Summer House

Palm Beach Post — She has a strong grip and broad shoulders and a rage that was so out-of-control she was called The Hulk.

Jen is just 22 and already has suffered years of abuse, from a boyfriend who burned her, beat her and tried to drown her, and from her own self-directed rage.

She believed she found a release and control over her anger and pain by cutting herself.

"It was sick and twisted," she said, curled up in a couch that wrapped its arms around her. "I would have the biggest smile on my face watching the blood run down my leg."

She tried to kill herself nine times, drank and took every kind of drug she could get.

It took courage and knowing that she was hitting bottom, but she finally got the guts to go to her father, who knew little about her abusive and addictive lifestyle, she said. He helped her find The Orchid Recovery Center in Delray Beach.

The staff there, in turn, helped her find a path toward peace through, among other treatments, yoga training.

Enter Angel Lucia, whose mission is to help heal women in recovery through yoga and meditation at her Bindu Yoga Studio in West Palm Beach.

Lucia partners with The Orchid and teaches at the facility and in her own studio.

Jen clearly has a loving addiction to Angel, who nods encouragingly at her while Jen talks about her horrendous experiences.

Nearby are the tranquil-looking yoga mats, candles, books and tapes that are an important part of this lifestyle.

The women in recovery are a close-knit group. They don’t like outsiders watching their yoga, but Jen explains how she is going from an enraged self-mutilator to accepting that life can hold joy for her.

"She winds us all down," Jen, who has been sober a little more than four months, says.

"I can come in angry, jumpy, and the yoga releases all the bad emotions. I like the breathing techniques."

Jen says she is clinically depressed, bi-polar and suffering from short-term memory loss. Yoga and the camaraderie of Angel and the addicted women in recovery at The Orchid have helped her become more centered, she says. She’s starting to like her life.

Angel smiles knowingly. She, herself, had an alcoholic father who threw the family into turmoil. She knows what it’s like to walk on eggshells around a person who can explode at any moment.

She attended family rehabilitation with her parents.

It was yoga and meditation that helped her physically unwind from the effects of a former career as a surgical assistant and a past laden with strained family relations.

"Mentally, I felt more balanced," she says of the yoga she learned and is teaching. "I moved into a more neutral state."

Now, she says, she takes what she knows works for her and tries to transfer it to her students.

"I can’t say I’m floating," she explains. "I can stop and reflect on what is building up in me. What is it and how can I reduce that? If I hold it, it will make me ill."

She watches Jen look at her with a little half-smile. You can almost imagine this powerful young woman she is helping, and whose fists could put Angel on the floor, breathing softly and learning to control her runaway emotions.

"She does have that understanding from having been through something like what we are going through," says Jen.

"When I’m with Angel, I turn off that cellphone, and I am moving and getting that hour of focus."

Angel says some of the women moan and groan and fight off her efforts to help them, not physically, but by withdrawing. She sends them out of the room until they re-engage.

Jen defends that kind of self-protective behavior.

"The feelings are new to us. Any kind of emotion is a shock and completely hard to deal with," she says of women who have learned to numb themselves with drugs and alcohol.

"She helps to keep people sober. She helps with acceptance of a lot of things and letting go. My anger has gone from major to manageable."

Adds Angel, "Yoga helps us to fill a spiritual void. I’m another bridge for them to that. I don’t want to say that I’m better than anyone else this way, but I know what I’ve overcome and know how to apply it to them."

(HealthDay News) — Drinking and alcohol dependence has increased substantially among women, particularly white and Hispanic women born since 1945, new study finds.

Alcohol use and dependency appeared to remain stable for men, while young Americans report having more lifetime alcohol problems than older Americans, despite having had less time to develop issues with drinking.

The findings were published in the May issue of Alcoholism: Clinical and Experimental Research.

"We found that for women born after World War II, there are lower levels of abstaining from alcohol, and higher levels of alcohol dependence, even when looking only at women who drank," the study’s corresponding author, Richard A. Grucza, an epidemiologist at Washington University School of Medicine, said in a prepared statement. "However, we didn’t see any significant tendency for more recently born men to have lower levels of abstention or higher levels of alcohol dependence."

The researchers’ findings came from analyzing two large, national surveys conducted 10 years apart (1991-1992 and 2001-2002). The polls compared lifetime alcohol-use rates from the same age groups and demographics.

