Exercise, Attention, Meditation

Drug treatment alternatives.

A prescription for aerobic exercise might seem trivial in the face of the life-or-death battle people wage against rampant addiction. But with or without anti-craving drugs, both diet and exercise—two non-pharmaceutical methods of altering neurotransmission—will have roles to play in recovery.

Exercise, attention to diet, and nutritional supplements are only three of the complementary avenues being explored as components of addiction treatment. Successes have been claimed for acupuncture as well.  The same can be said for hypnosis. It has its vociferous claimants, but it has not been widely tested and documented as an addiction therapy.

Meditation, in its many Eastern and Western derivations, is used by some recovering addicts as a means of dampening the panic and anxiety that often accompany detoxification. And again, there is a certain amount of good science behind the notion. Sources as disparate as Maharishi Mahesh Yogi and Harvard’s Dr. Herbert Benson have produced evidence that sitting meditation—in which the mind is either purposefully made blank, or else is focused on a mantra (the Maharishi’s mantras are Sanskrit, but Dr. Benson maintains that any soft-sounding set of syllables will do)—produces verifiable changes in blood pressure, heart rate, and oxygen exchange. Years ago, Dr. Benson named this phenomenon the “relaxation response.” Many addiction clinics use variations on this theme in an attempt to ease withdrawal symptoms.

All of these alternative modalities suffer from the same limitations: a lack of large scale clinical testing due to inadequate funding, and a lack of adequate insurance reimbursements. Nonetheless, almost anything goes in the sprawling treatment and recovery industry. There are, for example, numerous clinics and treatment centers based on the principles of naturopathic and homeopathic medicine. The 3HO SuperHealth program that bloomed in Tucson, Arizona, a “holistic substance abuse facility” inspired by the teachings of the Hindu Guru Yogi Bhajan, was accepted by Blue Cross/Blue Shield and other major insurance providers. (Gaining insurance accreditation is a major factor in the success or failure of many treatment providers and large-scale programs.) There are drug recovery programs based on the spiritual wisdom of American Indians, on the teachings of the German mystic Rudolf Steiner, on assorted holistic health practices such as yoga, guided imagery, lucid dreaming, biofeedback, massage, and other forms of “personal growth” work.

Alternative therapists maintain that recovery from addiction is as much a spiritual voyage of discovery as it is a path back to conventional health and sanity. Traditional psychotherapy in isolation is a frequently ineffective method of treatment, while anti-craving pills, congeners, and replacement therapies are still quite new.

 Any treatment that claims to work for all addicts all of the time, under all conditions, should be viewed with extreme skepticism. It is safe to say that any commercial treatment program advertising success rates of 50 per cent or more is very probably engaging in short-term follow-ups, and may be seriously misleading the buying public.

Photo Credit: http://steveroni.blogspot.com/

Put Down Your Cigarette Rag (Don't Smoke)

By Allen Ginsberg (1971)

