Category Archives: drug addiction

Drug Addictions Often Disappear Over Time

This article includes links to many research studies, some linked to below, for the rest go to the full article.

Most People With Addiction Simply Grow Out of It by Maia Szalavitz

By age 35, half of all people who qualified for active alcoholism or addiction diagnoses during their teens and 20s no longer do.

The average cocaine addiction lasts four years, the average marijuana addiction lasts six years, and the average alcohol addiction is resolved within 15 years. Heroin addictions tend to last as long as alcoholism, but prescription opioid problems, on average, last five years. In these large samples, which are drawn from the general population, only a quarter of people who recover have ever sought assistance in doing so (including via 12-step programs). This actually makes addictions the psychiatric disorder with the highest odds of recovery.

If you start drinking or taking drugs with peers before age 18, you have a 25% chance of becoming addicted, but if your use starts later, the odds drop to 4%. Very few people without a prior history of addiction get hooked later in life, even if they are exposed to drugs like opioid painkillers.

These results can give people hope when they, or loved ones, are suffering from an addiction. Treatment helps sometimes but also fails quite often. Even in the case where things are not looking good, there is hope that eventually things may run there course.

Of course, there is a risk, sadly, that before the addiction ends tragedy will strike. So hopefully we can keep researching methods to better treat addiction. But if things are failing (especially for one you love) there may be light at the end of the dark tunnel.

Related: The Success Rate of AA is Only 5-10%How Effective is Drug Addiction Treatment?What Does the Evidence of Treating Alcoholism Show?Combination Strategy to Treat Alcohol Dependence

The Success Rate of AA is Only 5-10%

The treatment of drug addiction continues to be difficult. Even finding data on success rates is hard. And analyzing that data is difficult (the data is not straight forward and leaves open many possible questions or criticisms). This study calls into question the effectiveness of a 12-step recovery method to treat addiction.

With Sobering Science, Doctor Debunks 12-Step Recovery

There is a large body of evidence now looking at AA success rate, and the success rate of AA is between 5 and 10 percent. Most people don’t seem to know that because it’s not widely publicized. … There are some studies that have claimed to show scientifically that AA is useful. These studies are riddled with scientific errors and they say no more than what we knew to begin with, which is that AA has probably the worst success rate in all of medicine.

It’s not only that AA has a 5 to 10 percent success rate; if it was successful and was neutral the rest of the time, we’d say OK. But it’s harmful to the 90 percent who don’t do well. And it’s harmful for several important reasons. One of them is that everyone believes that AA is the right treatment. AA is never wrong, according to AA. If you fail in AA, it’s you that’s failed.

The reason that the 5 to 10 percent do well in AA actually doesn’t have to do with the 12 steps themselves, it has to do with the camaraderie. It’s a supportive organization with people who are on the whole kind to you and it gives you a structure. Some people can make a lot of use of that. And to its credit, AA describes itself as a brotherhood, rather than a treatment.

image of the Sober Truth book cover

Dr. Lance Dodes has written a book looking at the data behind the results of AA. The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry.

Related: Looking at the Evidence of Treating AlcoholismHow Effective is Drug Addiction Treatment?, NIH studyImproving Addiction Treatment with The University of Wisconsin, MadisonMethods Used to Treat Addiction

The Death of Philip Seymour Hoffman Highlights the Increased Use of Heroin

We lost a great actor with the death of Philip Seymour Hoffman. Once again the danger of drug use has resulted in the loss of life. He sought treatment for his addiction but failed to avoid an untimely death.

photo of Philip Seymour Hoffman by Jean Jacques Georges

Philip Seymour Hoffman at the Paris premiere of The Ides of March in 2011 by photo by Jean Jacques Georges

Hoffman death puts focus on heroin’s comeback

Hoffman, 46, was found on the bathroom floor of his New York City apartment with a syringe in his left arm and glassine bags usually associated with heroin. Police say they are investigating substances found in the apartment to determine which drugs were present, but Hoffman has been open about his drug use, which included prescription pills and heroin, and his decades-long struggle to stay sober.

As authorities crack down on clinics that prescribe pain pills by the thousands and pharmaceutical companies change their formulas so the pills are more difficult to abuse, opiate addicts are turning to cheaper and more-plentiful heroin.

