Rules for a Night of Serious Drinking

Simple moves to dodge a hangover.

Let's face it: Despite all the folk remedies--ginseng, prickly pear extract, peanut butter, miso soup, and Vitamin B6, there really is no cure for a hangover except more alcohol.

However, there are things you can keep in mind when contemplating a night of serious drinking. What you do while you are drinking can mitigate or exacerbate the effects of the Day After. The following list was adapted from a post by the folks over at the Nursing Schools Network and Directory and used with their kind permission.

--If you're in it for the long haul, consider alternating an alcoholic beverage with a non-alcoholic drink. The reward for this is continual hydration, which helps offset the tendency of alcohol molecules to replace water molecules in the cells.

--Choose your liquor carefully. Red wine and cheap dark booze have more congeners, which are organic molecules that can contribute to a hangover. ML01, a genetically-modified yeast, is being touted as a way of cutting back on the headaches commonly associated with a night of red wine.

--Keep Count. When you lose count, it's time to stop. Know your measure.

--Skip the Sugar. Sweet drinks mess with your blood sugar level even more than regular drinks.

--Keep the smoking to a minimum. You'll need your oxygen come morning.

--Don't diss the bar and cocktail snacks. Foods high in fat well help absorb excess alcohol.

--Skip the Tylenol and Ibuprofen before going out. They probably won't help, and the combination with alcohol taxes the liver.

--Drink water. And keep drinking water. Morning-after dehydration causes many of a hangover's lingering effects.

--Stop drinking an hour before you go to bed. Better to nod off than to pass out, and you will have a better chance of sleeping through the night.

Picture Credit: www.ehow.com

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The Medicalization of Legalization

Punish the crime, treat the disorder.

The alcoholic in A.A. and the cocaine addict on the street share a common appetite. This shared appetite, and the behaviors that come with it, are played out in a larger social context. For a practicing addict, the world is filled with risks, and some of these risks are invariably connected with the web of prohibitive laws and legislation governing the sale and use of addictive drugs. The movement for drug legalization, which began to coalesce about twenty years ago, is a collection of public voices spanning a variety of political and cultural points of view. Many prominent voices in the ranks of the legalization movement are public officials who have become disillusioned with the current state of affairs, and are now convinced that the present system is doing more harm than good.

The essential argument against legalization is that some drugs are not bad because they are illegal—they are illegal because they are bad. If alcohol and tobacco are legal, and we are only now beginning to come to terms with the health implications of that historical decision, it is insane to add heroin and marijuana and everything else to the list.

Harvard psychiatrist Robert Coles, a specialist in working with children, holds that legalization would be tantamount to a “moral surrender of far-reaching implications about the way we treat each other.” Such an act, Coles believes, would signal an acceptance of the pursuit of hedonism for its own sake.

However, the medicalization of addiction requires people to consider the possibility that drug abuse is less of a problem than drug crime--and that drug crime can be attacked differently. Very few of legalization’s adherents can be considered “pro-drug.”

Drug prohibition itself is a major part of the reason why the more potent and problematic refinements of plant drugs keep taking center stage. Since crack cocaine is more potent, more profitable, and more difficult to detect in transit, it replaces powdered cocaine, which, in its turn, replaced the chewing of cocoa leaves. Similarly, in the old days bootleggers switched from beer to hard liquor, just as modern international drug dealers switch from cannabis to cocaine whenever the U.S. enforcement engine lumbers off in the direction of marijuana interdiction and eradication. Is there anyone prepared to argue that the gruesome scenes along the Mexican border, as rival militias battle it out for control of the drug trade and the U.S. tries to interdict it, is somehow helping alcoholics and other drug addicts find their way to abstinence?

While the fact of addiction may be beyond the individual addict’s control, addicts nonetheless have a responsibility to do something about their disorder. What would we think of a diagnosed diabetic who told us there was no point in trying to treat his disease; it was all genetic and physical and therefore a waste of time to treat, and impossible to overcome? We would think they were nuts.

From a legal point of view, the biochemical model of addiction does not change the basic proposition that, with few exceptions, people must be held responsible for the crimes they commit in connection with drug or alcohol use. But simple possession should rarely be one of those crimes.

In time, it may be possible to separate out the criminals suffering from concrete biochemical abnormalities, so that they can receive medical treatment in addition to, or in lieu of, a prison sentence.

Punish the crime, treat the disorder.

Adapted from The Chemical Carousel: What Science Tells Us About Beating Addiction.

Photo Credit: NIDA

It’s So Easy To Slip

Simple reasons to kick addictions.

In a recent article for Scripps Howard News Service, Dr. Barton Goldsmith, a family therapist in California, listed "10 Reasons to Kick Addictions."

Nothing in the doctor’s list is shocking, or especially revelatory, or novel. But what caught my eye about his list was the simplicity with which Goldsmith states certain common facts about abstinence--facts that struggling alcoholics and other drug addicts often tend to deny or “forget.”