Dont smoke dont smoke dont smoke

Dont smoke

It's a nine billion dollar

Capitalist Communist joke

Dont smoke dont smoke dont smoke dont smoke

Dont smoke

Smoking makes you cough,

You cant sing straight

You gargle on saliva

and vomit on your plate

Dont smoke dont smoke dont smoke dont smoke,

Dont smoke smoke smoke smoke

You smoke in bed

You smoke on the hill

Smoke till yr dead

You smoke in Hell

Dont smoke dont smoke in living Hell Dope Dope

Dont smoke dont smoke dont smoke

You puff your fag

You suck your butt

You choke and gag

Teeth full of crud

Smoke smoke smoke smoke Dont dont dont

Dont Dont Dope Dope Dope Dont Smoke Dont Dope

Pay your two bucks

for a deathly pack

Trust your bad luck

and smoke in the sack

Dont Smoke Dont Smoke Nicotine Nicotine No

No dont smoke the official Dope Smoke Dope Dope

Four Billion dollars in Green

'swat Madison Avenue gets

t' advertise nicotine

and; hook you radical brats

Dont Smoke Dont Smoke Dont Smoke

Nope Nope Dope Dope Hoax Hax Hoax Hoax

Dopey Dope Dopey Dope Dope Dope dope dope

Black magic pushes dope

Sexy chicks in cars

America loses hope

and smokes and drinks in bars

Don't smoke dont smoke dont smoke,

dont smoke dont dont dont dont dont

choke choke choke choke kaf kaf

Kaf Kaf Choke Choke

Choke Choke Dope Dope

Communism's flopped

Let's help the Soviet millions

Sell 'em our Coffin-Nails

and make a couple billions

Big Bucks Big Bucks bucks bucks

bucks bucks smoke smoke smoke smoke

smoke Bucks smoke bucks Dope bucks big

Dope Bucks Dig Big Dope Bucks Big Dope

Bucks dont smoke big dope bucks

Dig big Pig dope bucks

Nine billion bucks a year

a Southern Industry

Buys Senator Jesse Fear who pushes Tobacco subsidy

In the Senate Foreign Relations Committee

Dope smokes dope smokes dont smoke dont smoke

Cloak cloak cloak room cloak and; dagger

smoke room cloak room dope cloak

cloak room dope cloak room dope dont smoke

Nine billion bucks for dope

approved by Time and Life

America loses hope

The President smokes Tobacco votes

Dont Smoke dont smoke dont smoke dont smoke

Dont smoke nope nope nope nope

30 thousand die of coke or

Illegal speed each year

430 thousand cigarette deaths

That's the drug to fear

In USA Dont smoke Dont smoke Dont smoke

Get Hooked on Cigarettes

Go Fight the War on Drugs

Smoke any other Weed

Get bust by Government Thugs

Dont smoke dont smoke the official dope

If you will get in bed

and give your girlfriend head

then you wont want a fag

Nor evermore a drag

Dont Smoke dont smoke Hope Hope Hope Hope

O Please Dont Smoke Dont Smoke

O Please O Please O Please

I'm calling on my knees

Twenty-four hours in bed

and give your boyfriend head

Put something in your mouth

Like skin not cigarette filth

Suck tit suck tit suck cock suck cock

suck clit suck prick suck it

but dont smoke nicotine dont smoke

dont smoke nicotine nicotine it's

too obscene dont smoke dont smoke

nicotine suck cock suck prick suck tit

suck clit suck it But dont smoke shit nope

nope nope nope Dope Dope Dope Dope

the official dope Dont Smoke

Make believe yer sick

Stay in bed and lick

yr cigarette habit greed

One day's all you need

In deed in deed in deed in deed smoke weed

smoke weed Put something green

in between but don't smoke smoke dont smoke

hope hope hope hope Nicotine dont

smoke the official dope

Dope Dope Dope Dope Dont Smoke

Smoke weed indeed smoke grass yass yass

smoke pot but not nicotine no no

indeed it's too obscene

put something green

in between your lips get hip not square

listen to my wail don't dare smoke coffin nails

ugh ugh ugh ugh the government Drug

official habit for Mr. Babbitt

Dont smoke the official dope

dope dope dope dope don't smoke

Dont Smoke Dont Smoke.

Original version: First Blues: Rags, Ballads and Harmonium Songs

Extended version: http://www.youtube.com/

Photo Credit: http://berkshirereview.net/

Nicotine and the Humphrey Bogart Gene

You can lead a fish to water, but can you make it smoke?

Zebrafish embryo showing axon tracts in green, viewed from lateral (top) and dorsal (bottom) orientations------>

Common denizens of home aquariums, the humble zebrafish may dart about the tank like any other small tropical specimen, but zebrafish have become one of the hot genetic research tools of the moment. The lab rat may have met its match in the lab zebrafish, a popular non-mammalian organism that is currently playing a leading role in government-sponsored research on the genetic aspects of nicotine addiction.

Scientists are fond of these new fishy animal models because zebrafish are cheap, develop rapidly, and are more biologically similar to humans than anyone might naively assume. Their transparent embryos allow researchers to inject flourescent proteins into living animals, and in some cases to track the regulation of gene expression as it is happening.

