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Thursday, June 23, 2016

Pain Management Alternatives Meet Resistance

pain management
Everyone in the United States would like to see the end of the opioid epidemic. Both lawmakers and health experts unanimously agree that there is a lot of work to be done, if such a goal is to be accomplished. The main focus is providing expanded access to addiction treatment services for those already addicted, and reducing our reliance on prescription opioids for pain in order to prevent future cases of addiction. No easy task, but one that is necessary.

A number of bills have been passed that aim to address the aforementioned points, which should prove to be effective. Legislation is designed to: increase access to treatment, make it easier to acquire naloxone, encourage responsible prescribing and the use of prescription monitoring programs (PDMPs). It goes without saying that prescription opioids will need to be relied upon in certain situations, but both doctors and patients have become far too reliant on them—using opioids when alternatives could have been utilized. There are a number of methods that can be used to treat moderate and mild pain, such as:
  • Yoga
  • Massage
  • Meditation
  • Acupuncture
As you might imagine, the call for alternative forms of pain management has been met with some resistance, The New York Times reports. In fact, there are a number of obstacles in the way of offering opioid alternative pain management, setting aside the doctors and patients against such modalities. Lack of scientific evidence to support the use of alternatives will often times prevent insurance companies to cover such treatments. Physical therapy coverage varies from state to state.

Let’s face it, people want instant relief from even the mildest pain—making painkillers the ideal option among most patients, according to the article. On top of that, it's easier for doctors to write a ‘script’ rather than brainstorm and troubleshoot which pain management alternative will work best.

This year, the Centers for Disease Control(CDC) issued new guidelines for the use of prescription opioids. The agency called for the use of opioid analgesics only as a last resort, exhausting alternative treatments first.

Tuesday, June 21, 2016

Drug Testing Welfare Recipients: The Stigma of Poverty

drug test
In recent years there has been a lot of controversy surrounding certain states requiring drug testing for those who receive state assistance, such as Medicaid and Medicare. Drug testing requirements, many argue, discriminate against those living in poverty. Despite the fact that the American opioid epidemic has touched people from practically every demographic, there is still a long held belief that drug addiction affects those primarily of lower socioeconomic standing.

In fact, some 15 states have passed legislation requiring those that receive public assistance be subject to drug testing, and this year alone another 17 states have made similar legislative proposals, according to the National Conference of States Legislatures. In an attempt to point out the absurdity of denying the poor access to assistance for using a drug, a similar type of legislation has been proposed that would require people of means be drug tested before they are eligible to receive tax benefits.

Gwen Moore, a member of the U.S. House of Representatives from Wisconsin's 4th district has proposed the "Top 1% Accountability Act of 2016," a bill that would require taxpayers with itemized deductions greater than $150,000 to submit to the IRS a clear drug test, NPR reports. Moore was Inspired by House Speaker Paul Ryan’s unveiling of the "A Better Way" poverty plan in front of a substance use disorder treatment center, which the Congresswoman believes is “pushing this narrative that poor people are drug addicts” and “is as absurd as it is offensive.”

Congresswoman Moore, commenting on the legislation in a press release, said:

“Such baseless attacks against the poor inspired me to draft the Top 1% Accountability Act of 2016. My legislation would require taxpayers with itemized deductions of more than $150,000 to submit to the IRS a clear drug test, or take the much lower standard deduction when filing their taxes. It is my sincere hope that my bill will help eradicate the stigma associated with poverty and engage the American public in a substantive dialogue regarding the struggles of working- and middle-class families.” 

Those who use or abuse illicit drugs come from all walks of life, addiction does not discriminate. While it is hard to imagine Moore's plan will be passed, she is making a valid point and reigniting the conversation about political tactics that seem to make it harder for those already struggling to make it in life.

Friday, June 17, 2016

Sober Housing for Higher Learning

sober dorm
Teenagers who go off to college with a history of alcohol and drug use often find it difficult to maintain in a college setting—where drinking and drugging is pervasive. Keeping up with a full class load whilst intoxicated on a regular basis is no easy feat. It is quite common for students with substance abuse issues to drop out, then return to school only to drop out again. It is a cycle that is the result of addiction.

