There is a common phrase thrown around by those in recovery from drug and alcohol abuse that describes a sentiment while they were using: incomprehensible demoralization. While this phrase is applied to thousands of diverse stories and situations, the feeling is the same. Most in recovery can attest to their moments of incomprehensible demoralization.
Recently this sentiment was in the public eye with news stories about people getting drunk, doing very regretful things and woefully apologizing afterwards. Some of the things they did while intoxicated disrupted their careers and reputations with a swift and lasting effect that only serves to reinforce the sentiment of incomprehensible demoralization.
The first popular story occurred about a month ago when Reese Witherspoon’s husband got pulled over for drunk driving in Atlanta. Reese was caught on camera on the side of the road talking back to the police. In an aggressive and boastful tone she asked and asserted, “you don't need to know my name?!….Well, you are about to find out who I am!” She acted as if being famous exempted her from being treated normally – or in her case – handcuffed and arrested.
Overnight her reputation went from being the sweet girl next door to being egotistically irresponsible and rude. Days later she publically apologized and soberly knew that the police were “just doing their job.” The harsh reality is that what she did while drunk had no bearing on who she really is as a person. It is because of regretful drunk actions like this that people experience demoralization. Often what people do while drunk is far different what their normal selves would dictate – which consequently is also a telltale sign of a problem with alcohol.
In another incident last week, an Eco-Tourism Field Guide named Brian Masters, who had dedicated his education and life to garner that line of work, lost his job. This happened after a video went viral of him charging at an elephant while drunk as his friends recorded him. Now “the guide involved in the confrontation is no longer employed by Singita and further disciplinary procedures are in progress with regard to others involved," according to a post on the group's Facebook page. Singita describes the video as “disturbing," and say the elephant was "extremely agitated by the confrontation and retreated into the bush.”
In response to the event, Masters said “I admit full responsibility for the actions and am deeply, deeply remorseful…There has been a lot of baying for blood and a campaign to name and shame so here I am. I am so sorry this happened and I wish I could undo the stupidity of the act but I can’t; all I can do is apologize and hope people can see the sincerity I am trying to convey.” As aforementioned, although others may not relate to the story specifically, the sentiment is exactly the same. In short, Witherspoon and Masters likely feel the same exact way about themselves although their stories bear no resemblance.
These incidents depicted in the videos below show the destruction that even one night of alcohol abuse can cause. They show how character-changing alcohol can be and how it can cause deep regret. Luckily the demoralization eventually fades, especially after a sound apology as they have made and self forgiveness kicks in.
Wednesday, May 22, 2013
Sunday, May 12, 2013
Is the DSM V Diagnosing Addiction Right?
What has long been considered the go-to resource for diagnosing mental and addictive disorders, has been recently critiqued by Dr. Thomas R. Insel, the Director of the National Institute of Mental Health.
Dr. Insel is considered an expert in the field of mental health disorders and says that the Diagnostic Statistical Manual of Mental Disorders (DSM) doesn’t account for important diagnostic tools such as the role of biology, neuroscience and genetics. Currently, the DSM looks at symptoms as the driving criteria to diagnose patients for mental and addictive disorders. For example, the critera for substance dependence is:
1.Tolerance, as defined by either of the following: (a) A need for markedly increased amounts of the substance to achieve intoxication or the desired effect or (b) Markedly diminished effect with continued use of the same amount of the substance.
2.Withdrawal, as manifested by either of the following: (a) The characteristic withdrawal syndrome for the substance or (b) The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
3.The substance is often taken in larger amounts or over a longer period than intended.
4.There is a persistent desire or unsuccessful efforts to cut down or control substance use.
5.A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
6.Important social, occupational, or recreational activities are given up or reduced because of substance use.
7.The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance (for example, current cocaine use despite recognition of cocaine-induced depression or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).
