Breakingthecycles.com – Changing the Conversations

by Lisa Frederiksen

The following excerpt from an article describing recent survey findings (linked and referenced below) is something to be aware of:

…Girls appear more inclined than ever to reach for drugs and booze to help them emotionally, according to a survey by the nonprofit Partnership for a Drug Free America. For example, the 2009 survey of high school students found 53 percent of girls agreeing with the notion that drugs “help you forget your troubles,” up from 48 percent in 2008. The survey, which examines changes in substance use and attitudes, found the use of alcohol and marijuana jumped considerably more among girls than boys between 2008-2009.

Why should this, and any underage drinking/drug use by any young person regardless of gender, be of concern?

Early use is one of the Key Risk Factors for developing the disease of addiction. Science now understands that addiction is a developmental disease – meaning it doesn’t just strike one day – and it typically begins in childhood or adolescence.

Early use is such a problem because of the brain development that is occurring ages 12 – 20, often through 25 (namely, the neural network changes related to puberty, cerebral cortex development and the pruning/strengthening process). Because the cerebral cortex is the last part of the brain to more fully develop, the neural networks therein – like those needed to assess situations, make sound decisions and keep our emotions and desires under control – are especially vulnerable to the effects of alcohol and/or drugs.

Additionally, the fact that this critical part of an adolescent’s brain is still “a work-in-progress” puts them at increased risk for poor decisions (such as drinking or using drugs). Therefore, abusing drugs/alcohol while the brain is still developing may have profound and long-lasting consequences.  (NIDA, “Drug Abuse and Addiction”)

Unfortunately, society condones and often supports underage drinking as “something all kids go through” or accepts excuses such as, “remember when we were their age…,” or “I’d rather they drink at my house so I know they’re safe.” This makes it easier to “mask” the problem and virtually promote the drinking/drugging that can cause the kinds of chemical and structural changes shown in the brain image scans on this blog site (see “Brain Scans” category to the right).

Here are some facts about early use and alcoholism and why the risks and repercussions of underage drinking must be taken seriously:
• Early use, independent of other risk factors, strongly predicts the development of alcohol dependence, a.k.a. alcoholism.  Of all people who have met the diagnostic criteria for alcoholism in their lifetime, nearly half were addicted by age 21 and two-thirds by age 25.   (NIAAA, “Snapshot of Underage Drinking”)

• Young adults ages 18-20 have the highest rate of alcohol dependence (alcoholism) in the United States.  (U.S. Surgeon General 2007 Call to Action to Prevent and Reduce Underage Drinking)

[And, by the way, contrary to common belief, the Europeans do not have the issue of underage drinking figured out, either. It is a significant problem in many European countries. You can read more about this in the U.S. Surgeon General’s Call to Action referenced above.]

To read the remainder of the article, by Ellin Holohan, referenced in the opening of this blog post above, visit HealthDay Reporter.

This is an excellent, 8-minute video, that includes the voices of parents, teens, addictions’ specialists, a doctor, police officer and others to address one community’s underage drinking problem. It presents many important facts and suggestions for how and why it’s important to address underage drinking.

by Lisa Frederiksen

You have probably been told something like, “Alcoholism / drug addiction is just like any other disease.” After which you have probably said to yourself or to whomever made the statement, “Like *!?!#! it is! People with diabetes or heart disease don’t steal money from me or endanger my children by driving while under the influence!”  And, that’s because diseases like heart disease and diabetes are not brain diseases. They do not cause chemical and structural changes in the areas of the brain a person needs in order to think straight and act responsibly.

Addiction and other diseases, like diabetes and heart disease, share common characteristics true of all diseases:
- They are chronic .
- They have the potential to result in death if untreated.
- There is a genetic influence associated with vulnerability.
- They involve behavioral factors associated with the onset of the disease.
- They have the potential for relapse if treatment recommendations are not followed.

These similarities explain why effective addiction treatment requires a “disease management”   approach, as opposed to an acute care approach (i.e., “28-days and you’re good to go”).  While the components and deliveries will vary, because no single treatment component is appropriate for all individuals at all times,  the overall objectives of a disease management approach to addiction treatment should involve three phases: 1) detoxification/stabilization, 2) rehabilitation and 3) continuing care.

So how did we get so stuck in the acute treatment model?

Secrecy and shame.

