Monday, July 27, 2009

Visit to ATCPCC

I spent 3 days last week in Santa Barbara at the Addiction Treatment Centers & Professionals Consortium of California listening to treatment centers from all over the country talk about what they are doing. This conference was pretty interesting; it's always nice to keep a finger on the pulse of what people are doing across the country. A good chunk of providers were there, about 60 from around the country.

I was really impressed with a few people there (and of course I presented and thought I did well, talking about Sober Living By The Sea) and I thought I'd talk about the others doing good work around the country.
Hero House, with homes in Atlanta and San Juan Capistrano, CA, has a specific focus on college students, providing them a safe environment following treatment (like the TEACH program) complete with educational support. Randy Haveson, the founder and executive director, has a great passion for helping students recover and I'm looking forward to doing some work with him.

Jane Eigner Mintz of Real Life Interventions
, from the Cleveland area, rolled out her new model of intervention, the Field Model. This is based more on a clinical aspect rather than the Johnson or Systemic model. I'm really looking forward to seeing what this looks like. She also is developing a school for interventionists, which will be helpful in providing families with qualified professionals.

And of course, Jaywalker Lodge was impressive, bringing two of their therapists out from Carbondale, CO. They talked about the men's relapse prevention program, as well as their longer-term outpatient/sober living option. They have a wonderful small town feel and treat the client who is looking to hit the "reset" button and get a fresh start.

There are others out there also doing good work- these three stood out to me. We'll see what pops out in the next year or so.

Here's a video on opioids and the brain from HBO's "Addiction" special:

In other news, if you haven't checked out my favorite sports columnist, Bill Simmons, today is a good day. Here's a link to his ESPN website.

And for something hilarious click here.

As usual, follow me on Twitter and connect with me on LinkedIn. Become a fan of the blog on Facebook. And be sure to support my advertisers! See you this week.

Make sure to check out my podcast on The Afflicted and Affected starting today at 4 PM Pacific, and read my abridged life story on the Equinox Fitness website.

Wednesday, July 22, 2009

Quick Post

Hey guys,

Just wanted to let everyone know a couple of PR things:

A very short version of my recovery journey is on the Equinox Fitness website as one of their featured "Life Stories," click here to see it!

And on Monday, July 27th, I'll be appearing on the Afflicted and Affected podcast, talking about my personal experience in recovery as well as my experience working in the field. Check it out here.

I'll be at the Santa Barbara Addiction Treatment Consortium this week, stay tuned for details as I'll be live blogging and Twittering from the event.

Here's a good video from the National Geographic Channel on heroin addicts:

As always, follow me on Twitter, connect with me on LinkedIn and become a fan of the blog on Facebook. See you this week.

Monday, July 20, 2009

Marijuana- a gateway drug?

An article in the New York Times this week talks about a couple of individual stories of people who are dependent on marijuana. One of the people interviewed, Joyce, had this to say about pot: Smoking pot, she said, “was a slow form of suicide.” The article touches on the stigma of marijuana addicts- mainly that people who were addicted to substances like heroin or crack cocaine looked down on people who had problems with marijuana. However, according to the National Institute on Drug Abuse reports that the marijuana of today is up to five times more potent than the marijuana of the 1970s.

“We need to be very mindful of what we are unleashing out of a Pandora’s Box here,” said Dr. Richard N. Rosenthal, chairman of psychiatry at St. Luke’s-Roosevelt Hospital in Manhattan and professor of clinical psychiatry at Columbia University. “The people who become chronic users don’t have the same lives and the same achievements as people who don’t use chronically.” However, you can say this about EVERY drug. I mean, if someone had the ability to drink one glass of wine a week as opposed to someone who drank a bottle of wine a night, the person who drank less would have less adverse consequences, right? And you can repeat that with ANY drug.

More adults are now admitted to treatment centers for primary marijuana and hashish addictions than for primary addictions to heroin, cocaine and methamphetamine, according to the latest government data, a 2007 report by the Substance Abuse and Mental Health Services Administration. However, those numbers are a little skewed, as 57 percent of those people were admitted due to court requirements- so they may not have been a complete addict.

So the question that defines this- are there consequences from marijuana use? Are lives made unmanageable as a result of smoking pot? The answer, of course, is yes- and with the genetic link for addiction a proven fact, then obviously any psychoactive substance can activate that addiction. So- marijuana, like any other substance, can be addictive when it's used by a person prone to addiction.

About legalization- my view is this: If alcohol and tobacco are legal and cause as many negative health consequences as they do, then we really need to review our policies on marijuana. If controlled and managed well (at least as regulated as alcohol and tobacco), then we'll see a safer, more controlled version of the drug that's out there now. But we'll see what happens.

