Summer House
Alcoholism Gender Gap Is Closing Jul 09, 2008
(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.
Maryland — The lifestyles of Jean Duley’s clients run the gamut: long-time street drug users, those who were prescribed powerful painkillers after an injury or operation and are now addicted, and middle-class housewives who abuse prescriptions, to name a few.
"Prescription drug abuse is the biggest kept secret," said Duley, program director at Comprehensive Counseling Associates in Frederick. "It’s a lot more prevalent than people can imagine."
In December, Comprehensive Counseling became one of three practices in Frederick County to prescribe suboxone, which Duley calls a "miracle drug" for those addicted to pain medication. The center now prescribes suboxone to about 50 clients.
Suboxone is a partial opioid agonist, containing enough buprenorphine (an opioid) to eliminate cravings and symptoms of withdrawal. The pill also contains naloxone, an opioid antagonist, which blocks the user’s ability to get high on any other drug, Duley said.
Clients usually come to the center for suboxone in the midst of withdrawal, and with regular treatment, clients have gone from "living a nightmare, to feeling like they have a brain for the first time in a long time," said Dr. Allan Levy, a psychiatrist at Comprehensive Counseling.
Duley said while some people lie about the severity of their pain to acquire their abused prescriptions legally, physicians themselves can fuel prescription addiction. Some prescribe increasing strengths of painkillers and then abruptly stop after patients have already become dependent, forcing them to get their fixes from either prescriptions sold on the street or illegal drugs like heroin.
Others prescribe painkillers too loosely. Duley said some of the center’s suboxone clients have Percocet "handed to them like candy for every little ache and pain — it’s a culture of doctors not paying attention. The worst is OxyContin. That drug — is so highly addictive, it’s so difficult to come off of."
Some people can stop taking suboxone after a few months, but most continue for as much as a year before weaning themselves off, Levy said. For others, it becomes a lifelong maintenance drug.
While suboxone addresses the neurological aspect of addiction, Duley said giving medication without regular therapy defeats the drug’s purpose. She facilitates a support group at the center three times a week, and suboxone users are asked to attend at least once a week.
"They usually have all kinds of issues going on at the same time (as the addiction)," Duley said, including problems with employment, family and mental health. "You have to address the whole piece. The drug alone doesn’t work by itself."
And all addiction treatments should revolve around the key factor — a person’s health, Duley said.
"(Beating addiction) is a complicated issue, but it’s very doable," she said. "It’s not a moral issue, it’s not a criminal issue, it’s a health issue."
Exactly What is an Alcoholic? Jul 08, 2008
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.
.
The Painful Truth About Painkillers Jul 08, 2008
Las Vegas Sun — Nevadans consume about twice the national average of several prescription painkillers, making us among the most narcotic-addled populations in the United States, a Sun analysis has found.
The consequences are deadly. More people in Clark County die of prescription narcotics overdoses than of overdoses of illicit drugs or from vehicle accidents. In 2006, Nevadans were the No. 1 users per capita of hydrocodone — better-known by the brand names Vicodin or Lortab.
We took enough of the drug to equal 48 Vicodin pills for every man, woman and child in the state for a year.
And the numbers are climbing. From 1997 to 2006, the most recent year for which data are available, the per capita rate of hydrocodone used in Nevada jumped by 273 percent.
Nevadans are turning to other narcotic painkillers at an even faster rate.
The per capita use of oxycodone, best-known by the brand name OxyContin, climbed sevenfold from 1997 to 2006, while methadone use jumped 12-fold.
Nevada is ranked fourth in the nation for methadone, morphine and oxycodone use per person, the Sun analysis found.
Following crack cocaine in the 1980s and methamphetamine in the past decade, prescription narcotics are “the next big drug epidemic,” said Matt Alberto, deputy chief of investigations for the Nevada Public Safety Department, the lead prescription drug policing agency in the state.
Emergency room physician Dr. Edwin “Flip” Homansky, medical director of the Valley Health System and a member of the Nevada State Board of Health, said the dramatic rise in prescription narcotic use should be examined.
“When you see increases like that, it’s a warning sign to all of us,” he said, referring to the Sun’s analysis.
The Sun reached its findings after analyzing several thousand pages of Drug Enforcement Administration reports on the state-by-state distribution of controlled substances to pharmacies and health care practitioners. (The DEA monitors the production and distribution of prescription narcotics, which fall into the highest category of regulation for prescription drugs.) After breaking down the data by state populations to reach per capita figures, the Sun determined the highest per person consumption of each prescription narcotic, as well as how consumption has changed over time.
