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Neurobiology of Addiction: Alcoholics Misread Emotional Cues

Most of us have who have known an alcoholic, know the tendency that alcoholics misread emotional cues. One of the most frustrating and difficult aspects of alcoholism is the toll that it takes on relationships. When alcoholics misread emotional cues it often results in alcoholics taking offense when none was intended, or failing to interpret a loved one’s sadness, anger, disappointment, or even joy. And an alcoholics misread emotional cues can lead to further substance abuse followed by more deterioration of relationships and lives. However, Picture of the brain with highlighted limbic system, which plays a part in the tendency for alcoholics to misread emotional cues.

According to Medical New Today, a new study from Boston University School of Medicine found that individuals who have a long history of alcoholism, even those who have abstained (from one month to many years), showed abnormal brain activity when looking at facial expressions of others (a registering of less intensity). The brains of alcoholics, or former, alcoholics misread emotional cues because of an abnormality in their brain function. In this study, which was published in the August 11, 2009 issue of Alcoholism: Clinical and Experimental Research, researchers used functional magnetic resonance imaging (fMRI) to focus on abnormalities in the temporal limbic (the amygdale and hippocampus) part of the brain.

“Since ‘reading facial expressions’ is an important part of social interaction, alcoholics as well as other previously addicted groups, may be suffering from brain abnormalities in parts of the brain that control emotional perception and memory,” said author Marlene Oscar Berman, PhD, a professor of neurology (Neuropsychology) and psychiatry, in regards to the study’s findings about alcoholics misread emotional cues. “Furthermore, these results reveal neural substrates underlying alcoholism-related emotional anomalies and impairments of brain reward circuitry that mediate addictions such as alcoholism.”

Binge Drinking: Not Just a College Problem

A man holds a drink in each hand. Binge drinking can occur at any ageWhen we think of binge drinking, we usually think of college-age kids, frat parties, keg stands. Rarely do we associate binge drinking with those in middle age or retirement age. But according to research by Duke University and the National Survey on Drug Use and Health, 22 percent of men (more than one in five) and 9 percent of women, age 50 – 64 engage in binge drinking. Among those over the age of 65, 14 percent of men and 3 percent of women reported binge drinking. In fact, there are a considerable number of older Americans who consume enough alcohol on a daily basis to be classified as heaving drinkers (19 percent men and 13 percent women). This debunks the myth that binge drinking is only a problem among college students.

What’s troubling about these numbers it that heavy drinking poses more health risks for people over the age of 50 than it does for people of a younger age. One reason is because their bodies metabolize alcohol less quickly. Another reason is that they may be on other medications, many that become dangerous when combined with alcohol. This demographic may also have more existing health problems that alcohol consumption can exacerbate.

“We feel that our findings are important to the public health of middle-aged and elderly persons as they point to a potentially unrecognized problem that often ‘flies beneath’ the typical screen for alcohol problems in psychiatry practices,” said one of the authors of the study as reported by Medical News Today. “Clinicians who work with this age group would be well advised to ask specifically about binge drinking.”

Not only is binge drinking often missed by common screening methods, but it is often overlooked by physicians as a health risk in older individuals because of the misperception regarding age. Doctor’s aren’t asking their older patients, because they don’t expect them to be binge drinking. Don’t disregard the possibility of binge drinking because you or a loved one is not of a certain age.

A Family Affair: Addiction and Codependency

Codependency makes addiction a family affiar by effecting everyone involved with the problem.The codependency that exists between an addict and his or her family can be one of the biggest issues standing in the way of getting people into treatment and keeping them in recovery. Codependency makes addiction a family affair. One example of codependency, or becoming over-involved in the addict’s life, might be covering up bad behavior. Another is making excuses for the addict and not allowing them to suffer the consequences of their actions. When it comes to addiction and codependency, you have to remember that you cannot control the behavior of others, but you can refuse to support it.

