers at UC San Francisco have discovered a molecule that could be manipulated to do just that. The molecule is part of a pathway in the brain that signals memories related to addiction.
Work on blocking this pathway in rats is showing great promise for treating humans with addiction. The technique targets specific memories as opposed to blocking out memories without discretion.
The potential for being able to help recovering addicts avoid relapse by blocking memories is promising and hopeful. For addicts who have been clean for years, a relapse is still possible thanks to these powerful memories. It can be incredibly frustrating to be unable to resist a craving, but with more research and understanding of addiction and the brain, we may be able to break the hold drugs have on addicts.
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According to the Centers for Disease Control and Prevention, tobacco use is the leading preventable cause of death in the United States. This is why helping people quit smoking is such a priority. Unfortunately, most smokers find it very hard to give up the habit. The Smoking Treatment for Ontario Patients (STOP) program—funded by the Ontario Ministry of Health and Long-Term Care—is one approach that manages to increase quit-rates by providing nicotine patches and psychological treatment to smokers, and could serve as an example for U.S.-based organizations. The initiative started in 2005 and now runs numerous times per year, offering smokers the opportunity to break free of their addictions and get healthy.
Why Is It So Hard To Quit Smoking?
Although tobacco is a widespread and legal substance, quitting it is hard for many of the same reasons that it’s difficult to stop using illegal drugs. Nicotine—the addictive component of cigarettes—releases dopamine in the brain, the neurochemical responsible for the majority of addictions. When the body gets accustomed to it, the external “boost” that smoking provides stops, and this leads to an imbalance in brain chemicals followed by unpleasant symptoms. The problem is compounded by the fact that research indicates “cold turkey” (unsupported) quitting is the most popular method, but is a considerably less successful strategy than counseling, medications and nicotine replacement therapy (like gums or patches). In short, smokers—with an already difficult task ahead of them—often try to quit by themselves, which is statistically the least successful method.
Physical Withdrawal Symptoms Of Nicotine Withdrawal
Like with other drugs, when you stop consuming nicotine you may feel a wide range of physical symptoms. The most common smoking withdrawal symptoms are agitation, irritability, weight gain, depression and anxiety. The negative symptoms come on because the individual is no longer getting the nicotine he’s become dependent on, and the brain knows it, creating cravings in an attempt to make the individual succumb to temptation and give it another hit of nicotine.
Psychological Challenges Of Quitting Smoking
Although the physical withdrawal symptoms add to the discomfort of quitting smoking, the psychological effects are what drive many ex-smokers to relapse. Smoking, like other drug addictions, is a poor coping strategy for dealing with everyday problems, and when these problems return, the individual is at particular risk for relapse. Both internal and external “triggers” to smoke can make the process more difficult, with internal factors including things like stress and depression and external ones including things like being around a friend who smokes or taking a work break that you previously used for smoking. These things push the individual back to smoking, and in combination with the physical withdrawal symptoms, they make the process of quitting extremely challenging.
Benefits Of Initiatives Like STOP
These issues are what make initiatives like STOP so worthwhile. The core selling point of STOP is that attendees receive five weeks’ worth of free nicotine patches, which ordinarily cost around $30 per week, meaning they save around $150. This removes what some see as a financial barrier to getting the support they need, but the support also takes the psychological elements into account. Each qualifying smoker is also eligible to attend workshops and receive ongoing support to help manage triggers and cravings.
This broad range of support contributes to the impressive success rates enjoyed by the initiative. Oxford County’s tobacco control coordinator Dominique Bruce points out that those in the program have a quit rate that’s 50 percent higher than those not in the program. She also points to the cost savings and psychological support offered by the program. “If you slip up, you need to remember it’s just a slip up, not a fail,” Bruce said.
The Right Way To Help People Quit Smoking
There are many lessons that can be learned from programs like STOP, and although this initiative is in Canada, U.S.-based stop smoking initiatives can take a cue from the approach and work to reduce the preventable diseases and deaths caused by smoking. The smokers themselves face the biggest challenges, but with the right support and the guidance to help them push through the difficult periods, they have the ability to kick their tobacco addiction for good. As long as we understand the challenges inherent in quitting smoking—or kicking any addiction—we can find the compassion to help those in need and the wisdom to do so in the most effective way possible.
26 May 2014
If scientists can develop an understanding of how a casual user sometimes becomes an addict while others do not, they may be more equipped to prevent addiction. Understanding how casual marijuana experimentation turns into addiction may help in prevention and intervention strategies, in addition to shaping public policy. A recent study identified behavior patterns that may determine whether a person develops an addiction to marijuana.