If someone has experienced 3 of these critera within the same 12 month period, they are diagnosed with substance dependence. According to Dr. Steven E Hyman, former Director of the National Institute of Mental Health, the DSM “chose a model in which all psychiatric illnesses were represented as categories discontinuous with ‘normal.’” Hyman explains that this caused a scientific dilemma because those who qualify for one diagnosis qualify for five by default but don’t actually have five diseases. Both Dr. Insel and Hyman explain that patients have an underlying condition that causes the symptoms. Therefore, the lens through which we look at patients and research should be through the overall condition rather than just the symptoms.
Dr. Insel asserts that the DSM created in the 1960s and 10970s is outdated and “As long as the research community takes the D.S.M. to be a bible, we’ll never make progress,” because people think everything has to match the criteria. He explains that biology doesn’t follow the rigid criteria of the DSM and we should look at the causes and condition. For example, over the past 40 years neuroscience has shown that genetic abnormalities can put people at risk for addiction, schizophrenia or bipolar disorder. The drugs created for disorders like bipolar disorder show nothing about the causes of the disorder and therefore drug makers have no goal for drug development that targets the problem before it manifests. Dr. Hyman, Insel and other experts would like the current direction of cancer research, such as characterizing it by genetic and molecular signatures, to serve as a model for the direction of mental health research.
With the newest DSM since 1994 set to come out in a few weeks, practitioners say it shouldn’t be disregarded entirely. It is still the primary tool available to diagnose disorders, but those like Dr. Insel and Hyman say that while using it, keep in mind that it doesn’t reflect the entire picture of the disorder – namely the causes of the condition – and it should not guide research.
Dr. Insel is considered an expert in the field of mental health disorders and says that the Diagnostic Statistical Manual of Mental Disorders (DSM) doesn’t account for important diagnostic tools such as the role of biology, neuroscience and genetics. Currently, the DSM looks at symptoms as the driving criteria to diagnose patients for mental and addictive disorders. For example, the critera for substance dependence is:
1.Tolerance, as defined by either of the following: (a) A need for markedly increased amounts of the substance to achieve intoxication or the desired effect or (b) Markedly diminished effect with continued use of the same amount of the substance.
2.Withdrawal, as manifested by either of the following: (a) The characteristic withdrawal syndrome for the substance or (b) The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
3.The substance is often taken in larger amounts or over a longer period than intended.
4.There is a persistent desire or unsuccessful efforts to cut down or control substance use.
5.A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
6.Important social, occupational, or recreational activities are given up or reduced because of substance use.
7.The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance (for example, current cocaine use despite recognition of cocaine-induced depression or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).
If someone has experienced 3 of these critera within the same 12 month period, they are diagnosed with substance dependence. According to Dr. Steven E Hyman, former Director of the National Institute of Mental Health, the DSM “chose a model in which all psychiatric illnesses were represented as categories discontinuous with ‘normal.’” Hyman explains that this caused a scientific dilemma because those who qualify for one diagnosis qualify for five by default but don’t actually have five diseases. Both Dr. Insel and Hyman explain that patients have an underlying condition that causes the symptoms. Therefore, the lens through which we look at patients and research should be through the overall condition rather than just the symptoms.
Dr. Insel asserts that the DSM created in the 1960s and 10970s is outdated and “As long as the research community takes the D.S.M. to be a bible, we’ll never make progress,” because people think everything has to match the criteria. He explains that biology doesn’t follow the rigid criteria of the DSM and we should look at the causes and condition. For example, over the past 40 years neuroscience has shown that genetic abnormalities can put people at risk for addiction, schizophrenia or bipolar disorder. The drugs created for disorders like bipolar disorder show nothing about the causes of the disorder and therefore drug makers have no goal for drug development that targets the problem before it manifests. Dr. Hyman, Insel and other experts would like the current direction of cancer research, such as characterizing it by genetic and molecular signatures, to serve as a model for the direction of mental health research.
With the newest DSM since 1994 set to come out in a few weeks, practitioners say it shouldn’t be disregarded entirely. It is still the primary tool available to diagnose disorders, but those like Dr. Insel and Hyman say that while using it, keep in mind that it doesn’t reflect the entire picture of the disorder – namely the causes of the condition – and it should not guide research.