How many addicts/alcoholics and/or family members/friends with a loved one who has a problem with substance abuse actually talk about it — talk about it as they would if they or their loved one had cancer?

The founding of AA provided the first wide-spread effort to view excessive drinking as something beyond a “lack of willpower” and to approach treatment from the perspective of abstinence – not drinking any alcohol. Its fellowship viewed alcoholism as a “combination of physical, psychological and spiritual causes,” a combination that made alcoholics different from non-alcoholics.

AA provided a guide for how a member of its fellowship could achieve abstinence and a joyful life through its 12-steps and The Big Book. It proved to be life-changing then and continues to be life-changing now for the millions who grapple with alcoholism – today understood as one of the diseases of addiction. However, AA could not overcome the shame in which society had so thoroughly shrouded the problem, a shame so powerful it forced alcoholics to recover from their disease in anonymity, hence the name, Alcoholics Anonymous.

Treatment options for drug addictions took even longer. Narcotics Anonymous (NA) meetings patterned after AA did not appear until the early 1950s, and its guidebook, Basic Text, was published long after that.

Not until the early 1980s, with the co-founding of the Betty Ford Clinic by Former First Lady Betty Ford, did seeking treatment at a residential facility for alcohol and drug addictions gain public recognition.  Today, there are more than 11,000 addiction treatment programs in the United States, according to the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Awareness Services (SAMHAS). And organizations, such as the American Medical Association, the National Institute on Drug Abuse, the World Health Organization and the National Institute on Alcohol Abuse and Alcoholism, are making significant advances in the prevention and treatment of alcoholism and drug addiction.

Yet, these major inroads have not been enough to overcome the secrecy and shame in which society has so thoroughly shrouded the problem. As a consequence, alcoholism and drug addiction continue to be misunderstood diseases.  They continue to be diseases people try to conquer on their own or to recover from in anonymity for fear of the reprisals they may face socially, at school, in the workplace or within their extended families.

Thankfully, the new brain and addiction-related research is exploding our long-held beliefs about alcoholism and drug addiction being a matter of “choice.” Finally we can end the secrecy and shame! Finally, we can treat addiction (to alcohol or drugs) for what it is — a chronic, often relapsing brain disease. But first, we must TALK ABOUT IT!

by Lisa Frederiksen

The following is an excerpt from the book in some of my upcoming book, Love One In Treatment? Now What! The “research” it refers to is the 21st century brain and addictions-related research now available…

Applying This Research to the First Three Steps of AA and NA

Because the majority of addicts/alcoholics are introduced to and/or use Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) at some point in their treatment and/or recovery, it is helpful to talk about the first three steps of these programs (listed below). Most addicts/alcoholics in early treatment/recovery (and often their family members and friends) are not convinced there is a God or Higher Power, nor do they believe that turning their lives and wills over to one makes any sense. Even though newcomers are assured that their God or Higher Power can be whatever/whomever they so choose, as long as it is something greater than themselves, many report feeling conflicted when they contemplate the first three steps of NA or AA. Here are those steps:
1 – We admitted we were powerless over alcohol/our addiction – that our lives had become unmanageable.
2 – Came to believe that a Power greater than ourselves could restore us to sanity.
3 – Made a decision to turn our will and our lives over to the care of God as we understood God.

For those who are confused by or worried about the meaning of these first three steps, it can help to think of them in terms of the new brain research as described in the following adaptation:
1 – Came to understand the disease of addition as a chronic, often relapsing brain disease, and to accept that I have the disease.
2 – Given the power of addiction cravings and the chemical and structural changes that have occurred in my brain because of my disease and/or my risk factors, I accept that my way of “handling” it by trying to control how much I use or drink cannot work.
3 – Accepting that “my way” did not and cannot work, I know I must abstain from my substance entirely, and I am open to trying any of the various treatment components available. If one fails, I will try another.

Sometimes using a concept of the first three steps in this manner can help addicts/alcoholics (and their family members and friends) embrace the notion and benefits of treatment and recovery, even if they do not believe in and/or grasp the 12-step explanation of God or a Higher Power.

Excerpt from Lisa Frederiksen’s upcoming book, Love One In Treatment? Now What!  To pre-order a copy of Lisa’s upcoming book, click here.

