Breakingthecycles.com – Changing the Conversations

by Lisa Frederiksen

U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Agency (SAMHSA) is committed to promoting evidence-based and promising practices in serving persons with mental illnesses and/or substance use disorders. They’ve produced a new series, The Evidence-Based Practice (EBP) Knowledge Informing Transformation (KIT) series, with  materials that provide innovative, engaging, and effective learning tools that help shape mental health services toward recovery.

One I’d like to especially draw your attention to is titled, “Co-Occurring Disorders: Integrated Dual Disorders Treatment.” With over half of persons who have an alcohol misuse problem also having a mental illness, known as a dual diagnosis (aka, a co-occurring disorder), it is important to learn more about this new evidence-based treatment practice. This treatment approach helps people recover because it offers both mental health and substance abuse services at the same time and in one setting.

Click here for details, downloads and ordering.

by Lisa Frederiksen

This article, Depressed Parent’s Negative Effects on Kids are Combatable,” appeared in the Sunday, March 14, Los Angeles Times. It points to the impacts of a parent’s undiagnosed, untreated (and not discussed in an effective, straightforward manner) depression on their children. Impacts include the consequences of the parents’ inconsistent expectations and discipline, role reversals (children comforting parent or trying to be strong for parent) and parental withdrawal. The impacts, themselves, included depression and anxiety disorders, poor coping skills, learned helplessness and poor social relations. BUT, the good news is that the effects of parental depression can be reversed in two key ways: 1) the parent getting the help they need, and 2) the family openly and honestly talking about what is going on and what is being done to fix it.

I bring this article to your attention because it parallels what happens to children as a result of a parent’s undiagnosed, untreated (and not discussed in an effective, straightforward manner) alcohol misuse. Those negative impacts are very similar to the ones described above, and they, too, can be reversed if: a) the parent seeks help, and b) the family starts opening and honestly talking about it.

The “talk” does not have to be complicated nor deep nor all-encompassing; nor do you have to have all of the answers at once. In fact, talking in spurts and often is better with children. Equally important will be to let your children talk to you — to let them tell you their feelings without having those feelings corrected, fixed or explained. The Lucile Packard Foundation for Children’s Health website has some terrific resources that can help.

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

Straight from the Hiroshima train station, the public streetcar pushes into the crowded city center following a narrow channel through a blaring landscape of music, horns, and hawkers. Much unlike the corner inset of the tourist map, the actual guide keys to this area are a garish display of commercial signage that both overwhelm and yet substitute for the minimal municipal markers. Everything may not be bright and clean, but there can be no doubt that this city is fervently alive. After just a few stops, I see my destination. Now I am walking through an epitome of order where even the natural wildness of the river and the trees are tamed harmoniously with cut stone and planned lines. Children gallivant, couples bump shoulders, and teenagers carry out hidden agendas while those old enough, wise enough, or perhaps just unlucky enough ponder why and what happened here.

Near the Miyuki Bridge, there was a police box. Most of the victims who had gathered there were junior high school girls from the Hiroshima Girls Business School and the Hiroshima Junior High School No.1. They had been mobilized to evacuate buildings and they were outside when the bomb fell. Having been directly exposed to the heat rays, they were covered with blisters, the size of balls, on their backs, their faces, their shoulders and their arms. The blisters were starting to burst open and their skin hung down like rugs. Some of the children even have burns on the soles of their feet. They’d lost their shoes and run barefoot through the burning fire.

Even today, I clearly remember how the view finder was clouded over with my tears.

~ Testimony of Yoshito Matsushige cameraman for the Chugoku Newspaper

This is the Hiroshima Peace Memorial where the twisted, tattered remains of the old Prefectural Products Exhibition Hall now commonly called the Atomic Bomb Dome are preserved, an edificial testimony to the devastation of the world’s first nuclear weapon target. It is an ugly scar among 30 acres of pristine monuments dedicated to remembrance and peace; without it one could walk the grounds never realizing the absolute destruction of the first ground zero. Looking around, it seemed that many do just that… isn’t that what recovery is all about?

At the Hiroshima Peace Memorial the utter destruction, painful memories, and the slow rebuilding process have all been documented and molded into a recovery program. At least here, the lessons of the war are not forgotten. No anger, resentment, or revenge is displayed- just a message, a peaceful reminder to others that they should not repeat the mistakes of the past and suffer such dire consequences. In fact, as you exit the onsite museum you get exactly that- an audio presentation, a speaker’s meeting of the survivors like Toshiko Saeki who lived through the blast.

