Breakingthecycles.com – Changing the Conversations

by Lisa Frederiksen

Likely you are well aware that I preface the key points of just about every one of my talks, articles and posts with a comment about the “new brain research of the past 10-15 years has ______.” So when I read this article by Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), published on the Dana Foundation website, in which she summarizes some of the biggest advances in brain research in the past decade — the decade after the “Decade of the Brain,” I knew had to share it with you.

The following is just the beginning of what Dr. Volkow has to say… I urge you to read the rest of her article, “A Decade After the Decade of the Brain, Challenges and Opportunities in Drug Addiction Research:”

Neuroscience is at a historic turning point. Today, a full decade after the “Decade of the Brain,” a continuous stream of advances is shattering long-held notions about how the human brain works and what happens when it doesn’t. These advances are also reshaping the landscapes of other fields, from psychology to economics, education and the law.

Until the Decade of the Brain, scientists believed that, once development was over, the adult brain underwent very few changes. This perception contributed to polarizing perspectives on whether genetics or environment determines a person’s temperament and personality, aptitudes, and vulnerability to mental disorders. But during the past two decades, neuroscientists have steadily built the case that the human brain, even when fully mature, is far more plastic—changing and malleable—than we originally thought.¹ It turns out that the brain (at all ages) is highly responsive to environmental stimuli and that connections between neurons are dynamic and can rapidly change within minutes of stimulation.

Read more…

I recently discovered this website, Physicians and Lawyers for a National Drug Policy. There is SO MUCH on this site. I encourage you to browse through it.

To get you started, I’ve quoted from their introduction below:

Alcohol and other drug problems are concerns of the public health and justice systems, including the criminal, civil, and juvenile branches. The impact of alcohol and other drug problems in the justice system are not limited to cases involving drug-related offenses. Alcohol and other drug problems compound many of the complex issues the justice systems handle every day, including assault, vandalism, child abuse, and divorce.

While most attempts to decrease the number of drug-related offenses have often solely emphasized drug interdiction and incarceration, research has shown that they have had minimal—if any—impact on decreasing substance abuse or the violence associated with criminal activity by individuals with alcohol and other drug problems (Marlowe, 2002).

Effectively addressing problems requires an integrated public health and public safetyTreatment decreases drug problems, crime, and recidivism while improving health conditions. Treatment also saves money, and in today’s climate of growing fiscal constraints, it is imperative to re-evaluate spending priorities. Alcohol and other drug problems place a huge burden on our economy—resulting in high health care costs, productivity losses, and other expenses associated with crime and accidents (Belenko et al., 2005). A large portion of this economic burden falls on state justice systems (Join Together, 2006).

by Lisa Frederiksen

This article, DUIs in Drug Court Idaho, by Kendel Murrant, published in the Idaho Press-Tribune online, offers an excellent explanation of Drug Court – an alternative to incarceration for drug and alcohol related offenses, such as DUIs. As this article explains, treating the underlying problem — alcohol or drug misuse — for the presenting offense — a DUI, for example — is critical to preventing a recurrence of the presenting offense or the commission of an equally awful crime.

Quoting from Murrant’s article,

…High-risk offenders who don’t receive treatment through drug court either tend to not follow through with treatment, drop out or fail to follow conditions of probation, Jaeger said. But in drug court, “they stay in treatment long enough, are held accountable consistently and regularly enough to really change their behavior,” Jaeger said. “The treatment effect is more than skin deep.”

“Drug court — it gets right to the heart of the problem. They are there to treat people and help them overcome their addictions, period,” defense attorney Charles Crafts said.

And treatment also deals with more than the person’s addiction.

“It’s really focused on all the characteristics that makes a person pro-social, less likely to have attitudes toward committing crime … not just abstaining from the use of alcohol,” Jaeger said.

She said it’s common for repeat DUI offenders to have other attitude adjustments to make.

“They think, ‘Well, I can drink, I just need to be more careful, make plans to not drive.’ When they do drink, their judgment becomes impaired. The decisions they make in that condition are not good decisions.”

