Creating Conditions That Reduce the Likelihood That Teenagers Will Abuse Drugs

Treating people with drug and alcohol addition is very difficult. Preventing many of them from becoming addicted in the first place is a good way to avoid many of the problems caused by drug and alcohol addition.

Iceland knows how to stop teen substance abuse but the rest of the world isn’t listening

In Iceland, teenage smoking, drinking and drug use have been radically cut in the past 20 years.

“We didn’t say to them, you’re coming in for treatment. We said, we’ll teach you anything you want to learn: music, dance, hip hop, art, martial arts.” The idea was that these different classes could provide a variety of alterations in the kids’ brain chemistry, and give them what they needed to cope better with life: some might crave an experience that could help reduce anxiety, others may be after a rush.

At the same time, the recruits got life-skills training, which focused on improving their thoughts about themselves and their lives, and the way they interacted with other people. “The main principle was that drug education doesn’t work because nobody pays attention to it. What is needed are the life skills to act on that information,” Milkman says. Kids were told it was a three-month programme. Some stayed five years.

A few factors emerged as strongly protective: participation in organised activities – especially sport – three or four times a week, total time spent with parents during the week, feeling cared about at school, and not being outdoors in the late evenings.

Elsewhere, cities that have joined Youth in Europe are reporting other benefits. In Bucharest, for example, the rate of teen suicides is dropping alongside use of drink and drugs. In Kaunas, the number of children committing crimes dropped by a third between 2014 and 2015.

The solutions Iceland experimented with can’t be copied directly for elsewhere, cultures are different. But many of the concepts and practices can be adopted elsewhere. The idea of investing in helping teenagers live happy, engaged lives instead of locking up teenagers acting out is something we would all benefit from.

Related: The Causes of Drug Addiction are ComplexThe War on Drugs has been a Huge Failure with Massive Unintended ConsequencesFunding Drug Addiction Treatment Would Cost 1/7 the Cost of the Current Criminal System Focused PolicyAlmost everything we think we know about addiction is wrong

CC Sabathia Entered a Treatment Facility for Alcoholism

CC Sabathia a pitcher for the New York Yankees has announced he has entered a treatment facility for alcoholism as the Yankees are starting the playoffs.

photo of CC Sabathia

Photo of CC Sabathia, from his official web site.

His statement:

Today I am checking myself into an alcohol rehabilitation center to receive the professional care and assistance needed to treat my disease.

I love baseball and I love my teammates like brothers, and I am also fully aware that I am leaving at a time when we should all be coming together for one last push toward the World Series. It hurts me deeply to do this now, but I owe it to myself and to my family to get myself right. I want to take control of my disease, and I want to be a better man, father and player.

I want to thank the New York Yankees organization for their encouragement and understanding. Their support gives me great strength and has allowed me to move forward with this decision with a clear mind.

As difficult as this decision is to share publicly, I don’t want to run and hide. But for now please respect my family’s need for privacy as we work through this challenge together.

Being an adult means being accountable. Being a baseball player means that others look up to you. I want my kids — and others who may have become fans of mine over the years — to know that I am not too big of a man to ask for help. I want to hold my head up high, have a full heart and be the type of person again that I can be proud of. And that’s exactly what I am going to do.

I am looking forward to being out on the field with my team next season playing the game that brings me so much happiness.

It is good he realizes he has a problem and is seeking treatment.

Upon signing with the Yankees prior to the 2009 season, Sabathia became the highest-paid pitcher in MLB history. He is now 35 years old.

This is another reminder that alcoholism is a devastating problem to a large number of people. Treatment is helpful but we also really need better options for addiction treatment (and more study of what is effective) to help those in need.

Related: Jon Hamm Exits Rehab for Alcohol AddictionThe Success Rate of AA is Only 5-10%Colin Farrell Wanted To Be A Better Dad

Jon Hamm Exits Rehab for Alcohol Addiction

Jon Hamm is best known for his role as Don Draper on Mad Men. He has recently completed a stay at a rehabilitation center where he sought treatment for alcohol addiction.

Jon Hamm

Jon Hamm at PaleyFest 2014

He reportedly received rehab treatment at the Silver Hill Hospital in New Canaan, Connecticut which is affiliated with Yale University.

The hospital describes their addiction treatment program as follows:

The Addiction Program provides a highly structured, intensive program of education, behavioral skill development and increasing psychological awareness. The focus of this abstinence-based program is to help patients identify triggers and learn relapse prevention strategies that will help them remain substance-free.

