Categories
Addiction Prevention

Dr. Omar Manejwala: Craving

Dr. Omar Manejwala is a an addiction psychiatrist, SVP/CMO at Catasys, former Hazeldon Medical Director and the author of the new book Craving: Why We Can’t Seem to Get Enough. He is an addiction expert, with a strong background in psychiatry and addiction medicine, making him a remarkable resource for mental health professionals. In Craving, Dr. Manejwala digs deeply into the phenomenon of craving and provides real insight into what makes the addictive mind tick in a way that is accessible to everyone from the layperson to the mental-health practitioner.

 

Craving is that biting sensation in the mind and body, often relentless in its power. In the addictive mind, craving acts as fuel to the fire, creating a maelstrom of negative behaviors resulting in a bottomless, and often hopeless pit of dissatisfaction. This book is a timely interjection into the state of craving and addiction. Dr. Omar Manejwala provides tools to understand the root cause of our craving, providing useful tools and means with which to overcome them.

 

Tonight, we are honored to sit with Dr. Omar Manejwala and talk shop, ask questions, and engage in the process of gaining a deeper understanding of Craving and what that means for those of us working in the addiction field. Stay tuned for a follow-up blog.

 

Check out the video sneak of Dr. Manejwala talking about the book. You can also follow him on Twitter and on Facebook.

https://youtu.be/vkav7_wyh40

Categories
Addiction Smoking

E-Cigarettes: Harmless? We Think Not

It turns out those some of those fancy electronic cigarettes are being used to deliver something more sinister than nicotine. The “e-cigs” I’m referring to are called “Trippy Sticks” or “iVapor” by those who alter their purpose. This is the latest trend: taking hash oil (or any intoxicant that can be gelled or liquefied) and injecting it into electronic cigarettes or “portable herbal vaporizers.” These “vape pens” as they are called, have no smell, no smoke, and their true contents are virtually undetectable.  Based on e-cigarette technology, users have found a way to inject hash oil into these devices in order to evaporate high levels of THC without having to burn it.  Unless the e-cigarette is tested, no one would ever know it contains something other than nicotine.

E-Cigarettes were introduced in the US market in 2007. They were initially marketed as an innocuous solution to help smokers stop smoking tobacco. They don’t, however, curb the addiction to nicotine. Rather than getting one’s nicotine from the tobacco in cigarettes, e-cigarettes deliver it through a smoke-free nicotine vapor. And because e-cigs don’t necessarily contain tobacco, they are not subjected to the same tobacco laws—at least, not yet. There aren’t any age restrictions when it comes to purchasing the devices, particularly if you are buying online. Flavored and unflavored e-cigarettes are marketed in a fun, intriguing way, luring in the young and impressionable, and selling themselves to consumers as “harmless.” In fact, non-smoking teens will often smoke the flavored, nicotine-free e-cigarettes, which primes them to eventually smoke the real thing. Some parents may be fooled into thinking that their kids aren’t actually “smoking” and buy the e-cigarettes in an attempt to take preventative action.

 

As we wait for scientists to study the negative effects of e-cigarettes, I am afraid that the fast-paced drug culture has already opened the door for their misuse. It’s troubling that these “Trippy Sticks” are undetectable and that their use is spreading like wild fire. More disturbing is how little research has been done at this point. Warnings haven’t been released, no major upsets have taken place, and no one is in the hospital. Yet. As is often the case, our kids see using something they see as harmless and fun, without considering the possible consequences.

 

E-cigarettes are NOT a safe solution to a bad habit. They are not harmless. They are not something to be encouraged or ignored. With technology everywhere, our teens have easy access to any information, good and bad, but so do we! As parents, it’s the sinister side we have to pay attention to. Technology is how our current and future generations communicate, share, create, and thrive. We have a responsibility to investigate the unknown, ask our own questions, and come out of the dark. Being a Luddite is no longer an excuse for “not knowing” or not understanding our kids; what we don’t know has the power to alienate us and make us disengaged parents. Investigate technology, be in the know, be transparent, ask questions, show real interest in your kids and their lives, and create and hold boundaries. Trippy Sticks are just another fish in the pond of designer drugs, and one way we can nip the new drugs in the bud is if we make them less interesting.