Nevada leads a national trend in the growing use of narcotic painkillers. The National Institute on Drug Abuse reports the number of opiate prescriptions escalated from about 40 million in 1991 to 180 million in 2007 — a 350 percent increase at a time when the nation’s population increased by 19 percent.
A few doctors are doing most of the prescribing. A Sun analysis of a Nevada Pharmacy Board database that tracked all the prescriptions for controlled substances in the state, not just narcotics, showed that in 2007, 1 percent of medical practitioners in the database prescribed 51 percent of controlled substances in the database, and 5 percent of them prescribed 88 percent of the drugs.
No identifying information was made available to the Sun, but experts presume that the heaviest prescribers are pain management and cancer specialists.
Although analyzing individual prescribing habits could hint at who might be overprescribing narcotic painkillers, scrutinizing the database with that intent is banned by statute. Pharmacy board officials said that’s to allow doctors to make judgments and prescribe medicine without fear, which could compromise patient care. The database can be examined by police as part of an active investigation, but authorities can’t use it to go fishing for doctors who can be criminally prosecuted for overprescribing narcotic painkillers.
Assemblywoman Sheila Leslie, D-Reno, said it’s important to understand the factors surrounding the rise in prescription narcotic use and abuse, so legislators may need to “take a closer look” at the law that prevents analyzing the state’s highest prescribers.
Narcotic painkillers are derived from opium, a drug made from poppies that has been used medicinally for thousands of years. Opiate use was common in the United States in the 19th century, and by the early 1900s, when it was recognized that doctors were overprescribing opiates and addiction was a problem, their use was regulated and the drugs fell out of favor. They were mainly prescribed to cancer or terminal patients until the 1990s, when their use was expanded to people with chronic pain. Now we’re in a prescription narcotics boom.
The increasing use of prescription narcotic painkillers in America illustrates the evolving understanding and treatment of pain.
Among the chief challenges to doctors who prescribe potentially addictive painkillers is that pain can be described only subjectively, by the patient. It can’t be measured clinically, like blood pressure or pulse rate.
As a result, pain treatment is both an art and a science. Is the doctor to believe the patient is in pain, or is the doctor being conned by an addict or a drug dealer on the hunt for painkillers? Even the best pain management specialist will say he can’t always tell the difference.
The lines separating prescription narcotic dependence, abuse and addiction are blurry, making it difficult to say whether the skyrocketing drug use is a welcome relief, an epidemic, or something in between.
And experts disagree on how to interpret the growing use of narcotic painkillers. Law enforcement complains about the illegal activity, addiction specialists decry that more people are becoming hooked on drugs, and pain management specialists talk about the benefits of narcotics.
Research on narcotics’ effectiveness in treating pain is inconclusive. In fact, there’s some evidence they can increase pain.
Alarmed experts from all fields agree the rising rate of prescription narcotic use shows no sign of abating.
•••
The use of narcotics to treat pain got a tremendous boost in 1995 from the American Pain Society. Its corporate members include the pharmaceutical companies Purdue, maker of OxyContin; Abbott, maker of Vicodin and UCB, and Watson, maker of the hydrocodone drugs Lortab and Norco.
The society set guidelines saying proper pain management includes urging patients to report unrelieved pain. At the time studies had shown that cancer patients were suffering needlessly because they were not being given enough painkillers.
In January 1999, the Veterans Affairs Department, citing the American Pain Society’s statement that pain is one of the main reasons people consult a doctor, launched a campaign known as “Pain is the Fifth Vital Sign.”
The initiative encouraged health care providers to monitor a patient’s reported level of pain — a subjective symptom — as they did the four measurable vital signs: blood pressure, breathing rate, pulse and temperature. Health care providers asked patients to rank pain on a scale of 1 to 10, and were then urged to treat it.
Dr. Mel Pohl, a Las Vegas addiction recovery specialist, criticizes the pharmaceutical industry’s role in making pain the fifth vital sign.
“The rationale was that we don’t want people to suffer,” Pohl said. “In the best case that’s what it was about. In the worst case, somebody was working this out with the (financial) bottom line in mind. Probably both factors are part of it.”