I could not help but think of Hiroshima as a recovery Mecca, ideal for the pilgrimage of recovering alcoholics. A vibrant city that was scoured down to the rock bottom by nuclear fires only to be built up again bigger and better under no pretenses of victimization or singular blame, just pure acceptance and a vow to honor the past, enjoy the present, and to protect the future.

If you need a spiritual reminder of what real recovery is all about, I suggest you make the trip to the Hiroshima Peace Memorial.

Top 7 Best Alcoholics Anonymous Alternatives List
In several blog posts over the past two years, we have examined Alcoholics Anonymous (AA) and a lively discussion has followed those posts. AA is a group that many have very strong feelings about – both positive and negative. For some, AA has truly been a life-saver and allowed them to manage their addictions, while for others, the experience has not been as positive. Based on that feedback, we wanted to take a moment and provide information on the top 7 alternatives that we’ve found on the internet for addiction support. We hope these will be helpful to those out there that are looking for a new (or additional) support group solution to managing addictive behaviors. Read more…

I Know My Child is Drinking
If your child has been caught using alcohol or diagnosed with an alcohol abuse problem, there are steps you can take at home to help prevent continued underage drinking: Read more…

The following is a guest post by Bill White, M.S., a counselor, author, mentor, blogger and speaker specializing in depression, anxiety and general mental health issues. He hosts a blog, http://chipur.com, and does a lot of E.R. psychiatric emergency work in Chicago’s suburbs where he also spends time with his two teenage children.

“S.A.I.L.” Stop-Assess-Interpret-Logic

Here’s a technique I came up with that’ll be easy to etch upon your mind, allowing it to be there for you at a moment’s notice. The next time you begin to sense the tiptoeing of a panic attack in your immediate vicinity…stop everything. Now, slowly take a few refreshing abdominal breaths and begin whispering to yourself, “S.A.I.L.”…”S.A.I.L.”…”S.A.I.L.” And as you’re saying it, imagine feeling warm and gentle breezes of relief upon your skin. And here’s the magic of the acronym…

STOP everything in your life right now.

ASSESS exactly what’s going on within, and outside of, you.

INTERPRET if the situation is truly threatening and merits alarmed reaction.

LOGIC your way to an appropriate emotional and behavioral response.

Of course, I could go on and on with more details on the technique; however, newsletter constraints won’t allow it. But I think you get the idea. Give it a go, and if you want to learn more about S.A.I.L. and tons of other panic and anxiety tidbits of relief, check out Panic! …and Poetic Justice.

by Lisa Frederiksen

One of the more confounding aspects of all this is why some people who drink too much and behave terribly and cause problems within their families because of their drinking can learn to “re-drink,” get their drinking and lives back under control, and why others, who do all of the same things, can’t.

This fact is what causes so many alcoholics and family members, alike, to go along with, “This time, it’ll be different. I’m going to only drink on Friday nights and holidays, but that’s it!” (or some variation thereof). And, sometimes that promise lasts for a while. Sometimes the person even stops drinking all together — for years. But, then “it” starts, again… the glasses get larger and the sneaking creeps back in and pretty soon, it’s right back where it started.

Why?

The reason it works for some — and some can be very heavy drinkers — and not for others is the disease of addiction. Alcoholism is one of the diseases of addiction, which is a chronic relapsing brain disease. This means an alcoholic’s neural networks have been so corrupted – hijacked – by their addiction, the chemical and structural changes that have occurred in their brains makes it impossible for them to EVER drink ANY amount of alcohol, if they want to be able to stop their drinking behaviors long-term.

Watch these two videos to better understand (Note: when Dr. Volkow refers to “drugs,” that includes alcohol):

• The Hijacked Brain — found in the right column, top video.
• Brain Imaging (You can stop watching this one when Dr. Volkow starts her interview with a patient.)

So how can a person (family member or the drinker) tell whether a person should stop trying for “controlled drinking” and get treatment for alcoholism?

One thought is to understand the Risk Factors for developing the disease. The more Risk Factors a person has, the more likely they are to develop the disease of alcoholism; one of the diseases of addiction. Risk Factors include:

• Early use – because of the critical brain development that occurs from ages 12–25, alcohol affects the developing brain DIFFERENTLY than it affects an adult brain. The developing brain is especially vulnerable to the chemical and structural changes caused by alcohol misuse. (See this related link for more information.)
• Genetics – persons whose parent or sibling are alcoholics are 4-7 times more likely to become alcoholics themselves.
• Social environment – people who live, work or go to school in an environment in which the heavy use of alcohol is common – such as growing up in a home where heavy drinking is seen as ‘normal’ or living in a school setting where it is viewed as an important way to bond with fellow students – are more likely to abuse alcohol themselves. That abuse of alcohol causes chemical and structural changes in the brain.
• Mental illness – just over one-half of persons diagnosed as alcoholics or alcohol abusers have also experienced a mental illness (e.g., depression, PTSD, ADHD, bipolar) at some time in their lives. With mental illness there are also chemical and structural changes in the brain. Persons with a mental illness may turn to alcohol to self-medicate and/or their alcohol misuse may make their mental illness worse.
• Childhood trauma – abuse (such as verbal, physical or mental abuse) or neglect of children, persistent conflict in the family (such as that surrounding a family member’s unacknowledged alcohol abuse or alcoholism), sexual abuse and other traumatic childhood experiences can shape a child’s brain chemistry — especially during the early development ages of birth to about 12 — and subsequent vulnerability to alcohol misuse.
• Alcohol Abuse – binge drinking, for example, is alcohol abuse, and it is the kind of drinking that causes drinking behaviors — which in turn causes problems. It is also the kind of drinking that can change the chemical and structural make up of the brain, which is a contributing factor to the developing the disease of alcoholism.

Bottom line…. if a person has tried repeatedly to control their drinking but keeps finding it does not work for one reason or another, it might help to determine how many Risk Factors they have.  If a person can “see” any, they may be able to better “see” the problem and thus more inclined to get help or talk to a professional. Equally as important is for the family member to do this exercise, as well. That way the family member can give up believing that this time the controlled drinking plan will work and instead, do what they need to do to help themselves.

One last suggestion…. a person (family OR drinker) can always go to NIAAA’s website, Rethinking Drinking, to do an anonymous assessment of their drinking patterns and find suggestions for further help.

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©Lisa Frederiksen, www.breakingthecycles.com. The information contained in this post may be freely used and copied for education and other non-commercial and non-promotional purposes, provided any use or reproduction of the information be accompanied by an acknowledgment of Lisa Frederiksen, Breaking the Cycles.com, as the source.

by Lisa Frederiksen

Here are three key concepts for alcoholism recovery that a person who has been diagnosed with alcoholism or one who has decided on their own they are an alcoholic may want to focus on:

1. Accepting that alcoholism is one of the diseases of addiction; addiction is a chronic relapsing brain disease (which is what makes it impossible to drink any amount of alcohol and succeed in long-term recovery).

2. Accepting one has the disease (which is what helps a person accept they cannot  successfully drink some amount of alcohol some day).

3. Understanding there are many options to help with successfully treating the disease and that various options work better than others, depending on the individual and on their stage in their recovery process.

For more information on these three concepts:

for #1, click here

for #2, click here

for #3, click here and/or click here.

Rev. 2/26/10

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…

Here is an excellent video created by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Office of Research on Women’s Health, National Institutes of Health, titled, “Alcohol: a Women’s Health Issue,” appearing on the Research Channel.

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

Joanne Kimberlin of The Virginian-Pilot has written an in-depth piece on prescription medication abuse in the US with a focus on the state of Virginia. It begins with an assessment of current conditions by Cathy Pederson, a Norfolk undercover drug agent who explains addicts no longer fit the old stereotypes.

More and more, she finds herself busting business executives, lawyers, teachers, gray-haired grandmothers, teenage girls – all caught in the grip of a blossoming addiction to opiates like OxyContin, Vicodin and Percocet. Pederson has noticed another common thread: “They didn’t meet opiates at a party. They didn’t start taking them for fun. There’s usually a car accident or a surgery somewhere in their background, and they became addicted to their pain meds.”

A sidebar gives the stats on the alarming number of people abusing prescription drugs, mostly pain killers.

Who are the drug abusers?

- $50,000-plus The family income bracket reported by 42 percent of oxycodone abusers.

- 1 in 4 Troops admit abusing prescription drugs within a one-year period.

- 1 in 10 High school seniors say they’ve abused Vicodin.

- 40-49 The age bracket that accounts for about half of all prescription drug abuse.

- 9 million Americans currently abusing prescription drugs. Pain relievers are by far the most popular.

- 180 Estimated number of health care professionals arrested for prescription crimes in 2009 by a special unit of Virginia’s State Police.

The article is extremely detailed and informative covering the urgency and size of the problem, how it is occurring, and what authorities are doing about it. I found it odd but not surprising though that not once was methadone treatment discussed, especially since this is one of the most effective and accessible means known to treat long term addiction to opioids. It has been my experience that there is general misunderstanding of this treatment that many consider either taboo or just plain counterproductive despite the obvious benefits.

There’s an epidemic of opioid (pain med) drug abuse and addiction sweeping our nation and if we have any hope of keeping up with those that are “Jones-ing”… then we better start looking at methadone maintenance and medically assisted recovery programs as a solution instead of a stigma.