Wednesday, May 1, 2013
Swedes Created Breathalyzer that Detects Drugs
A recent advancement in the technology used for Breathalyzers may benefit the state of Colorado in preventing substance abuse related accidents. Colorado has seen its fair share of drunk driving and the recent passing of Amendment 64 has made people question the safety and legality of drivers under the influence of marijuana.
Apparently Switzerland has a high rate of substance related accidents as well, which promoted them to create a new device that can detect 12 different substances including the most commonly abused drugs such as marijuana, morphine, crystal meth, cocaine and heroin. Currently the process and enforcement mechanisms behind testing drivers for drugs other than alcohol have been limited at best. Testing for substances require blood and urine samples – which police can't conduct roadside.
The Swedish designed Breathalyzer was tested on 47 patients in an addiction clinic and was able to detect drugs with an accuracy rate of 87% - which is in line with the accuracy rate of most urine and blood tests. One drawback of the device is that it was able to pick up on the use of substances 24 hours after they were reportedly used. Therefore the level of substances and determination if one is “under the influence” at the time they are suspected cannot be accurately detected. According to the lead of the study published in the Journal of Breath Research, Professor Olof Beck, future studies can be refined to correlate the breath with actual concentrations of the drugs.
In this way, law enforcement could use the Breathalyzer preliminarily at the scene and then later confirm it by urine and blood tests. While this seems viable, a lot of regulations would be required – such as determining the levels of drugs that would be deemed “over the limit” according to the height, weight, history of use, developed tolerance and gender of the suspect. Prosecution and enforcement would be difficult as DWI and DUI defense attorneys would have a field day with the amount of indeterminate factors of what is "over the limit" for each substance. But considering and fine tuning this option in the future seems increasingly important as the Center for Disease Control reports that the aforementioned drugs are involved in roughly 18% of fatal car crashes.
Apparently Switzerland has a high rate of substance related accidents as well, which promoted them to create a new device that can detect 12 different substances including the most commonly abused drugs such as marijuana, morphine, crystal meth, cocaine and heroin. Currently the process and enforcement mechanisms behind testing drivers for drugs other than alcohol have been limited at best. Testing for substances require blood and urine samples – which police can't conduct roadside.
The Swedish designed Breathalyzer was tested on 47 patients in an addiction clinic and was able to detect drugs with an accuracy rate of 87% - which is in line with the accuracy rate of most urine and blood tests. One drawback of the device is that it was able to pick up on the use of substances 24 hours after they were reportedly used. Therefore the level of substances and determination if one is “under the influence” at the time they are suspected cannot be accurately detected. According to the lead of the study published in the Journal of Breath Research, Professor Olof Beck, future studies can be refined to correlate the breath with actual concentrations of the drugs.
In this way, law enforcement could use the Breathalyzer preliminarily at the scene and then later confirm it by urine and blood tests. While this seems viable, a lot of regulations would be required – such as determining the levels of drugs that would be deemed “over the limit” according to the height, weight, history of use, developed tolerance and gender of the suspect. Prosecution and enforcement would be difficult as DWI and DUI defense attorneys would have a field day with the amount of indeterminate factors of what is "over the limit" for each substance. But considering and fine tuning this option in the future seems increasingly important as the Center for Disease Control reports that the aforementioned drugs are involved in roughly 18% of fatal car crashes.
Wednesday, April 24, 2013
Gun Violence at Denver's 4/20 Rally
Denver has had several 4/20 celebrations but last weekend was their first since the passing of Amendment 64 and was also the first celebration wrought by gun violence. Amendment 64 supporters say incidents like this could curtail marijuana legalization.
Speculations that the gun violence was associated with the legalization of marijuana, the volume of people that attended the celebration or a product of local gang violence have been made. The attendance figures far exceeded those of previous years and the rally was scheduled to be a two day rather than one day event. Because there were larger crowds expected the police presence was larger. Prior to the rally, Denver police spokesman Sonny Jackson asserted, "Our biggest goal is to ensure everyone is safe in this environment…We'll have the necessary number of officers to ensure the safety of the public."