Research funded by the National Institute on Drug Abuse (NIDA) and  published in the Proceedings of the National Academy of Sciences used zebrafish in a hunt for genes

affecting nicotine exposure. Like rats, the fish show characteristic behaviorial responses to low doses, high doses, and the nicotine sensitization process. According to NIDA, the scientists “induced mutations in particular DNA segments of the zebrafish and looked at changes in the nicotine response profile of mutant carriers compared to their siblings.” The changes in nicotine response observed between the groups were mediated by two genes, which the scientists dubbed bdav/cct8 (bette davis) and hbog/gabbr1.2 (humphrey bogart), named after “celebrities that suffered from tobacco-related cancers.” These two genes, when expressed, caused zebrafish to respond more positively to nicotine.

“We all know how hard it is to quit smoking,” Dr. Ekker told Mayo’s online research magazine, Discovery’s Edge. “What most people don’t know is that genetic differences significantly contribute to the degree of nicotine dependence. We want to understand the genetics behind different responses to nicotine and come up with more effective and individualized treatments for people addicted to nicotine.”

The Mayo Clinic in Minnesota has taken a leading role in developing the fish for research, having established the Zebrafish Core Facility in 2007 under the direction of Dr. Stephen Ekker. Mayo’s zebrafish are now being used in various research laboratories for research in the fields of developmental biology and functional genomics. The fish are now a crucial part of biological research on cancer and heart disease, as well as addiction.

Graphics Credit: http://www.ucl.ac.uk/

Petzold AM, Balciunas D, Sivasubbu S, Clark KJ, Bedell VM, Westcot SE, Myers SR, Moulder GL, Thomas MJ, & Ekker SC (2009). Nicotine response genetics in the zebrafish. Proceedings of the National Academy of Sciences of the United States of America, 106 (44), 18662-7 PMID: 19858493

National Alcohol and Drug Addiction Recovery Month

Presidential Proclamation

Each day brings new opportunities for personal growth, renewal, and transformation to millions of Americans who have chosen to forge a path toward recovery from addiction to drugs or alcohol.  While addiction can destroy self confidence, family ties, and friendships, recovery can restore the promise of a brighter tomorrow.  During National Alcohol and Drug Addiction Recovery Month, we express support for those living healthy and productive lives in long term recovery, we applaud those working to help struggling Americans break the cycle of abuse, and we encourage those in need to seek help.

This year's theme, "Join the Voices for Recovery:  Now More Than Ever!," calls us to an urgent mission to save lives from the hazards of addiction.  As we make quality and affordable health care more accessible to all Americans, we also resolve to build a healthier Nation by increasing access to treatment and recovery programs in our health care system.  To help achieve this goal, the Affordable Care Act supports services available to address addiction.  Together, we can reduce the harmful consequences of untreated addiction, such as violence, failure in school, job loss, child abuse, crimes, and death.  I encourage all Americans to visit RecoveryMonth.gov for more resources and information.

 The journey to recovery requires great fortitude and a supportive network.  As we celebrate National Alcohol and Drug Addiction Recovery Month, we also express our appreciation for the family members, mutual aid groups, peer support programs, health professionals, and community leaders that provide compassion, care, and hope.  Across America, we must spread the word that substance abuse is preventable, that addiction is treatable, and that recovery is possible.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim September 2010 as National Alcohol and Drug Addiction Recovery Month.  I call upon all Americans to observe this month with appropriate programs, ceremonies, and activities, and to celebrate the lives freed from addiction to illicit drugs, alcohol, or prescription medications.

IN WITNESS WHEREOF, I have hereunto set my hand this thirty-first day of August, in the year of our Lord two thousand ten, and of the Independence of the United States of America the two hundred and thirty-fifth.

BARACK OBAMA

Why Drug Stigma Still Matters

More sinned against than sinning?

 “Psychological theories of illness are a powerful means of placing the blame on the ill. Patients who are instructed that they have, unwittingly, caused their disease are also being made to feel that they have deserved it.”

--Susan Sontag, Illness as Metaphor

Addiction is always a hot topic, in its way, if only because of an endless supply of fallible starlets. More seriously, valuable research is taking place in myriad directions—the psychology of addiction, the disease of addiction, the neurobiology of addiction, the neuropsychopharmacology of addiction, etc. What sometimes goes missing is any serious analysis of the stigmatization of drug addiction.

