Breakingthecycles.com – Changing the Conversations

by Lisa Frederiksen

One of the most difficult aspects about changing how we view and therefore talk about and therefore begin to treat addiction is the confusion over what it “really” is. Family members and friends, addicts and alcoholics will go to the ends of the earth trying to convince themselves that heavy use is not addiction; that this time really will be different than all of the other times; that all will go back to “normal” if s/he would just stop drinking/using. The swirling of conflicting emotions, beliefs, feelings, actions and inaction eventually starts to tear family members and friends apart.

Should any one person and/or all concerned accept the problem is more than something a loved one can just wrest control of — that a different kind of help is needed — new questions arise. How is it that addiction a brain disease? Or is it?  How does someone “get” this disease? How is it different than just drinking or using too much? What do you mean, powerless? And, what is codependency? Science-based answers to these questions and more are now possible, thanks to 21st century brain and addiction-related research. The resulting findings are exploding long-held beliefs about substance abuse, addiction and addiction treatment, as well as what happens to the family members and friends — in other words, the impacts of secondhand drinking/drugging.

The pdf link below allows you to download my two-sided piece, titled, “Essential Information for Family Members and Friends Navigating the Path of a Loved One’s Substance Abuse and/or Addiction, Treatment and/or Recovery.” This piece provides some of the highlights of this new research and offers a starting point for changing views about addiction, treatment and/or recovery for the addict/alcoholic and the family members and friends.

BTC Essential Information For Family-Friends.8.8.10 (to start the pdf download, click on the small page-looking icon that appears)

If you have questions or questions specific to your situation, don’t hesitate to use the confidential “Contact Us” link — you will not be added to a mailing list, nor will your email address be stored in any way.

by Lisa Frederiksen

I share the following excerpt from an article by Simona Sikimic, titled, “Alcoholic Anonymous Takes Root in Lebanon, Attracts Clients From Across the Region,” appearing August 6, 2010, online, at The Daily Star, Lebanon, to remind us all that addiction is worldwide. It knows no boundaries. There is no “typical” alcoholic or addict.

But addiction, to both alcohol and drugs, is a growing problem in Lebanon and the Middle East alike. It is eating away at the lives of hundreds of thousands of people and is indiscriminate of age, sex or religious belief.

The number of alcoholics is known to be rising, especially among young women, while the number of drug addicts in Lebanon alone is estimated to be somewhere between 10,000 and 15,000. Even staunchly conservative Saudi Arabia has not escaped this trend and has one of the world’s worst amphetamine problems with the UN Office of Drugs and Crime (UNODC) revealing that almost half of the world’s illegal-pharmaceutical amphetamine seizures take place in the kingdom.

“The program is big in Saudi Arabia, too big! There are chapters in nearly every city,” said Said, a recovering Saudi addict who visited AA Lebanon for the first time in July. “There is every kind of drug there. It is just more underground but just as destructive. I didn’t know there was a meeting in Lebanon but I’m grateful to be here at the fellowship and that the meetings happen in Arabic.”

While numbers across the region may be rising, understanding and acceptance of the problem remain low and treatment options are limited. Close family ties often mean that an alcoholic or addict will be sheltered from the worst of their problem by their relatives, claims Bob.

I encourage you to read the article in its entirety – Alcoholic Anonymous Takes Root in Lebanon, Attracts Clients From Across the Region.

Why Do Drug and Alcohol Rehab Programs Recommend 12 Step Programs?

The answer is relatively simple. The original alcoholics anonymous 12 step program has been around longer, worked for more people, and has been proven in many studies be more effective than any other program of recovery when used in conjunction with clinical therapy. It’s tough to argue with success. That being said, it would almost be almost irresponsible not to recommend them. To finish reading this article posted on Addiction Treatment Challenges, click here…

Nutrition in Addiction Recovery; How Eating Right Helps You Heal

Healing in recovery requires paying attention to many different things, and nutrition is right up there at the top of the list. In fact, eating right can help speed recovery by giving your body the essential ingredients it needs to maintain or restore energy, elevate mood, and keep vital organs functioning at optimal levels.