Unfortunately the public wasn’t safe, as bullets were fired into the crowed causing upwards of 80,000 people to flee into nearby streets. Fortunately, only two people sustained non-life threatening gunshot wounds and one was grazed by a bullet. Denver police released descriptions of the gunmen but haven’t made any arrests yet but may have identified one of the suspects and there is growing speculation that this was a gang related incident.
Advocates for marijuana legalization say the gun violence and the nature of the festival could damage legalization efforts by portraying a tainted public image of marijuana users. The dialogue around the 4/20 celebration rally and those who attend it is about “getting high” or the excessive use of marijuana, alcohol and other drugs. It is a place to party and binge on substances which is why, according to Joe Megysey the spokesman for the Amendment 64 campaign says these events give marijuana users a negative public image: “The vast majority of legitimate industry condemns these events, but most people watching television coverage of the event will see instead images of a 30-year-old stoner... rambling about how great pot is.” Megysey also predicts that these types of rallies will lose their appeal, saying, “As we move toward normalizing marijuana and as legalization moves forward, these kinds of rallies will become a thing of the past.”
While the rallies seem to encourage and celebrate the excessive use of marijuana they also don’t help with drug prevention either. Young adults and youth that attend these festivals are exposed to behaviors that they may think are "cool" to model. There have been various studies linking early use of substances like marijuana with the development of substance abuse disorders later in life. In light of this, hopefully Megysey’s prediction is right that these types of rallies will lose their appeal and the public doesn’t have to worry as much about exposure to marijuana abuse – or gun violence.
Speculations that the gun violence was associated with the legalization of marijuana, the volume of people that attended the celebration or a product of local gang violence have been made. The attendance figures far exceeded those of previous years and the rally was scheduled to be a two day rather than one day event. Because there were larger crowds expected the police presence was larger. Prior to the rally, Denver police spokesman Sonny Jackson asserted, "Our biggest goal is to ensure everyone is safe in this environment…We'll have the necessary number of officers to ensure the safety of the public."
Unfortunately the public wasn’t safe, as bullets were fired into the crowed causing upwards of 80,000 people to flee into nearby streets. Fortunately, only two people sustained non-life threatening gunshot wounds and one was grazed by a bullet. Denver police released descriptions of the gunmen but haven’t made any arrests yet but may have identified one of the suspects and there is growing speculation that this was a gang related incident.
Advocates for marijuana legalization say the gun violence and the nature of the festival could damage legalization efforts by portraying a tainted public image of marijuana users. The dialogue around the 4/20 celebration rally and those who attend it is about “getting high” or the excessive use of marijuana, alcohol and other drugs. It is a place to party and binge on substances which is why, according to Joe Megysey the spokesman for the Amendment 64 campaign says these events give marijuana users a negative public image: “The vast majority of legitimate industry condemns these events, but most people watching television coverage of the event will see instead images of a 30-year-old stoner... rambling about how great pot is.” Megysey also predicts that these types of rallies will lose their appeal, saying, “As we move toward normalizing marijuana and as legalization moves forward, these kinds of rallies will become a thing of the past.”
While the rallies seem to encourage and celebrate the excessive use of marijuana they also don’t help with drug prevention either. Young adults and youth that attend these festivals are exposed to behaviors that they may think are "cool" to model. There have been various studies linking early use of substances like marijuana with the development of substance abuse disorders later in life. In light of this, hopefully Megysey’s prediction is right that these types of rallies will lose their appeal and the public doesn’t have to worry as much about exposure to marijuana abuse – or gun violence.
Monday, April 15, 2013
A Sober Bar is Opening in Chicago
In NYC there is a bar called The 13th Step where you can reportedly purchase drinks with AA sobriety chips. A bar opening at the end of April in Crystal Lake near Chicago is antithetical to The 13th Step, because it will support sobriety rather than mock it.