The "closing gender-gap in alcoholism" may be due to higher levels of problems facing women, while men have been more or less steady in their levels of dependence, he said.

"Clearly, there were many changes in the cultural environment for women born in the ’40s, ’50s and ’60s compared to women born earlier," Grucza said. "Women entered the work force, were more likely to go to college, were less hampered by gender stereotypes, and had more purchasing power. They were freer to engage in a range of behaviors that were culturally or practically off-limits, and these behaviors probably would have included excessive drinking and alcohol problems."

Shelly F. Greenfield, associate clinical director of the Alcohol and Drug Abuse Treatment Program at McLean Hospital, added to Grucza’s assessment.

"One possible explanation is that between 1934 and 1964, the social acceptability of women’s drinking increased. As it was more socially acceptable for women to drink, a greater number of them became drinkers. Because women have a heightened vulnerability to the effects of alcohol — that is, greater blood alcohol levels at similar doses of alcohol — we may therefore see a concomitant rise in alcohol dependence among those who ever drank."

Another potential factor: immigrants arriving to America from cultures with more conservative values about drinking tend to stick with their native cultural norms, but their children are more likely to follow comparatively lax U.S. norms regarding alcohol.

"We can think of U.S. culture as having been traditionally dominated by white men," added Grucza. "As women have immigrated into this culture, they have become acculturated with regard to alcohol use."

He said the added barrier of race may be what is keeping black women, who still have the lowest rates of drinking among the demographic groups looked at, from adopting the alcohol-use standards of the dominant U.S. culture.

Greenfield suggested that targeting females with gender-specific prevention programs might lower drinking rates or delay when drinking begins, which could help prevent later alcohol problems.

"It would also be helpful to educate women about the gender differences in metabolism of alcohol, and the associated heightened female vulnerability to alcohol’s adverse health consequences at lower doses than men," she said.

NEW YORK (Reuters Health) - Young adults who abuse amphetamines may be raising their risk of suffering a heart attack, a new study shows.

Texas researchers found that among more than 3 million 18- to 44-year- olds hospitalized in their state between 2000 and 2003, those who were abusing amphetamines were 61 percent more likely than non-users to be treated for a heart attack.

What’s more, the rate of amphetamine-linked heart attacks rose by 166 percent over the 4-year study period. That compared with a 4-percent rise in cocaine-related heart attacks, the researchers report in the journal Drug and Alcohol Dependence.

"Most people aren’t surprised that methamphetamines and amphetamines are bad for your health," lead researcher Dr. Arthur Westover said in a statement.

"But we are concerned because heart attacks in the young are rare and can be very debilitating or deadly," added Westover, an assistant professor of psychiatry at the University of Texas Southwestern Medical Center at Dallas.

Amphetamines stimulate the central nervous system and some are used to treat attention-deficit hyperactivity disorder, or ADHD. But they are also frequently used illegally; one potent form of amphetamine, methamphetamine, is a growing problem in many U.S. cities.

Cases of heart attack in young people have been linked to amphetamine abuse before, but the current study appears to be the first large- scale look at the epidemiology of the problem.

Westover and his colleagues used a statewide database to examine information on more than 3.1 million 18- to 44-year-olds discharged from Texas hospitals between 2000 and 2003. Overall, 11,011 of these patients (0.35 percent) were treated for a heart attack.

The database also contained information on whether a patient had been diagnosed with any type of drug-abuse problem. The researchers found that patients with a diagnosis of amphetamine abuse or dependence were at increased risk of suffering a heart attack.

Amphetamines have various effects that could precipitate a heart attack, Westover and his colleagues point out. The drugs are well known to speed up heart rate and blood pressure, but they can also trigger spasms in the heart arteries and promote blood clotting.

In people who already have "plaque" deposits in their heart arteries, amphetamines may cause a plaque to rupture, which can then lead to a heart attack.

Besides the risk to individual amphetamine users, Westover said, "we’re also concerned that the number of amphetamine-related heart attacks could be increasing."

"We’d rather raise the warning flag now than later," he added. "Hopefully, we can decrease the number of people who suffer heart attacks as the result of amphetamine abuse."

