Archive for October, 2015

Addiction now defined as brain disorder, not behavior issue

Posted on: October 30th, 2015 by sobrietyresources No Comments

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By alcoholicsguide on October 22, 2015 • ( 4 Comments )

ASAM

We generally have a lot of time for ASAM and their sometimes long winded definitions of addiction.

Their new definition of Addiction is as “a chronic brain disorder and not simply a behavior problem…and also describes addiction as a primary disease, meaning that it’s not the result of other causes, such as emotional or psychiatric problems… Brain circuitry that governs impulse control and judgment is also altered in the brains of addicts, resulting in the nonsensical pursuit of “rewards,” such as alcohol and other drugs.”

This is an issue for us as it does not appear to fully understand the role of emotions in some of the mechanisms which they include in their definition such as impulsivity, judgement and even reward dysregulation.

This is a poor understanding of brain mechanisms.

Emotions are involved in most basic brain processes from simple motor processes, to other cognitive processes such as judgement and decision making. In fact, impaired emotion processing directly prompts poor decision making via impulsivity by recruiting more motoric parts of the brain rather than cortical prefrontal areas of the brain.

Thus emotion cannot be discounted as secondary to a primary disease it is in fact a primary factor in many brain processes including cognitive processes.

Poor emotion processing means one cannot identify,  label, describe and thus “send” the words for these emotions to the pre frontal cortex part of the brain so this, the pre frontal and cognitive part of the brain, cannot use this emotion  information to make goal-directed adaptive decisions.

We make decisions based on emotion information regardless of whether we are aware of it or not. If we removed the role of emotion on decisions we would simple make the same mistakes over and over again as we do have not an internal “gauge” of these decisions not being optimal, so can not correct them.

Instead undifferentiated emotions which “read” as distress-like recruit more limbic and motoric parts of the brain. In other words, these undifferentiated emotions prompt  a “fight or flight” type response to cope with these distress states. Thus decisions are based on alleviating this unpleasant feeling state and the pre frontal cortex is not recruited properly in decision making. It is a reactionary decision making profile.

This is seen in many studies which use delay discounting paradigms. Addicted individuals usually choose immediate short term gains over waiting a little longer for greater gains. We believe this distressed based impulsivity in decision making is evident in most addicted individuals and is based on relieving unpleasant feeling states as they are aware of the greater gains but still choose immediate rewards.

To say that emotions are not part of a primary disease also ignores the overwhelming research evidence that emotion regulation an processing regions of the brain in addicts and alcoholics are impaired, neuro-anatomically smaller, have network connectivity and functionality deficits and so on.

This means that the impaired emotion regulation networks are primary dysfunctions which represent a pre-morbid vulnerability to later addiction, as these are all seen in children of alcoholics, so emotion can not be discounted as a secondary influence.

Also this emotion regulation deficit can not only be genetically inherited  but also greatly impacted on via adverse environmental influences such as child maltreatment often in families where emotion regulation and stress coping strategies are lacking.

Finally emotion dysregulation also potentiates (heightens) reward in those vulnerable to later addiction (so they like stuff more). Negative emotion becomes “regulated” by external means which make them “feel better”.

Stress and emotion dysregulation also continue to become pathologically impaired in the addiction cycle and reward dysfunction is increasingly the consequence of this too.

Addicts have a primary emotion disease and emotions and brain structure can not be disassociated in the manner ASAM attempt to do.

Emotion is the fuel that drives brain processes, the sooner we all grasp this the better for everyone, particularly people who need recovery.

Addiction is a neuro-endocrinological (stress based) disease state, with high genetic and environmental input but which also blends with issues such as insecure attachment and resultant negative self schema.

Not feeling good enough drives addiction as well as any altered neurobiology. In fact it is an altered neurobiology which contributes to brain allostasis as much as so-called primary factors.

 

Source: Addiction now defined as brain disorder, not behavior issue

http://insidethealcoholicbrain.com/2015/10/22/addiction-now-defined-as-brain-disorder-not-behavior-issue/

 

In Washington D.C., a new generation rises up in fight against addiction

Posted on: October 14th, 2015 by sobrietyresources No Comments

In Washington DC

Laura Haven, left, and Luke Kassa, both of Baltimore, Maryland, sing along to a song performed by John Rzeznik of the Goo Goo Dolls at the first ever UNITE to Face Addiction rally. Both said they are in recovery. Merrily Cassidy/Cape Cod Times

  • By K.C. Myers kcmyers@capecodonline.com
  • Posted Oct. 5, 2015 at 2:00 AM Updated Oct 5, 2015 at 7:38 AM

WASHINGTON, D.C. — Imagine a rock concert with no one drinking or using drugs.