In recent years, the number of people abusing prescription pain pills has dropped steadily as heroin use increased. The number of people 12 and older who regularly abuse OxyContin dropped from 566,000 in 2010 to 358,000 in 2012, the National Survey on Drug Use and Health reported in December. The number of regular heroin users soared from 239,000 in 2010 to 335,000 in 2012, the survey found.

The tragedy caused by the abuse of drugs damages millions every day. We have to do a better job of reducing the damage done to society due to the abuse of drugs. Celebrities shine a light on the problem but it is a widespread problem that has an immense impact throughout society.

Related: Russell brand’s testimony on dealing with drug addictionPrescription painkillers kill more every year in usa than heroin and cocaine combined - Eminem’s ‘relapse’ explores his drug addition and rehabilitation

The Causes of Drug Addiction are Complex

image of comic panels from rat addiction experiment

Comic panels, by Stuart McMillen, of the rat park drug addiction experiment, see the full comic.

The causes of drug addiction are not simple. Like many medical issues they are a complex interaction of factors.

Drug addiction: The complex truth by Tom Stafford

Many studies have shown rats and monkeys will neglect food and drink in favour of pressing levers to obtain morphine (the lab form of heroin). With the right experimental set up, some rats will self-administer drugs until they die. At first glance it looks like a simple case of the laboratory animals losing control of their actions to the drugs they need. It’s easy to see in this a frightening scientific fable about the power of these drugs to rob us of our free will.

But there is more to the real scientific story, even if it isn’t widely talked about. The results of a set of little-known experiments carried out more than 30 years ago paint a very different picture, and illustrate how easy it is for neuroscience to be twisted to pander to popular anxieties. The vital missing evidence is a series of studies carried out in the late 1970s in what has become known as “Rat Park”. Canadian psychologist Bruce Alexander, at the Simon Fraser University in British Columbia, Canada, suspected that the preference of rats to morphine over water in previous experiments might be affected by their housing conditions.

Rats are smart, social creatures. Living in a small cage on their own is a form of sensory deprivation. Rat Park was what neuroscientists would call an enriched environment, or – if you prefer to look at it this way – a non-deprived one. In Alexander’s tests, rats reared in cages drank as much as 20 times more morphine than those brought up in Rat Park.

As the article notes more research is needed, but there should be more research into the importance of social environment on drug abuse and drug abuse treatment.

Related: Methods to treat addictionHow effective is drug addiction treatment in the USA?Prescription drug abuse in the USALooking at the evidence of treating alcoholism

What Should Society Do About Drug Addicts That Are Not Seeking Treatment?

What to do about drug addicts that are not interested in treatment (yet?) is open to debate. Strict law enforcement would say that the government shouldn’t provide any support to those that are taking illegal action (taking drugs they can’t legally take). And that argument makes some sense. The biggest problem with it is the results of such policies have not been very effective. Society suffers. Should society suffer because taking action to reduce burdens on society can be seen as taking it easy on criminals?

Denmark offers rooms monitored by nurses for drug addicts to use, and crime seems to have been reduced:

Year on year, burglaries in the wider area are down by about 3%, theft from vehicles and violence down about 5%, and possession of weapons also down. “From the police perspective, I can see the benefits,” said Orye. “It feels calmer.”

Critics say that such rooms make it easier for drug users to abuse themselves and send the wrong message. Only five people using Copenhagen’s room have been put on treatment since October.

Petersen, like many others using the room or floating around the courtyard outside, said that she does not want and would never seek treatment. But every day that she comes here to inject she meets health professionals, social workers and people offering treatment in case she suddenly want to rise from rock bottom, say the room’s staff. Petersen might change her mind one day, said Nanna Gotfredsen, a lawyer who campaigned for the room.

Michael Olsen, a local resident who was a key figure in persuading authorities to accept the idea of a consumption room, said that he felt moved to champion the cause when he found addicts taking drugs in his bins, and women urinating in a phone box because all the toilets in the area had been sealed to stop addicts injecting there.

The best strategies for society are not obvious. The last 50 years have not been a very successful period for society dealing with the problems caused by drug addiction. Hopefully we can experiment and find solutions that are better.

I do think we have moved toward more support for treatment for those seeking help to overcome drug addiction and to stay clean. Moving more in that direction seems wise to me.