Treatment for addiction disorders often begins in our inpatient level of care. Patients are admitted for detoxification from alcohol, prescription medication and other substances. Simultaneous treatment of psychiatric symptoms is also provided for mood and other psychiatric disorders as needed. The goals of this phase of treatment are crisis stabilization, symptom reduction and medication management. This phase of care is generally covered by insurance.

After stabilization, the next phase of treatment is our Transitional Living Program. Patients reside on campus as they focus on developing a psychological understanding of their illness and developing new behavioral skills to manage their recovery process. The length of stay for this phase of treatment is 4 weeks, and some patients extend their treatment beyond this minimum. This program is self-pay – a small portion of the program may be covered by insurance. Our staff will help you determine if you have this benefit.

Related: Representative Patrick J. Kennedy Spends a Month in RehabRobert Downey Jr. Rehab SuccessRussell Brand’s Testimony on Dealing with 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 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

Looking at the Evidence of Treating Alcoholism

AA is Faith-Based, Not Evidence-Based

Alcoholics Anonymous is the most widely used treatment for alcoholism. It is mandated by the courts, accepted by mainstream medicine, and required by insurance companies. AA is generally assumed to be the most effective treatment for alcoholism, or at least “an” effective treatment. That assumption is wrong.

We hear about a few success stories, but not about the many failures. AA’s own statistics show that after 6 months, 93% of new attendees have left the program. The research on AA is handily summarized in a Wikipedia article. A recent Cochrane systematic review found no evidence that AA or other 12 step programs are effective.

The 1992, the National Institute on Alcohol Abuse and Alcoholism’s National Longitudinal Alcohol Epidemiologic Survey studied 42,000 Americans. 4500 had been dependent on alcohol at some time in their lives. Of these, only 27% had had treatment of any kind, and one-third of those who had been treated were still abusing alcohol. Of those who had never had any treatment, only one-quarter were still abusing alcohol. George Bush is a well-known example of someone who stopped drinking on his own without attending AA and without admitting that he was an alcoholic.

To me what matters is finding solutions that work. It is known that the success rates for treating addiction are not great no matter what treatments are used. We certainly should be doing more study of the effectiveness of various treatment methods to improve the success rates people experience. The impact on people’s lives is too large to rely on whoever markets better to end up being the deciding factor.

Related: How Effective is Drug Addiction Treatment? from the NIHCombination Strategy to Treat Alcohol DependenceResults of 4 Year Study of Women in Drug Treatment

Alcohol Topped List of Drug Addictions for Rehab Patients

Alcohol rehab numbers outstrip hard drugs

While alcohol was the major sole factor, Mr Pitts said 70 per cent of admissions also listed it as “among their reasons for seeking treatment” and this demonstrated how pervasive alcohol dependence had become across society. It was also viewed as an “easily accessible, socially acceptable and relatively inexpensive drug to self-medicate life’s difficulties and challenges for older people”, he said.

Amphetamine-type substances including ice and ecstasy accounted for 21% of Odyssey House admissions in 2009 (23% in 2008), while heroin and cannabis each accounted for 18% (19% and 18% respectively in 2008).

Methadone accounted for 8% of admissions, while gambling and other drugs like benzodiazepines, buprenorphine, morphine and cocaine accounted for 9%.

Alcoholism remains a huge problem. Rehabilitation programs for those with addictions to alcohol continue to have success but they also continue to have plenty of people in need of treatment. It is not a problem that society has been effective at dealing with. While we have some success there remains much to do.

Related: Top 10 Luxury Rehab CentersCombination Strategy to Treat Alcohol DependenceAlcohol Remains a Major Cause of Drug Rehab Admissions

Research on the Brain and Behavior on Addiction

New research on the brain and behavior clarifies the mysteries of addiction by Craig Lambert, Harvard Magazine, March 2000.

Early experiences with drugs, whether in the womb or as an adult, have ineradicable effects. Drug users often describe a wish to recapture the bliss of their first high. But this goal proves elusive because once the brain has neuroadapted to drugs, it is physiologically and structurally changed. The director of the National Institute on Drug Abuse and many others argue that voluntary drug consumption alters the brain in ways that lead to involuntary drug consumption. The question of whether drug habits are voluntary or not leads us to ask how people get over their addictions, and raises some of the moral issues surrounding compulsive behavior.