Another benefit to rehabilitation through problem-solving courts, Jaeger said, is that offenders can keep social supports.

“Having a job, having a family, taking care of your bills are protective factors, assets in making a recovery,” Jaeger said. “Those social supports are important in making lasting behavior change. The more supports that you can keep for a person, the greater likelihood that they can establish a lasting recovery.”

Crafts said the community-based treatment in problem-solving courts is a “progressive-thinking model” for rehabilitating offenders.

“I think that we have a tendency when someone gets in trouble to just turn around and want to punish them,” Crafts said. “Drug court — it’s definitely a punishment to be in drug court, but they do build in these motivations for people to be successful in the program. … It’s much more of a progressive-thinking model of rehabilitation.”

Click here to read the complete article.

by Lisa Frederiksen

I’ll be returning home tomorrow evening from an amazing week in Mexico City working with the other partners of GARNET (Global Addiction Recovery Network). We collaborate with groups, treatment centers and governments to develop culturally sensitive programs they can then implement and in turn use to help families, addicts/alcoholics,  communities and governments grapple with all aspects of the family disease of addiction.

This was my first effort in Mexico with GARNET, and I was truly honored to  be working with our conterparts there. Addiction and its impacts on families and communities is universal. How we prevent and treat it can be greatly advanced by inter-cultural collaboration. We have so much we can learn from each other.

by Lisa Frederiksen

I was researching the costs of untreated alcoholism and came across an excellent website, Ensuring Solutions to Alcohol Problems, a project of the Center for Integrated Behavioral Health Policy, part of the Department of Health Policy at the School of Public Health and Health Services, The George Washington University Medical Center in Washington, DC.

Quoting one of the Q & As on their site:

This week is Great Britain’s annual Alcohol Awareness Week, which began Monday, so I thought I’d post a few article links highlighting their efforts. It helps all of us around the world to understand and appreciate that alcohol abuse and alcoholism are global issues.

A whisky expert has called for children aged five and over to be “educated” about alcohol in a bid to combat its misuse.

Whyte and Mackay master blender Richard Paterson said it was important to shape children’s behaviour around alcohol from a young age.

Mr Paterson said:”We need to talk to young people about the consequences of abusing alcohol.”

NHS Health Scotland said it encouraged parents to talk about alcohol. Read more…

Almost a quarter of people in Wales drink alcohol at home several times a week, often because it is cheaper than going out to drink, research suggests.

Wales’ chief medical officer, Dr Tony Jewell, said some were more likely to indulge in “heavy” drinking.

Alcohol Concern is using alcohol awareness week, which starts on Monday, to highlight the potential dangers. Read more…

Alcohol Awareness Week 2009

Wednesday, 21, Oct 2009 02:02

Alcohol Awareness Week will begin on 19 October and will see a week of activities highlighting the most important issues in relation to alcohol policy. Alcohol Concern will be using the week to try to influence Government and highlight the need to take decisive action on alcohol misuse now. Read more…

Rethink Your Attitude Towards Drink During National Alcohol Awareness Week

To encourage a healthy attitude towards drinking,  the Safer Portsmouth Partnership is running a series of activities during National Alcohol Awareness Week to promote low risk drinking and highlight the support that is available for those that need it.

National Alcohol Awareness week starts on the 19th October. The local activities that will take place to help Portsmouth residents rethink their drink include:

There’s alcohol awareness stands at:

• Probation Services (Monday pm)
• Ella Gordon Unit (Tuesday evening)
• Cascades Shopping Centre (Tuesday)

‘Rethink Your Drink’ scratch cards are available to all staff at the Civic Offices as well as online version to staff at Portsmouth City Council, Portsmouth City Primary Care Trust, Fire Service, Police and Portsmouth Hospitals Trust – the online version is available at www.hampshire.nhs.uk/your-health/rethink-your-drink. 4,000 scratch cards are available at GP surgeries, St. Mary’s Walk-in Centre and A&E.  Read more…

This is a guest post from The Discovering Alcoholic, who writes a top rated recovery blog, www.discoveringalcoholic.com, covering alcoholism, substance abuse, treatment and recovery issues.