Soon after, the methods advocated by Veterans Affairs were endorsed by the Joint Commission, the agency that monitors and regulates hospitals. Every hospital is now expected to measure pain in a similar manner.
Dr. Jim Marx, a Las Vegas addiction medicine and pain management specialist, praised the advances, saying doctors now realize they can safely treat patients for pain. This allows patients such as blue-collar workers in Las Vegas to continue in their jobs, he said.
The advent of direct-to-consumer marketing by pharmaceutical companies has also contributed to the rise of prescription narcotics. In 1997, the Food and Drug Administration allowed drug companies to hype their brand-name medicines directly to consumers, which has helped remove any stigma attached to their use. Doctors say patients are now demanding drugs by name.
Homansky, the emergency room doctor, recalled the case of a tourist who said she’d left her bottle of hydrocodone pills at home and needed more. After Homansky recommended a nonnarcotic treatment, she stormed out of the hospital, cursing the staff along the way.
“We’ve had people who get physically abusive, verbally abusive and expect that we’re just there to provide them whatever they want,” Homansky said.
The pharmaceutical companies also market their narcotic painkillers by unleashing cadres of sales representatives on doctors and hosting dinners where physicians offer testimonials about the companies’ medicines.
“There’s a lot of money in the drug industry and they push really hard,” one pain doctor said.
No one can say with certainty why so many narcotic painkillers are used in Nevada, but experts make several educated guesses. The lifestyle of night life and partying leads to more drug-seeking and abuse, doctors said. Also, pain is a complicated symptom of multiple diseases that’s intensified by psychological distress. Las Vegas is a transient place where many people are without social and family support and where the nation’s highest rate of suicide shows a population with mental health problems, doctors said.
The city’s physician shortage also likely plays a role, several experts said. Doctors stressed for time may treat the symptomatic pain rather than explore the problem that’s causing the pain. And once the treatment begins it may continue under the logic that it’s what the patient is accustomed to.
Doctors may further be predisposed to cave in to patients’ requests for narcotics because of how they are reimbursed by insurance companies: by the number of patients they see, not the time spent with each. This may lead providers to take the path of least resistance by writing a prescription. Pohl, the addiction recovery specialist, said it takes doctors “five minutes to say yes and 45 minutes to say no” to a patient’s demand for drugs.
•••
Larry Pinson was browsing in a shop recently when a greeting card caught his eye: “The best part of getting sick is Vicodin,” the card read. “So make sure you save me some, and don’t tell your doctor!”
When greeting cards joke about illegal narcotic abuse, Pinson said, “We’ve got a problem.”
The United States makes up less than 5 percent of the world’s population, but is supplied 99 percent of its hydrocodone and 71 percent of its oxycodone, according to the National Institute on Drug Abuse.
As executive director of the Nevada Pharmacy Board, Pinson presides over the licensing of thousands of pharmacists, pharmacies, technicians and wholesalers, plus about 7,000 doctors, nurse practitioners and dentists who prescribe the drugs and about 180 drug distributors.
About a decade ago the board became aware of the emerging practice of “doctor shopping,” the illegal practice of conniving patients’ visiting multiple providers to get drugs, either to feed an addiction or to sell.
So the Nevada Pharmacy Board created a database that would list every prescription written in the state for certain controlled substances, with the name of the provider and the patient, and the date of the transaction. The monitoring program would help catch patients who might be “doctor shopping.” Regulators from about three dozen other states have followed Nevada’s lead.
A growing number of health care practitioners are using the online database to track their patients’ use of prescriptions. In 1997, the first year of its existence, the database was used 480 times. The number grew exponentially to 65,372 reports in 2007, nearly double from the previous year.
The database flags patients who make a certain number of visits to doctors within an allotted time frame, though officials will not say exactly what type of patient behavior triggers the system, for fear addicts will adjust their behavior accordingly. The database then alerts the doctors to patients who may be shopping for drugs.
Pain management specialists in Las Vegas say the prescription monitoring program is one of many safeguards they use to ensure patients are not abusing painkillers.
“Our attitude is that when a patient leaves our office with a month’s worth of medication, it’s the equivalent of leaving the office with a loaded gun,” said Dr. Michael McKenna, a Harvard- and Stanford-trained pain specialist in Las Vegas.
Among the precautions pain specialists can take to guard against abuse are requiring contracts with patients that discourage doctor shopping, urine tests to verify drug use and monthly visits to track prescriptions and lessen the number of pills a patient has at a given time.