The UK Drug Policy Commission (UKDPC) is an independent research group comprised of 12 “expert commissioners” charged with providing objective analysis on drug policy matters. The group recently issued a paper authored by Charlie Lloyd of the University of York. In “Sinning and Sinned Against: The Stigmatisation of Problem Drug Users,” (PDF) Lloyd set out to pull together the evidence-based research on the effects of stigmatizing  “problem drug users.” The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) defines problem drug use as “injecting drug use or long-duration/regular use of opioids, cocaine and/or amphetamines.”

According to Lloyd’s analysis of the research literature, the groups most frequently referred to as stigmatized are the disabled, the mentally ill, minority ethnic groups—and drug addicts. To make matters worse, multiple problems often attach to addicts: “Problem drug users frequently report suffering from other stigmas: being black, female, Hepatitis C or HIV positive, disabled, or suffering from a mental disorder. However, research shows that problem drug user status is the most stigmatising.” The stigma is continuously cemented in place by rhetoric about the “war on drugs.” There is no comparable public war on disability, or mental illness, or ethnicity—at least not overtly.

I cannot vouch for Lloyd’s analysis, but a good deal of it smacks of common sense at the street level. Others have suggested it is logical to assume that the stigma attached to hard drug addiction serves, by example, to deter others. “However,” Lloyd writes, “attempts to scare young people away from drug use have not proved effective. The evidence reviewed here suggests that stigma keeps users away from treatment.”

So this is not a theoretical concern. Stigmatization “may be a major stumbling block to successful rehabilitation.” Health professionals and hospital staff “can be distrustful and judgmental in dealing with problem drug users but drug users can themselves be aggressive and manipulative. In the United States staff who choose to work in hospitals serving the most deprived, inner-city populations appear to be more compassionate and patient.”

The prevailing public view, Lloyd writes, is that problem drug users tend to be “dangerous, deceitful, unreliable, unpredictable, hard to talk with and to blame for their predicament. Young people may have more negative views in this respect than adults.”

Of course, drug addicts can be all those things at one time or another. Drug abusers often stigmatize themselves. For the user, these conflicted feelings lead some of them to feel that “the very act of seeking treatment serves to cement an ‘addict’ or ‘junkie’ identity, which can lead to further rejection from family and friends.” This is most commonly experienced by users on methadone maintenance treatment, “who feel particularly stigmatised, in comparison to other treatment types.” Lloyd notes that a lifetime stigma sometimes attaches to heroin and cocaine addiction, continuing “to haunt such ex-users, preventing access to good housing and employment.” As he trenchantly observes, there is plenty of room “to stigmatise users less, without rendering heroin or crack-cocaine significantly more attractive.”

Lloyd concludes that the primary culprit, the complicating factor, is “blame.” Compared to “blameless groups” such as the disabled and the mentally ill, problem drug users, he writes, “are blamed for taking drugs in the first place and are also perceived to have a choice whether or not to take drugs in the future.”

If public and professional stigma has the power to prevent addicts from entering treatment (as it formerly held a similar power over the mentally ill, and before that, the disabled), what can be done about it? Lloyd makes several concrete suggestions, most of which center, predictably, on education:

--Drug education in schools should focus on the causes and the consequences of active addiction, rather than relying on scare stories.

--It’s time to teach health care and pharmacy staff about the medical, social, and psychological aspects of drug addiction.

--Treatment agencies need to focus on the whole person, “and not see problem drug users as solely problem drug users. Some drug addicts are also bird-watchers.”

--Users themselves, as well as their families, often benefit from a greater understanding of the mechanisms of addiction. This can have the effect of reducing “the self-blame felt by many drug user’s parents.”

--Finally, “police need to reflect on their practice in policing problem drug users at street level.” ‘Nuff said on that.

DrugScope, a leading U.K. charity with a membership drawn in part from the ranks of drug treatment and education workers, praised the report as “timely and insightful.” Martin Barnes, chief executive of DrugScope, said that the report effectively “evidences stigma as a barrier to recovery and reintegration.”