Look for Lisa’s latest book, Loved One In Treatment? Now What!, an Essential Handbook for Family Members and Friends Navigating the Path of a Loved One’s Addiction, Treatment and Recovery, coming late August 2010 — just in time for National Recovery Month in September!

Cover Design by Irene E. Yu

How can addiction be a brain disease?

There is a great deal of 21st Century brain and addiction-related research now possible thanks to advances in brain imaging technologies. These findings are exploding long-held beliefs about addiction and addiction treatment and the impacts of a loved one’s substance misuse on family members and friends. Loved One In Treatment? Now What! simplifies this research and answers questions, such as:

- What causes addiction? Why do some people become addicts/alcoholics and others do not?
- What is “effective” treatment? Is there a difference between treatment and recovery?
- Who among family members and friends can help a loved one get treatment? Or can they?
- What does coping with a loved one’s addiction do to family members and friends, and what is available to help them?

What readers are saying about this book:

“A thoughtful, well-researched, and highly accessible review of the neurobiology of addiction. Lisa Frederiksen captures this exciting and developing field of science with clarity, compassion, and hope.” Catherine M. Bitler, Ph.D., FACN

“Loved One In Treatment? Now What! is an outstanding, fact-filled, clear, easy-to-read and understand book aimed at helping friends and family, as well as the medical community, comprehend and approach one of the most baffling conditions that we face today.” Stan Fischman, M.D., Child and Adolescent Psychiatry

“Revolutionary…science-based answers, a checklist of next steps – a must read for anyone dealing with a loved one’s addiction.” Caroll Fowler, M.A., MFT, Addiction Specialist

“…what good is the latest research if it can’t be put to good use? This is one of the few practical guides to recovery tailored specifically for the family – highly recommended!” Gavin DeFreese, discoveringalcoholic.com

To pre-order a copy of Lisa’s upcoming book, click here.

One of the most encouraging things about all of the new brain and addiction-related research is learning we can actually change and heal neural networks and thereby change and repair our brains. This can be especially helpful to addicts/alcoholics and their families and friends because addiction is a brain disease. And as a disease, it can be treated.

The following is an excerpt from “Challenges and Opportunities in Drug Addiction Research, A Decade After the Decade of the Brain,” by Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), published by The Dana Foundation on February 18, 2010:

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.

… For example, scientists are using imaging technologies in neurofeedback programs that train people to voluntarily recalibrate their neural activity in specific areas of the brain, allowing them to gain unprecedented control over, for example, pain perception(5) or emotional processing.(6) During drug addiction treatment, this approach could greatly reduce the risk of relapse by enabling a patient to control the powerful cravings triggered by a host of cues (e.g., people, things, places) that have become tightly linked, in the brain of the user, to the drug experience….

To read the entire article, click here: “Challenges and Opportunities in Drug Addiction Research, A Decade After the Decade of the Brain.”

This sounds like an amazing conference sponsored by SAMHSA and TASC and cosponsored by equally important organizations. Click here for complete details and find the invitation summary below…

Join with leaders, colleagues and stakeholders as we create a two-and-a-half-day Conference Community to dialog on the current research, innovations and trends serving women and girls with substance use disorders and their families.

The Fourth National Conference on Women, Addiction and Recovery: Thriving in Changing Times is grounded in the principles of recovery and gender-responsive, trauma-informed care. The conference offers opportunities to explore a wide array of topics such as the following.

• family-centered treatment
• health policy affecting women’s treatment
• women and the criminal justice system
• co-occurring mental and health conditions
• comprehensive recovery support for women
• using technology in innovative ways
• culturally responsive approaches
• workforce development strategies

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.

This is an interesting lecture by Professor Philip Zimbardo about modern man’s perspective of time and how it relates to relationships, learning, and behavior. Pay close attention to the last half where he talks about kids living in a world they create separated from reality, where knowledge of consequences doesn’t necessarily change behavior, and why they don’t wear watches. I think another example he could have used is why drunks never learn. It’s this kind of stuff that reinforces my belief in the mental disease (faulty brain programming/training) aspect of addiction. Regardless of your thoughts on the disease concept, watch this video anyway because it’s a great topic presented in a unique graphic manner that really reinforces the content. Enjoy.

by Lisa Frederiksen

One of the problems for those in recovery — the family member, friend and/or alcoholic/addict — is the tendency to get stuck in a thought loop or to find oneself reverting to an old reaction, over and over and over, again. The following quotes may help you to jar your thinking when those old, embedded neural thought networks kick-in.