The study, which was led by Peggy van der Pol of the Trimbos Institute of the Netherlands Institute of Mental Health and Addiction, suggests that theories about whether increased levels of the psychoactive ingredient delta-9-tetrahydrocannabinol (THC) can influence addiction may not be relevant. With varying potencies of THC available in marijuana, the researchers wanted to see whether potency, habits of the user or both determined the likelihood of them becoming addicted.
Some scientists have argued that even when THC is more potent users may compensate by inhaling less. However, the authors say there is a much more relevant predictor.
While smokers of more potent pot receive more THC now than users of older generations of marijuana, the style of smoking is a better predictor of which users are likely to become dependent. Van der Pol explains that while every drug carries risk, the more potent forms of marijuana cause the user to take in more THC.
How Is Dependence Developed?
Other studies have focused on frequency of use when examining how dependence developed, as well as THC levels. Van der Pol’s team looked at data from 98 young adults enrolled in a long-term study on regular marijuana use in the Netherlands. The users were recruited from cannabis dispensing coffee shops, as well as through referrals. The participants all reported using marijuana at least three days per week in the previous year. One in three of the participants met criteria for dependence at baseline. The participants were mostly men and were an average age of 23.
Eighteen months after recruitment, and at another follow-up point at three years, the participants were interviewed about their cannabis use, and were even asked to smoke during the interview.
The researchers documented the specific behaviors each participant demonstrated, from rolling their joints to how often they puffed on the joint. To provide a picture of regular behaviors, the participants were asked to bring their own cannabis and roll their own joints.
The smokers who used more potent pot containing higher concentrations of THC did not roll weaker joints. Instead, they used more pot in each joint when compared to users of less-potent marijuana.
The potent pot users did inhale less smoke and had a slower pace of smoking when compared with their peers. However, these adjustments weren’t sufficient to compensate for the higher level of THC in the marijuana.
Instead of THC exposure, the study results showed that only behaviors specific to smoking were predictors of dependence. How many puffs a smoker took, and the amount they smoked, were the only strong predictors of dependence at three years following the initial examination.
The study’s findings may have an immediate impact on how users are educated about marijuana dependence. New users may be exposed to a stronger potency of marijuana and consume high levels of THC.
Even in our connected and technological age, stigma persists about drug addiction. Parents may not want to believe that their child could become a drug addict, and there is still much misunderstanding about things such as prescription drug abuse and its risks. Education is a vital approach for dealing with this stigma and these prevalent misconceptions, and a recent forum held by the Council on Addiction Prevention and Education (CAPE) and the Wappingers Central School District (Dutchess County, New York) is a perfect example of the value of the approach. The increasing rates of drug abuse in Dutchess County is of great concern to politicians and local experts, and the success of the mid-March program by the Wappingers school district has led numerous other districts to plan similar events in April, with the aim of curbing the growing issue.
What Happens At Drug Abuse Forums?
Drug abuse forums give those with direct experience of addiction and the process of recovery to share their stories, offering educational messages to the audiences, who are often teens but could also include their parents and members of the local community. This allows those in attendance to understand the sheer scope of the harm caused by drug abuse and addiction, and although not all of the stories end positively, many offer hope to those struggling with addiction by showing that recovery is possible. Talks will either be given by the ex-users themselves or by family members or loved ones. Due to their emotional nature, they are frequently poignant, moving and memorable.
Lessons Learned The Hard Way
The event held in March featured many such stories told to a full auditorium at John Jay Senior High School. This was partially thanks to a new initiative on the part of high school coaches that makes attendance mandatory for student athletes, an approach praised by CAPE. The talks cut through the stigma surrounding addiction and showed that the process is very much one of “learning lessons the hard way.”
One speaker was Suzanne DeCosta, who spoke about her son’s addiction to narcotic painkillers and heroin. She described him as “smart, funny and lovable,” but during his teen years, what was once recreational drug use turned into addiction. DeCosta comments that “as a parent, you don’t ever want to believe your child is an addict,” but points out that this is wishful thinking—it can happen to anyone. Her son Michael overdosed on heroin, and has had numerous stretches in rehab. At present, he is two years sober, but the family is more than aware that it will require continued effort on his part to stay in recovery. They say they’re lucky to have him alive.