Categories
Addiction Adolescence Mental Health Recovery Treatment

Adolescent Residential Treatment: Visions Style

Adolescent residential treatment can seem like a daunting place to send your child, even if the situation warrants it. We know how overwhelming adolescent addiction and mental illness is to the family and friends of the person or people suffering. There is fear, anger, shame, love, fury, disappointment, numbness, and depression, among other things, which typically surface in a family affected by addiction. That’s where a safe container for healing is necessary, and it is also where adolescent residential treatment comes in.

 

Visions adolescent residential treatment is unique because we make every effort to provide individualized treatment for our clients. We understand there is no one-size-fits-all treatment for addiction and mental illness and we also are aware that no two clients are the same. For example, a client suffering from trauma will participate in an expressive dance class to encourage the trauma to exit their body. Or a surfer who looks to the ocean for spiritual growth will surf as part of their treatment plan. If someone comes into our adolescent residential treatment facility with mental-health issues or their primary addiction is gaming or love addiction, we modify our step-one packet to meet their specific needs. For example, we might take some of our clients to a local Buddhism in Recovery group  (in addition to the usual 12-step groups) where they are able to confront their addiction issues and find cohesive support in a different but safe setting. We essentially provide options above and beyond the normative curriculum in many adolescent residential treatment facilities.

 

Student-led groups are encouraged. They not only empower the clients, they teach them to walk through their fears while honoring their process of recovery. We offer art therapy with the amazing Susan “the Art Lady” O’Conner, equine therapy, music groups, nutrition counseling, and we have both eating disorder and trauma specialists available. We will do whatever we can to meet our clients needs while ensuring a solid foundation of recovery. Visions adolescent residential treatment is a safe place to begin. We have created an environment that honors the client, supports the family, and offers the greatest opportunities for adolescents and their families to heal. We know that addiction and mental health are family issues.

 

We have an absolutely phenomenal team of recovery professionals. They happen to be some of the most dedicated people I’ve ever come across. They are particularly skillful at finding the many ways to laugh in the face of adversity. The Vteam, as we so lovingly call ourselves, understands the healing capacity of laughter and the deep need to let it all go. How often does someone come into treatment barely “holding it together,” right? Another incredible asset of our team is the amount of alumni that have come back to work with us. Note, I said “with” us not “for” us. That right there is a key factor of being part of this team.  To quote Patrick, who says it beautifully, “Our staff is unmatched. We have the perfect blend of compassionate, hard working, fun-loving professionals in the Western Hemisphere.  Everyone here loves this work and it shows.” So, is adolescent residential treatment a death sentence? Nope! It’s more like a prescription to “get your life back in order.”

Categories
Addiction Adolescence Parenting Synthetic Drugs

Smiles: The Dark Side of a Joyful Symbol

Smiles, yet another designer drug to hit the US seems to be just as deadly as the other synthetic drugs we are more familiar with. According to the DEA, this drug is “a synthetic drug abused for its hallucinogenic effects,” and has “been encountered in a number of states by federal, state, and local law enforcement agencies.”  Still, the findings regarding this substance are so preliminary, all we really have to refer to are user stories on YouTube, and that’s not an ideal source. The popularity of drugs like Smiles, K2, Spice, and Bath Salts is partly due to the ease of their availability and their inexpensive price tag. They are easily purchased online, in liquor stores, and particularly in states that haven’t elicited new, prohibitive laws regarding these synthetic drugs. What’s troublesome is these drugs are typically created and recreated faster than the FDA can process requests to ban them. Often times, it’s a sudden increase in ER visits by patients suffering similarly which alerts professionals of a new drug is on the scene.

What is Smiles? 

We don’t know much, but we do know that 2C-1 aka Smiles is an amphetamine/hallucinogen whose effects have been compared to a combination of LSD and MDMA. Some even say it’s similar to PCP.  2C-1 (Smiles) was initially popular in Europe, emerging onto their party scene in 2003. Smiles is classified as aphenethylamines—essentially amphetamines but with an additional chemical compound added which change its effects. Instead of the increased heart rate and feeling of speediness so commonly associated with amphetamine use, the effect of 2c-1 is more euphoric and psychedelic, again more in line with that found in psychedelics.  Like most of these synthetic drugs,  they are commonly manufactured in illegal labs, which make it terribly difficult to regulate.