Marin Independent Journal — THE OLD JOKE in medical school was that you weren’t an alcoholic unless you drank more than your physician. Come to think of it, that wasn’t funny then, and it isn’t funny now.

Lately, a number of people have been telling me about friends or family members who may have a drinking problem, and they ask me, "Is he an alcoholic?" Sometimes they’ll tell me: "Well, she may have a drinking problem, but at least she isn’t an alcoholic."

Although we have all grown up knowing the word "alcoholic," this term is very nonspecific and means something very different to each of us.

In the medical profession, we do not use this term because it is so vague. Instead, we describe the illnesses, collectively known as substance-related disorders, in several categories based on specific criteria, as defined in a text known as the DSM IV R, which defines criteria for all psychiatric and behavioral disorders. The advantage of this specificity, instead of using the term "alcoholic," is that it helps guide treatment as well.

One diagnosis within the category of substance-related disorders is "Alcohol Abuse," which is coded in the text as DSM 305. To be diagnosed with alcohol abuse, a person must show "a destructive pattern of alcohol abuse, leading to significant social, occupational or medical impairment, as manifested by at least one of the following within a 12 month period:

- Recurrent substance use resulting in failure to fulfill major obligations.

- Recurrent substance use in situations in which it is physically hazardous.

- Recurrent substance-related legal problems.

- Continued substance use despite persistent or recurrent social or interpersonal problems related to alcohol.

For example, two traffic violations for DUI (driving under the influence) within one year would meet the criteria. If one is repeatedly late for work, or coming to work "hung over," this would also meet these criteria.

Another diagnosis is Alcohol Dependence, coded as DSM 303.9. The criteria for this diagnosis reflect that the patient is physiologically dependent upon alcohol, and would suffer alcohol withdrawal symptoms when he stops drinking. To be diagnosed with Alcohol Dependence, one must meet three of the following criteria:

- Alcohol withdrawal symptoms, such as rapid heartbeat, sweating or confusion.

- Alcohol tolerance – need for increased amounts, or diminished effect.

- Alcohol taken in larger amounts over a longer period than intended.

- Persistent desire or unsuccessful effort to cut down on alcohol consumption.

- Increased time spent attempting to obtain alcohol.

Many people who are alcohol dependent try to hide their alcohol consumption from friends or family. They travel out of town to purchase alcohol. Some try to stop, or at least verbalize that they wish to stop, but cannot.

Alcohol withdrawal is more than just the "shakes." It is a true cardiovascular emergency, with rapid heartbeat (tachycardia), fever and very high blood pressure, which occurs as the autonomic nervous system, which has become accustomed to a certain level of alcohol in the body, now tries to adapt to its absence.

Alcohol-related disorders are rampant, as are substance disorders related to other drugs, such as narcotics, cocaine and crystal meth. People who suffer these disorders hide them well, rarely exhibiting the stereotypic behaviors that we all describe as those of an "alcoholic."

I remember one family member whom everyone decided was not an alcoholic because they never saw him drunk. He was generally jovial and charming, and was the center of attention at a party, although he could be withdrawn on occasion. He drank a minimum of five mixed drinks every day, starting around noon.

If you are wondering if a person might be an "alcoholic," or if you find yourself questioning a loved one’s consumption, please put the term "alcoholic" out of your mind. It will lead you astray. Instead, contact your physician and describe the behaviors that you have witnessed.

Please act before it is too late.

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New York Times — From “Scarface” to “Miami Vice,”Florida’s drug problem has been portrayed as the story of a single narcotic: cocaine. But for Floridians, prescription drugs are increasingly a far more lethal habit.

An analysis of autopsies in 2007 released this week by the Florida Medical Examiners Commission found that the rate of deaths caused by prescription drugs was three times the rate of deaths caused by all illicit drugs combined.

Law enforcement officials said that the shift toward prescription-drug-abuse, which began here about eight years ago, showed no sign of letting up and that the state must do more to control it.

“You have health care providers involved, you have doctor shoppers, and then there are crimes like robbing drug shipments,” said Jeff Beasley, a drug intelligence inspector for the Florida Department of Law Enforcement, which co-sponsored the study. “There is a multitude of ways to get these drugs, and that’s what makes things complicated.”

