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Addiction

Painkillers: Common Risk Factors for Addiction?

A Geisinger study, published in Addiction in 2010, found that patients with four common risk factors have a significantly higher risk of addiction to painkillers. Chronic pain patients who are 65 years or younger, have a history of depression, and use of psychiatric medication were common risk factors for the development of a substance abuse problem. A history of drug abuse further compounds the risk. Among the patients attributed with these risk factors, statistics show that one in four (26 percent) suffer with painkiller addiction.

The significance of these findings, as reiterated by the senior investigator of the study, is that most of this information can often easily and quickly be found in a patient’s medical record. “These findings suggest that patients with pre-existing risk factors are more likely to become addicted to painkillers, providing the foundation for further clinical evaluation,” said Joseph Boscarino, PhD, an epidemiologist and senior investigator at Geisinger’s Center for Health Research, cited online at HCP Live. “By assessing patients in chronic pain for these risk factors before prescribing painkillers, doctors will be better able to treat their patients’ pain without the potential for future drug addiction.”

Additionally, even without a history of chronic pain, patients with these risk factors may still be more likely to become addicted.

The study investigators accessed an electronic database to identify patients with back pain and related orthopedic conditions, who were prescribed painkillers for more than 90 days. The sample size was 705 patients. These patients were interviewed and had their DNA collected to be studied.

The team studied a gene located on chromosome 15 that was implicated in alcohol, cocaine, and cigarette smoking dependencies.  The data suggests there is an association of DNA variants in a gene cluster on this chromosome with opioid and nicotine addiction as well.

September is National Drug and Alcohol Recovery Month

In observance of September being National Drug and Alcohol Recovery Month, the national website, Recovery Month, “aims to promote the societal benefits of alcohol and drug use disorder treatment, laud the contributions of treatment providers, and promote the message that recovery from alcohol and drug disorders in all its forms is possible.” Be sure to check it out for stories and event information in your area. The U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) and its Center for Substance Abuse Treatment (CSAT) created the materials being distributed for Recovery Month.

RecoveryMonth.gov website is a wealth of resources. Download the PDF version of the Toolkit (32MB)

The toolkit contains three separate sections and a special section showcasing real-life examples of people in recovery:

  • Media Outreach – Provides instructions to plan and promote Recovery Month activities and events, as well as templates to customize and send to local and online media outlets.
  • Targeted Outreach – Offers audience-specific information about the benefits of recovery, effectiveness of treatment, and tips to overcome challenges during the recovery process.
  • Resources – Provides resources to help plan and prepare for Recovery Month events, as well as tips to cultivate partnerships with other organizations.
  • Join the Voices for Recovery – Presents a snapshot of individuals who are on the road to recovery after struggling with mental and/or substance use disorders.

Email contact@ExecuCareARC.com or comment below and let us know what you and/or your organization are doing to promote awareness and recovery this month. Let us know about an event. Or share  your own story of recovery!

Alcohol Dependence Damages Memory and Awareness of Memory

A study in the November 2010 issue of Alcoholism: Clinical & Experimental Research, reaffirmed that alcohol dependence has a negative effect on the brain’s cognitive processes such as memory. However, the study also confirmed that aside from inhibiting the proper function of memory, alcohol dependence  damages a person’s “metamemory,” or a person’s ability, albeit subjective, to know one’s memory processing capabilities.

Memory refers to the brain’s ability to encode, store, and retrieve information. Previous studies have found that not only can alcohol dependence impair one’s episodic memory functioning while drinking, but that even when not drinking, episodic memory function can still be in decline.

What this new study found was that most people who have poor memory function are able to recognize it with their metamemory and find ways to overcompensate for their forgetful ways. For example, someone who has difficulty remembering where they leave their car keys might put a dish by the door that they only leave them. Or someone who has a difficult time remembering what to buy at the store will make sure they write out a list beforehand. Metamemory enables us to adapt our behavior in everyday life so that a person can use his or her memory skills as efficiently as possible. Alcohol dependency not only disrupts the a person’s ability to properly encode, store and retrieve information, but it interferes with them knowing or recognizing their limits in order to adjust their behavior accordingly.

In fact, the study found that the alcohol dependent participants with chronic alcoholism believed their memory was as effective as the healthy control group, despite their episodic memory impairments being well-established during the study. The alcohol dependent group had a tendency to overestimate their memory capabilities and they also showed overestimation of mnemonic device abilities, such as tools used to aid in the retention and recollection of information stored in one’s memory.

The Dangers of Mixing Medications with Alcohol

Many of us know that mixing medications with alcohol is something that shouldn’t be done, and that goes for both prescription and over-the-counter meds. But it isn’t always clear why this is, and what dangers it poses. And often the warning is overlooked or underestimated. But lets take quick look at some numbers from the National Institute on Alcohol Abuse and Alcoholism:

  • 70 percent of adults consume alcohol at least occasionally with more than 10 percent consuming it on a daily basis
  • 14 billion prescriptions are written by doctors annually for the 2,800 prescription drugs on the market (as well as 2,000 types of over-the-counter medications)

With these figures, the chance of at some point using alcohol and medication at the same time seems nearly inevitable.

So what other risks are involved in combining alcohol and medication? For example, why shouldn’t you mix Tylenol or other forms of acetaminophen with alcohol? Because high, continuous levels of alcohol activate an enzyme that metabolizes this medication into compounds that impair liver function. The combination also increases the risk of gastric bleeding. This is especially true for older adults.