Other stories didn’t have the same positive, uplifting ending: Marcia Grant’s son, Roger, died at the age of 41 from a heroin overdose in a motel room. She described her son in his youth as “bright” and “affectionate,” but added that he was impulsive and reckless, pointing out that he broke a lot of bones. Doctors advised them that he would experience a lot of pain, and Marcia says they were right, “Pain, both physical and emotional […] kept bringing him back to drugs.”
The first signs of a problem came in his teen years when Roger’s grades began to slip and his behavior changed notably. He started to lie and his moods changed, and eventually—at the age of 22—he admitted to his issues and his parents tried to get him help. He was in and out of rehab centers, attending 11 inpatient programs, but would only have brief periods of sobriety and stability. He almost overdosed several times, and got into trouble with the law through his addiction. “At the time we didn’t realize that there was no simple fix,” said Martha. She added that he’d wanted to warn children about the risks of drugs, and she wanted to pursue this goal for him, in his absence.
Why These Events Are Essential
Drug education is vital, but dry repetition of statistics, risk ratios and far-off consequences don’t always pack much of a punch, particularly from an emotional perspective. The stories shared at drug abuse forums provide evidence for the potential consequences, but also offer a personal insight into the nature of addiction and the difficulties faced in recovery. The stories are real, told by somebody at the center of it all, and have more power to capture the attention of teens as a result. The consequences of drug abuse might not come immediately, but these speakers remind teens and parents that they do come eventually. If you don’t learn the lessons now and try to get clean, the problem will snowball until you’re forced to learn them the hard way. As more of these messages get out, fewer teens will need to learn them from life-threatening, first-hand experience.
Marijuana as a recreational drug is now legal in Washington and Colorado, and it’s legal medicinally in 18 other states. But a recent research paper raises legitimate questions about the drug’s safety. One of proponent’s main arguments in favor of legalized marijuana has been the absence of overdose deaths associated with sole use of the drug. The article calls that assertion into question.
Public perception is that a person who uses marijuana on its own is safe. In fact, a 2011 U.K. Department of Health report said “no cases of fatal overdose have been reported” due to marijuana use and “no confirmed cases of human deaths” had been found.
The new report suggests that marijuana is not quite that safe. In the study, German researchers took a look at 15 individuals whose deaths were somehow related to use of marijuana. The investigators performed careful post-mortem tests to identify and rule out other factors which may have been responsible for the deaths.
Scientists ran genetic tests, examined organs, performed an autopsy and asked for a toxicology report to screen for possible problems, such as liver disease, alcohol abuse or other conditions which could seriously compromise health and life.
Is Marijuana Overdose Possible?
One of the German researchers involved with the study said he believes marijuana overdose to be rare but possible. They discovered that two of the 15 persons were found to have the psychoactive ingredient THC in blood samples in amounts that indicated they had been using marijuana just hours before they died. In both cases the men’s hearts had experienced arrhythmia, meaning their hearts were beating either too quickly or too slowly. The change was drastic enough that it killed the two men, ages 23 and 28. One was found to have a significant but formerly undetected heart condition, and the other had a personal history of substance abuse apart from marijuana use. The study did not determine how marijuana caused the deadly arrhythmias.
The report is considered the first proof that deadly marijuana overdose is possible, even if infrequent. It suggests that further investigation is warranted into cases where marijuana use took place near to the time of death. Other risks, such as impaired memory, schizophrenia and depression have been associated with use of marijuana. Now it’s time to re-evaluate whether deadly overdose is another potential risk.
Social anxiety is a term used to describe the presence of substantial feelings of unease, tension or fear in social settings that most individuals don’t view as particularly negative or harmful. People seriously affected by these feelings may qualify for a diagnosis of a mental health condition called social phobia or social anxiety disorder. In a study published in January 2014 in the Journal of Studies on Alcohol and Drugs, researchers from Louisiana State University examined the connection between social anxiety and the chances that a college undergraduate will use marijuana or other forms of cannabis. These researchers found that socially anxious people tend to use cannabis only when they believe that certain social norms support this behavior.
Identifying Social Anxiety Disorder
Doctors consider diagnosing social anxiety disorder in people whose levels of social anxiety interfere with their ability to maintain a reasonable sense of mental equilibrium or participate in various aspects of a typical daily routine. Symptoms commonly found in people affected by serious social anxiety include:
- fear of judgment from others
- unease in the presence of others
- difficulty communicating with others
- tendency to avoid voluntary social contact
- extreme self-consciousness or easy embarrassment
- difficulty establishing or maintaining friendships
Physical indicators of social anxiety are:
- excessive sweating
- blushing in social situations
Most people first develop tendencies toward social anxiousness in early childhood or during their teenage years. Equal numbers of men and women experience symptoms profound enough to merit a social anxiety disorder diagnosis.