The report’s findings track with similar studies by the federal Drug Enforcement Administration, which has found that roughly seven million Americans are abusing prescription drugs. If accurate, that would be an increase of 80 percent in six years and more than the total abusing cocaine, heroin, hallucinogens, Ecstasy and inhalants.

The Florida report analyzed 168,900 deaths statewide. Cocaine, heroin and all methamphetamines caused 989 deaths, it found, while legal opiods — strong painkillers in brand-name drugs like Vicodin and OxyContin — caused 2,328.

Drugs with benzodiazepine, mainly depressants like Valium and Xanax, led to 743 deaths. Alcohol was the most commonly occurring drug, appearing in the bodies of 4,179 of the dead and judged the cause of death of 466 — fewer than cocaine (843) but more than methamphetamine (25) and marijuana (0).

The study also found that while the number of people who died with heroin in their bodies increased 14 percent in 2007, to 110, deaths related to the opioid oxycodone increased 36 percent, to 1,253.

Florida scrutinizes drug-related deaths more closely than do other states, and so there is little basis for comparison with them.

It has also witnessed several highly publicized cases in recent years that have highlighted the problem. Only last year, an accidental prescription drug overdose killed Anna Nicole Smith in Broward County.

Still, the state has lagged in enforcement. Thirty-eight other states have approved prescription drug monitoring programs that track sales. Florida lawmakers have repeatedly considered similar legislation, but privacy concerns have kept it from passing.

As a result, federal, state and local law enforcement officials say, Florida has become a source of prescription drugs that are illegally sold across the country.

“The monitoring plan is our priority effort, but that is not enough,” William H. Janes, the Florida director of drug control, said in a statement accompanying the study. He said Florida was also looking at ways to curb illegal Internet sales and to encourage doctors and pharmacists to identify potential abusers.

Some local police departments have taken a more novel approach.

In Broward County on May 31, deputies completed a “drug takeback” in which $5 Wal-Mart, CVS or Walgreens gift cards were distributed to 150 people who cleaned out their medicine cabinets and turned in unused drugs in an effort to keep them out of young people’s hands.

“The abuse has reached epidemic proportions,” said Lisa McElhaney, a sergeant in the pharmaceutical drug diversion unit of the Broward County Sheriff’s Office. “It’s just explosive.”

(HealthDay News) – Sticking to a regimen of prescribed medications is the most effective way to reduce withdrawal symptoms and urges to drink alcohol in those being treated for alcohol dependence, according to a U.S. study.

The study compared two medications (naltrexone and acamprosate) used in combination with two behavioral treatments — low-intensity medical management (MM) and moderately intensive combined behavioral intervention (CBI).

The researchers analyzed data from 846 males and 380 females who took part in the National Institute of Alcohol Abuse and Alcoholism’s Combine study, a large-scale, multi-site, combined medication and behavioral treatment study.

The participants were randomly assigned to one of eight different combination treatments involving naltrexone, acamprosate, a placebo, MM, and CBI. After 16 weeks of treatment, the patients’ primary outcomes — including percent days abstinent and time to first heavy drinking — were compared.

"First, high medication adherents fared better than low medication adherents across all combinations of behavioral and pharmacological treatment conditions," Allen Zweben, associate dean for academic affairs and research in Columbia University’s school of social work, said in a prepared statement.

"Second, CBI — a specialty alcohol treatment — surprisingly had a beneficial impact on nonadherents receiving the placebo. This raises the issue of whether or not CBI may serve as a cushion or have a protective function for these patients," said Zweben, the corresponding author for the study.

"Conversely, CBI did not provide similar benefits for naltrexone-treated patients; their relapse rates appeared to be more a function of inadequate exposure to naltrexone and less influenced by CBI," he added.

Overall, specialized CBI did not perform better than the more primary-care MM.

"Both of these behavioral treatments performed equally as well with regard to treatment adherence and medication adherence rates," Zweben said.

The findings show that combing MM and naltrexone could benefit a large percentage of alcohol-dependent patients.

"Alcohol-dependent patients could be managed in nonspecialized or general health care settings, which, in turn, could broaden the treatment options for individuals diagnosed as alcohol-dependent," Zweben said. "We will need to adapt these findings to ‘real world’ medical settings and follow the results."

The study was released online by the journal Alcoholism: Clinical and Experimental Research and was to be published in the September print issue.