What population is using Smiles?

The same population that uses this elicit drug is the same one that uses drugs like Ecstasy, Spice, Bath Salts, K2, and other club drugs: high-school and college students and other young adults that frequent party and club settings. Like the others, Smiles is easy to get, cheap, and not always easy to detect in drug tests. Because the evolution of these synthetic drugs is so fast, parents, teachers, mental health and law enforcement professionals may be caught off guard. Awareness is going to be your best defense.

So, what can you do?

  • Be aware of your young adults’ friends and sudden changes in those social circles.
  • Do you really know where your kids go when they “hang out”? Sudden secrecy (more than the usual we expect from adolescents) should raise a red flag. Instead of approaching your concern with anger, show concern with an open heart. Try and remember how YOU felt as a teen.
  • Look into your teens’ eyes: Are the pupils dilated (huge)?  Are they pinpoints?
  • Watch for sudden changes in grades or attendance.
  • Gather information from viable, legitimate sources (NIDA, DEA)
  • Get some support for yourself: therapy, support groups, et cetera.
  • Practice self-care. It’s harder to care for others when you are not taken care of.

These drugs are serious. They are unknown in many ways, and that fact alone makes them deadly. Stay tuned; I’m sure there will be more information to follow. In the meantime, be as transparent as you can be with your kids. Chances are, if they feel emotionally safe enough to confide in you and talk to you in general, they are less likely to hide the important things and travel along a path of self-destruction.

Categories
Addiction Recovery Substance Abuse

Remembrance: International Overdose Awareness Day 2012

Today marks the 12th annual International Overdose Awareness Day. The idea behind this day is to commemorate the lives of those lost to drug overdoses. This event originated in Melbourne, Australia in 2001. A woman named Sally Finn, the manager of a Salvation Army needle and syringe program, founded International Overdose Awareness Day in response to the lives she’d seen destroyed by overdoses. This is an event of remembrance.

International Overdose Awareness Day presents an opportunity to honor those whose lives were lost to their addiction, to acknowledge and honor your grief as a result of that loss, and an opportunity to bring awareness to the detrimental effects of an overdose.

This year’s theme is Prevention and Awareness. The goal is to lesson the shame, stigma, and guilt associated with addiction and so you can begin to meet it with compassion and understanding. We need to become transparent in our discussions about addiction and the potentially fatal outcome of using illicit drugs and alcohol; we’ve seem far too many young lives lost to addiction. International Overdose Awareness Day is a call to lift the lid on the darkness of drug use and shed a light of hope for the families and individuals suffering at the hands of this disease.

The statistics regarding overdoses are quite grim. See here for an extensive list.

Here are some ideas to help in your efforts to raise awareness.

  • Tweet using the hashtag #OD12 and help build momentum today.
  • Hold a memorial service.
  • Light a candle.
  • Plant a tree.
  • Raise awareness.
  • Celebrate and commemorate.

We’d love to hear how you’ve raised awareness, so please share your thoughts with us in the comments, on Facebook, or on Twitter!

Categories
Addiction Heroin Opiates

OxyContin Use Down, Heroin Use On the Rise

When the manufacturers of OxyContin changed their formula in 2010 to lesson its potential for abuse, I don’t think they intended to drive addicts to use other drugs. Unfortunately, that’s what happened. As a result of OxyContin’s new formula being harder to snort or inject, addicts ultimately flocked to the streets. The unfortunate drug of choice: heroin—because it’s easier to obtain and cheaper than its pharmaceutical counterpart.

Dr. Theodore Cicero, professor of neuropharmacology in psychiatry at Washington University, and the principal investigator for a three-year research study of OxyContin use noticed a significant drop in OxyContin use after its formula change.  In fact, “Respondents indicating OxyContin as their primary drug of abuse dropped from 35.6 percent at the start of the study to 12.8 percent now.”   Further, the number of subjects who stated they’d used OxyContin to get high at least once in the last 30 days “fell from 47.4 percent to 30 percent.” Unfortunately, the Washington University team found that their respondents’ use of heroin grew from 5 percent to 15 percent—these numbers nearly tripled during that same 30-day period!