“We cannot tell what may happen to us in the strange medley of life. But we can decide what happens in us — how we can take it, what we do with it — and that is what really counts in the end.”    Joseph Fort Newton

“Forgiving is not forgetting, it’s letting go of the hurt.” Mary McLeod Bethune

“The lure of the distant and the difficult is deceptive. The great opportunity is where you are.” John Burroughs

“It does not matter  how slowly you go
So long as you do not stop.”  Confucius

“You never find yourself until you face the truth.”   Pearl Bailey

“The question is not what a man can scorn, or disparage, or find fault with, but what he can love, and value, and appreciate.”   John Ruskin

“If you work on your mind with your mind, How can you avoid an immense confusion?”  Seng-ts’an

The following is a guest post by my friend, 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 E.R. psychiatric emergency work in Chicago’s suburbs where he also spends time with his two teenage children.

“I am almost 25 but I feel like a scared little kid. In the mornings I have trouble getting out of bed, sometimes I don’t get up until 2pm. I clutch my blanket or a pillow and these thoughts come into my head that if I stay in bed I will be safe.”

And so began a heart-wrenching email I received today from a woman who’d read an article I’d written on a web resource site. Receiving such emails is not at all uncommon, and I can tell you I never become immune to their emotional impact. I’ve begun an email helping relationship with this woman; however, I have some thoughts I’d like to share with all of you.

How ’bout I paint this picture…

Your life is in shambles. I mean, the list goes on and on – relentless anxiety, mood lower than a rattlesnake’s belly, very scary thoughts zooming in and out of your head, weird physical phenomena, hair-trigger nerves, and intense fear.

And to make matters worse, you’re in financial turmoil and you have no idea how you’re going to keep your job, feeling as you do. And if you don’t have one, you’re not at all motivated or inspired to look. In fact, you find your motivation to do most anything has taken the last train for the coast.

Actually, at this point you wonder if it would be better to just curl-up into a ball and roll away. It’s so tempting, isn’t it?

So what now?

Well, I can tell you I’ve been smack-dab in the middle of it; and it’s about as hopeless, helpless, cold, and lonely a feeling as one could ever conjure up.

To me, this isn’t the time for “what to do,” it’s the time for “what not to do.” That said, here’s looking at you kid.

The chipur “I’m in the midst of hell on earth” NOT To Do List…

1. Do not expect to feel hopeful – and trash that “everything’s okay” look and attitude. Everything isn’t okay and every component of your mind and body are telling you so. How else do you think you’d feel?
2. Do not attempt to solve all 9,000,000 issues just now. Not only will you fail, you’ll implode.
3. Do not in any way assign your immediate circumstances to who you really are as a person (mom, dad, spouse, etc.). Never forget how powerful our inboard “butt-kicking” mechanisms are.
4. Do not prognosticate on how you’ll feel in, say, two weeks based upon how you feel now. I mean, that’s like trying to imagine one day feeling well as you’re doing all you can to survive a gastrointestinal flu bug.
5. Do not go to folks for insight and counsel in whom you have questionable trust.
6. Do not hesitate to talk with someone, even if it’s on a crisis-line, should you feel in any way unsafe.
7. Do not turn to substances for relief. I know it sounds awfully good, but every time you dodge a growth episode (and that’s what this is), major opportunities for positive change are missed. And besides, you don’t need anything messin’ with your judgment just now.
8. Do not do the “24-hour stay indoors” thing. Get out-and-about even if you have no reason to. And if you’re not up to driving, find someone who is or take a walk. I assure you, you’ll more than survive the outing.
9. Do not believe this is the end of the line for you. Believe me, others have endured the same and made it out. What makes them more deserving of good things than you?
10. Do not push away those you love, and who love you. As much as you may want to isolate, you’re shooting yourself in the foot.

Bottom-line is this – I don’t care how cooked you may think your goose is, it ain’t over ’til you say it’s over! And managing the immediate caving-in of the walls is a lot less complicated than you might think.

So there you have it, chipur readers – the latest in Top 10 lists. It’d be great if you’d come up with #’s 11-100 in a comment (or two).

Click here to link back to Chipur.com to read more terrific articles.