Related: UK Drug Policy Commission Recommends Decriminalizing Drug UseRussell Brand’s Testimony on Dealing with Drug AddictionHow Effective is Drug Addiction Treatment?2012 National Drug Control Strategy for the USA

2012 National Drug Control Strategy for the USA

The USA has published their 2012 National Drug Control Strategy. The intro from President Obama includes:

Illicit drug use in America contributed to an estimated $193 billion in crime, health, and lost productivity costs in 2007, the year for which the most recent estimate is available. In today’s challenging economic environment, we cannot afford such a drain on our economy and public resources. While difficult budget decisions must be made at all levels of government, we must ensure continued support for policies and programs that reduce drug use and its enormous costs to American society.

Research has documented that substance use disorder treatment is a sound public investment. For example, a 2006 study found that every dollar spent on treatment yielded an average of seven dollars in costs savings. The majority of these savings came from reduced criminal justice system involvement and increased employment earnings. **Benefit-cost in the California treatment outcome project: Does substance abuse treatment‘pay or itself’? Health Services Research, 41(1), 192-213, 2006**

Other studies document substantial cost-offsets in the healthcare domain alone . Another 2006 study reported a net savings of $2,500 per person per year in Medicaid costs associated with treatment, and a State of Washington report found that treatment yielded a con- servatively estimated $252 per person per month in cost reductions associated with medical care and state and community psychiatric hospitalizations. **The effect of substance abuse treatment on medicaid expenditures among general assistance welfare clients in Washington State, The Milbank Quarterly, 84(3), 555-576, 2006 and Washington State supplemental security income (SSI) cost-offset pilot project: 2002 progress report.

In 2010, an estimated 23.1 million Americans (9.1%) aged 12 or older needed specialized treatment for a substance use disorder, but only 2.6 million (roughly 11.2% of them) received it. We need to stop wasting money and lives and costing our society much more over the long term.

In 2010, over seven million people in the United States were under the supervision of the criminal justice system: over two million incarcerated and the remaining five million on probation or parole.

Compounding the significant expenditures on corrections is the fact that far too many offenders return to drug use and reenter the criminal justice system. Among state prisoners with substance use disorders, 53% had at least three prior sentences to probation or incarceration, compared to 32% of other inmates.

Many offenders deal with a chronic substance use disorder—a disease for which too many are inadequately treated. These offenders need effective substance use disorder and mental health treatment while incarcerated and should continue with recovery support services that assist with employment, housing, medical care, and other support upon their reentry into the community.

Related: UK Drug Policy Commission Recommends Decriminalizing Drug UseDrug Treatment Funding Can More Than Pay For Itself With Reduced Crime CostsImproving Addiction Treatment with The University of Wisconsin – Madison

Prescription Drug Abuse in the USA

Some key findings from the Council of State Governments study on Prescription Drug Abuse in America (from 2004). The report is obviously a bit outdated but the problem continues to grow.

  • More than 6.2 million people were current illicit users of prescription drugs in 2002.
  • In 2001, prescription drug abuse and misuse were estimated to impose approximately $100 billion annually in health care costs.
  • In Florida, there were 328 deaths attributed to heroin overdoses in 2001 compared to 957 deaths due to overdoses of the prescription pain medications. The trend continued in 2002, when more Floridians died from prescription drug overdoses than use of illegal drugs.

Prescription Drugs: Abuse and Addiction from the NIH (revised in 2011).

Although most people take prescription medications responsibly, an estimated 52 million people (20 percent of those aged 12 and older) have used prescription drugs for nonmedical reasons at least once in their lifetimes.

The number of prescriptions for some of these medications has increased dramatically since the early 1990s. Moreover, a consumer culture amenable to “taking a pill for what ails you” and the perception of prescription drugs as less harmful than illicit drugs are other likely contributors to the problem. It is an urgent one: unintentional overdose deaths involving opioid pain relievers have quadrupled since 1999, and by 2007, outnumbered those involving heroin and cocaine.

Years of research have shown that addiction to any drug (illicit or prescribed) is a brain disease that can be treated effectively. Treatment must take into account the type of drug used and the needs of the individual. Successful treatment may need to incorporate several components, including detoxification, counseling, and sometimes the use of addiction medications. Multiple courses of treatment may be needed for the patient to make a full recovery.

Related: How effective is drug addiction treatment?Center for substance abuse treatment (US HHS)Brett Favre overcomes painkiller addiction

UK Drug Policy Commission Recommends Decriminalizing Drug Use

Decriminalise drug use, say experts after six-year study

A six-year study of Britain’s drug laws by leading scientists, police officers, academics and experts has concluded it is time to introduce decriminalisation.