Mother’s Against Drunk Driving (MADD) has linked up with a Canadian marketing firm to introduce a line of MADD sponsored and labeled mojitos, margaritas, pina coladas, beer, and red, white and sparkling wines that are 100% alcohol free.

They’re an alternative for people who want to serve drinks with “the great taste needed to make guests feel like they are part of the party — but without the alcohol,” said MADD’s national president, Laura Dean-Mooney. ~ The Associated Press

Even though I am a supporter of MADD and agree that non-alcoholic “mimic” drinks may be a good alternative for designated drivers, I do question the wisdom of putting their name on adult beverages regardless of the content. MADD already has a large host of detractors from the ABI to minimum age opponents, and this move will certainly give them a controversial issue to target.

A good example of making hay with “MADD drinks” is this opinion piece from DUIattorney.com accusing MADD of selling out… and making a very convincing argument.

It looks to me like MADD is taking it’s esteemed reputation—earned and bolstered by thousands of volunteers, private donations and federal and state tax dollars—and turning it into a name-brand. MADD is using MADD.org to bolster the marketing for MADD, Inc, and thereby profiting from its years as a tax-exempt organization.

Final verdict, I think MADD has made a poor move here. For those that don’t have abuse issues non-alcoholic beverages are fine substitute, but since they have no problem abstaining in the first place it’s sort of a moot point. And for those of us with a history of abuse I strongly discourage the use of these products- it’s not a terribly smart path. Non-alcoholic mimic beverages seem like a good idea on paper, but the market and their realistic use is overestimated in my opinion. MADD will gain another revenue stream from this line of products, but the possible alienation of their supporters and the assured attacks from their opponents may not be worth the effort.

by Lisa Frederiksen

We often think of alcohol abuse and/or alcoholism problems as being a local, statewide and/or national problem, but it’s an international concern, as well.

On May 24, 2008, the 61st World Health Assembly adopted resolution WHA61.4, which calls for the development of a draft global strategy to reduce the harmful use of alcohol based on all available evidence and existing best practices. A draft working document is now in circulation amongst Member States with requests for feedback.

To help all of us better understand and appreciate the global scale of the consequences of alcohol misuse, below you will find six points recorded in the “Working Document for Developing a Draft Global Strategy to Reduce Harmful Use of Alcohol,” prepared by the World Health Organization, Department of Mental Health and Substance Abuse.

SETTING THE SCENE
1. Alcohol is consumed by almost half the world’s population, although there is considerable variation between and within countries, and its consumption is a part of social and cultural practices in many parts of the world. Alcohol is, however, a toxic and psychoactive substance that can lead to dependence, and its harmful use has serious effects on public health.

2. In the context of this strategy, the concept of harmful use of alcohol1 is broad and encompasses both the drinking that causes detrimental health and social consequences for the drinker, the people around the drinker and society at large, and the patterns of drinking that are associated with increased risk of detrimental health outcomes. Harmful use of alcohol is one of the main risk factors for poor health globally. It compromises both individual and social development. It can ruin the lives of individuals, devastate families, and damage the fabric of communities.

3. Alcohol is a significant contributor to the global burden of disease and is the fifth leading risk factor for premature deaths and disabilities in the world.2 It is estimated that 2.5 million people worldwide died of alcohol-related causes in 2004, including
320 000 young people between 15 and 29 years of age. Alcohol consumption was responsible for 3.8% of all deaths in the world in 2004 and 4.6% of the global burden of disease as measured in disability-adjusted life years lost, even when consideration is given to the modest protective effects, especially on coronary heart disease, of low consumption of alcohol for some people aged 40 years or older.

4. Harmful drinking is a major avoidable risk factor for neuropsychiatric disorders and other noncommunicable diseases such as cardiovascular diseases, cirrhosis of the liver and various cancers. For some diseases there is no evidence of a threshold effect in the relationship between the risk and level of alcohol consumption. A significant proportion of the disease burden attributable to harmful drinking is determined by unintentional and intentional injuries, including those due to road traffic crashes, and suicides. Fatal injuries attributable to alcohol consumption tend to occur in relatively young people. Some vulnerable or at-risk groups and individuals have increased susceptibility to the toxic, psychoactive and dependence-producing properties of alcohol.