But not every provider takes these precautions.
Jennifer Hilton says that after she had a tooth filled, her dentist handed her a prescription for Vicodin even though she was not complaining about pain. She bristled at the unsolicited prescription because she’s a program coordinator for an inpatient drug addiction program for adolescent girls that’s run by Westcare, a Las Vegas nonprofit that specializes in substance abuse treatment.
Hilton admonished her dentist to ask whether his patients have addiction problems before handing them Vicodin prescriptions.
She said the dentist replied that patients should inform him if they have a drug problem.
“I’m sure some of my clients would have loved to have him as a dentist,” Hilton said, incredulous.
Las Vegas medical professionals repeatedly fail to take addiction seriously, Hilton said. On every clinic visit her teenage drug addicts hand doctors a medical feedback sheet that says: “This person is in a residential treatment facility. Please do not prescribe them anything of a narcotic or addictive nature.”
Still, about one in three kids returns with a narcotic painkiller prescription.
Las Vegas doctors say they are aware of physicians who prescribe whatever drug patients desire, so they will return. It’s good for business.
One drug addict told the Sun addicts share information about the doctors who are quick to write prescriptions.
“If you want (the drugs), you know where to go,” the woman said.
She said a few doctors ran her name through the Nevada Pharmacy Board’s database, recognized her as a doctor shopper and refused to give her drugs. But they never helped her or talked to her about treatment options, she said. Instead they sent her on her way.
The woman, who did not want to be identified, said she is trying to quit drugs and is detoxifying at home. Her only hope is her own motivation to get clean. Her only support is from fellow addicts in her 12-step program.
“I could go to the doctor tomorrow and mess it all up,” she said.
Dr. Jerry Jones, a Las Vegas obstetrician-gynecologist who is president of the Clark County Medical Society, said there may be a few unethical doctors who are overprescribing narcotics. “Most primary care doctors are extremely cautious and conservative about their narcotics prescriptions,” Jones said.
•••
Experts struggle to explain the notably high use of narcotic painkillers in Nevada. Two popular explanations are based on myths or outdated assumptions propagated in the medical community.
Every medical professional interviewed by the Sun cited what each said was Nevada’s aging population — assuming older people need more drugs because they suffer from more cancer or painful chronic conditions.
But U.S. Census figures show that Nevada is actually the 11th-youngest state in the country.
National experts said the same thing, and indeed the median U.S. age — reflecting aging Baby Boomers — rose from 35 in 1997 to 37 in 2007, according to Census figures. But the population aged 65 and older decreased in the same time frame from 12.6 percent to 12.4 percent.
The other common explanation for the high rate of narcotic use was that pain is undertreated in the United States and that Nevada doctors are prescribing more, as they should. But data suggesting the undertreatment of pain are dated and don’t reflect the exponential growth of prescription narcotic use in the past decade.
James Zacny, a psychopharmacologist at the University of Chicago who studies opiates, said the undertreatment of pain is no longer a concern for most patient populations. “I’ve heard the pendulum has swung the other way,” he said. “Now there’s some concern about overprescribing.”
The tragic irony is that painkillers may not work as well as people think. Many doctors say they’re not ideal for long-term use for chronic pain. And some studies show, paradoxically, that they can increase pain. McKenna said the research is relatively new, but shows that some patients actually improve when the medication is withdrawn.
“Pain is very complicated,” McKenna said. “But throwing opiates alone at pain is probably not the best approach.”
Prescribed Meds Still Best Treatment for Alcoholism Jul 08, 2008
(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.
Meth Addiction – What it Does to the Brain Jul 08, 2008
Utah — “Methamphetamine addiction has the worst long-range organic effect on the brain of any drug,” said Glen Hanson, University of Utah Addiction Center director.
Hanson’s blunt comment defines extent of the the public health problem in meth-damage control in Utah.
He was speaking at an all-day meth workshop before 30 participants; family members, caregivers and health care professionals in Roosevelt on June 21.
Addiction of any kind is a learned repetitive behavior, but meth is the worst, ” explained Hanson, “It alters the brain biology in ways similar to Alzheimer’s or Parkinson’s disease.”
Why would anyone choose to damage their brain to such a degree? The answer, because “it feels good,” may be the best an addict can offer after treatment.