But what constitutes eating right in recovery? To read the remainder of Drug Addiction Treatment’s August 5, 2010, blog, click here…

Poll: More Americans Drinking Alcohol

Gallup’s annual drinking poll indicates that 67% of U.S. adults drink alcohol, an increase over last year and the highest rate of alcohol consumption since 1985. The poll also showed that beer remains the most popular drink in the U.S., followed by wine and then liquor. What is fueling the increase in drinking? To read the rest of Buddy T.’s August 5, 2010, post on About.com: Alcoholism, click here…

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

This NPR news piece, “Food For Thought: Meat-Based Diet Made Us Smarter,” by Christopher Joyce, appearing on KQED’s August 1, 2010, program/website,  brings to mind the importance a healthy diet plays in a person’s recovery from an addiction or the impacts of secondhand drinking/drugging (SHDD). Both (addiction and SHDD) cause brain changes, and its the rewiring of these brain changes (changing them back, if you will) that helps a person recover from an addiction or the impacts of SHDD (living with a loved one who misuses substances – alcohol or drugs). 21st century brain research now shows the importance of nutrition in that change process.

The following is an excerpt from my upcoming book, Loved One In Treatment? Now What!. The other keys to brain health/changes are: exercise, sleep and mindfulness activities. You can read all about these and other important research when the book is released August 20, 2010.

Unlike other body organs, the brain is incapable of making and storing glucose, which is its sole fuel source. No fuel, no brain activity. The brain requires a daily dose of about twenty percent of the body’s glucose supply – a staggering amount given the brain is only two percent of the body’s total weight. (1)

The brain gets its glucose supply from the carbohydrates in the foods we eat, which are broken down and transported to the brain via the bloodstream. For optimum brain health, however, it can’t be any old carbohydrates, like those in candy or sugar-packed soft drinks. The brain needs the complex carbohydrate variety, such as that found in whole grains, fruits and vegetables.

And while glucose is essential, so is protein (like that found in lean meats, poultry, fish, beans, eggs, milk products). Protein serves as “the basic building block of the brain’s tissue,” AND it helps in the production of neurotransmitters(2) and neurotrophins.

Healthy fats, like omega-3 fatty acids found in tuna and salmon, are important for building the neuron’s cell membrane and nerve fiber insulation,(3)  as well as “synaptic plasticity” and functions related to memory and learning.(4)

And it goes on and on from there.

Healthy nutrition is astoundingly important to brain health – something only known and understood as a result of the new brain research. But if you are not inclined to learn the nitty-gritty about nutrition, and let’s face it, who has the time when grappling with a loved one’s addiction and/or treatment, following the U.S. Department of Health and Human Services and U.S. Department of Agriculture’s Dietary Guidelines (visually shown in the Food Pyramid) covers the basics. In a nutshell, these guidelines suggest you:
- emphasize fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products
- include lean meats, poultry, fish, beans, eggs, and nuts
- keep saturated fats, trans fats, cholesterol, salt (sodium) and simple sugars low
- stay within daily calorie needs(5) (yes, excess calories impact brain health – especially the flexibility of the synapses and increased vulnerability to cell damage(6)).

Visit www.mypyramid.gov/guidelines for more information.

Think of nutrition as “food” for “thought.” The more nutrient-rich the food, the “better” the thought.

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1) Carter, Rita, et al., The Human Brain Book, New York: DK (Dorling Kindersley Limited) Publishing, 2009, p. 45.

2) Gilmour, Patricia, “Nurturing Health Brains,” Bardstown City Schools Comprehensive School Health, January 4, 2010, http://bardstownschools.us/health/bloghealth/?p=146

3) Gilmour, Patricia, “Nurturing Health Brains,” Bardstown City Schools Comprehensive School Health, January 4, 2010, http://bardstownschools.us/health/bloghealth/?p=146

4) Wolpert, Stuart, “Scientists Learn How What You Eat Affects your Brain – and Those of Your Kids,” UCLA News, www.newsroom.ucla.edu, July 9, 2008, <http://newsroom.ucla.edu/portal/ucla/scientists-learn-how-food-affects-52668.aspx>

5) USDA’s Dietary Guidelines, U.S. Department of Health and Human Services and U.S. Department of Agriculture, <http://www.mypyramid.gov/guidelines/>

6) Wolpert, Stuart, “Scientists Learn How What You Eat Affects your Brain – and Those of Your Kids,” UCLA News, www.newsroom.ucla.edu, July 9, 2008, < http://newsroom.ucla.edu/portal/ucla/scientists-learn-how-food-affects-52668.aspx>

by Lisa Frederiksen

1 in 4 American children live in a home where there is alcohol abuse or alcoholism. Countless others live in homes with illegal or prescription drug abuse or drug addiction. Helping the children in these families is critical.