Addicts and drug abusers had clearly moved to the streets, the suburbs, and to heroin. They have essentially migrated toward a drug that is easier to inject or snort, much like the old formulation of OxyContin.  Dr. Cicero compared drug abuse to a “large balloon.” He explains it thusly,  “You press in one area, and the volume doesn’t decrease, it just simply moves to another spot.” This analogy fits well here as we look at the decline in OxyContin use and the increase in heroin use. As Dr. Cicero’s analogy deftly points out, the Oxy problem hasn’t really been solved; it has just been diverted.

While OxyContin is regulated and easily identifiable, heroin is not. In a weird way, you know what you’re getting with Oxy. But let’s be honest, anytime we put something in our arm or in our noses in an effort to alter our mind and body, we are playing the part of lab rat. Heroin is a problem: it’s unpredictable from one source to the next – sometimes it’s nearly pure, increasing one’s potential for an overdose.

The bottom line is the overall increase in opioid use: this is troublesome and growing into an epidemic. While we can treat addicts when they’re ready, how can we prevent addiction or abuse in the first place? Let’s start the conversation before it becomes a problem, taking preventative measures during the early years of our children’s lives: that perfect time when they’re just starting to dip their toes in the burgeoning years of curious adolescence.

Categories
Recovery

Know Your Facts: The Increase in Prescription Drug Abuse

(part 2 of 3)

Monitoring the Future released their latest study, noting that alcohol use was down, but marijuana, synthetic marijuana, and prescription drugs were up. In part one of this series, we focused on marijuana and its synthetic counterparts, bringing attention to the
perceived harmlessness of marijuana and the growing trend toward the use of synthetics. Here, we’ll talk about the rampant use of prescription drugs and the myriad dangers which accompany their use.

When it comes to prescription drugs, the ease of acquisition is often as simple as going through a parents’ or relative’s medicine cabinet, raiding a friend’s house, or simply trading with friends at school or at parties. The use of opioid prescriptions like Oxycontin and Vicodin are rampant…and deadly. As reported in Monitoring the Future’s 2010 National Results on Adolescent Drug Use: Overview of Key Findings, “54% of high-school seniors said ‘opioid drugs other than heroin (e.g., Vicodin) would be fairly easy to get.’” Why are teens using prescription drugs with such frequency? Could it simply be the ease with which they’re obtained? Or is it the built-in societal respect for doctors and their judgment which allows us to look away when the pen flies across the prescription pad.

Take note of the behaviors and physical symptoms which surround prescription drug addiction (via Educate Before You Medicatewww.talkaboutrx.org):

Behavioral signs:

  • Sudden mood changes:
    • Irritability
    • Negativity
    • Personality change
    • Extreme change in friends or hangout locations
    • Lying or being deceitful
      • Skipping school
      • Avoiding eye contact
      • Losing interest in personal appearance, extracurricular activities, sports
      • Sudden changes in appetite
      • Sudden drop in grades and/or academic or athletic involvement
      • Borrowing money or having extra, unexplained cash
      • Acting especially angry or abusive, or engaging in reckless behavior

 Physical Signs and Symptoms (these are varied, depending on the drug being used/abused):

Stimulants can bring about:

  • Hyperactivity
  • Shaking
  • Sweating
  • Dilated pupils
  • Fast or irregular heartbeat
  • Elevated body temperature
  • Seizures
  • Paranoia/nervousness
  • Repetitive behaviors
  • Loss of appetite or sudden and unexplained weight loss

Sedatives/depressants can bring about:

  • Loss of coordination
  • Respiratory depression
  • Slowed reflexes
  • Slurred speech
  • Coma

Opioids can bring about:

  • Sleep deprivation or “nodding.”
  • Pinpoint/constricted pupils, watery or droopy eyes
  • Nausea, vomiting, constipation
  • Slow, slurred speech
  • Slow gait
  • Dry skin, itching, infections
  • Constant flu-like symptoms
  • Track marks (bruising at injection sites)

The unfortunate, but common misconception is that prescription drug use is safer than illegal drugs like cocaine and heroin: because it’s been prescribed, it’s “okay.” The problem with this ideology is doctors consistently prescribe and sometimes inadvertently over-prescribe narcotics, A: because they work, and B: because it’s easy. What this influx of prescription drugs does, however, is provide an underground stockpile of prescription opioids in the homes of our adolescents and their friends. As patients, start asking for non-narcotic alternatives. It makes no difference to the doctor but it may make the difference of life and death for you or someone in your family.