Mixing alcohol with certain antibiotics not only can weaken the effect of the antibiotic or cause adverse effects, but lead to headaches, nausea, vomiting and even convulsions. Alcohol decreases the effectiveness of common medications, such as Inderal, used to control blood pressure; it may also lead to dizziness of fainting. In addition, chronic alcohol consumption increases the risk of liver damage from surgical anesthetics such as Ethrane and Fluothane.

Combining alcohol with allergy or cold medications increases drowsiness and dizziness, especially in older adults. And products with diphenhydramine, such as Benadryl, can be increasingly more sedative. Some antipsychotic drugs, such as Thorazine, can lead to “fatal breathing difficulties” (according to the NIAAA) with mixed with alcohol. And the anti-seizure drug, Dilantin, may not control epileptic seizures as effectively if alcohol is involved.

Most people know that it is extremely risky to drink while taking prescription sedatives, opiates and other painkillers, as well as anti-anxiety medication like Xanax or Valium, but it is important to reiterate. This particular combination can be fatal, causing many to stop breathing, permanently.

With prescription drugs, alcohol can have a direct effect on a drug’s availability and its effectiveness. A night of drinking can increase a drug’s availability by competing for the same set of metabolizing enzymes. Hence, increasing the risks of harmful side effects. Long-term, heavy or chronic drinking can cause the opposite situation by decreasing a drug’s availability and effectiveness by activating metabolizing enzymes (sometimes even without the direct use of alcohol).

Ending Discrimination Against Addiction

People with drug or alcohol addiction problems often face severe discrimination (both publicly and privately) that restricts their access to necessary health care, employment, benefits, and discourages them from seeking treatment (which is both detrimental to the addict as well as costing society millions of dollars). Because of this, Join Together, a project of Boston University’s School of Public Health, formed a national panel to address this situation. As a result the panel outlined two guiding principals and ten recommendations if an effort to end this discrimination.

The first principle included the notion that addiction to drugs or alcohol is a treatable, chronic disease that needs to be seen and addressed as a public health issue. This means that those suffering from addiction need to be allowed to receive necessary treatment and recovery support to the extent of other chronic illnesses. The second principle established is that people seeking treatment or recovery from the disease of addiction should not be at risk of legally imposed bands or other barriers based solely on their addiction. Such as someone being repeatedly punished for the same offense.

In light of these two principles, the following recommendations were made.

  • Insurance coverage for addiction treatment needs to be available at the extent it is for other illnesses.
  • Insurance companies should not be able to deny claims to injury that occurs while someone suffering from addiction is under the influence.
  • Treatment for addiction needs to be personalized to each patient and based on the best scientific protocols and standards of care and including services that significantly enhance the likelihood of success. This may include a variety of treatment options including Neurotransmitter Restoration, behavioral therapies, and more. There are many different type of treatments for addiction, and no single treatment is right for every individual. The “one size fits all” treatment model is outdated and ineffective.
  • Employees who voluntarily seek treatment for substance abuse should not be at risk for discriminatory actions or dismissal from employment. It was estimated in 2000 that 70 percent of people who needed treatment were employed.
  • It’s estimated that 75 percent of people who admit to a prospective employer that he or she is in recovery, will not get the job. This admission should not be a consideration unless relevant to the job.
  • People in recovery with prior drug convictions should not face obstacles in getting student loans, grants, scholarships, or access to government training programs.
  • People in recovery with non-violent drug convictions should not be subject to bans on food stamps and cash assistance.
  • Public Housing agencies should use the discretion afforded them by law to help people find treatment instead of barring them and their families from housing.
  • People who are disabled as a result of their addiction disease should be eligible for Social Security Disability Income and Supplemental Security Income.
  • Decision regarding custodial cases should be made in the best interest of the child based on what is happening at home, and not solely on the presumption that a positive drug test automatically means neglect or abuse.

This report sheds some interesting light on a difficult matter at hand and offers hope for change in the future.

Older Americans and The Changing Scope of Substance Abuse

A recent study by the Substance Abuse and Mental Health Services Administration (SAMHSA) revealed that since 1992 the number of older Americans being admitted into substance abuse treatment has nearly doubled. And even though alcohol remains the top reason for admission among this age group, the study showed a sharp rise since 1992 in the illicit drug abuse involving admissions and this older age group (ages 50 and older).

Among this age group, admissions since 1992 due to heroin abuse more than doubled, cocaine abuse quadrupled, and prescription drug abuse rose from 0.7 percent to 3.5 percent. The study also found that admissions involving abuse of multiple substances nearly tripled from 13.7 percent to 39.7 percent since 1992. (Medical News Today)

While over three quarters of these admissions involved a primary use of a substance beginning by age 25, there was a significant increase in the proportion of admissions that involved a substance introduced within five years prior to admission. In 2008, cocaine abuse is an example of a leading cause of admission that older Americans reported having begin use within five years prior to admission. Prescription drug abuse was second.

Researchers for the study explained the findings as indication of “the changing scope of substance abuse problems in America.” It also raises new wellness concerns for the health and social services already providing assistance to seniors.

The study is also an example of the indiscriminate nature of substance abuse, and the need to de-stigmatize addiction in order to best treat those suffering and at-risk.

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