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How Effective are Behavioral Approaches for Substance Abuse Treatment?

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As we know, a key part of effective substance abuse treatment can include emotional or cognitive therapies – helping people manage parts of their lives that just might be at the center of their addition challenges.

How effective can these approaches be? A 2017 research study offers useful insights.

The study is titled “Psychosocial interventions for cocaine and psychostimulant amphetamines related disorders,” and is part of theNational Drugs Library, an Ireland-based “information resource for researchers, policy makers, and people working in the areas of drug or alcohol use and addiction, or related fields.”

The authors note: “Psychostimulants such as amphetamines and cocaine are used, at least in part, because of their effects on mood, cognition and behavior. People who abuse or are dependent on them often have a long history of repeated periods of intoxication and of withdrawal and after long-term use they can develop a stereotyped behavior, paranoia, and aggressive behavior.”

To evaluate the effectiveness of various treatment efforts, the researchers “identified 27 randomized controlled studies involving 3663 participants who were dependent on cocaine (crack or intravenous) in all but one Australian trial where oral amphetamine was the psychostimulant used. The other trials took place in the US.” The trials ranged from 12 weeks to nine months in duration.

How did the cognitive approaches work?  The behavioral approaches seemed to make a difference:

  • “Overall, cognitive behavioral interventions reduced dropouts from treatment and use of cocaine when compared with drug counseling.”
  • “Behavioral interventions also clearly performed better than clinical management (psychotherapy sessions attended), usual care (lower rates of cocaine users at 1 and 3 months), information and referral (non-attendance).“
  • “A multimodal intensive intervention was more effective than non-intensive delivery and cognitive behavioral treatments with some form of contingency management (involving the incentive of vouchers that are exchangeable for retail items) also showed benefits.”

The bottom line: Effective substance abuse treatment can include cognitive behavioral approaches

 

 

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Top Ten Most Abused Drugs of 2017

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Top Ten Most Abused Drugs of 2017

As the year 2017 comes to an end, many studies show a clear list of the top ten drugs abused this year. Sadly, many individuals continue to struggle with addiction to these drugs. But, on a brighter note, several individuals have overcome their addictions this year or are on their way to doing so in recovery. Hopefully, 2018 will bring even more success for the many individuals who fight against addictions to these top ten powerful drugs.

The top ten list of most abused illegal drugs in 2017 is as follows:

1-Crack Cocaine

2-Heroin

3-Methamphetamine

4-Bath Salts

5-Cocaine

6-Amphetamines

7-Methadone

8-Benzodiazepines

9-Ecstasy

10-Marijuana

In the coming weeks, watch for more in-depth descriptions of these top ten most abused drugs of 2017 on this site.

Sources:

https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts

https://www.drugabuse.gov/drugs-abuse

https://medlineplus.gov/drugabuse.html

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Top 10 Most Abused Drugs

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Top 10 most abused drugs

Recent statistics show that there has been a slight shift in the top 10 most commonly abused drugs. The most noteworthy is marijuana, moving from 3rd place to 2nd place recently. Most speculate this is due on part to the legalization of recreational marijuana in many parts of the country.

1-Alcohol: The CDAC notes that, “with over half (51.8%) of U.S. population identified as drinkers, alcohol is the #1 most abused substance. Nearly a quarter of the population participates in binge drinking (58.6 million), and 6.7% of the population reported heavy drinking (16.9 million). As a depressant, alcohol produces impaired coordination and judgment, slurred speech, and blackouts.”

2- Marijuana: Marijuana is the #1 most abused illicit drug and the third most abused drug according to the CDAC. The CDAC reports that, “the dried parts of the Cannabis plant can cause distorted perceptions, impaired coordination and problems with learning and memory.”

3- Tobacco: At least one quarter of Americans (6.9 million) are users of a tobacco product making it the second most abused drug. Many individuals are drawn to smoking because it stimulates the pleasure centers in the brain and turn on the body’s natural chemicals that produce euphoria. Cigarette smoke contains over 4000 chemicals, causing long-term systemic effects. These risks include high blood pressure and smoking has been proven to increase the risk of cancer.

