Breakingthecycles.com – Changing the Conversations

by Lisa Frederiksen

The following is another  excerpt from our upcoming booklet, Seven Myths That Can Kill… If you’d like to purchase a copy for your college student, high school student, of if a parent, yourself, so that you’ll be prepared with what to say to your middle school student, use the Contact Us link. The booklets are $1.95 each (does not include CA sales tax or postage/mailing), and should be available by September 1, 2010.

Myth #4:  Drink lots of water and eat a big meal, and it will “absorb” the alcohol.

Reality: Surprisingly, this is not true – surprising in the sense that alcohol dilutes in water, so why wouldn’t that dilute the alcohol? And, it all goes to the same place – the stomach – so why doesn’t eating food absorb the alcohol?

It’s because alcohol is not digested like other foods, which are broken down by the digestive system into smaller molecules of nutrients to nourish cells and provide energy. Alcohol avoids the normal digestive process and goes directly to the bloodstream from the small intestine.

Drinking water, however, does help a person minimize hangover symptoms which are caused in part by the dehydration that alcohol can cause.

With regards to food – we are constantly told not to drink on an empty stomach, which is, by the way, excellent advice to follow. But it’s not because the food will absorb the alcohol. (Remember – food and alcohol are processed differently – food is digested by the body’s digestive system, alcohol is metabolized by the liver.)

Food is important because it slows down how fast the stomach empties its contents (in this example, alcohol) into the intestine, and from there to the small intestine, and from there into the bloodstream. And, it is this slowing down that can help a person stay in control of how much they drink. Having a couple quick drinks on an empty stomach, allows the alcohol to move quickly into the small intestine and from there into the bloodstream. And, as you read under Myth #1, alcohol dissolves in water, travels through the bloodstream to body tissue high in water content – the brain, for example. Alcohol “sitting” in the brain, while it “waits” to be metabolized by the liver, causes the alcohol to suppress normal brain functions. And it’s that that gets in the way of a person’s ability to think straight, act responsibly and/or behave “normally.” Instead s/he can tell him/herself things like, “I’m f-i-n-e, I’ll just have another, and then I’ll stop.” Or “No worries. I’m okay to drive.”

Bottom line: drinking water helps hydrate you, reducing hangover symptoms; food slows how fast alcohol enters the bloodstream. Neither water nor food, however, will keep you from getting drunk if you drink more than the brain and body can process.

So how much is too much? The rule of thumb for this is to follow what are known as “moderate” drinking limits:
•    For women, that’s no more than 7 standard drinks in a week, with no more than 3 of those 7 in any one day.
•    For men, that’s no more than 14 standard drinks in a week, with no more than 4 of those 14 in any one day.

[Note: Binge drinking was previously defined as 4 or more drinks on an occasion for women and 5 or more for men. The definition here, showing a per day limit of 3 for women and 4 for men, is to help people avoid rationalizing two “occasions” in the same day as a way to drink all, or a majority, of their weekly drink quantities at once.]

As you’ve gathered, the idea behind these limits is to help a person maintain brain and body control. Additionally, it helps a person avoid the chemical and structural changes caused by repeated alcohol abuse. And, these changes are real!

© Lisa Frederiksen, Excerpt from the 20-page booklet, titled: “Seven Myths That Can Kill…” by Lisa Frederiksen, available September 2010.

Dr. John Knight, Director of the Center for Adolescent Substance Abuse Research at Children’s Hospital Boston and a consultant to NIDA, NIAAA and the President’s Office of National Drug Control Policy, answers questions about underage drinking in this short video clip.

by Lisa Frederiksen

NPR’s news program, today, “Commanders Have Ignored Major Mental Health Issues, Army Report Concludes,” reinforces the importance of talking about the connection between substance abuse and mental illness. [Note: substance abuse and addiction are two different things, although both cause changes in the brain.]

Substance abuse (whether it is of alcohol and/or prescription or illegal drugs) causes chemical and structural changes in the brain (see SPECT scan below). Thirty-seven percent of alcohol abusers and fifty-three percent of drug abusers [NOT addicts or alcoholics but drug or alcohol abusers] also have at least one serious mental illness,(1)(2) such as depression, PTSD, bipolar, anxiety, schizophrenia. Often what happens is the person starts to drink or use drugs to self-medicate the mental illness.

When you change the chemical and structural make-up of the brain, you change how the brain works, which in turn, changes how a person thinks, feels and behaves. This is because “neural networks” in the brain control EVERYTHING we think, feel, say and do. “Neural network” is a name for the process by which neurons talk to one another. In the brain, neurons are also known as brain cells. The way our brain cells talk to one another is determined by how our neural networks wire – talk to one another. Drinking too much or abusing drugs interrupts neural networks, which is part of what makes a person unable to think straight or behave “normally.” Repeatedly drinking too much or abusing drugs can cause chemical and structural changes in the brain like those shown in the image on the left, below.

SPECT Surface Scans, Courtesy Amen Clinics, Inc., www.amenclinics.com

LEFT = SPECT Surface Scan confirming substance abuse. RIGHT = SPECT Surface Scan of normal brain.