Start disposing of any unused medications and store those that are necessary in a secured place. Honestly, these days, the medicine cabinet should probably only be used for toothpaste and Tiger Balm.

Categories
Addiction

America’s #1 Health Problem

A new CASA (The National Center on Addiction and Substance Abuse) report on adolescent substance abuse hit the wires today. Their findings were disheartening, stating, “Adolescent substance abuse is America’s #1 health problem.” The report studied smoking, drinking, the misuse of prescription drugs, and illicit drugs. CASA also delved into the science of addiction itself, identifying it as a “complex brain disease with origins in adolescence,” and going on to document how “adolescence is the critical period for the initiation of substance use.” They not only looked at the drugs being used or the age of the user, but at American culture itself—for example, the way the media romanticizes the use of alcohol in its advertising.

Here are some highlights from their report:

  • 90 percent of Americans who meet the medical criteria for addiction started smoking, drinking, or using other drugs before age 18.
  • 1 in 4 Americans who began using any addictive substance before age 18 developed an addiction, compared to 1 in 25 Americans who started using at age 21 or older.
  • 75 percent of all high school students have used addictive substances including tobacco, alcohol, marijuana or cocaine; 1 in 5 of them meet the medical criteria for addiction.
  • 46 percent of all high school students currently use addictive substances; 1 in 3 of them meet the medical criteria for addiction

The ads we see plastered on enormous billboards on the busiest corners in Los Angeles are there to intrigue us. They aren’t just selling a beer, or some whiskey, they’re selling a lifestyle: one that’s full of handsome men and gorgeous women, all ready and willing to party at will. Life looks perfect in those ads, but we all know it is anything but perfect. It sure can seem alluring, though, particularly when we’re young, rebellious, and feeling the pressures of growing up and being “cool.” The intrigue is also directly fueled by the current generation’s perpetually perceived boredom, which stems from our culture of instant gratification. In our current climate, drugs and alcohol are culturally accepted: we have medical marijuana and a pill for every problem.

Our brains are vulnerable in adolescence and at the height of development. In fact, they aren’t fully developed until we’re around 25! As we spoke about in our recent post, once we begin indulging in the use of mind-altering substances, we are essentially performing science experiments on ourselves.

Susan Foster, senior investigator of the study, notes: “By recognizing this as a health problem and respondingto it, we can actually make the difference by improving the life prospects ofteens and saving costs in society.”  This brings us back to what I always say, get involved and start talking to your kids! Teens are under an inordinate amount of pressure: school, peers, hormones, et cetera. At some point, we have to start looking at how those we love are actually managing such an incredible stress load. I once heard a therapist say, “Little people, little problems; big people, big problems.” She was specifically talking about the value in addressing issues when they begin rather than waiting things explode. When we’re trying to preserve and heal family dynamics, it’s far less challenging to deal with an angry 8-year-old than a drug-addicted teen.

Related articles:

Study: Drug Addiction Among Teens On The Rise (newyork.cbslocal.com)

Addiction Starts Early in American Society, Report Finds(nlm.nih.gov)

Categories
Addiction Adolescence Mental Health

Doctor, Doctor, Gimme the News

Image by WhatDaveSees via Flickr

Is your teen playing doctor? Surely, this is an appropriate question for parents of adolescents who are concerned about teens entering a sexually intimate relationship before he or she is ready.