Here's a great article by Freakonomics author Stephen J. Dubner from the New York Times about the economics of legalization.

Stephen Baldwin vs. Ron Paul on legalization:

And here's the trailer from "Reefer Madness," the overblown movie from 1936 against marijuana:

Here's something funny.

As always, follow me on Twitter and connect with me on LinkedIn. Become a fan of the blog on Facebook. Support our advertisers! And see you later this week.

Tuesday, July 14, 2009

When eating disorders strike in mid-life

Eating disorders, especially anorexia and bulimia, are generally classified as a young woman's disease. Now, according to a recent New York Times article, more and more women in their 30s and 40s are developing eating disorders.

“I think the degree of despair we are seeing among adult women about their bodies is unrivaled,” said Margo Maine, co-author of “The Body Myth: Adult Women and the Pressure to Be Perfect” (Wiley, 2005). “Eating disorders creep up during periods of developmental transitions, so the peak had been 13 to 15 and 17 to 19 — moving into adolescence and moving into college. Now, we are seeing them again during or after pregnancy and as women hit other life phases, such as empty nesting.”

“A problem is that friends, and even doctors, get used to seeing someone in their overly skinny state and may not recognize their habits and physique as dangerously unhealthy,” said Dr. David Herzog, the director of the Harris Center for Education and Advocacy in Eating Disorders at Massachusetts General Hospital. He is also the endowed professor in the field of eating disorders at Harvard Medical School.

WebMD even has a specific section of their website geared towards older women and eating disorders. This is an awareness that is growing among addictions- that these kind of things can strike anyone, anywhere, whether it's drug addiction, eating disorders or other compulsive behaviors. Money, success, fame (see Michael Jackson) or any other factor can't completely shield someone from these terrible diseases. The best we can ask for is awareness and the ability to get help.

What Dr. Herzog said above, about doctors not being able to recognize the behavior, is one of the biggest problems in America. Doctors receive little education around recognizing and treating eating disorders and addiction unless they really ask for it or specialize in it. This leaves an entire generation of doctors on their own, trying to help people in a general practice where these things may go unnoticed for long periods of time. Once again- educate, educate, educate and raise awareness! If you think there's a problem- if you're asking yourself if you drink too much, smoke too much pot, or aren't eating enough, ask for help! There is no shame in getting better. I think that's the biggest stigma in our culture- that somehow living with a huge problem and not getting help, attempting to pull oneself up by the bootstraps if you will, is a better option than asking for help with a major problem. This is something each individual can change for themselves. If you need help, you won't get it if you don't ask.

Miss America Kristen Haglund is involved in eating disorder awareness:

And here's a video on older women and eating disorders from CBS:

Watch CBS Videos Online

Here's something funny.

As always, follow me on Twitter and connect with me on LinkedIn. Become a fan of the blog on Facebook. And see you later this week.

Friday, July 10, 2009

Michael Jackson and his pill problem- more is revealed

Not shocking- it turns out that Michael Jackson's pill problem was more serious than we all thought. As I talked about in a previous blog post, Jackson had some major problems dealing with a childhood filled with trauma, the fame he was dealt, and all of his familial and personal issues which eventually lead to his too-early demise. Now CNN is reporting that Jackson, in 2004, was taking more than 10 Xanax a night. He also had his security guards picking up prescriptions in their own names for him, as well as prescriptions from doctors as far away as New York.

The amount of Xanax that Jackson alleged took surprised CNN chief medical correspondent Sanjay Gupta.In addiction cases, people develop a tolerance to drugs and have to take more and more pills, Gupta said. "No matter how you cut it, this is an extremely high dosage of Xanax," Gupta said. "It is a huge red flag, even with the tolerance that I was talking about. This dosage is exceedingly high for any human being."

According to the website, who cite a number of reliable resources and studies, said this: Taking prescription drugs without a prescription, not taking them as directed, or mixing them with alcohol are all unsafe and potentially deadly. A 2008 study based on 224,355 U.S. death certificates for which people died from medication errors showed that there was a 3,196 percent increase between 1983 and 2004 in deaths at home from combining prescription drugs with alcohol and/or street drugs.

In 2006, Jackson was trying to jumpstart his career with a series of concerts in Las Vegas. According to Jack Wishna, a promoter who was helping Jackson secure the series of concerts in Vegas, Jackson had to pull out of the concerts due to his weakened condition. According to Wishna, Jackson appeared emaciated and incoherent, and often had to use a wheelchair to get around.