The Crystal Lake bar will be a sober bar, called The Other Side, started by a local non-profit group that will provide a healthy atmosphere for people both in and out of recovery who want a sober space to hang out in. For many people who don't drink, there are few sober spaces to hang out and not participating in the societal norm of drinking can be isolating.
This is especially true for young people in recovery in the suburbs of Chicago or for those who are just out of addiction rehab and need a supportive atmosphere. The Other Side will give the suburban sober community a place to hang out and share experiences. Housed in a warehouse loft space filled with couches, pool tables, TVs, a dance floor, a stage area for a band and a DJ – the only real difference between The Other Side and regular bar is that the drinks don’t have alcohol in them. People will even be carded at the door to make sure they are at least 18 and sober.
The warehouse where The Other Side will open has been used by people in recovery as a hangout spot for some time. At first, it just had a few folding chairs and a boom box, but as the volume of people hanging out in the warehouse grew, so did the idea for The Other Side. The local community and those in recovery banded together and made The Other Side – opening April 27th – possible. The sober bar will be open Thursday through Sunday evenings and the profits will go toward drug education and addiction treatment initiatives.
The Crystal Lake bar will be a sober bar, called The Other Side, started by a local non-profit group that will provide a healthy atmosphere for people both in and out of recovery who want a sober space to hang out in. For many people who don't drink, there are few sober spaces to hang out and not participating in the societal norm of drinking can be isolating.
This is especially true for young people in recovery in the suburbs of Chicago or for those who are just out of addiction rehab and need a supportive atmosphere. The Other Side will give the suburban sober community a place to hang out and share experiences. Housed in a warehouse loft space filled with couches, pool tables, TVs, a dance floor, a stage area for a band and a DJ – the only real difference between The Other Side and regular bar is that the drinks don’t have alcohol in them. People will even be carded at the door to make sure they are at least 18 and sober.
The warehouse where The Other Side will open has been used by people in recovery as a hangout spot for some time. At first, it just had a few folding chairs and a boom box, but as the volume of people hanging out in the warehouse grew, so did the idea for The Other Side. The local community and those in recovery banded together and made The Other Side – opening April 27th – possible. The sober bar will be open Thursday through Sunday evenings and the profits will go toward drug education and addiction treatment initiatives.
Sunday, April 7, 2013
April is Alcohol Awareness Month
Alcohol Awareness Month, founded by the National Council on Alcoholism and Drug Dependence (NCADD) in 1987, occurs every April. Addiction treatment providers across the nation work to raise public awareness about alcoholism and to de-stigmatize it.
Although the stigma associated with alcoholism has improved since the 1980s, there is still much work to be done to reduce the negative public impression of what being “alcoholic” entails that discourages many from seeking the alcoholism treatment that they need. More than 8.5% of Americans over the age of 18 suffer from alcohol disorders and many have yet to seek addiction treatment.
Famous alcoholics like Betty Ford and movies depicting all walks of life suffering from alcohol abuse disorders have helped reduce the shame and dishonor associated with being an alcoholic. However, a lot more work needs to be done to help youth, middle aged and elderly alike to seek treatment. Some reasons of the reluctance in seeking help include losing professional stature, being shamed in one’s community or feeling socially alienated from friends or family who drink.
The theme of this year’s Alcohol Awareness Month is “Help for Today. Hope for Tomorrow” with a specific focus on how alcoholism and alcohol related problems impact young people and the children that compose our future. A total of 25% of children in the US are exposed to alcoholism in their families. Also, alcohol is the number one drug of choice for American youth, and is reported by NCADD to be more likely to kill young people than all illegal drugs combined.
Other statistics that shed light on the enormity of the problem of alcoholism among youth and young adults include:
Alcohol Awareness Month is purposefully in April because it is a time when youth are often exposed to alcohol and peer pressure to drink. Social gatherings from prom to high school and college graduation often involve alcohol use and abuse. Thousands of organizations and addiction treatment providers will work to raise awareness and educate people about prevention and treatment of alcoholism while encouraging people to make smart choices when it comes to use of alcohol throughout the month of April.