Photo Credit: http://www.zazzle.com/

Is Post-Traumatic Stress Medication a Danger to Veterans?

I have not run any guest posts lately, but some months ago the AllTreatment site was kind enough to feature a guest post of my own, so I've arranged to return the favor with an article by Brandon Yu. He is a Managing Editor of Alltreatment.com. AllTreatment is an online rehab center directory and substance abuse information resource.‬

Opinions expressed in guest posts are not necessarily those of Addiction Inbox.
-----
By Brandon Yu

After spending weeks, months, or years on the battlefield, veterans often experience Post-Traumatic Stress Disorder (PTSD) when returning to civilian life. The Department of Veteran Affairs reports that 60% of men and 50% of women, not just veterans, experience some sort of trauma in their lifetimes. PTSD has been known to cause insomnia, depression, and a sense of detachment, making it difficult for veterans to readjust to society, and throwing their personal and professional lives into disarray.

While there may not be a cure for Post-Traumatic Stress Disorder, there are treatments, and certainly medication, to sooth its side-effects. The most popular medication for PTSD is the pharmaceutical Quetiapine, marketed as Seroquel by the biologics company AstraZeneca. A potent antipsychotic, Seroquel is often prescribed to treat symptoms of psychoses including schizophrenia, bipolar disorder, and acute manic episodes; numerous physicians claim that it is one of the few treatments that curbs the nightmares, insomnia and anxiety that come with PTSD. It is not considered a controlled substance, and not deemed addictive like other sleeping pills.

However, several families of veterans are calling for a Congressional investigation of Seroquel after reports of mistreatment over the drug have arisen. After some complaints that the treatment was not working, some doctors prescribed progressively larger doses for given patients, with certain ones receiving more than double the maximum recommended. Though only six similar deaths have been noted, there is a belief that there have been others. The New England Journal of Medicine recently published a report linking Seroquel use to heart failure, noting that 3 of 1,000 patients who suffered from cardiac arrest were noted to be on Seroquel at the time of death.

Seroquel is one of the more common medications in America, as it is one of the Department of Veterans Affairs’ most prescribed drugs and the fifth best-selling drug in the nation. It has been reported to help schizophrenia and PTSD, but some of its side effects, such as diabetes, weight gain, and uncontrollable muscle spasms, have caused AstraZeneca to receive multiple trips to court, with an estimated 10,000 product liability lawsuits. It is noted that although it is commonly prescribed for those suffering PTSD, Seroquel has not received FDA approval as proper treatment for insomnia. Families of veterans who are attempting a Congressional investigation on Seroquel are hoping for a clearer guideline of the side effects as well as the risk to one’s health.

Today is Overdose Awareness Day

Annual global day of action coordinated by Red Cross.

According to the most recent figures from the Centers for Disease Control and Prevention (CDC),  more than 26,000 Americans die needlessly, pointlessly, from accidental drug overdoses.  For example, in San Francisco, there were more drug-related accidental deaths in 2007 than there were deaths by automobile crash. These days, oxycodone is  our leading killer, followed by cocaine and heroin.

The Harm Reduction Coalition notes the success of the DOPE project (Drug Overdose Prevention and Education) in San Francisco. DOPE is a community group composed of members trained to recognize and respond to drug overdoses. In San Francisco, one person dies every other day from a preventable drug overdose death.

"Overdose Awareness Day is a time for us to remember the thousands of lives lost to accidental drug overdose every year and to restate our commitment to effective strategies to reduce overdose deaths in our community," said DOPE Project Director Eliza Wheeler.  "This year, we would like to publically thank the courageous people who have successfully revived their friends, family members and partners using naloxone."

Over at Injecting Advice, they have gathered together twitter hashtag posts about Overdose Awareness Day:

“Today (31st August) is International Overdose Awareness day and all around the world there are services (and individuals) working hard to raise awareness of the main course of death for people who use drugs. As you'd expect a lot of these people are now using social media like twitter, so I've decided to collect together the mentions of the official 'hashtag' for overdose awareness day.”

In addition, www.injectingadvice.com offers a downloadable OD Awareness Workshop.