More times than not, college age young adults struggling with addiction need to find recovery before they are able to seriously have a shot at obtaining a degree. However, going back to school after finding recovery is still a challenge. Just because one manages to find sobriety, doesn’t mean that they will not be exposed to drugs and alcohol upon returning to school. Being in close proximity to other students who use mind altering substances can be a trigger for those who work a program of recovery. So what is one to do? Not go back to school for fear of triggers?

As you might expect, choosing to not move forward with one’s dreams of achieving a higher education due to the potential of a relapse is not the optimal choice. In fact, in recent years a number of colleges across the country have begun to offer dorm buildings specific to people in recovery or for people committed to abstinence. Universities that offer sober living services to their students, provide an environment where like-minded people working towards the same goal of graduating and maintaining their recovery can flourish.

In light of the American opioid epidemic, more and more schools are seeing the need to offer sober dorms. In fact, using the model that Rutgers University developed in 1988, colleges outside of New Jersey have begun to implement similar services to their students, PBS NewsHour reports. The Association of Recovery in Higher Education found that 95 percent of students involved in college recovery programs manage to hold on to their recovery.

Sober dorms are a “major new development in the recovery movement. They’re unique because they get to the heart of the beast,” said Dr. Robert DuPont, who heads the drug policy think tank the Institute for Behavior and Health, and served as White House Drug Chief from 1973 to 1977. 

Below are some schools who have gotten on board:
  • University of Vermont started a recovery housing program in 2010.
  • Texas Tech began offering substance-free housing in 2011.
  • Oregon State University will begin a similar program in the fall semester of 2016.

Thursday, June 16, 2016

Facebook Launches Suicide Prevention Tool

The month of May was Mental Health Month (MHM), a time to raise consciousness about mental illness, which millions of Americans struggle with each year. The goal is to educate the public about mental health disorders, fight for equal health care services and end the stigma surrounding a number of debilitating conditions.

We wrote last week about June being designated as the National Post Traumatic Stress Disorder (PTSD) Month, a condition which falls under the umbrella of mental illness that affects both veterans and average Americans alike. The vast majority of people living with PTSD, as with other mental health disorders, are unable to get the help they desperately need.

Those who are left behind typically turn to drug and/or alcohol to cope with PTSD. Sadly, a significant number of people suffering from post traumatic stress turn to suicide in order to end their suffering—which brings us to the topic of discussion for today—preventing suicide.

Almost daily, millions of people in the United States and over 1.65 billion people worldwide login into their Facebook account. While a large number of people use Facebook to share what they are having for dinner or a new and improved selfie—others update their status to inform their friends about their day and how they are feeling. Naturally, sometimes such post can be rather dark which can be indicative that someone is struggling.

Recently, a suicide was prevented because a potential victim posted what appeared to one friend as a suicide letter, prompting said friend to reach out to authorities who were then able to intervene, The New York Times reports. As a result, Facebook is taken a revolutionary approach to saving the lives of would be suicide victims.

This week, the tech giant added new features to the existing platform that will allow users to flag posts of their friends that appear to be suicidal in nature, according to the article. The flagged posts are then analyzed by a team at Facebook. The group will provide the flagger with specific language for talking with the potentially suicidal friend—as well as information on suicide prevention.

“Given that Facebook is the place you’re connected to friends and family, it seemed like a natural fit,” said Dr. Jennifer Guadagno, a researcher at Facebook who is leading the suicide prevention project.

Thursday, June 9, 2016

PTSD Awareness Month 2016

It is quite common in the field of addiction recovery to meet people with a substance use disorder who are also affected by another mental illness. When that is the case, it what is called a co-occurring disorder, previously referred to as dual diagnosis. The most co-occurring disorders to accompany addiction, include:
  • Anxiety
  • Bipolar Disorder
  • Depression
  • Post Traumatic Stress Disorder
Addiction experts believe that in order for addiction treatment to have the best chance of success, it is paramount that both the addiction and co-occurring disorder be treated simultaneously. Failure to treat one without the other can be recipe for disaster. People living with any form of mental illness will often turn to drugs and alcohol as a mechanism for coping with their symptoms. It is widely agreed upon that self-medicating one’s mental illness with mind altering chemicals only makes the condition worse.

In the United States, in particular, we have thousands of young service men and women coming home from conflict in the Middle East. Overburdened Veterans Affairs facilities across the country have had a hard time treating the thousands of PTSD cases. As a result, veterans turn to the resources they have available, this often comes in the form of drugs and alcohol. As was said earlier, illicit drug use and heavy drinking are not effective forms of coping with any form of mental illness. Dependence and/or addiction often ensues, feeling like one has few options or hope often times lead people with PTSD to make rash decisions that can result in loss of life—i.e. overdose and suicide.