According to other sources, around this time Janet Jackson was planning an intervention for Michael. According to the report, Janet recruited her brothers to help stage the intervention, however Michael told his bodyguards to prevent his family from entering his property and refused to accept phone calls from his mother Katherine, CNN reports.

This becomes a difficult situation- what happens when someone has procured so much power that they seem to be untouchable? Why didn't the security guards step in? They must have known there was a problem- the guards couldn't have thought his pill consumption was normal, especially since they were filling prescriptions in their own names for him. Were they blinded by loyalty to Jackson? Or money? It's hard to believe that no one ever stepped in- people had to know something was wrong. Perhaps with a family intervention and treatment, Jackson would've had a chance to get better. The world will never know.

Here's Sanjay Gupta from CNN talking about Jackson's death:

And here's Dr. Gupta talking about Michael Jackson's final rehearsal:

Here's a breakdown of recent statistics on pill abuse:

Here's something funny.

As always, follow me on Twitter and connect with me on LinkedIn. Become a fan of the blog on Facebook. Support my advertisers. And have a great weekend!

Wednesday, July 8, 2009

Exercise and Substance Abuse Prevention

Don't know how I missed this in my previous post about exercise and recovery, but there have been some articles published about the effectiveness of exercise and sports as actual deterrents to substance abuse. About a year ago, the Associated Press posted an article about exercise as a prevention tool. The National Institute on Drug Abuse received a $4 million grant to explore this further. "Exercise has been shown to be beneficial in so many areas of physical and mental health," said Dr. Nora Volkow, NIDA Director. "This cross-disciplinary meeting is designed to get scientists thinking creatively about its potential role in substance abuse prevention."

There has been other research: Brown University took smokers to the gym three times a week and found adding the exercise to a smoking-cessation program doubled women's chances of successfully kicking the habit. The quitters who worked out got an extra benefit: They gained half as much weight as women who managed to quit without exercising, says lead researcher Dr. Bess Marcus.

''Exercise improves blood flow to the brain, it helps the body detoxify, it puts you on a better cycle of physical behavior, and it leads to decreased stress. It also improves thinking and mental function and decreases your tendency toward addiction,'' said Dr. Marc Siegel, an internist at New York University Medical Center and an associate professor of medicine at the NYU School of Medicine in New York City.

For example, ''there's evidence that exercise is maybe the best non-pharmacological antidepressant we have - studies have shown that it works better than some drugs. It's also a great anti-anxiety intervention,'' said James Maddux, a professor of psychology at George Mason University in Fairfax, Va., and an expert on the mind-body health connection.

I know when I was in treatment, I used exercise as a type of coping tool- gaining a "runner's high" and creating a challenge to complete. I still work out today as a way of keeping my cravings (especially around nicotine!) at bay. Not to mention the fact that working out creates chemical changes in our mind and body to make us feel better and happier. I know my mood has improved since I started working out more often. For now, let's list exercise as a tool in a toolkit for fighting addiction- it's not the end-all/be-all, but it's another way to encourage this next generation to avoid the pitfalls of addiction.

If you're looking for a great blog about exercise, staying in shape and diet advice, check out Move Ur Body- great content and advice here. Be sure to check out Phoenix Multisport, a group in Boulder, CO who uses exercise as a recovery tool. And Sober Living By The Sea, where I work, provides physical activity to their patients as an ongoing part of treatment.

Here's a great video about Todd Crandell of Racing For Recovery, an individual who used triathlons to help defeat his own addiction:

And Jaywalker Lodge, an extended care program for men who have been through multiple addiction treatments, does expeditions every year. Here's a video of their winter expedition:

As always, follow me on Twitter and connect with me on LinkedIn. Become a fan of the blog on Facebook. And see you later.

Monday, July 6, 2009

Drugs and the Tour de France

I've written about athletes and performance-enhancing drugs before, but I for some reason forgot to touch on cycling. With the Tour de France starting this 4th of July weekend, the question of doping in the peloton has started to run rampant again. The Tour has a long and illustrious history of performance-enhancing drug use (you can see the full history on Wikipedia here) and it's finally starting to get better- we think. More stringent testing for EPO (or Erthropoietin) and steroids have at least created a shield for the Tour to protect them from the scandals of the past. Floyd Landis, the last American to win the Tour in 2006, was tested and reported positive the day after his win- and was stripped of the title. He just made his comeback this past year after a two-year suspension.

