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Tuesday, November 24, 2015

Staying Sober Over Thanksgiving

Maintaining a program of recovery can be challenging during the holiday season. Juggling one’s program with family gatherings and work parties can prove difficult, but it is possible to accomplish. With Thanksgiving just a couple of days away, it is vitally important to have a plan for your day. Having a schedule in place will reduce the possibility of running into obstacles that could jeopardize your recovery.

When attending family and/or work gatherings, it is safe to say that alcohol will be present. Most people in recovery would like to maintain their anonymity. Not having a drink in one’s hand could raise flags, requiring you to explain why you are not drinking. While family members tend to be understanding about your recovery, it’s typically not ideal to have to explain to a boss or work peer that you have a history with substance abuse. Fortunately, it is OK to tell your coworkers that you do not drink without divulging your life story, such as saying:
  • I don’t drink.
  • I’m driving tonight.
  • Alcohol affects me negatively.
If you are in early recovery, it is best to attend events, which might involve alcohol, with a friend in recovery. Your sponsor may be willing to accompany you. If not, perhaps you have made friends with people who have substantial periods of recovery under their belt. It is usually a sound practice to leave parties early, as time goes by people can become intoxicated, which can be unsafe and little fun to be around.

Be sure to attend your home group on Thanksgiving. If you cannot make it because of a prior obligation, no worries, there are meetings happening all day long during Thanksgiving. It is not uncommon for people in recovery to attend multiple meetings during a holiday. Being around your recovery peers throughout the day is a sure way to maintain your sobriety. If you happen to be traveling, you can find local meetings at:
Hope by the Sea would like to wish everyone in recovery a safe and sober Thanksgiving.

Monday, November 23, 2015

Over 9 Million Americans With Drug Use Disorders

Drug addiction affects millions of Americans; it’s probably fair to say that our government has not always had the most appropriate response to dealing with the problem. Addiction is an illness, a disease of the mind that has been treated as a crime for nearly a century or more. In the United States, government officials have begun viewing addiction differently in the wake of the opioid epidemic; calling for treatment over jail is a huge move towards acknowledging that addiction is not a moral failing. Nevertheless, the stigma of addiction remains a hard nut to crack, and many addicts fail to seek help for their problem.

New research suggests that over nine million Americans had a 12-month drug use disorder (DUD) diagnosis, and 9.1% had a lifetime diagnosis, under the currently accepted diagnosis in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5), Medical News Today reports. What’s more, less than a quarter (24.6 percent) of people with lifetime DUDs received any kind of treatment.

Using data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), Bridget F. Grant, PhD, and her team of researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), looked at the prevalence and treatment of DUDs. The drugs the researchers focused on included:
  • Amphetamines
  • Cannabis
  • Club Drug
  • Cocaine
  • Hallucinogens
  • Heroin
  • Nonheroin Opioids
  • Sedative/Tranquilizers
  • Solvent/Inhalants
The researchers found that there are many factors that play into drug use disorder rates, and some demographics were more likely to abuse drugs than others, according to the article. People most affected by DUDs included:
  • Men
  • White and Native American individuals.
  • Young, divorced or never married adults.
  • People with lower incomes and education.
  • People living in the Western U.S.
The researchers point out that their findings are probably conservative, considering that the data did not include people with DUDs that were incarcerated.

"Findings also indicate an urgent need to destigmatize DUD and educate the public, clinicians, and policymakers about its treatment to encourage affected individuals to obtain help," said the researchers. 

The research was published in JAMA Psychiatry.

Wednesday, November 18, 2015

Who Gets A New Liver?

Should a person’s past and/or current behavior dictate whether or not they can receive an organ transplant? If you are thinking that that is a complex question, you are right! A large percentage of people who are in need of a transplant have done things in their life that damaged their organs, such as smoking cigarettes and drinking alcohol. Since organs are limited and extremely valuable, it may be easy for some to argue that people who have willingly harmed their health, may be less deserving of a transplant than people who have lived health conscious lifestyles. What’s more, many people who are in need of an organ are still using harmful substances.

In the United States, transplant centers have different policies when it comes to potential liver recipients - how their use of cigarettes, drugs or alcohol affects their chances of getting a transplant. The question of liver transplantation in patients with a history of addictive disorders was covered by panelists at the American Association for the Study of Liver Diseases (AASLD) annual Liver Meeting, MD Magazine reports. The panelists consisted of transplant experts.

“You don’t want to waste a liver, but you don’t want to deny a patient a life-saving therapy either, just because he’s a smoker,” said David Riech of Hahnemann University Hospital in Philadelphia. “A lot of people who need liver transplants are smokers.” 

Panelist Michael Lucey, MD, chief of the division of gastroenterology and hepatology at the University of Wisconsin School of Medicine in Madison, WI surveyed 134 transplant centers in the United States, according to the article. Lucey received responses from 42 of them, and they account for about half of all the livers transplanted in the US

Dr. Lucey found that very few centers require patients to be in a smoking cessation program. 27 centers required a six-month period of abstinence from opiates. The majority of centers were found to have no policy regarding marijuana use, which the experts agreed that marijuana’s effect on the liver was understudied, the article reports.