What Are Social Norms?
A social norm is a spoken or unspoken rule that helps govern the ways people interact in interpersonal, group or community settings. Some norms only operate on a relatively small scale (e.g., within a family or a close peer group), while others may operate on several levels or only on a broader social scale. As a rule, certain norms only have an effect when an individual believes that important or powerful people in his or her social group also endorse those norms. Other norms don’t necessarily receive an endorsement as acceptable behavior; nevertheless, they have an impact because an individual sees respected or influential people following them in everyday life. Broadly speaking, any person’s social environment is formed from a combination of norms he or she should follow and norms he or she actually follows.
Social Anxiety, Norms And Cannabis Use
In the study published in the Journal of Studies on Alcohol and Drugs, the Louisiana State University researchers looked at the interactions between social anxiety, cannabis use and the desire to follow social norms. They conducted their work with the help of 230 undergraduates at the university who were known users of marijuana or some other form of cannabis (i.e., hashish or hashish oil). The researchers undertook their study for a couple of reasons. First, mental health professionals and addiction specialists know that socially anxious people may develop problems with marijuana use more often than the general population. In addition, despite this fact, researchers know very little about how social norms influence the drug-using behaviors of socially anxious people.
After analyzing the social anxiety levels, social norms regarding cannabis use and actual cannabis-related behaviors in the study participants, the researchers concluded that social norms do have a significant impact on the chances that a socially anxious person will or won’t use cannabis or develop significant cannabis-related problems. However, perhaps surprisingly, the main influencing norms come from college students’ parents, not their peers. When a socially anxious student believes that his or her parents have a favorable view of cannabis use, the odds for participation in cannabis use increase substantially. In addition, a socially anxious student who believes his or her parents follow pro-cannabis norms has a greater chance of developing relatively minor and relatively severe problems related to cannabis intake. Conversely, a college student affected by social anxiety tends not to get involved in cannabis use when his or her parents regularly express anti-cannabis points of view.
The authors of the study published in the Journal of Studies on Alcohol and Drugs do not discount the potential of social norms established among peers to influence a socially anxious college student’s chances of using cannabis or experiencing cannabis-related harm. However, they note that parental influences appear to play a much more prominent role. The study’s authors believe that their work can help deepen understanding of the factors that can potentially contribute to the onset of diagnosable cannabis use disorder (cannabis abuse or addiction) in people affected by social anxiety.
Not all people get involved in substance abuse for the same reason. Broadly speaking, some people are motivated primarily by the desire to increase their experience of pleasure, while others are motivated primarily by the desire to escape or avoid painful experiences. According to the results of a study published in March 2014 in the journal Addictive Behaviors, the underlying reasons for marijuana use have a significant impact on the results of treatments designed to address cannabis addiction. It appears that addicts motivated by pain avoidance have a harder time maintaining their recovery than their peers motivated by pleasure-seeking.
What Is Cannabis Use Disorder?
Marijuana or cannabis addiction is officially classified as part of a larger condition called cannabis use disorder. Some people affected by this disorder are not addicted to marijuana or other forms of cannabis, but still experience serious life impairment as a result of their drug use. Other affected individuals have undergone the long-term changes in brain chemistry that set the stage for marijuana/cannabis addiction and all other forms of substance addiction. Many people think that marijuana/cannabis addiction is a rare phenomenon. However, current evidence indicates that nine out of every 100 users of marijuana will develop symptoms that qualify them for an addiction diagnosis. Teenage marijuana users develop diagnosable addiction symptoms at close to twice this rate. In addition, addiction rates skyrocket among daily users of all ages; one-quarter to one-half of these individuals will eventually develop diagnosable symptoms.
Much of human behavior stems from the conscious or unconscious impact of various emotions and emotion-based motivations. Psychologists commonly refer to pleasure-seeking motivations as “positive” reasons for engaging in a behavior. Conversely, they commonly refer to pain-avoidance motivations as “negative” reasons. When it comes to substance intake, the terms “positive” and “negative” don’t mean that some people have “good” reasons for using drugs or alcohol while others have “bad” reasons. Instead, they simply mean that some people use drugs and alcohol because they believe that substance use will enhance their pleasurable experiences, while others use drugs or alcohol because they believe that substance use will help them avoid feeling bad or escape current bad feelings. Individuals with “positive” motivations for substance use can develop problems with abuse and/or addiction just like people with “negative” motivations. However, the two groups of substance users typically hold distinctly different mental/emotional points of view about themselves, their surroundings and their experiences.