The 2007 Tour was especially marked by rampant doping violations. The Tour winner, Alberto Contador, was not allowed to participate in the 2006 Tour de France due to his possible involvement with Operacion Puerto, a doping sting against doctor Eufemiano Fuentes and a number of accomplices, started in May 2006. He is accused of administering prohibited doping products to 200 professional athletes, to enhance their performance.

American cyclist Tyler Hamilton announced his retirement from cycling this past April, after multiple positive doping results. He had been battling depression for years and years, and stated that his doping and taking of supplements were taken in an unstable state of mind. An article in VeloNews, a cycling news organization, touched on depression in cyclists after the death of Marco Pantani.

It's well known that exercise can help combat depression and anxiety; that a healthful lifestyle will contribute to a better state of mind. Newsweek wrote about Phoenix Multisport, a group in Boulder, CO that I've written about before who use outdoor activities as part of a therapeutic lifestyle change.

However, when it comes to high-end, competitive athletics, doping has become a huge problem. We've seen it in major league baseball, as up to 103 athletes were named in the Mitchell Report of 2007. And now, with the Tour in the spotlight, we can look back in 2004 where 8 young cyclists died of doping-related heart attacks. In order to help these athletes, we need to provide a comprehensive education and accountability program. There will always be people who cheat, who seek the best edge, and who want every advantage available to them no matter the consequences; the best we can hope for is a level of accountability that provides stringent guidelines and punishments to those who violate the sanctity of sport.

Here's Greg LeMond, a very famous cyclist, talking about steroids and how they've changed sports:

And here's Lance Armstrong, talking about how to prevent doping:

Here's something funny.

As always, follow me on Twitter and connect with me on LinkedIn. Become a fan of the blog on Facebook. And see you later this week.

Wednesday, July 1, 2009

Pain Relievers- Too Dangerous?

A federal advisory panel finalized a close vote on Tuesday to recommend a ban on Percocet and Vicodin, two of the most popular prescription painkillers in the world, because of their effects on the liver. Since people who take these pain medications for long periods of time often need a stronger dose, the odds of liver damage increase drastically. Acetaminophen, a chief ingredient in these medications (and also in Tylenol and Excedrin), can cause liver damage when taken at high doses for a long period of time.

Vicodin (and its generic equivalent) is prescribed over 100 million times a year in the US alone- so this is a huge business decision. In a statement, Johnson & Johnson, Tylenol’s maker, said it “strongly disagrees” with the proposed restrictions on acetaminophen, adding that they would be likely to “lead to more serious adverse events as consumers shift to other over-the-counter products,” like Advil and aspirin.

However, without abuse or overmedicating, the odds of actual overdose or severe liver damage goes down. “If you keep track of what you’re taking, none of this is an issue for you,” Dr. Jan Engle, a panel member and head of the Department of Pharmacy Practice at the University of Illinois in Chicago, said in an interview after the meeting.

We need to be on the lookout for the long term affects of misusing pain management drugs. With the new recommendations on banning pain meds such as Vicodin and Percocet, people may be looking for something stronger, or at least something different. SAMHSA has publish some disturbing trends around prescription drug abuse:

* Over the past decade-and-a-half, the number of teen and young adult (ages 12 to 25) new abusers of prescription painkillers such as oxycodone (OxyContin) or hydrocodone (Vicodin) has grown five-fold (from 400,000 in the mid-eighties to 2 million in 2000).
* New misusers of tranquilizers such as diazepam (Valium) or alprazolam (Xanax, called "zanies" by youth)-medicine normally used to treat anxiety or tension-went up nearly 50 percent in one year (700,000 in 1999 to 1 million in 2000).
* More than 17 percent of adults over 60, wittingly or not, abuse prescription drugs.
* In 2000, more than 19 million prescriptions for ADHD drugs were filled, a 72 percent increase since 1995. An estimated 3 to 5 percent of school-age children have ADHD. A study of students in Wisconsin and Minnesota showed 34 percent of ADHD youth age 11 to 18 report being approached to sell or trade their medicines, such as Ritalin.
* Among 12- to 17-year-olds, girls are more likely than boys to use psychotherapeutic drugs nonmedically.

And the Office of National Drug Control Policy has some good facts on prescription abuse and awareness as well. Check that out here.

As we hear more and more about Michael Jackson and his prescription drug abuse, the need for awareness and prevention continues to rise. The medicine cabinet can be just as dangerous as the guy on the street corner. Doctors can be drug dealers too.

Here's video about the rise of prescription drug abuse:

And here's another one:

And here's something funny.

As always, connect with me on LinkedIn and follow me on Twitter. Become a fan of the blog on Facebook. And see you this week.