This hour long film celebrates September as National Alcohol & Drug Recovery Month and is produced by CSAT (Center for Substance Abuse Treatment) and SAMHSA (Substance Abuse and Mental Health Services Agency). It  presents a panel discussion on this critical situation because children who grow up in an addict/alcoholic famly live in chaotic family environments with little stability or emotional support. As a result, many will develop behavioral and emotional probems that may impaire their ability to live happy and normal lives. Watching this film is important for this is a condition that affects some 28.6  million American children of alcoholics, of which 11 million are younger than 20 — figures that do not include the numbers of children whose parents are addicted to drugs.

Can I buy you a drink? Genetics may determine sensitivyt to other people’s drinking behavior
Your friend walks into a bar to meet you for happy hour. He sidles up to the bar and orders a drink — does that make you more likely to get a drink yourself? According to new findings reported in Psychological Science, a journal of the Association for Psychological Science, genetics may determine the extent to which you are influenced by social drinking cues — signals such as advertisements, drinks placed on a bar, and seeing other people around you drinking.  Click here to read the remainder of this post on Science Daily, July 23, 2010.

Should You Tell Your Kid if YOU Did Drugs as a Teen?
Remember those anti-drug public service ads from the ’80s? One of the most memorable showed a father finding his teen son’s stash and angrily confronting him about it, only to face the boy’s furious, devastating rejoinder, “I learned it by watching you, Dad!” Click here to finish this article by Kate Tuttle, posted on the blog, MomLogic.

Washington [State] Imposts New Rules on Prescribing Powerful Painkillers
The state of Washington plans to impose tough new rules on doctors who want to prescribe opiate painkillers to patients, including mandatory third-party evaluation of patients who request higher doses of the drug but don’t show signs of improvement, the New York Times reported July 28. Read the rest of this News Summery on Join Together.org.

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.

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(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.

Finding effective addiction treatment — a program that addresses the individual’s specific needs — is difficult. Throw in insurance vs. no insurance; location; dual diagnosis treatment and the like, and it becomes even more difficult.

Adi Jaffe, a doctoral student at UCLA, himself a former drug dealer and meth addict, founded All About Addiction (A3), which has recently launched a treatment program finder, the A3 Rehab Finder. When asked about A3’s new rehab finder, Adi had this to say:

Why – I decided to put together the rehab-finder because I thought it was sad that with all the technology we have, the best way to find treatment was either to do a general google search (cue paid ads by providers that charge a lot and can therefore pay for advertising) that results in lists upon lists of providers, or go the SAMHSA treatment locator, which only searches by location. I thought we could do better. I believe that if we can make it easier for people to find the right treatment we will increase enrollment in treatment (because people will find treatment they can afford) and improve treatment outcomes (because the treatment-client fit will improve).

The idea came to me years ago in the form of an actual call center, but not having the money to do anything like that, I had to figure out something smaller, hence the online tool, which by now is probably the better option anyway.

How – When clients fill out our form in its entirety, we have more than 20 different variables to use when choosing the right provider for them. For the most part, we don’t match people based on the treatment approach (CBT, MI, 12 step, or others), that’s been tried and failed – there seems to be little difference and we don’t know how to match there yet. What we do is match on gender, age, insurance, mental health status, specific addiction specialty, and other factors like the need for detox, specific treatments for specific drugs (like buprenorphine for heroin). Overall, we get pretty good matches, especially when the alternative, or lack thereof, is considered. The next step for us (I’m applying for funding right now) is to run an actual study assessing the effectiveness of this thing. I’d like to set up a few different versions (including a location-only search like SAMHSA’s) and see if our version works better. It also lends itself to constant improvement based on the actual results obtained. I’m kind of hoping to make this one of my long-term research projects…

So check it out — Adi is looking for feedback and would love to know what works and doesn’t work about A3’s new rehab locator.