Impact On Treatment Outcomes
In the study published in Addictive Behaviors, researchers from the University of Washington and Virginia Polytechnic Institute and State University looked at the treatment outcomes of marijuana addicts whose drug use stems from “negative” motivations. They conducted their work with information gathered from 87 adults who underwent treatment for issues related to a chemical reliance on marijuana. These participants provided information on the reasons they used marijuana in any given situation. In turn, for each participant, the researchers matched these motivations to three known markers of diminished mental well-being: lack of belief in the ability to control one’s behavior, use of ineffective coping strategies to deal with unpleasant emotions and an impairing state called psychological distress.
The researchers concluded that marijuana addicts who use the drug for “negative” reasons have increased chances of believing they can’t control their actions, using ineffective coping mechanisms to deal with their emotions and developing substantial amounts of psychological distress. The researchers also concluded that each of these adverse impacts develops independently of the others, which means that attempts to address one of the three issues will not reduce risks for the other two. In addition, the researchers found that, compared to marijuana addicts who don’t use the drug for “negative” reasons, marijuana addicts who do use the drug for these reasons have greater problems achieving or maintaining abstinence from marijuana intake after they complete their treatment programs.
The authors of the study published in Addictive Behaviors note that their new findings echo previous research efforts that indicate that “negative” reasons for drug or alcohol use produce more problems during recovery than “positive” reasons for drug or alcohol use. Current psychotherapeutic approaches for people affected by marijuana addiction typically focus on dealing with unpleasant or unwanted emotional states. The study’s authors believe that their work validates this approach and serves as an additional reason for continuing to focus on treating “negative” emotions in people who develop cannabis-related addiction issues.
21 Mar 2014
Prescription painkillers are serious drugs that are effective and help many people, but they are also risky. These medications are opioids, which means that they produce a euphoric feeling in the user, or a high, and they are addictive. If someone you love has been prescribed a narcotic painkiller, be aware of the dangers and the possibility of abuse. Know how to read the signs that he is abusing the pills and be prepared to intervene before it is too late.
What Are Opioid Painkillers?
Opioid painkillers are controlled substances used to treat severe and chronic pain. An opioid is any drug that is derived from the compounds found in the opium poppy. Heroin, the highly addictive street drug, is an opioid. Prescription opioid painkillers include oxycodone, hydrocodone, morphine and hydromorphone. They are sold under various brand names. These drugs block pain signals, but they also cause a pleasant feeling, and if abused, create changes in the brain that often lead to dependence.
What Are The Signs Of Opioid Abuse?
It is important to understand that there is a difference between abuse and addiction. Your loved one may be abusing painkillers if he is using them to get high or if he is taking more than he was directed by his doctor to take. Abuse is not addiction, but it can easily lead to that state. Being aware of the signs of abuse is important so that you can help him before he becomes addicted. If he is abusing his medications, chances are he will try to hide it from you. Here are some signs to watch for:
- Look for signs that your loved one is high on opioids. If he is taking them as directed he may experience a little bit of a high, but if he is abusing his pills the symptoms will be greater. Someone who is high on opioids will become drowsy and have slowed breathing and movements. He may also become anxious, have mood swings or become apathetic or depressed.
- Opioid abuse causes a lack of energy. If your loved one seems tired all the time, especially throughout the day, and skips out on activities he normally enjoys, he may be abusing his medications.
- Opioids also cause people to lose focus. Look for signs that your loved one’s attention span is changing. Maybe he can’t focus on his favorite television show. Maybe he is having problems at work because he loses focus and drifts.
- Look for physical signs. Opioids cause certain physical changes that you can watch for. Look for a lot of itching, flushing in the neck or face, extremely constricted pupils, a runny nose, a lot of yawning, nausea and vomiting and flu-like achiness.
- Watch for secretive behaviors. If your loved one is abusing his medications, he likely knows he is doing something wrong, and he will probably try to hide the behavior from you. Be aware of any behaviors that seem unusual or that indicate he may be hiding something from you.
- Be aware of mood swings or personality changes. Any kind of drug abuse can cause behavioral and personality changes. If he is acting strangely and you have no other explanation for his mood swings, drug abuse may be the culprit.
If your loved one has been prescribed opioids for pain, there is no reason to assume he will begin abusing them. However, many people have fallen into that trap without meaning to do so. Be aware of the signs of abuse and pay attention. You could be saving his life by intervening.
Read About Teens Abusing Painkillers