Unfortunately, this is not what I’m addressing. John Lieberman, our Director of Operations sees quite a bit of this and is concerned that “adolescents are literally playing doctor in the worst way, taking both prescribed and over-the-counter medications to treat perceived illnesses and issues.” They are reading information on the Internet, getting advice from peers as to what medications they should take, and they’re often mixing and matching drugs while they’re at it. While some of these Internet sites have some valuable information regarding symptom checks and corresponding information about illnesses, they also present a danger. Any time we look at something from the perception of a layperson, we risk finding and relating to symptoms within the descriptions of many illnesses. That’s what real doctors are for: differentiating reality from the natural misinterpretation from those of us lacking the vital MD title. Pharmaceutical-related overdoses have increased, proving the increasing danger in this behavior, and spurning an all out war against the pharmaceutical industries.

Drugs like Vicodin, Oxycontin, Percocet, and Demoral are all opium derivative drugs. This particular class of drug is highly addictive and can easily lead to an overdose. Xanax, Ativan, Klonopin, Soma, Lunesta and others are benzodiazepines. These, too, can create a physical addiction in a short period of time and in worse cases, cause death. Adderal, Ritalin, and Vyvance are amphetamines primarily used to treat ADHD and are subsequently very powerful drugs that can cause heart attack and stroke, particularly when used inappropriately. The latter are often traded amongst kids in an effort to get high, or even as an attempt to increase their focus at school.

Our kids are playing doctor with quite a varied array of drugs, and this does not take into account the rampant abuse of illicit drugs or alcohol. According to John Lieberman, “Our teens are using very powerful psychoactive drugs during a time in their lives when they are emotionally vulnerable and when their brains are in a major stage of development.” According a 2010 statement by the APA:

“The brain’s frontal lobes, essential for functions such as emotional regulation, planning and organization, continue to develop through adolescence and young adulthood. At this stage, the brain is more vulnerable to the toxic and addictive actions of alcohol and other drugs.”

This isn’t just about playing doctor, kids are also doing chemistry experiments…with their own brains.

This blog was co-written by John Lieberman, our Director of Operations.

Additional links:

Causes of Increase in Opioid Deaths Probed

Be the Wall

Partnership for a Drug Free America

Categories
Addiction Synthetic Drugs

Spice: Your Synthetic Nightmare

Spice, K2, Cloud Nine, Potpourri: call it what you will, it’s all the same: a legal, synthetic, psychotropic drug lurking at the counters of your local liquor store.  Some use these drugs once and walk away, disillusioned by the multitude of negative effects. The addiction-prone continue, disregarding the negative nuances, anxious to get high.  Addiction is funny that way: the bad never seems bad enough to stop.

Recently, 20/20 did an exposé on bath salts, K2, and Spice, exposing the dangers and widespread concern amidst parents and law enforcement officials. Our medical director, Dr. David Lewis, addressed some of the risks related to these substances, telling 20/20: “If you take a developing brain and you put a tremendously psychoactive substance in the middle of that, that developing brain, what you really have is a chemistry experiment.” Dr. Lewis is all too familiar with the negative consequences manifesting in kids who have been using these drugs, and like parents, he also worries about the ease with which one can purchase K2 and Spice. Lewis says, “These people sell the drugs to our kids, no matter what the consequences are.” When 20/20 sent in hidden cameras with underage kids, the truth of this was caught on tape. The retailers are in it for the buck. Show them the money, and they’ll sell you the drugs, regardless of the 18-and-over age restriction.

Unfortunately, this rampant, devil-may-care attitude is substantiated by Dan Francis, the Executive Director of The Retail Compliance Association, who says, “a ban is dangerous” because it “sends it underground.” He even questions the government, saying,” What is wrong with euphoria and what gave them the right to regulate it?” Nothing is wrong with euphoria if it’s obtained through non-harming activities like completing a marathon, or a 2-hour Ashtanga yoga class. But that’s not what’s happening here—instead shops are selling a chemical recipe for disaster. We essentially have kids purchasing substances that have the capability of eliciting a desire to self-harm or increase the potentiality of suicidal ideation. It would be irresponsible if we ignored it.

Related articles:

Stores Fight Proposed Federal Ban on Spice, ‘Legal Marijuana’ (abcnews.go.com)

Synthetic pot can cause psychosis that can last for months, research shows (thenewstribune.com)

Teens Able to Purchase ‘Legal Pot,’ Despite Potentially Deadly Side Effects (abcnews.go.com)

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