Imagine that concert with Joe Walsh of the Eagles, who battled cocaine and alcohol addiction for more than 20 years, singing about how it was hard for him to leave a party because he could not find the door.

That show happened on the National Mall on Sunday. Instead of drugs and alcohol, the thousands of fans at the first ever UNITE to Face Addiction rally were there to celebrate recovery and fight for those lost to addiction and the countless others still struggling.

Harwich native Michael O’Malley, 29, was among them.

O’Malley’s journey to the nation’s capital was a peak among many valleys in his short life.

“I was part of the OxyContin generation,” he said. “And I was part of the heroin epidemic.”

View a photo gallery from the rally in Washington, D.C.

UNITE to Face Addiction was organized by Greg Williams, who founded the nonprofit Facing Addiction and made the documentary “Anonymous People.” It was part concert and part political.

“Today is the day when the silence ends,” Williams told the crowd.

Between sets by Walsh and Goo Goo Dolls singer John Rzeznik, speakers included recovering addict and former U.S. Rep. Patrick Kennedy, Michael Botticelli, the director of the U.S. Office of National Drug Control Policy, and U.S. Surgeon General Dr. Vivek Murthy.

“I am with you,” Murthy told a cheering crowd Sunday.

“UNITE to Face Addiction will mark the first time our nation will collectively stand up to addiction, a health problem that impacts 1 in 3 households,” Williams stated before the event. “Twenty-two million Americans are currently suffering from a substance use disorder, and more than 23 million others are living in recovery.”

As a point of comparison, more than 29 million people in the United States have diabetes, according to the U.S. Centers for Disease Control and Prevention.

But, unlike diabetes, treatment for the disease of addiction is underfunded by insurance and stigmatized by society.

As Kennedy told the crowd, the Mental Health Parity and Addiction Equity Act of 2008 is still ignored by insurance companies.

“The bottom line is, the insurance industry isn’t following the federal law,” Kennedy said.

Dozens of Massachusetts residents joined this rally, including Gosnold on Cape Cod president and chief executive officer Raymond Tamasi.

“Today is the day when the silence ends,” Williams told the crowd.

Between sets by Walsh and Goo Goo Dolls singer John Rzeznik, speakers included recovering addict and former U.S. Rep. Patrick Kennedy, Michael Botticelli, the director of the U.S. Office of National Drug Control Policy, and U.S. Surgeon General Dr. Vivek Murthy.

“I am with you,” Murthy told a cheering crowd Sunday.

“UNITE to Face Addiction will mark the first time our nation will collectively stand up to addiction, a health problem that impacts 1 in 3 households,” Williams stated before the event. “Twenty-two million Americans are currently suffering from a substance use disorder, and more than 23 million others are living in recovery.”

As a point of comparison, more than 29 million people in the United States have diabetes, according to the U.S. Centers for Disease Control and Prevention.

But, unlike diabetes, treatment for the disease of addiction is underfunded by insurance and stigmatized by society.

As Kennedy told the crowd, the Mental Health Parity and Addiction Equity Act of 2008 is still ignored by insurance companies.

“The bottom line is, the insurance industry isn’t following the federal law,” Kennedy said.

Dozens of Massachusetts residents joined this rally, including Gosnold on Cape Cod president and chief executive officer Raymond Tamasi.

“This is kind of emotional,” said Tamasi, surveying the huge stage and thousands of people standing together to destigmatize addiction.

“We’re at the dawn of a new era,” he said. “This is an illness, a misunderstood illness.”

O’Malley’s own struggle mirrored many of the speakers on stage.

Beginning in 2000, when he was 14 years old, his friend encouraged him to look inside his father’s medicine cabinet, where they found and began to take Vicodin.

At the Harwich High School library, he and his friends played table hockey with their Vicodin pills without knowing the painkillers were dangerous.

“No one realized it back then,” he said.

He became hooked and began stealing money from his father’s wallet while his father showered in the morning.