Here is a brief synopsis of some of Goldsmith’s observations:

--“Your friends and family will be happy to see and count on you again.”

In part, that’s because you will no longer being blaming them for your own problem.

--“You will like yourself better.”

Say goodbye to a whole lot of guilt and misdirected anger.

--“Your body and mind will feel awake and alive once again. One reason people continue to drink and use is because they physically experience the withdrawals of the substance and need to continue the addiction just to "feel normal.’”

The idea of a certain subset of people using drugs to “feel normal” is one of the crucial insights into modern research on addictive disorders.

--“You will make the world a tiny bit better. Just by being a little nicer, as well as extending a helping hand to others, (which will help you stay sober), you will make this world a better place.”

This may sound a bit twee, but it is a guiding principle in Alcoholics Anonymous and other non-profit self-help groups. Committing charitable acts for others is a classic way of seeking to go beyond the boundaries of the commanding self.

--“Others can once again trust you. An added benefit is that you can also trust yourself again, because you have gotten through one of the most frightening things in life.”

If you can do this one thing, you can do practically anything.

--“You will have more joy in experiencing a day rather than sleeping through it.”

You will also find that you have considerably more time available to you. In the early going, that can be a challenge, but it eventually becomes a wonderful thing.

-- “You will have more money.”

Indisputably true.

Photo Credit: www.zazzle.com

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A (Belated) Review of "The Los Angeles Diaries"

A powerful—and true—memoir of addiction.

I’ll admit it: I don’t like drug memoirs. I didn’t like drug memoirs even before James Frey blew up the whole genre by telling a heartfelt story about addiction that turned out to be a tissue of lies.

But The Los Angeles Diaries by James Brown transcends all that. I’ve never read a better true story about addiction. It’s also one of the best modern autobiographies I have ever read, addiction notwithstanding. In addition to having been an alcoholic and a meth head, James Brown is a very talented writer, the author of four novels, and it shows.

First published in 2003, The Los Angeles Diaries is a spare, utterly harrowing account of the author’s experience in a family marked by a history of virulent alcoholism. Brown’s unvarnished truth-telling about addiction is evident early on: “I know there’s no excuse for getting drunk when you’re supposed to be home with your family and I wish knowing this would stop me from doing it. I wish that’s all it took. That I could will it to happen. But it doesn’t work that way, it never has, and in my state of mind, at this particular moment, I can’t imagine living without it.”

While offering up memorable sketches of his boyhood in Los Angeles, Brown paints a devastating picture of the “denial and rage” that characterize full-blown addiction. He deals with the suicide of family members, divorce, the neglect of his children—all of it caused by addiction—without a shred of self-justification. It is, he writes, “a constant quest for more when there can never be enough.”

Interspersed throughout are the author’s mordantly funny adventures in the screen trade, as book after book is optioned for the movies, taken apart and ultimately scrapped before reaching the screen. However, we are never far from the author’s chilling revelation: “Never underestimate the power of denial.”

I can’t improve on the review that appeared in Washington Post Book World: “It’s the balance of agony and grace, of course, that makes life so ferociously interesting. Brown has perfectly captured that balance in his unpretentious, very profound book.”

Inspiring, witty, and bleak, all at the same time, James Brown’s book will appeal to anyone with an interest in addiction—and anyone who enjoys tough, spare prose.

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E-Cigarettes: Another Look

FDA remains conflicted over safety concerns.

The Food and Drug Administration (FDA) issued a controversial Safety Alert over electronic cigarettes, known as “e-cigarettes,” then held a press conference to explain itself. The agency’s muddled response to the issue has prompted increased advertising and online sales for Asian e-cigarette manufacturers, as well as a countering burst of criticism about the newest nicotine delivery system under the sun.

The FDA conducted a small-scale lab analysis of two different brands of e-cigarettes, and found “carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze.” The FDA’s Division of Pharmaceutical Analysis also found evidence of small amounts of cancer-causing nitrosamines. “These products do not contain any health warnings comparable to FDA-approved nicotine replacement products or conventional cigarettes,” the agency bulletin said. Therefore, the agency “has no way of knowing, except for the limited testing it has performed, the levels of nicotine or the amounts or kinds of other chemicals that the various brands of these products deliver to the user.”

The agency did not seek to ban e-cigarettes, as Canada did in March. However, in a written statement to CNN in March, the FDA admitted it had been detaining or refusing importations of electronic cigarettes for more than a year.

Debate has raged recently over the safety of e-cigarettes, which are battery-operated cigarette substitutes that technically dodge no-smoking bans, since no actual smoke is emitted. When a smoker inhales on the e-cigarette, the battery warms liquid nicotine stored in a plastic filter, producing a smokeless but inhalable form of synthetic nicotine. Upon exhalation, there is a small puff of vapor that quickly evaporates (See my earlier post, "E-Cigarettes and Health").

Michael Levy, director of compliance for the FDA’s division of drug evaluation and research, said he believes the products are illegal. However, “There is pending litigation on the issue of FDA’s jurisdiction over e-cigarettes,” he said.