In attempt to raise awareness about post traumatic stress disorder and the treatments available in this country, the the United States Senate has designated June 27th as National PTSD Awareness Day. The month of June is PTSD Awareness Month sponsored by the National Center for PTSD. Everyone can do their part to help millions of Americans get the help they so desperately need.

Please take a moment to share a PTSD guide on your social media sites.

Wednesday, June 8, 2016

Alcohol, Memory and External Stimuli

Alcohol is everywhere and it is addictive. It the most commonly used mind altering substance on the planet, and is also abused more than any other drug. Despite the fact that alcohol can lead to addiction and cause serious life threatening health problems, alcohol is legal for adult consumption in every major western country. Abstaining from alcohol use after years of drinking can be difficult, often requiring substance use disorder treatment and/or the use of the 12-step model of recovery.

Recovering from an alcohol use disorder requires eternal vigilance if one is to avoid relapse. If you are in recovery for alcoholism, or know someone who is, it is likely you've heard the saying: “putting down alcohol is the easy part, not picking it back up is the more difficult task.” Those words could not be further from the truth, even setting aside the fact that alcohol withdrawal is no walk in the park.

Unlike other drugs commonly abused, alcohol is unique due to the fact that it is a legal drug. Practically everywhere you go, whether out for a drive or attending a sporting event, it is nearly impossible to not be bombarded by alcohol advertisements or people drinking on any given day. For those trying to recover from alcoholism, the aforementioned sights can trigger one to want to drink—a slippery slope that can lead to a relapse.

A new study has sought to understand how alcohol affects memory, with regard to how humans respond to external stimuli, ScienceDaily reports. In fact, little research has focused on how mind altering substances affect “learning or memory for drug-associated stimuli on humans.” The findings were published in the journal Alcoholism: Clinical and Experimental Research.

The cues in question, include images of both alcohol-related beverages and neutral beverages, such as:
  • Beer Bottles
  • Liquor Glasses
  • Water Bottles
  • Soda Cans
The researchers found that one’s sensitivity to “alcohol's positive rewarding effects” are more likely to remember “alcohol-related environmental stimuli” encountered when they were intoxicated, according to the article. They may be more susceptible to more intense memory associations with alcohol-related stimuli—putting them at greater risk of relapse.

Thursday, June 2, 2016

Can We Change How the Brain Responds to Triggers?

relapse triggers
Addiction can manifest in a number of different ways, and while it could be argued that some forms are more insidious than others—they all can severely impact the qualities of one's life. Those in the field of addiction have long known that addiction is a brain disease, a researcher's work day in and day out to get a better grasp of the nature of mental illness. The more we know about addiction, the better equipped those who work in the field are to develop and implement effective treatments.

While many people who suffer from drug and alcohol addiction have a hard time understanding other forms of addiction, such as eating disorders or gambling addiction, there is not much of a difference between the different forms of the disease and they are rooted in the same areas of the brain. In fact, how people are affected, or triggered, by external cues occurs in the same area of the brain for both eating disorders and substance use disorders.

Scientists have located, with a strong certainty of exactness, the area of the mind that connects an external trigger to binge-eating or drug-seeking behavior, Medical News Today reports. Inhibiting certain cells in the pinpointed area deep in the brain resulted in diminished motivation and urgency to respond to triggers when using rat models. The implications of this research could result in the development of new methods for combating addictive behavior. The research was published in the journal Neuron.

"External cues - anything from a glimpse of powder that looks like cocaine or the jingle of an ice cream truck - can trigger a relapse or binge eating,” said study lead author, Dr. Jocelyn M. Richard, a psychological and brain sciences researcher at Johns Hopkins University in Baltimore, MD. “Our findings show where in the brain this connection between environmental stimuli and the seeking of food or drugs is occurring." 

The area of the brain that the researchers are working with is known as the ventral pallidum (VP), the article reports. The VP is an assemblage of brain cell clusters found underneath the cerebral cortex. The research team was able to selectively turn off brain cells in the VP which resulted in abnormal responses to cues that would have normally caused a quick response to triggers. The findings could result in treatments that calm the response to triggers, potentially preventing a relapse.
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