When it comes to alcohol, he found that:
  • 24 centers require a set period of abstinence from alcohol.
  • 15 centers said “it depends.”
  • Only one center said “no.”
Naturally, providing a new liver to someone with a history of alcohol abuse raises some questions. There is always a chance that the patient will relapse, potentially harming the new liver. Although, there is no way to quantify a person’s risk of relapsing, the article writes.

There is not enough information on the impact of various addictions on transplants, according to the panel.

Tuesday, November 17, 2015

A New Cure for Hepatitis C

Intravenous drug use is extremely dangerous, a behavior that can easily result in an overdose. Over the last several years, people in the United States have witnessed a dramatic rise in overdoses related to illicit opioid use, an epidemic that has been steadily getting worse. On top of the exponential rise of overdoses, there has also been a surge in infectious disease transmissions, such as HIV and hepatitis C.

While the aforementioned viruses are not a new problem, new cases were fairly minimal for a number of years. The American opioid epidemic, in conjunction with limited access to clean needles, has resulted in a number of new cases. In Indiana, Governor Mike Pence issued a state of emergency due to an outbreak of HIV tied IV Opana use, a prescription opioid. As a result, IV drug users can now acquire clean needles in the affected areas. Providing greater access to clean needles reduces the potential of infectious disease transmission. Needle exchanges give substance use disorder counselors an opportunity to discuss treatment options with addicts - which is great.

But, what about those who have already been infected? 

Unfortunately, a cure for HIV/AIDS has not been developed, but the medicines available today allow many of those infected to live longer lives. On the other hand, hepatitis C patients have options available now that can cure the disease at a high rate of success. An experimental drug, made by Merck & Co., cured 95 percent of 301 IV drug using patients living with hep C, Bloomberg Business reports.

Merck stated that 67 percent to 84 percent of IV drug users that are being treated with addiction medicine have been infected with hepatitis C, according to a Merck news release.

“Injection drug use is a major factor fueling the global hepatitis C crisis, yet people with chronic hepatitis C virus infection who inject drugs often remain overlooked and underserved,” said Dr. Ronald Nahass, president, ID CARE, New Jersey. “Patients in this study with chronic hepatitis C virus infection on opioid agonist therapy, including many who continued to use drugs during the trial, were able to complete treatment with elbasvir/grazoprevir and achieve high virologic cure rates.” 

The study findings were presented at The American Association for the Study of Liver Diseases Annual Meeting.

Wednesday, November 11, 2015

The Issues Resulting From Ignoring Fetal Alcohol Spectrum Disorder

Drinking alcohol while pregnant can cause a number of preventable problems, the worst of which being Fetal Alcohol Syndrome (FAS). Exposing fetuses to alcohol can result in a number of other disorders, many of which are hidden in the surface affecting the brain. Such problems fall under the fetal alcohol “umbrella” known as Fetal Alcohol Spectrum Disorder (FASD).

In the United States, products containing alcohol have labels which caution women who may be pregnant that consuming alcohol may result in birth defects. What’s more, bars are required to post signage which reads the same. Nevertheless, a significant number of pregnant women choose to consume alcohol and many babies are born with preventable disorders.

The use of alcohol in Europe is a little bit different than the United States. In many countries people can begin legally using alcohol at younger ages than America’s age requirement of 21. Alcohol is viewed differently than it is viewed here, so it is not surprising that European governments handle alcohol in very different ways. A new assessment suggests that in the United Kingdom, there is an dire need for better prenatal alcohol exposure diagnoses, Science Daily reports. As well as better pathways for diagnosis, assessment and support.

The report found that FAS cases (babies born with both mental and physical alterations) are extremely prevalent, about one in every 100 babies in England and Wales. Those cases make up more than the combined of babies born with:
  • Down's Syndrome
  • Cerebral Palsy
  • Sudden Infant Death Syndrome (SIDS)
  • Cystic Fibrosis
  • Spina Bifida
Dr Mary Mather, a retired Community Paediatric Consultant and a Trustee of the FASD Trust, points out that UK has conducted very little research on FASD, and the UK is hesitant to accept the views of the rest of the world on the subject, according to the article.

"A recent search for the term 'fetal alcohol' in an archive of worldwide medical publications produced more than 14,500 articles. Virtually none of them emanated from the UK and to highlight what is happening here has not been an easy task. This lack of research and definitive guidance in the UK has led to unconsidered and diverse opinions about alcohol, where every professional has a different view and pregnant women are left confused and uncertain." 

Mather adds:

"The UK is the binge drinking capital of Europe and 50% of pregnancies are unplanned; every day that alcohol is ignored or downplayed, more damaged babies are being born. There is an urgent need for action and research. [...] Clear national guidelines about totally avoiding alcohol during pregnancy are essential. [...] Many more diagnostic clinics are needed with doctors with the expertise to run them. Training for midwives, social workers, doctors, foster carers and others in preventing and managing FASD is essential." 

The assessment was published in the SAGE journal Adoption & Fostering.

Tuesday, November 10, 2015

How Do States Rank With Tobacco Control?