Harmony Foundation addresses problem drinking among youth by offering an addiction treatment track for young adults who need rehab. For more information on our program that helps empower young adults to stay alcohol free, please click here.
Although the stigma associated with alcoholism has improved since the 1980s, there is still much work to be done to reduce the negative public impression of what being “alcoholic” entails that discourages many from seeking the alcoholism treatment that they need. More than 8.5% of Americans over the age of 18 suffer from alcohol disorders and many have yet to seek addiction treatment.
Famous alcoholics like Betty Ford and movies depicting all walks of life suffering from alcohol abuse disorders have helped reduce the shame and dishonor associated with being an alcoholic. However, a lot more work needs to be done to help youth, middle aged and elderly alike to seek treatment. Some reasons of the reluctance in seeking help include losing professional stature, being shamed in one’s community or feeling socially alienated from friends or family who drink.
The theme of this year’s Alcohol Awareness Month is “Help for Today. Hope for Tomorrow” with a specific focus on how alcoholism and alcohol related problems impact young people and the children that compose our future. A total of 25% of children in the US are exposed to alcoholism in their families. Also, alcohol is the number one drug of choice for American youth, and is reported by NCADD to be more likely to kill young people than all illegal drugs combined.
Other statistics that shed light on the enormity of the problem of alcoholism among youth and young adults include:
- More than 6,500 youth under the age of 21 die each year from injuries related to alcohol.
- Over 1,700 college students in the US are killed each year because of alcohol related injuries.
- Everyday 7,000 kids in the US under the age of 16 take their first drink and those who take their first drink before the age of 15 are 4 times more likely to develop a drinking problem than those who wait until they are 20 to drink.
Alcohol Awareness Month is purposefully in April because it is a time when youth are often exposed to alcohol and peer pressure to drink. Social gatherings from prom to high school and college graduation often involve alcohol use and abuse. Thousands of organizations and addiction treatment providers will work to raise awareness and educate people about prevention and treatment of alcoholism while encouraging people to make smart choices when it comes to use of alcohol throughout the month of April.
Harmony Foundation addresses problem drinking among youth by offering an addiction treatment track for young adults who need rehab. For more information on our program that helps empower young adults to stay alcohol free, please click here.
Friday, March 22, 2013
Addiction Doesn't Discriminate - Especially not Against Attorneys
Addiction does not discriminate, it impacts professionals, students, the famous and the unemployed alike. That is why it came as no shock that Los Angeles criminal defense attorney was arrested last week on drug charges.
The lawyer, who is now suspended from practicing law, is 49-year-old Kenneth Roger Markman. He was first arrested in October of 2011 after a failed attempt at smuggling balloons of heroin and meth into a jail holding facility in downtown Los Angeles. He was reportedly trying to smuggle the drugs to a client who had a court appearance that day.
A month after that incident, Markman was at a courthouse in Lancaster, CA after security officers found drug paraphernalia and two small bags of cocaine in his wallet. Despite his attempt to grab his wallet and leave the building, he was arrested. Last week he faced sentencing for these incidences – to which he pleaded no contest. His sentencing includes one year in county jail and one year in a residential addiction treatment program as part of three years of supervised probation.
The State Bar of California has suspended Marksman’s license pending a decision on whether he will be allowed to continue to practice law. The fact that his license isn’t revoked all together is in part due to the high incidences of lawyers today being treated for alcoholism and addiction. The American Bar Association estimates 15% to 20% of lawyers suffer from substance abuse and chemical dependency.
Born out of the growing number of attorneys who need addiction treatment are programs and policies that help them regain their careers after getting sober. This has allowed those convicted, like Markman, have a second chance and has incentivized lawyers who need help to come forward without the gripping fear that they will ruin their careers. Similar programs exist for medical professionals and airline pilots – all of whom deserve a second chance at life and career once they get sober.
If you are an impaired professional and need addiction treatment, Harmony has specialized treatment programs that can help.
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