Now look at SPEC Surface Scans of the brain of a person with ADHD below (for comparisons, look at the bottom, right scan — that’s the same view as the two scans above). As you can see, mental illness also changes the brain.

SPECT Surface Scan Showing ADHD, Courtesy Amen Clinics, Inc., www.amenclinics.com

Looking at scans like these helps one see what substance abuse (such as repeated binge drinking) and  mental illness, such as ADHD, do to the structural make-up of the brain. This in turn can help you appreciate why a person whose brain has experienced these kinds of changes does not “think” or “behave” normally. It helps explain, in part, why suicide can seem like the best option to those who suffer from an undiagnosed, untreated mental illness and a substance abuse problem. A person suffering PTSD or bipolar or anxiety or depression needs help (see Resources below). A person who is abusing substances also needs help (again, see Resources below).

Looking at these kinds of scans also helps us appreciate that just removing the substance – the “coping skill” – without replacing it with something else (such as treatment and/or medication for the mental illness), or treating the mental illness without stopping the substance abuse, is a set-up for failure.

THE BOTTOM LINE: the brain change change. A person can heal their brains with proper treatment. Healing the brain changes how a person thinks, feels and behaves.

RESOURCES:

The Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services offers a Locator database with comprehensive information about mental health services and resources in the United States.

The National Alliance of Mental Illness (NAMI) offers excellent, free self-help programs. Visit www.nami.org for information and locations in your community.

NIAAA’s (National Instittue on Alcohol Abuse and Alcoholism) Rethinking Drinking website can help a person anonymously assess his/her drinking patterns and find tips for cutting down.

NIDA’s (National Institute on Drug Abuse) Info Facts: Science-Based Facts on Drug Abuse and Addiction

Bring Change 2 Mind.org – working to end the stigma associated with mental illness.

_____________________________________________________________________
(1) “Factsheet: Dual Diagnosis,” Mental Health America, <http://www.nmha.org/index.cfm?objectid=C7DF9405-1372-4D20-C89D7BD2CD1CA1B9>
(2) “Dual Diagnosis and Integrated Treatment of Mental Illness and Substance Abuse Disorder,” National Alliance on Mental Illness, <http://www.nami.org/Content/ContentGroups/Helpline1/Dual_Diagnosis_and_Integrated_Treatment_of_Mental_Illness_and_Substance_Abuse_Disorder.htm>

For help with talking to teens, visit The Partnership for a Drug Free America or SAMHSA’s Start Talking Before They Start Drinking for suggestions.

by Lisa Frederiksen

This is a question most parents dread being asked if they did drink in high school. Worried about how to respond so it doesn’t make is seem okay for their adolescent to do the same. Worried not to answer truthfully. Believe it’s okay because they did it, and they turned out just fine.

Whatever your thoughts on this subject, consider reading the article appearing on today’s NYTimes.com, by Perri Klass, M.D., “Q. Did You Ever Smoke Pot?  A. It’s complicated.” Though the drug is different, the issues are the same. In view of the new brain and addiction-related research now available, it’s an article well-worth the read, regardless of how old your child may be.

by Lisa Frederiksen

Boy… this seems like a terrific resource for groups wanting to put together coalitions to address underage drinking issues. It was created by the National Association of Governor’s Highway Safety Representatives (NAGHSR) and provides a comprehensive list of organizations that have an interest in or knowledge about underage drinking issues.

Click here to read/print a copy.

by Lisa Frederiksen

Little did we know until the Decades of the Brain (1990’s) and Discovery (2000’s) that the brain could take until age 25 to fully develop. Little did we know that the kinds of brain developmental activities that occur from ages 12 – 20, often through 25, explain why teens do the things they do (seek risks, not consider potentially negative outcomes) and why alcohol and/or drug abuse can be so problematic for young people’s brains.

The following is an excerpt from an article, “Teen Brain’s Uneven Development Explains Why Teens Act the Way They Do,” appearing on ManhassetPress:

…It’s as if, while the other parts of the teen brain are shouting, the Prefrontal Cortex is not quite ready to play referee. This can have noticeable effects on adolescent behavior. You may have noticed some of these effects in your teen:

- difficulty holding back or controlling emotions,

- a preference for physical activity,

- a preference for high excitement and low effort activities (video games, sex, drugs, rock ‘n’ roll),

- poor planning and judgment (rarely thinking of negative consequences),

- more risky, impulsive behaviors, including experimenting with drugs and alcohol.

…The use of drugs and alcohol may also disrupt the development of the adolescent brain in unhealthy ways, making it harder for teens to cope with social situations and the normal pressures of life.

Moreover, the brain’s reward circuits (the dopamine system) get thrown out of whack when under the influence. This causes a teen to feel in a funk when not using drugs or alcohol—and going back for more only makes things worse… Click here to continue reading.

To learn more about this underage brain development, see brain scans showing brain development ages 5 – 20 and better understand why a person under age 21 can become an alcoholic, click here.

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.

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.