4-Prescription painkillers: The abuse of prescription drugs is on the rise and has moved up in ranking to be the fourth most abused type of drug. Painkillers, such as Vicodin and OxyContin, are the most abused prescription drugs. These drugs can produce effects similar to heroin. Painkillers can have negative effects on the physical body causing heightened sensitivity to sound and light, hallucinations, blackouts and problems with the lungs, central nervous system, stomach, intestines, liver, kidneys, heart and death from overdose.

5-Cocaine: Although cocaine gained popularity back in the 1980’s, it still remains on the top 10 list of most abused drugs: listed as the fifth most abused. According to the CDAC, nearly 1.5 million people in America are current users of this white powder. Cocaine use results in severe psychological dependence and intense drug cravings. This is due to cocaine’s short-lived yet powerful effects of euphoria. With cocaine, tolerance builds quickly, making it more dangerous.

6- Prescription Sedatives: The most common sedatives are benzodiazepines and tranquilizers. Approximately 2.4 million people in the U.S. are using sedatives for non-medical purposes. These are highly addictive and can cause memory loss, poor motor coordination, paranoia, stupor, suicidal thoughts, aggression, respiratory depression and coma. Mixing sedatives with alcohol is very dangerous and can cause death.

7- Prescription Stimulants: Prescription stimulant drugs have a high addictive rate and about 1.2 million Americans are currently taking prescription stimulants for non-medical purposes. These stimulants, such as Ritalin or Adderall, are usually prescribed for people who have narcolepsy or ADHD. These drugs increase the level of dopamine in the brain causing feelings of euphoria. Abuse of stimulants can cause heart attacks, strokes, depression, malnutrition, hostility and paranoia. Because stimulants increase energy and focus, teenagers are abusing the drug because they believe it will enhance their learning and test scores. The abuse of these drugs has increased significantly on college campuses across the country.

8- Hallucinogens (LSD, ecstasy): Approximately 1.1 million people are currently taking hallucinogens in the U.S. Hallucinogenic drugs are known as PCP, mescaline, Ecstasy, LSD and psilocybin mushrooms. These drugs cause hallucinations and profoundly affect the perception of reality. Some negative effects of using hallucinogenic drugs are delusions, paranoia, panic, terror, despair, psychosis, and psychological illness. Flashbacks from some of these drugs may occur at anytime after using the drug. LSD is reported to be the most popular hallucinogen among users. LSD, also known as “acid,” is the most potent hallucinogen in the world. It is often sold on blotting paper, or “window panes.” The effects of LSD are unpredictable, altering the user’s mood, personality, and sensations of reality. (CDAC, 2012).

9- Heroin: Heroin is known as the most powerful and addictive drug in the world and its use is increasing in the U.S. Heroin induces euphoria by binding to the opioid receptors that control consciousness, breathing and blood pressure. Long-term effects of using heroin include collapsed veins, partial paralysis, memory loss, intellectual impairment, and disease of the heart, liver and kidneys. Heroin is often diluted with other substances creating a high risk of physical complications and death. It is made from poppy plants and is a highly addictive opiate. It can be injected, smoked, or sniffed and creates a feeling of a euphoric rush. Users feel an increased ability to communicate easily with others, and report heightened sexual performance.

10-Methamphetamine: The tenth most abused drug is methamphetamine, also known as meth, crank, or speed. Although last on the list, it shouldn’t be ignored. Meth is popular among young adults. Meth produces feelings of well-being and energy which can last from 4 to 16 hours. Because of its lasting effects, it is a popular drug for both parties and nightclubs. Meth is highly addictive, and burns up the body’s resources and can cause permanent damage to the brain and body.

