come check out our brand new place!!!

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Come check us out there!!!

New Addiction Forum!!!

Hey everyone,

I started a new forum where people can get together and discuss issues related to addiction.

The link is here, but you can also find it in the blogroll on the right sidebar or in the pages link above the blog (under the header)….

I hope the forum will provide a way for more of our hundreds of readers to be able to speak up and tell stories, or ask questions that they are interested in.

All the best,

Adi

Addiction and the brain part IV – Opiates

Okay, we’ve talked about meth and cocaine and how they affect the brain. As I mentioned, both cocaine and meth interfere with the way the brain stores and cleans up important neurotransmitters, including, most importantly, Dopamine and Norepinephrine.

The class of drugs known as opiates, which includes morphine, heroin, codeine, and all their derivatives (including oxycontin), acts on the brain in a completely different manner. Let’s turn our attention to this class of drugs next.

Opiates

While cocaine and meth work by disrupting the normal functioning of molecules responsible for cleaning up released neurotransmitters, opiates work by activating the actual receptors that naturally occuring neurotransmitters themselves activate. Substance like this are known as agonists; they perform the same action (identically or to a lesser, or greater extent) as a substance the body already manufactures.

In the case of morphine, heroin, and most other opiates, the receptors most activated receptors are known as μ-opioid receptors. Activation of the μ-opioid receptors is associated with analgesia, sedation, and euphoria, which makes sense given the relaxing, pleasure inducing effects of opiates.

Natural opioids (also called endogenous opioids), which include endorphins, are used by the body to relieve pain and increase relaxation, especially during periods of extreme stress. These are the chemicals that make sure we can function during accidents, after breaking our leg…

Opioids also increase the amount of dopamine in the brain indirectly. As I mentioned in the earlier posts, dopamine is thought to be the reward indicator in the brain. Unlike meth and cocaine, heroin and its relatives increase the activity of dopamine neurons by releasing the hold that other neurons (that use GABA) have on them. Think of this as the release of pressure on a hose spraying water on a lawn. When the pipe is pinched, only so much water can get through, but once the clasp is released, water can flow in greater quantity; this is essentially what opiates do.

Like I said before, this doesn’t sound so bad, does it? All we’re talking about here is the increasing of the functioning of system that already exists in the brain. The problem isn’t so much in the process, the problem starts when this system gets activated for long periods of time.

Heroin addicts, and other frequent users of opiates complain about the extreme discomfort they feel when they stop using the drugs. This discomfort has been described as the worse case of the flu you could imagine. Doesn’t sound too appealing, does it? In fact, withdrawal symptoms associated with stopping opiate use are at least one of the main reasons many users return to the drug after trying to clean up. This in addition to all the other effects of the drug on the brain to make wanting to stop so much harder.

The reason for the pains and aches? Given the overactivation of its pain suppression system, the body not only reduces its own supply of opioids, but it also turns up the sensitivity on its pain receptors. Heroin users notice this as an increase in tolerance, but they compensate for it by simply using more. However, when they stop, they’re left with a body unable to suppress its own, hyper sensitive pain system. The results are more than uncomfortable, they’re simply excruciating…

Another common complaint of addicts is diarrhea. This, again, is simply the reversal of the constipation caused earlier by heroin.

I’ve heard addicts speak online about the slow recovery from opiate addiction and I want to dispell a myth here:

Opiates DO NOT stay in your system for weeks or months – The drug itself is gone from the body within days. The reason for the continued suffering is the slow adjustment of your brain and body back to the way things were before the drugs. Think of how long the tolerance took to develop… Now play the tape back in reverse. That’s what happening to you. You can help relieve the pain, but know that if you use anything in the opiate family, you’re making the process last much longer…

So, in summary: As usual, the actions of opiates on the body and brain are not all the severe, extreme, or inappropriate. Opiates are still used in medicine for pain suppression, not only because they work, but because the potential for abuse when used in this way are minimal to non-existent. However, as with all drugs, continued, chronic, abusive use will change the way your body functions in ways that will produce the exact opposite effects of those users like so much. This leaves people not only with possible addiction problems, but also with a terrifyingly uncomfortable return back to normal functioning.

One is too many, 1000 no enough: Is the dreaded relapse really that scary?

A couple of researchers studying alcohol relapse have just reported a very interesting finding: When alcoholics who have gone through treatment have a drink after a certain length of sobriety, most don’t go off the deep end.

The old AA adage: “One drink is too many, and a thousand not enough,” refers to the fact that alcoholics who are sober are assumed to return to their evil ways after a relapse. This notion is meant to warn AA members to resist temptation lest they find themselves right back where they started.

Most research into sobriety considers a person a success only if they remain sober throughout the study period. Have a drink, and you’ve lost. Game over.