5. The main purpose of the draft global strategy is to support global, regional and national efforts to reduce this public health burden.

6. A substantial knowledge base exists for policy-makers on the efficacy and cost-effectiveness of strategies and interventions to prevent and reduce alcohol-related harm,1 and, with better increased awareness, there are increased responses at national, regional and global levels. However, these policy responses are often fragmented and do not always correspond to the magnitude of the impact on health and social development. For example, legislative frameworks and mechanisms for the enforcement of existing laws are often insufficient.

You will find a wealth of information and a better appreciation (and validation) of the scope and extent of the problems caused by harmful alcohol use — it’s not just our city or our state or our country — it’s around the world. Download a copy of the full report by clicking here.

by Lisa Frederiksen

Alegent Health, Bio-Medicine, Health & Fitness msn.com and other news sources have been reporting on a study titled, Long-Term Effects of Minimum Drinking Age Laws on Past-Year Alcohol and Drug Use Disorders, by Karen E. Norberg, Laura J. Bierut, Richard A. Grucza. Theirs was a study of 33,869 adults who grew up at a time and place when/where it was legal to purchase and drink alcohol under age 21.

Quoting Alegent Health’s breaking health news article:

…The authors found that adults who could legally buy alcohol before the age of 21 years had a higher likelihood of meeting criteria for alcohol use disorder or other drug use disorder (odds ratios, 1.31 and 1.70, respectively), even during middle age.

“These surprisingly strong results are consistent with the hypothesis that late adolescence may be a ’sensitive period’ for an environmental exposure closely tied to the timing of changing minimum legal purchase age laws. However, the minimum legal drinking age (MLDA) effects do not seem to be working through age of drinking initiation, per se; instead, we hypothesize that the long-term effects of MLDA exposure may work through the frequency and intensity of drinking or the social networks and social norms around drinking that develop in late adolescence,”…

All three articles share some of the research and findings and are interesting reads. For a full text of the findings, click here (log in and purchase fees do apply).

by Lisa Frederiksen

A number of municipalities / states have laws to try curb drunk driving known as “over-service laws — laws that say an alcohol server cannot serve a visibly intoxicated customer.” The problem is that by the time a person is “visibly intoxicated,” they are flat out drunk and should have been cut off long before that.

Look at this story, for example, posted on wral.com, about a Raleigh, N.C., doctor “who is facing a murder charge in a weekend DWI [after he] had been drinking the afternoon prior to the wreck that killed a Winston-Salem ballet dancer.” The doctor’s last stop of the day was the Piper’s Tavern. Earlier he had “played golf and drank at the Raleigh Country Club.” According to the article, the doctor “had only two drinks before he was cut off [at the Piper's Club]” and left around 8:15 p.m. The crash happened about 15 minutes later, less than 3 miles away.

The doctor was traveling at 90 mph in a 45 mph zone when he slammed into the back of the vehicle of Elena Bright Shapiro, a 20-year old dancer from Winston-Salem who was scheduled “to perform three parts in the dance company’s upcoming rendition of ‘Swan Lake’.”

Vail, Colorado’s Town Council is grappling with this same problem. According to Lauren Glendenning’s article in the Vail Daily News, “Judge Says People Are Drinking Harder,” Judge Allen finds “people are doing more shots — slamming concentrated amounts of alcohol into their systems in short periods of time, meaning blood alcohol contents are higher and higher in the cases he sees, he said. It used to be that a .2 blood alcohol level was unusually high, but now it’s almost normal for Allen to see blood alcohol levels at .2 and higher, he said.’” Judge Allen goes on to say that proving “over service” laws are difficult. One Town Council member suggested an alternative law — perhaps one that would limit the number of drinks a person can order or have in front of them. The doctor in Raleigh, N.C., demonstrates that doesn’t necessarily work.

So… what do you think?