 

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W-18: A New Dangerous and Addicting Street Drug

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M-18 Street DrugW-18: A New Dangerous and Addicting Street Drug

Health officials are growing concerned about the recent emergence of a drug called W-18, a synthetic opiate like fentanyl that produces a heroin-like high, but is 100 times as potent and powerful as heroin and 10,000 times more powerful than morphine. W-18 is making it’s way into North America. Although it was developed in Canada as an alternative painkiller, it wasn’t manufactured and sold until a Chinese chemist discovered the formula.

Most likely, W-18 is being produced in labs in China then is being shipped to North America through services such as FedEx. Being sold as a quick high for users, W-18 has made its way first in Canada, and then slowly into the United States. The circulation of this drug is very concerning for many reasons – mostly because there are so many unknowns. The effects of this drug is unknown because there were no formal tests or trials conducted. It is also undetectable in in urine and/or blood and therefore a physician would not be able to tell if a patient is overdosing from this specific drug. After some instances where W-18 was involved in overdosing in Florida, a local Florida epidemiologist was reported to say, “This is the most deadly drug trend I’ve seen in 31 years.”

Recently, reports indicate that W-18 is moving up the coast from Florida into cities such as Philadelphia. Another huge concern with W-18 is that there are rumors that W-18 is being mixed with or cut-in with other drugs, such as heroin, making them even more potent and deadly.

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Post Surgery Prescriptions and Addiction

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postsurgerydrugabusePost Surgery Prescriptions and Addiction

A recent study at University of Buffalo showed that addiction to prescription meds develops easily after surgery –often unintentionally. This rising epidemic is real and is of concern. The study found that 31 out of 75 patients entering an opiate addiction detox clinic developed their addiction from a prescription they received post surgery for pain management. Further, although they began their addiction with a legal prescription, 92% of those individuals illegally purchased other narcotics when in the grips of their addiction.

Also disheartening in the study was the fact that out of 53 patients, 74% of their doctors prescribed narcotic medications without asking if a history of substance abuse existed.

Drug addiction to prescription meds post surgery can easily develop especially when there is easy access with no questions asked regarding addictive tendencies/behaviors. Sadly, many who develop prescription drug addiction had no intention of abusing their prescription. But, because of the highly addictive components of many painkillers prescribed post surgery, individuals who would not otherwise develop addictions to these substances end up with major drug abuse problems.

In identifying if an addiction is present, even if the medication was prescribed legitimately, look for the following warning signs:

  • Continued use after the initial pain has ceased
  • Seeing multiple doctors to obtain more prescriptions
  • Illegally buying the prescription or other drugs
  • Increasing dose without or against doctors recommendation
  • Isolating from friends, family and society
  • More interested in medication than treatment options
  • Mood or behavior changes, such as becoming hostile, agitated, anxious or irritable
  • History of addiction
  • Withdrawal from prescription pain medicine
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New Teen Drug: Triple C

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coughSyrupNew Teen Drug: Triple C

Many teens no longer turn to the shady school dealer for their highs these days. In fact, most just reach inside the medicine cabinet. Across the country, kids are taking dangerous handfuls of cold medicines known to them as “triple C.”

Cold, cough and congestion medications that are based on dextromethorphan, such as Coricidin are the new drug of choice for teens. The dangerous part is that they can find them at any grocery store or even in your home medicine cabinet – without parental permission.

Most teens take this triple C drug cocktail because it gives them euphoric effects. When they take these medicines at a dose higher then recommended, they feel very happy and may have hallucinations.

However, the hard truth is that although these over the counter drugs seem harmless to teens, the long term effects of abuse can include: psychosis, coma, movement problems, liver damage, and even heart trouble.

Parents need to be aware that cold medicines are being abused by kids. They should openly discuss the effects and long-term problems associated with taking too many pills or too much syrup devised to treat colds like in the triple C cocktails that are being experimented with.

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Facts about Utah High School Students and Substance Abuse

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The U.S. Department of Health and Human Services recently published results of a study that examined Utah High School Students and substance abuse. The findings were very positive for the most part. In fact, High School Students indicated much less substance abuse in Utah than in the rest of the U.S.   However, when asked about inhalants and prescription drug abuse, Utah High School Students matched the U.S. statistic, indicating that High School Students in Utah are abusing inhalants and prescriptions in the same amount as teens across the U.S.