Addiction is not all pharmacology, neurotransmitters, and intrapsychic states; the social settings of drug consumption have powerful effects. They can influence basic brain chemistry–which is one reason Gene Heyman rejects the notion that “addictive behavior is insensitive to persuasion, that there’s an irresistible urge to take the drug.” Heyman agrees that drugs alter the brain, but disputes the idea that they change the brain in ways that make choice impossible–he does not believe, in other words, that neuroadaptation makes drug use involuntary. Exhibit A, he says, is 50 million ex-smokers who have voluntarily ended their intake of nicotine.

One reason people believe drug use is involuntary is that recovery rates for addicts treated at clinics are quite bad. Within one year of treatment, relapse rates of 67 to 90 percent are common for alcohol, opiate, cocaine, and tobacco users. “But most of the people who become addicted to drugs don’t go to clinics,” says Heyman. “Actually, only 30 to 40 percent go to clinics. Yet this clinic population has greatly influenced our vision and concept of addiction.”

It turns out that addicts who don’t go to clinics have much higher recovery rates.

This is an interesting article with interesting data. Remember the different recover rates for those that go to clinics and those who does not mean going to a clinic reduces the odds of success. It seems reasonable to guess most of those that go to clinics are drawn from the subset that failed to quit without going to a clinic. So it could be that fail to quit on their own then will fail only quit on their own 3% of the time and quit in a clinic 10% of the time (these numbers are not based on anything just an example of what you must consider about the above statistics).

Even though cigarette smoking is the direct cause of 400,000 American deaths annually, while alcohol directly causes only 100,000 deaths, “alcoholism is a major reason that people don’t stop smoking,” says Vaillant. “Those who keep on smoking after age 50 tend to be alcoholics.” In hospitals, alcoholics cost six times as much as other patients. Half of all people who show up in emergency rooms with severe multiple fractures are alcoholics. “But the emergency rooms treating multiple fractures ignore blood alcohol levels,” Vaillant says. “The causal link isn’t made.”

“No other drug of addiction impairs one’s aversion to punishment the way alcohol does,” he continues. “Yes, compulsive gambling impairs your aversion to being poor, and heroin use impairs your aversion to being arrested. But alcoholism goes across the board. When drinking, people are much more likely to engage in all kinds of dangerous, life-threatening behavior–wife beating, child abuse, unprotected sex with strangers, smoking, drunk driving. You can be five foot two and willing to take on anyone in the bar.”

Related: Alcohol is a Major Cause of Drug Rehab AdmissionsHow Effective is Drug Addiction Treatment?Methods to Treat AddictionWhy Can’t Drug Addicts Quit on Their Own?

Combination Strategy to Treat Alcohol Dependence

New combination of treatments is effective for alcohol dependence

McLean Hospital researchers, along with colleagues from 11 other study sites nationwide, report that the medication naltrexone and up to 20 sessions of alcohol counseling delivered by a behavioral specialist are equally effective treatments for alcohol dependence when delivered with structured medical management in the Journal of the American Medical Association.

Results from the National Institutes of Health-supported Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) study show that patients who received naltrexone, specialized alcohol counseling, or both demonstrated the best drinking outcomes after 16 weeks of outpatient treatment. All patients also received Medical Management, an intervention that consisted of nine brief, structured outpatient sessions provided by a health care professional. Contrary to expectations, the researchers found no effect on drinking of the medication acamprosate and no additive benefit from adding acamprosate to naltrexone.

“This was the largest clinical trial looking at the effectiveness of pharmacologic and behavioral treatments for alcohol dependence ever conducted and the results are promising,” said Roger Weiss, clinical director of the Alcohol and Drug Abuse Treatment Program for McLean Hospital, a Harvard Medical School affiliate. Weiss was also the principal investigator of COMBINE for the McLean study site.

Related: Why Can’t Drug Addicts Quit on Their Own?Methods to Treat Addiction

Alcohol is a Major Cause of Drug Rehab Admissions

Alcohol major cause of drug rehab admissions, again

Alcohol has again topped harder drugs like ice and heroin as the addiction which drives the most Australians into crisis rehab. Seventy per cent of people admitted to the major not-for-profit rehab centre Odyssey House, based in Sydney, in the past financial year listed alcohol as among their reasons for seeking treatment.

For almost one in three (29%), alcohol was their primary addiction – up from 28% in 2006-07 and 20% in 2005-06. Amphetamines such as speed, ecstasy and ice accounted for 23% of Odyssey’s admissions in 2007-08 followed by heroin (19%).

Too many people continue to fall victim to alcohol and drug addiction. A big challenge for modern society is to do a better job of helping people lead healthier lives and avoid the ravages of caused by addition to drug and alcohol.

Related: How Effective is Drug Addiction Treatment?Study: Drug Treatment Success Rates in England