Simplistic as it sounds, it is not wrong. Meth over-stimulates the “feel-good” portion of the brain and can severely damage a person’s cognitive abilities.
“The brain is a network of 100 billion cells that transmit information by making 2,000 connections individually,” Hanson said, telling the group why an addict’s ability to communicate has been compromised.
“Stimulated brain cells respond by releasing dopamine to anything that feels good” he continued. “Over-stimulated brains release too much dopamine. Then the free radicals that are chemically abundant in dopamine will eventually destroy portions of the brain.”
Meth stimulates the release of dopamine in excess. The more an addict uses the more they crave. It affects the cognition system in the brain by “turning-off” the prefrontal cortex.
As a consequence, meth addicts loose inhibitory control, tending to act on impulse rather than reason. They overreact to situations, tending toward rage.
This is partly due part to the “damage to the orbitofrontal cortex which ultimately inhibits saliency,” said Hanson. “The addict becomes motivated most by getting and using meth over anything else.”
It fouls up the meth addict’s ability to appreciate consequences like taking care of their children, themselves or being cognizant of others.
“Meth addicts may steal from or abuse their family members with little conscience,” the researcher explains. “All they think of is the drug, because the reward portion of their brain is on all the time.”
Hanson referred to the amygdala reward-region of the brain, which processes memory and emotional control. Damage to the region and the adjacent hippocampus region leaves the addict agitated and often aggressive.
Once these areas are damaged the memory portion of the addict’s brain often fails to recover even with treatment.
“Rehabilitating cognitive systems requires exercise,” explained the researcher. “Sometimes that means establishing new pathways in the brain around damaged portions that will never return.”
“Treatment is lengthy,” he continued, “requiring five to seven months for brain function to stabilize and restore saliency. It’s hardest for meth addicts because their familial support systems are often irreparably damaged. They’ve hurt the very people they need most.”
In the end, there are successful treatments to re-develop cognitive skills through mental exercise. One way, Hanson explained is through literacy education, which seems to help re-establish cognitive functions.
So, why with all this wreckage would anyone choose to use meth? Hanson’s research suggests that there is a strong sociocultural component contributing to the meth scourge in Utah.
“Meth abuse demographics indicate that it is the primary drug of choice among women,” he explained. “Thirty-seven percent of all women in treatment are addicted to meth. Men use it too, but represent fewer addicts in treatment than women.”
Some women are attracted to meth as it is readily available, cheap and long-lasting in effect. Others discover more energy, weight loss or help with social inhibitions through meth abuse.
“In Utah, there’s a sociocultural tendency of women toward perfection,” said Paul Smith, eastern Regional Director of the Division of Child and Family Services. “Perfect wife. Perfect mother. Perfect beauty. Too much pressure toward perfection drives the social component of meth abuse.”
“Whatever the cause, abuse is only part of addiction,” Hanson said. “Only 15 percent of users become severely addicted, which means 85 percent of users are out there managing their drug use.”
Why people become addicted may, in part, be genetic. For example, researchers found that many women in treatment suffer from other repetitive disorders like smoking or alcoholism.
The most interesting connection was re-occurrence of attention deficient-hyperactivity disorder. The familial connection of ADHD or alcoholism may include a predisposition toward drug addiction among family members.
There’s also the social aspect of addiction. Meth tends to stay in the family. A documentary shown at Saturday’s seminar showed women frankly admitting that, “My daughter introduced me to meth and then I gave it to my sister, and so on.”
Hanson notes that addictions like alcoholism re-occurs in families, but there is hope. Children removed from addictive families show no greater addiction rates than children from non-drug abuse families.
However, children left in addictive families are almost certainly going to experiment with drugs. Addictions, particularly those with long-term treatment requirements like meth are a burden on Utah society.
“Forty-seven percent of women in treatment for meth addiction have children,” Hanson continued. “Worse still, 45 percent of female meth addicts end up in prison. Incarcerated women cost the state $30,000 each and an additional $33,000 for each child placed in foster care. All totaled, jailed addicts cost the state about $100,000 a year.”
Treatment, on the other hand, costs the state about $15,000 per person. More recently, the treatment alternative has become policy in the criminal justice system of Utah. The effort is to stop the revolving door of prison addicts.
“New strategies for treatment are highly successful, but the addict must remain in rehabilitation,” said Hanson. “Judges are learning that success requires mandated, long-term compulsory treatment. I guess they figured that success means more taxpaying Utahns.”