Other signs of codependency in a family are:

  • The addiction is never discussed outside of the family
  • Family members may feel that they can’t say what they really think or feel about the problem
  • Problems arise, not from the drug use, but from the denial of the problem
  • The addicts drug use takes center stage in family life
  • The problem is never mentioned

Often times family members are unaware that they are contributing to the problem. In an effort to help the addict, they make decisions based on what they think the addict needs. Codependency is a family affair because the behavior doesn’t just effect the addict, it effects each member. Aside from hindering efforts to get an addict help, codependency can have the following effects on family members:

  • Role confusion within the family and in other personal and professional relationships
  • Unhealthy avoidance of conflict or it’s opposite
  • Difficulty communicating emotions
  • Constant need for approval
  • Trust and control issues
  • Difficulty in setting and maintaining healthy boundaries with others

Destructive behaviors develop when an addiction problem is left untreated in a family. Since codependent behaviors become routine, you and your family may have trouble recognizing them or seeing how unhealthy they are. It’s also not easy to see how they are contributing to the problem because the intentions are good. And different families are affected by codependency in different ways. It varies depending on how long the addiction has existed, how advanced it is, how much shame and secrecy surrounds the problem, and the roles and responsibilities of the addict.

Substance Abuse Denial Stands in the Way of Help

Substance Abuse Denial Stands in the Way of Getting HelpSubstance abuse denial stands in the way of getting help. I know it seems impossible, but because of substance abuse denial, spouses and close relatives are often the last to know about a loved one’s problem. That’s because substance abuse denial is a strong force. It’s often our love or protective instincts that cause the substance abuse denial. We make excuses for an addict’s behavior or ignore the warning signs even when they are right in front of us.

An example of substance abuse denial is when Diane Schuler drove the wrong way down the Taconic Parkway in New York in July 2009. She crashed and killed her 2-year-old daughter, three nieces, and three men in a car she hit. Her five-year-old son survived, but suffered a severe brain injury.

To many, Diane was a take-charge wife, devoted mother who constantly volunteered at her children’s school, and an highly-payed cable-TV executive. But, as CBS News reported, a bottle of vodka was found in the mangled wreckage of Schuler’s minivan. A preliminary autopsy of Schuler ruled out a stroke, heart attack, or aneurysm. And a toxicology report found her blood-alcohol level was more than twice the state’s legal limit (the equivalent of ten shots of vodka), and she had high levels of the key ingredient of marijuana in her system. Despite these findings, her husband and closest relatives continued to display symptoms of substance abuse denial. Her husband at a press conference even stated, “I never saw her drunk since the day I met her.” He failed to answer questions about any marijuana use.

Why and how does substance abuse denial exist? Often times, loved ones do recognize the warning signs or red flags of substance abuse. But fear or inability to deal with the reality of the problem, keep families in the dark. This is what causes substance abuse denial. We are so scared of what we would do if we were to acknowledge the problem, that we continue the denial. This is why it’s important to reach out to places like ExecuCare, who have a team of specialists trained to deal with situations of substance abuse. Denial doesn’t need to stand in the way of getting help.

Challenging the Addiction Stigma

Buzz Aldrin walks the moon and challenges the addiction stigmaBecause of the negative addiction stigma, many addicts are still embarrassed or scared to talk about their illness. This is despite continuous scientific evidence that addiction is a brain disease. Science makes clear that addiction is not a choice, a lack of willpower or a character flaw. Hopefully, the more that people talk about their disease of addiction, the more it will challenge the addiction stigma and make obvious that addiction shows no discrimination. It can effect anyone, regardless of socioeconomic class, ethnicity, age or gender.