This is why the recent findings reported in the journal Psychology of Addictive Behaviors are so intriguing:

When looking at the behavior of 563 participants, the researchers found that 30% stayed sober for the entire 12 month follow-up period. This leaves a whopping 70% who had at least a drink in the year following treatment. However, the vast majority of those who drank in the first year after treatment (82%) developed moderate, infrequent, drinking habits. In fact, only about 6% started drinking heavily and frequently after their relapse. Even of those who drank, as many as 25% were completely dry for at least an entire month after their relapse.

These findings suggest that at least for a year after becoming sober, a relapse is not necessarily the detrimental, destructive, event it has always been feared to be. it is surely possible that these drinking habits change, but according to these findings, if drinking frequency goes anywhere after the initial relapse, it’s down, not up.

Citation:
Witkiewitz, K. & Masyn, K. E. (2008). Drinking trajectories following an initial lapse. Psychology of Addictive Behaviors, 22, 157-167.

Social anxiety and drugs: A lesson from monkeys.

If you ever doubted the idea that monkeys are über similar to humans, read this:

A number of researchers at Wake Forest University school of Medicine looked at the social organization in 4 groups of monkeys. They then took either a dominant or subordinate monkey and put it in a cage next to a group of unfamiliar monkeys. The monkeys couldn’t hurt each other, but they could yell and scream, which they did, creating an emotionally stressful situation for the lone monkey.

After this stressful event, the researchers gave the monkey a chance to relax, human style: They were brought back to their normal housing and allowed to pull either on a lever that gave them food, or a lever that gave them a dose of cocaine. Want to guess what happened?

The subordinate monkeys were giving themselves a lot more cocaine than they had been before the stressful event, while the dominant monkeys were giving themselves less.

Brain scans during the event itself showed that the dominant monkeys showed increased activation in the brain’s pleasure regions but the subordinate monkeys showed less activation in stress and anxiety management areas. Sounds like a typical high-school bullying scene, the dominant monkeys were actually enjoying the fight! It was the socially inferior monkeys that were becoming stressed out.

The study supports the idea that stress can increase the tendency to do drugs, especially in those that are less able to protect against it.

The researchers caution that in humans, there are many more stressors than social rank. That’s definitely true, but try telling that to a high-school student…

Addiction Genetics – The new treatment paradigm.

Genetics are making their way into every facet of research nowadays, and addiction treatment is no slouch in that area.

If you haven’t heard of pharmacogenomics yet, you are sure to soon. The idea that medications affect individuals differently based on their unique genetic makeup has picked up a lot of steam in the last few years.

Well, the same way of thinking is beginning to emerge in addiction treatment.

Just as the latter (pharmacogenomics) is said to greatly increase the usability of certain drugs while reducing the worse side effects, so is the use of genetics in addiction treatment purported to bring more personalized, effective treatment to patients.

In a recent congressional hearing, Dr. Nora Volkow, the head of the federal agency entrusted with advancing addiction research, NIDA, told congress that about 75% of a person’s inclination to begin smoking, 60% of one’s tendency to become addicted, and about 54% of a person’s ability to quit were genetically determined.

Wow, those are some sobering numbers…

Now you want it, now you don’t… Context specific addiction???

When most people think about addiction, they imagine a person completely unable to control their cravings, always wanting the thing they’re addicted to.

So what happens when you just can’t have it? What happens when you’re not allowed to? What happens if your life depended on it?

In a way, this question was at least partially answered recently in an article by a number of psychologists at the University of Tel Aviv. What the authors did was simple: They asked a group of heavy Orthodox smokers about their cravings, irritability, and difficulty avoiding smoking on a regular workday, and random day in which they were not allowed to smoke, and the Sabbath (the Jewish day of rest), during which they’re not allowed to smoke for religious reasons. The simple finding was that the participants craved smoking a lot less, were less irritable, and found it a lot easier to avoid smoking on the Sabbath than on any of the other two day.

The moral of the story? Smoking may be really addictive, but when the choice is a cigarette or eternal damnation, it’s a pretty easy one to make…

In the future, I’ll talk about how this idea of addiction within specific contexts has been shown to also exist for the effect of the drug (or behavior) itself!

Enforcement Vs. Prevention

The U.S. policy regarding the drug problem is centered mainly on the enforcement of its drug laws and the intervention in the drug supply both within the U.S. and from bordering countries. There is no question that this “crusade” has an impact. Importing a kilogram of cocaine into the US costs approx $15000 while sending a regular package weighing the same costs about $100 (1).

Still, the recent assassination of the Mexican “drug czar”, points to another fact: Where there’s money, there’s a way. Drug cartels will find a way to deliver their product as long as customers are waiting on the other side of the border. One of the battles in this war has to be fought on the prevention/intervention side.

Health insurance in the United States rarely covers any of the cost involved in drug treatment, even though at least 42 states require them to do so by law! Even when they do, insurance companies often limit coverage to 30 days of residential treatment. I’ve made it clear before, but I feel that the notion that 30 day treatment can work needs to be removed from our consciousness (2). I realize this may require hypnosis…

Anyway, without funding, the hope of making drug treatment truly affordable and accessible is small and dwindling as it requires more medical treatment, which is obviously costly. I hope that this aspect of health care coverage finds its way into the ongoing debate, especially given the high, and increasing prevalence of drug abuse in this country.