The report by the UK Drug Policy Commission (UKDPC), an independent advisory body, says possession of small amounts of controlled drugs should no longer be a criminal offence and concludes the move will not lead to a significant increase in use.

The experts say the criminal sanctions imposed on the 42,000 people sentenced each year for possession of all drugs – and the 160,000 given cannabis warnings – should be replaced with simple civil penalties such as a fine, attendance at a drug awareness session or a referral to a drug treatment programme.

They also say that imposing minimal or no sanctions on those growing cannabis for personal use could go some way to undermining the burgeoning illicit cannabis factories controlled by organised crime.

But their report rejects any more radical move to legalisation, saying that allowing the legal sale of drugs such as heroin or cocaine could cause more damage than the existing drugs trade.

Abusive drug use should be a medical matter not a criminal one. The appropriate treatment options to provide people the change to regain their lives is what is needed; we don’t need to throw them in jail. Use the money saved from wasting people’s lives in jail and all the costs associated with that to help provide better drug abuse treatment options.

Related: The Rise and Fall of America’s First Prison for Drug AddictsStudy: Drug Treatment Success Rates in EnglandRussell Brand’s Testimony on Dealing with Drug AddictionPrinciples of Effective Drug Treatment and Rehabilitation

Drug Treatment Funding Can More Than Pay For Itself With Reduced Crime Costs

Some interesting details and data from Texas government web site.

Drug users constitute a large and growing proportion of the criminal justice population. Drug users not only commit a substantial amount of crime, but as the frequency of drug use increases, the frequency of crime increases and the severity of crimes committed also increases.

Drug use in the general population appears to have declined over the past decade, yet the number of drug-involved offenders is increasing. The number of convictions for drug violations in Texas has increased from 8,103 in 1980 to 23,126 in 1988, a 185 percent increase in less than ten years.

Estimates of lifetime drug users among the nation’s incarcerated population range from 80 to 87 percent.

The American Correctional Association notes that more than 95 percent of drug and alcohol offenders will be discharged from prison, most without receiving any treatment. Because of the high association between drug abuse and recidivism, it is in the public interest to place offenders in the kinds of treatment programs that have been found effective. A noticeable reduction in drug use and criminality can occur with an alliance between the criminal justice system and drug abuse treatment.

Public expenditures for drug abuse treatment are wise and prudent investments. Treatment works to reduce crime, drug abuse, and recidivism. Sustained reductions in recidivism can be achieved up to six years after treatment. With appropriate drug abuse treatment more than 75 percent of offenders with chronic substance abuse histories can reenter the community and lead socially acceptable life styles.

For every dollar spent for drug treatment, $11.54 is saved in social costs, including law enforcement costs, losses to victims, and government funds for health care.

Research has shown that funds invested in drug treatment reduces future criminal justice costs for treated offenders. Every dollar spent on residential drug treatment in probation saves $2.10 in future criminal justice costs. Every dollar spent on outpatient drug treatment in probation saves $4.28 in future criminal justice costs.

This is an old report, from 1997 but the basic model doesn’t change. A large amount of criminal activity is driven by drug addiction. To reduce crime in society drug addiction needs to be reduced. While success rates of drug addiction treatment centers are far from perfect the results more than pay for the cost – just in reduced crime costs (without even considering the better lives these people lead and the benefits to their children and loved ones).

Related: The Rise and Fall of America’s First Prison for Drug AddictsResults of 4 Year Study of Women in Drug TreatmentAlcohol is a Major Cause of Drug Rehab AdmissionsHow Effective is Drug Addiction Treatment?

Russell Brand’s Testimony on Dealing with Drug Addiction

Celebrity Russell Brand makes very intelligent comments to a UK government inquiry on how to deal with drug addiction problems. He was an addict and has been drug free now for years.

His main point seems to be that we need to take a pragmatic approach to what is a primarily a health problem not a criminal problem. Abstinence (all all drugs – including legal ones such as alcohol) based recovery is what he has succeeded with and he believes in. “I think what we need is love and compassion… because it deals with the problem and reducing crime”

Russell’s book, My Booky Wook, discusses this life including his drug use and recovery.

Related: Eminem’s ‘Relapse’ Explores His Drug Addition and RehabilitationPrinciples of Effective Drug Treatment and RehabilitationHow Effective is Drug Addiction Treatment?