Tobacco use in the United States, while significantly less in recent years, is still a major concern - especially among teenagers and young adults. People who smoke are at an increased risk of developing life threatening illnesses, and tobacco related illnesses are one of the leading causes of preventable death in this country. A number of states and municipalities have taken drastic measures to reduce the toll of tobacco use, such as raising prices and age limits and educating young people about the dangers associated with use.

However, in several states where tobacco use has caused the most damage, little is done to combat the problem. A new analysis conducted by USA Today found that states hit the hardest by tobacco use often have the least aggressive approach to mitigating the problem. It probably comes as little surprise to learn that the states in question are those known for tobacco cultivation. Despite Kentucky, Georgia and Tennessee having the poorest and sickest residents, they only spend a minor fraction of the federal government’s recommended minimum for tobacco education and enforcement.

States found to be doing the worst with regard to tobacco control and have the highest impact of use include:
  • Kentucky
  • Tennessee
  • Missouri
  • West Virginia
  • Mississippi
The analysis found that states which scored high on aggressiveness and low on tobacco impact included Hawaii, New York and Utah, according to the article. It’s probably worth noting that Hawaii recently became the first state to raise the minimum age for tobacco use to 21. A number of other states are considering similar legislation.

The researchers used government smoking data to create two scores for grading states, an “impact score” and an “aggressiveness score.” The impact score was arrived at by combining smoking rates and the public perception about the dangers of use, the article reports. The aggressiveness score combined:
  • Taxes
  • Bans
  • State Spending
  • Advertising Restrictions
  • Severity of Fines for Selling to Minors
On top of being deadly, tobacco use is highly addictive. There have been studies that indicate that people in recovery for addiction should be weary of tobacco use. Recent findings indicate that tobacco use can significantly increase one’s risk of relapse.

Wednesday, November 4, 2015

Rise In Mortality Among Middle Aged Whites

In advanced nations, such as the United States, people typically live longer than ever before - the direct result of advances in medicine and more health conscientious attitudes, especially towards tobacco use. However, in the U.S., statistics are painting a picture than should not be expected for a major western nation. A recent review of statistics shows that since 1999, many white middle-aged Americans are dying at a higher rate, The Washington Post reports.

Interestingly, 1999 was the year arguably considered to be the beginning of the opioid epidemic in America. The rise in mortality for any large demographic in a major country is practically unprecedented, according to the article. The only other time something like this has been seen in modern times was in Russia after the fall of the Soviet Union.

Causes for the increase of white middle aged men and women living shorter lives between 1999 and 2013, according to researchers, include:
  • Legal and Illegal Drug Use
  • Alcohol Use
  • Suicide
“Drugs and alcohol, and suicide. . .are clearly the proximate cause,” said Angus Deaton, the 2015 Nobel laureate in economics, who co-authored the paper with his wife, Anne Case. “Half a million people are dead who should not be dead,” he added. “About 40 times the Ebola stats. You’re getting up there with HIV-AIDS.” 

David Weir, the director of the health and retirement study at the Institute for Social Research at the University of Michigan, points out that while African Americans in the same age group still have a higher death rate than whites, the findings are startling considering that white Americans typically have more advantages. Weir points out that there are a number of factors at work (on top of the one’s pointed out by the authors) with the rise in middle aged white mortality rates, the article reports. The factors include:
  • Economic Insecurity
  • Community Decay
  • The Breakdown of Families
  • The National Opioid Epidemic
The paper was published in the Proceedings of the National Academy of Sciences.

Tuesday, November 3, 2015

Doctor Convicted of Murder for Overdose Deaths

The overprescribing of opioids by doctors in many states has led to a dramatic rise in overdose deaths in recent years. There are many who feel, and perhaps rightly so, that doctors should be held culpable for such deaths under certain circumstances. The toll that overprescribing has taken on families and society is staggering; addiction treatment centers are treating opioid addicts at unprecedented rates, the numbers of overdose death rates every year are through the roof, and the country is seeing new infectious disease outbreaks that have been directly linked to prescription opioid misuse.

Last week, for the first time in U.S. history, a doctor was found guilty of murder for overprescribing drugs, CNN reports. California doctor, Hsiu-Ying "Lisa" Tseng, was found guilty of 23 counts. Tseng’s attorney plans appeal the decision.

Among the charges Tseng was convicted, 19 were for unlawful controlled substance prescriptions. On Friday, Tseng was convicted of second-degree murder for three individuals who died of overdoses between March and December of 2009. The victims included:
  • Vu Nguyen, 28, of Lake Forest, CA
  • Steven Ogle, 24, of Palm Desert, CA
  • Joseph Rovero, 21, of San Ramon, CA
"This verdict sends a strong message to individuals in the medical community who put patients at risk for their own financial gain," District Attorney Jackie Lacey said. "In this case, the doctor stole the lives of three young people in her misguided effort to get rich quick." 

Once doctors realize that they can lose their freedom for overprescribing drugs, they will be more apt to refrain from doing so. Prescription opioids are extremely dangerous, and without careful prescribing practices - people lose their lives. Physicians are fully aware of the risks that prescription opioids carry with them; doctors have a moral responsibility to prescribe them with the utmost discretion.

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