He was charged with his first felony when he was 18, he said. He has a criminal record with about 16 felonies. He sold drugs and robbed his neighbors.

O’Malley has done time in jail and had more than three years of recovery when he enjoyed a life in the Boston music industry. He has been clean for several months after his last relapse this winter. O’Malley works at the Massachusetts Organization for Addiction Recovery, helping promote public policies related to addiction.

This weekend he came to Washington, D.C. to be part of a new generation, one that knows personally what it’s like to be controlled by drugs, to commit crimes, to be hated and feared. And if the advocacy at the UNITE to Face Addiction Rally takes hold, he may know what it’s like to be understood as sick with a brain disease.

O’Malley said the rally gives him hope.

“For the first time on a national level to see all these people are here,” he said. “It’s amazing. It’s a great demonstration that everyone is affected.”

“Addiction is a disease,” Botticelli said to the crowd of thousands. “Jails and prisons should not be the treatment of choice.”

“I’d like to go to the Harwich Town Meeting and say, ‘When I use OxyContin and heroin, I will steal from you and I’m a terrible person to my family and to my community. But this is how I got better … I went to treatment.’

You cannot criminalize it,” he said.

People from all over the United States of every color and age stood before the giant stage on the National Mall. They wore T-shirts bearing photos of lost loved ones and slogans that told the world their view on addiction.

“By our silence, we let others define us,” read one shirt. “Visual, valuable, vocal,” was printed on another. The event’s invocation was done by leaders of churches, mosques and a Buddhist temple.

Afterward, Tamasi and other treatment professionals from Massachusetts plan to spend two days in Capitol Hill talking to policymakers and legislators.

“We have to keep up the momentum,” Tamasi said.

As for O’Malley, he plans to continue working to make sure the public understands addiction is a disease.

“I know what a choice is. I know what a habit is. I have plenty of those,” he said. “But this is different. I’ve cried using (drugs) because what your brain is telling you to do is, ‘Do it or you’ll die.’”

— Follow K.C. Myers on Twitter: @KcmyersCCT.

Watch videos from the weekend rally against drug addiction

http://www.capecodtimes.com/article/20151005/NEWS/151009712

Heroin deaths in Lancaster County on pace for '100 percent increase over last year'

Posted on: October 14th, 2015 by sobrietyresources No Comments

  • Susan BaldRidge Staff Writer     Updated Oct 5, 2015 Comments

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Dan Marschka /Staff

The number of heroin deaths is surging in Lancaster County despite a renewed focus on treating addicts and the widespread use of a drug that can reverse overdoses.

The death toll from heroin in the first nine months of 2015 has already surpassed the total for all of last year and is likely to double as addicts are being turned away from detox centers that are at full capacity, officials said.

“It will likely be a 100 percent increase over last year,” said Dr. Stephen G. Diamantoni, the Lancaster County coroner. “It’s very sad. It’s clear that heroin is widely available and far less expensive than in the past. I think it’s become a more popular option than any other drug.”

Despite a greater focus statewide on the heroin crisis and the expanded use of the heroin antidote naloxone, 29 people have died of heroin or opiate overdoses through September.

In all of 2014, there were 20.

This year the county saw its 20th heroin-related death before the end of June.

The coroner said he’s seen more young people overdose on heroin this year than in previous years. Although the exact data will not be available on who’s overdosing until the end of the year, the coroner said more high school-aged teens overdosed in 2015.

“I think when something becomes this widely available,” he said. “You can expect younger users to access the drug.”

Lancaster County Coroner Dr. Stephen Diamantoni

herion deaths pic2

No beds for detox

These grim milestones come as treatment options grow more scarce. Last week every single detox bed in Lancaster County was filled and there was a waiting list.

White Deer Run Treatment Centers have more than 120 detox beds across seven different facilities in Pennsylvania, but none are open, said Stephanie Conkle, a senior adviser for admissions at White Deer Run’s national call center, in Carlsbad, California.

There is one detox center in Lancaster County for men that has seven potential openings. The closest detox facility for women is in York.

“When clients call, we tell them we will do a bed search but they often have to wait,” said Conkle. “Pennsylvania is one of the hardest places to find a bed and in Lancaster (County) there are none.”

Conkle said the scarcity of beds is a result of the high demand for drug treatment in central Pennsylvania.