 

Taken from hhs.gov, the statistics among high school students (grades 9-12) in Utah and the U.S. were as follows:

 

Percent of high school students who never tried cigarette smoking (even one or two puffs) Utah United States
Total 77% 55%
Male 74% 54%
Female  81% 57%
Percent of high school students who smoked cigarettes on at least one day (during the 30 days before the survey) Utah United States
Total 6% 18%
Male 7% 20%
Female  5% 16%
Percent of high school students who tried to quit smoking cigarettes (among students who currently smoked cigarettes, during the 12 months before the survey) Utah United States
Total N/A 50%
Male N/A 47%
Female  N/A 54%
Percent of high school students who usually obtained their own cigarettes by buying them in a store or gas station (during the 30 days before the survey) Utah United States
Total N/A 14%
Male N/A 17%
Female  N/A 10%
Percent of high school students who used chewing tobacco, snuff, or dip on at least one day (during the 30 days before the survey) Utah United States
Total 4% 8%
Male 6% 13%
Female 1% 2%

 

 

Percent of high school students who drank alcohol for the first time before age 13 years (other than a few sips) Utah United States
Total 11% 20%
Male 13% 23%
Female  8% 17%
Percent of high school students who had at least one drink of alcohol on at least one day (during the 30 days before the survey) Utah United States
Total 15% 39%
Male 16% 39%
Female  13% 38%
Percent of high school students who had five or more drinks of alcohol in a row within a couple of hours on at least one day (during the 30 days before the survey) Utah United States
Total 9% 22%
Male 11% 24%
Female  7% 20%
Percent of high school students who usually obtained the alcohol they drank by someone giving it to them (among students who currently drank alcohol, during the 30 days before the survey) Utah United States
Total 39% 40%
Male 33% 35%
Female  47% 46%
Percent of high school students who drove when drinking alcohol one or more times (in a car or other vehicle during the 30 days before the survey) Utah United States
Total 4% 8%
Male 5% 9%
Female  2% 7%
Percent of high school students who rode with a driver who had been drinking alcohol one or more times (in a car or other vehicle during the 30 days before the survey) Utah United States
Total 13% 24%
Male 14% 23%
Female 12% 25%

 

 

Percent of high school students who ever used marijuana one or more times (during their life) Utah United States
Total 20% 40%
Male 22% 42%
Female 17% 37%

 

 

Percent of high school students who ever sniffed glue, breathed the contents of aerosol spray cans, or inhaled any paints or sprays to get high one or more times (during their life) Utah United States
Total 11% 11%
Male 11% 10%
Female 10% 12%

 

 

Percent of high school students who used any form of cocaine one or more times (for example, powder, crack, or freebase, during the 30 days before the survey) Utah United States
Total 3% 3%
Male 4% 4%
Female 2% 2%

 

 

Percent of High School Students ages 12-17 who used pain relievers for nonmedical reasons (during the 12 months before the survey) Utah United States
Total 7% 6%

 

 

Sources:

Study results, charts, data, are from: U.S. Department of Health and Human Services; Office of Adolescent Health. Retrieved July 27, 2015, from http://www.hhs.gov/ash/oah/adolescent-health-topics/substance-abuse/states/ut.html

 

High school data are from: Centers for Disease Control and Prevention. (2012). 1991-2011 High School Youth Risk Behavior Survey data. Retrieved October 19, 2012, from http://apps.nccd.cdc.gov/youthonline

 

Pain reliever and receipt of treatment data are from: Substance Abuse and Mental Health Services Administration. (2012). State Estimates of Substance Use and Mental Disorders from the 2009-2010 National Surveys on Drug Use and Health, NSDUH Series H-43, HHS Publication No. (SMA) 12-4703. Table C.8, C.21, C.22. Rockville, MD. Retrieved October 19, 2012, from http://www.samhsa.gov/data/NSDUH/2k10State/NSDUHsae2010/NSDUHsaeAppC2010.htm