Citations:

(1) Reuter & Pollack (2005). how much can treatment reduce national drug problems?

(2) McLellan, Lewis, O’Brien, & Kleber (2000). Drug Dependence, a Chronic Medical Illness Implications for Treatment, Insurance, and Outcomes Evaluation.

Yoga practice and mindfulness in addiction recovery

contributing author: Katie McGrath

Continuing with our posts on positive addiction, let’s discuss the benefits of yoga and meditation.

America first turned to yoga in the 60s as a way to get high without using drugs. Over the years, yoga has grown in popularity as evidence regarding it’s mental and physical health benefits accumulated. Yoga incorporates stretching and strengthening exercises that unite the body, mind, and spirit.

There are different forms of yoga that are available depending on one’s goals and personal preference. Ananda and Hatha are more gentle versions of yoga that focus on meditation and breathing to provide a relaxing escape after a busy day. Ashtanga and Kundalini are aerobic and energizing forms of yoga that are perfect for people who crave a more demanding workout.

Mindfulness is a popular meditation technique that is often used in combination with yoga to promote self-awareness. The concept of mindfulness is to become aware of one’s own thoughts, emotions, and sensations by breathing and concentration. Mindfulness increases sensitivity to bodily movements and states which may explain why it has been linked to improved immunity (1).

Yoga and mindfulness form a union to enhance positive feelings and outlooks. Research has suggested that the combination of yoga and mindfulness can provide energy, satisfaction, and stability on an addict’s road to recovery (1).

Yoga produces long lasting changes which helps maintain a healthy lifestyle (2). It is a positive way to cope with negative emotions, depression, and anxiety (1). Yoga creates a sense of calm and solace that most people do not have the chance to experience in their everyday life.

Yoga Journal has a collection of stories revealing the healing powers of yoga and can be used as one source to direct you if you’re interested in looking into yoga practice.

Stay tuned for more positive practices…

Citations:

1. Schure, Marc B., Christopher, John, Christopher, Suzanne. Mind-body medicine and the art of self-care: Teaching mindfulness to counseling students through yoga, meditation, and Qigong. Journal of Counseling & Development. Vol 86(1), Win 2008, pp. 47-56

2. Holthaus, Stephanie M. A phenomenological study: Yoga during recovery from drugs or alcohol. Dissertation Abstracts International: Section B: The sciences and Engineering Vol 65 (8-B), 2005, pg.4289

So what is sex addiction???

contributing author: Sangeetha Rao

What do you think of when you hear the words “sex addict”? Do you imagine someone who has sex dozens of times a day? Someone who owns a lot of sex toys? Someone who spends all their time immersed in pornography?

While all of these scenarios, and others, could identify someone with a sexual addiction, the crucial part of identifying an addict has to do with the consequences of the behavior and the person’s inability to control them.

A sexual addict experiences the same type of uncontrollable compulsions that others feel in different forms of addiction (like substance, alcohol, gambling, shopping, etc). In his book (Out of the Shadow: Understanding Sexual Addiction) Carnes talks about the compulsive sexual behavior as guiding a misperception of the self.

In simple words: Sex addicts’ view of themselves depends on their relationship with this behavior, and since they can’t control the latter, they often have trouble with the former.

Let us look at some of the NOTS of sexual addiction. Sex addicts are not people who are just hypersexual and get satisfied with their sexual behaviors; rather, they are often not satisfied with the sexual activities that they engage in. Sex addicts are not necessarily Casanovas, but are often normal functioning people who find themselves having to hide their compulsive sexual urges.

Sex addiction is a major problem in our society. Some estimate that as many as 15 million people in the U.S. are sexual addicts (roughly 8% of all men and 3% of women). Easy access offered by the internet has most likely increased the prevalence of sexual addiction in the past decade.

The costs for those suffering from sex addiction are also numerous: Relationships and families are disrupted and destroyed, the addict’s self esteem diminishes as they are unable to be productive in other areas of their life; illegal activity (like prostitution) ends up causing arrests, and health is often affected through the contraction of diseases.

Now, don’t immediately assume that you are a sex addict because you fantasize about sex a lot. But how does one know if they are addicted to sex?

The simple rule is: no impairment, no addiction.

On the other hand, if day to day functioning is effected by the behavior (in this case, something sexual), this may be an indication of a problem. So, whether it be having sex often, thinking of sex, or even just being extremely horny, if it’s making a person’s daily activities or relationships dysfunctional and if they are unable to control their behavior they may be defined as a sex addict.

In future posts we will look more into the symptoms, forms, theories, and treatments related to sex addiction. In the mean-time, keep reading, and if you feel brave enough, share your story; who knows, you may be able to help someone else!

Question of the day:
Do you have any personal experiences with sexual addiction (your own or of someone close to you)?
In what ways has it affected your own life?