Rick Kastner, executive director of the Lancaster County Drug and Alcohol Commission, confirmed that finding a place for addicts who want treatment in a facility right now is “problematic.”

Kastner said typically addicts continue their “drug of choice” when no bed is available to avoid going through withdrawal without support.

Not just Lancaster

Lancaster is not the only county in the region experiencing increases in heroin use.

Lebanon County government officials announced the formation of a heroin task force this week as their overdose tally hit 17 deaths — almost the same number they had in all of 2014.

York County, which had one of the highest overdose rates in the region last year at 64, has reported 28 confirmed heroin deaths and 14 pending.

“But we could have been looking at twice that many deaths if we wouldn’t have had more than 40 saves by Narcan (the heroin antidote),” said York County Coroner Pam Gay.

“Heroin use is still significant here,” she said.

http://lancasteronline.com/news/local/heroin-deaths-in-lancaster-county-on-pace-for-percent-increase/article_6406ae74-693b-11e5-84f1-879863935c63.html

 

 

CVS offering anti-overdose drug without

Posted on: October 14th, 2015 by sobrietyresources No Comments

Health Jon Collins · Oct 8, 2015

CVS offering anti

Naloxone, also known as Narcan, is a prescription drug used to stop an opiate overdose. Jeffrey Thompson | MPR News 2012

Pharmacists at one of the largest drugstore chains in Minnesota can now distribute an antidote over the counter that can reverse opiate overdoses.

CVS has announced that pharmacists at stores in Minnesota and 11 other states are now able to distribute the anti-overdose drug naloxone without a prescription. Another pharmacy based in southern Minnesota is exploring a similar program that’s expected to launch before the end of the year.

“Naloxone is a safe and effective antidote to opioid overdoses and by providing access to this medication in our pharmacies without a prescription in more states,” CVS Vice President Tom Davis said in a statement. “We can help save lives.”

The number of people who die from opiate overdoses has skyrocketed in Minnesota and across the country in recent years. The National Institute on Drug Abuse reported that more than 37,000 Americans died from drug overdoses in 2013, most of which were caused by prescription pain pills or heroin.

Opiate overdoses can cause death by shutting down the victim’s respiratory system. Naloxone, also known by the brand name Narcan, can reverse the overdose and restore respiratory functions.

“Naloxone is completely safe,” said Lexi Reed Holtum of the Steve Rummler Hope Foundation, which advocates for expanded access to naloxone. “There’s no harm that can come from giving someone naloxone that didn’t need it. There’s no abuse potential.”

Legislation known as Steve’s Law was passed in Minnesota in 2014 to broaden the public’s access to naloxone by allowing law enforcement officers to carry and administer it. It also allows doctors to issue a standing order so that public health groups or pharmacists can distribute naloxone without the need for a prescription for each patient.

Reed Holtum said it’s sometimes been difficult to get the antidote into the hands of people most at risk of overdose, but that the CVS decision represents a big leap in providing access across the state.

“People can walk into the pharmacy, having not seen their doctor,” Reed Holtum said. “Anyone who is in need of naloxone can go to their local CVS, go up to the pharmacist and let them know, ‘I need naloxone,’ and then the pharmacist will give you a brief training on how to use naloxone.”

CVS operates about 60 pharmacies across Minnesota, according to the company’s website. A survey of five CVS pharmacies in the Metro area on Thursday found that none had naloxone in stock. A spokesperson for the company said that the product can be ordered for overnight delivery if it isn’t immediately in stock.

Another chain of pharmacies based in southern Minnesota and Iowa also plans to implement a similar program before the end of the year. Jessica Astrup Ehret, Sterling drugstores’ community pharmacist, said rural residents can often have a tougher time getting their hands on naloxone.

“Rural areas often don’t have access to large organizations,” Astrup Ehret said. “I hope that some other pharmacies will jump on board in smaller areas, because we do have a large overdose problem.”

The Sterling program will provide the naloxone for free to low-income patients in partnership with the Steve Rummler Hope Foundation.

“I believe that we can help people and they can find recovery, but they need access to the resources and they need a second chance,” Astrup Ehret said. “If they do overdose, naloxone can be that second chance for them.”

 

http://www.mprnews.org/story/2015/10/08/naloxone-over-the-counter-minnesota

 

 

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