Proponents of the e-cigarette claim that the devices are self-evidently safer than smoking cigarettes, and can help people stop using tobacco products. Critics respond that the safety of synthetic nicotine drug-delivery devices has not been established. Moreover, the range of fruit and candy flavors offered by e-cigarette manufacturers suggests to Jonathan Inickoff of the American Academy of Pediatrics Tobacco Consortium that the devices seem “tailor-made to appeal to kids,” while addicting them to nicotine and turning them into future cigarette smokers.

With half a million Americans dying prematurely each year from smoking, according to figures from the Centers for Disease Control (CDC), some doctors and tobacco researchers have pointed out that nitrosamines are also found in everything from nicotine patches to bacon. According to one researcher, “FDA should be encouraging, not maligning the manufacture and sale of electronic cigarettes, and working with manufacturers to assure the highest possible quality control.”

For a robust discussion of the e-cigarette question, see www.e-cigarette-forum.com


Photo Credit: www.politech.wordpress.com

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Treating Addicts Like Human Beings

Addiction stigma is alive and well.

Over at ScienceBlogs, Abel Pharmboy of Terra Sigillata blogged about astronaut Buzz Aldrin’s long struggle with depression and alcoholism. He also noted how he “hadn't really thought about our relative lack of discussion of substance abuse and chemical dependence in the context of scientific training and academia.”

In response, a student left this comment:
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“Thank you so much for this post. I am a recovering drug addict and am in the process of applying to graduate programs. I have a stellar GPA, have assisted as an undergraduate TA, and have been engaged in research for over a year. I also have felony and was homeless for 3 years. I don't hide my recovery from people once I know them, but I sometimes, especially at school, am privy to what people think of addicts when they don't know one is sitting next to them. It scares me to think of how to discuss my past if asked at an admissions interview. Or whether it will keep me from someday working at a university. I've seen a fair amount of posts on ScienceBlogs concerning mental health issues and academia, but this is the first I've seen concerning humanizing addiction and reminding us that addiction strikes a certain amount of the population regardless of status, family background or intelligence. I really appreciate this post. Thank you.”
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Two quick points: This is how bloggers in the field of health and medicine get their reward. Secondly--and obviously--the addiction stigma lives on-- (See my post, “Would you live next door to a drug addict? ). It is hard to imagine these anxieties stemming from someone with diabetes or sickle cell anemia. These days, we can also add unipolar depression and bipolar illness to the list of disorders that have recently emerged from the closet, so to speak.

If only the same reasoned compassion could be brought to bear on addiction one day.

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The Cybernetics of Alcoholics Anonymous

Is there a secular Higher Power?

Hitting bottom, in A.A. terms, may come in the form of a wrecked car, a wrecked marriage, a jail term, or simply the inexorable buildup of the solo burden of drug-seeking behavior. While the intrinsically spiritual component of the A.A. program would seem to be inconsistent with the emerging biochemical models of addiction, recall that A.A.’s basic premise has always been that alcoholism and drug addiction are diseases of the body and obsessions of the mind.

When the shocking moment arrives, and the addict hits bottom, he or she enters a “sweetly reasonable” and “softened up” state of mind, as A.A. founder Bill Wilson expressed it. Arnold Ludwig calls this the state of “therapeutic surrender.” It is crucial to everything that follows. It is the stage in their lives when addicts are prepared to consider, if only as a highly disturbing hypothesis, that they have become powerless over their use of addictive drugs. In that sense, their lives have become unmanageable. They have lost control.

A.A.’s contention that there is a power greater than the self can be seen in cybernetic terms—that is to say, in strictly secular terms. As systems theorist Gregory Bateson concluded long ago after an examination of A.A principles in Steps to an Ecology of Mind:

“The ‘self’ as ordinarily understood is only a small part of a much larger trial-and-error system which does the thinking, acting and deciding... The ‘self’ is a false reification of an improperly delimited part of this much larger field of interlocking processes. Cybernetics also recognizes that two or more persons--any group of persons--may together form such a thinking-and-acting system.”

Therefore, it isn’t necessary to take a strictly spiritual view in order to recognize the existence of some kind of power higher than the self. The higher power referred to in A.A. may simply turn out to be the complex dynamics of directed group interaction, i.e., the group as a whole. It is a recognition of holistic processes beyond a single individual—the power of the many over and against the power of one. Sometimes that form of submission can be healthy. Many addicts seem to benefit from being in a room with people who understand what they have been through, and the changes they are now facing. It is useful to know that they are not alone in this. “The unit of survival—either in ethics or in evolution—is not the organism or the species,” wrote Bateson, “but the largest system or ‘power’ within which the creature lives.” In behavioral terms, A.A. enshrines this sophisticated understanding as a first principle.

Excerpted from The Chemical Carousel: What Science Tells Us About Beating Addiction by Dirk Hanson © 2008

Photo Credit:www.zazzle.com.au

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