A good example of this: Col. Edwin Eugene “Buzz” Aldrin, Jr. Heard of him? Probably you have. He played a central role in one of the greatest accomplishments in human history: the Apollo 11 space mission. Astronaut Buzz Aldrin was the second man to walk on the moon. It made him one of the most famous people on our planet with countless children aspiring to be just like “Buzz.” Even before he changed the course of mankind, Col. Aldrin was considered an overachiever. He turned down a full scholarship to M.I.T. to attend West Point, where he graduated third in his class with a B.S. in mechanical engineering. He joined the Air Force and was a decorated fighter pilot in the Korean War. And to this day, he is one of only twelve or so people to succeed at the near impossible feat of walking on the face of the moon. However, few people know the rest of the American hero’s story. He released a memoir in 2009 titled, “Magnificent Desolation: The Long Journey Home from the Moon.” In it, he recounts his long-time struggle with alcoholism and depression. In an attempt to challenge the addiction stigma,  he is quoted as saying, “From the pinnacle of Apollo, my greatest challenge became the human one — overcoming alcoholism and living beyond depression — a challenge that required more courage and determination than going to the moon.”

The addiction stigma is so pervasive in society that we rarely think of a successful business person, doctor, lawyer, or astronaut as an addict. Yet these people are just as likely to suffer from the disease of addiction as any other. The addiction stigma continues to perpetuate a false stereotype of what an addict is. In doing so, the addiction stigma reinforces behavior of stress, fear, denial and secrecy, all of which exacerbate the problem and stand in the way of people getting help. In fact, one of the main reasons people report for not seeking treatment is the negative addiction stigma.

Col. Aldrin, and many like him, are testimony to the fact that the disease of addiction can strike anyone, regardless of how strong, successful, intelligent or willful. It is stories like his that will hopefully help change the negative addiction stigma, and encourage those who need help to seek it. Because the good news is, addiction is a treatable disease. People who get help are able to live wonderful, fulfilling lives in long-term recovery.

Doctor’s Orders: Problems with Prescription Drug Abuse

Three prescription drug bottles that can lead to prescription drug abuse.Recognizing a prescription drug abuse problem can be difficult, especially since it is often a trusted doctor that’s prescribing the drugs. Currently, prescription drug abuse has hit an all time high. Millions of Americans are misusing prescription drugs. According to the Drug Enforcement Agency, there are more people abusing prescription drugs than cocaine, heroin, hallucinogens and ecstasy combined. The problem of prescription drug abuse is serious.

The tricky thing about prescription drug abuse it is that, yes, there are traditional drug dealers, online pharmacies and other black markets that sell prescription drugs like codeine, Vicodin or OxyContin. But the real suppliers are doctors, prescribing drugs for pain, anxiety, and more. At ExecuCare, we’ve seen the number of prescription drug abusers climb in Atlanta and the rest of the country. And lately, we’ve seen in the media a rise in the number of deaths surrounding prescription drug abuse: Michael Jackson, Whitney Houston, Heath Ledger. Sometimes it’s not just the amount of the prescription drug being abused but the combination of drugs that causes a lethal cocktail.

One sign that prescription drug abuse is present is “doctor shopping.” This is when an individual visits multiple doctors to try and obtain the same prescription without a problem of abuse being detected. In July 2009, CNN ran an article called “Using Dentists as Dope Dealers”. The article reported the increasing problem of “dentist-shopping”. While most primary care doctors asked patients to schedule an appointment to discuss pain, the article found that dentists often prescribed medication over the phone for toothaches and other mouth pain. Some people were even targeting veterinarians for pain medication. For doctors with patients complaining of pain, it is difficult to assess what is real or what is an attempt to get the prescription drug of abuse.

More common signs of prescription drug abuse are:

  • Taking someone else’s prescribed drugs.
  • Visiting multiple doctors for the same or similar prescription.
  • Taking more than the prescribed dose.
  • Combining medications without discussing risks with doctor.

At ExecuCare, we are well-equipped to handle prescription drug abuse. Not only does our detox program safely and quickly help someone stop the use of prescription drugs, but we have the necessary resources to help stage an intervention and guide someone through treatment. We also have an extensive after-care program that helps ensure long-term recovery.

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