 

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Substance Abuse and the Elderly

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Father and SonSubstance Abuse and the Elderly

When the issue of substance abuse is discussed, society often thinks of it being a problem among teens, or perhaps young or reckless adults. However, this notion is completely incorrect. The nytimes.com recently reported that, “Baby boomers, who came of age in the ’60s and ’70s when experimenting with drugs was pervasive, are far more likely to use illicit drugs than previous generations. For example, a 2011 study by the Substance Abuse and Mental Health Services Administration found that among adults aged 50 to 59, the rate of current illicit drug use increased to 6.3 percent in 2011 from 2.7 percent in 2002. Aside from alcohol, the most commonly abused drugs were opiates, cocaine and marijuana.” The realization that many of these individuals came of age during a time when drug experimentation was normal, allows more understanding of why these same individuals are struggling with addictions and abuse patterns in their later years.

The elderly most commonly abuse alcohol as their drug of choice. Again, nytimes.org reports that, “Numerous surveys document problematic drinking among the elderly. For example, a 2011 National Survey on Drug Use and Health found that 8.3 percent of adults 65 and older reported binge drinking, defined as having four or five drinks on one occasion in the past month, while the rate of heavy drinking was 2 percent. Given the increased sensitivity to the harmful effects of alcohol with aging, the National Institute of Alcohol Abuse and Alcoholism recommends that men and women aged 65 or older have no more than three drinks on any day and no more than seven drinks per week.”

Oasas.ny.gov recently indicated that, “In his work at the University of Kentucky, Dr. Hays found that 2.5 million older adults and 21% of older hospital patients had alcohol-related problems. (Hays, L. et al. Presented at a symposium for the American Academy of Addiction Psychiatry 2002 Symposium: Substance Use Disorders in the Elderly: Prevalence, Special Considerations and Treatment.)” Many of the elderly report beginning to abuse alcohol later in life. Oasas.ny.gov reports that the elderly’s “alcohol abuse is often triggered by changes in life such as: retirement, death or separation from a family member, a friend or a pet, health concerns, reduced income, impairment of sleep and/or familial conflict. Because alcohol has a higher absorption rate in the elderly, much like it does in women, the same amount of alcohol produces higher blood alcohol levels, causing a greater degree of intoxication than the same amount of alcohol would cause in younger male drinkers.”

However, close on the heels of alcohol abuse is prescription drug abuse. Interestingly, women far outnumber men when it comes to prescription drug abuse: by as much as 20% more. Most of the elderly end up addicted to prescription drugs not after trying to get “high”, but rather in an attempt to avoid physical and emotional pain that comes with age. However, the risks associated with prescription drug abuse among the elderly are severe. Most are battling physiological or psychiatric illnesses in their increasing age already and adding a drug addiction to that battle is dangerous.

When you couple prescription drug abuse in the elderly with alcohol abuse in the elderly, and add to that the abuse of over the counter (OTC) drugs, there can be severe adverse reactions. The elderly spend over $500 million yearly on medications. Antihistamines, laxative, caffeine and other OTC medications cause imbalances, especially when combined with alcohol. The side effects of these imbalances due to drug abuse by the elderly can be negative or even fatal.

When considering if an elderly loved one has a substance abuse problem, The Center for Substance Abuse Treatment published a list of symptoms that may indicate alcohol or drug (whether prescribed or OTC) problem:

  • Memory trouble after having a drink or taking a medication
  • Loss of coordination (walking unsteadily, frequent falls)
  • Changes in sleeping habits
  • Unexplained bruises
  • Being unsure of yourself
  • Irritability, sadness, depression
  • Unexplained chronic pain
  • Changes in eating habits
  • Wanting to stay alone much of the time
  • Failing to bathe or keep clean
  • Having trouble concentrating
  • Difficulty staying in touch with family or friends
  • Lack of interest in usual activities

Sources: nytimes.org, oasas.ny.gov

 

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