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Types of Addiction

Buprenorphine Tapering Less Effective for Prescription Opioid Addiction

Posted on May 28, 2015 in Prescription Drug Addiction

Buprenorphine Tapering Less Effective for Prescription Opioid AddictionPrescription drug abuse is a huge problem in the U.S., and determining the most effective ways to help people struggling with it is an understandable priority for public health. Many physicians opt for a “tapering” approach to detoxification, where an alternative opioid like buprenorphine or methadone is prescribed in a gradually-decreasing dosage. The theory is that this will enable those addicted to drugs like OxyContin to reduce their dependence while also minimizing withdrawal symptoms, but a new study has indicted that tapering using buprenorphine doesn’t work as effectively as simple maintenance using the same drug.

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Internet Addiction Epidemic in China

Posted on May 18, 2015 in Internet & Video Game Addiction

Internet Addiction Epidemic in ChinaIn most parts of the world, Internet addiction is not officially a disorder. The main guide for diagnosing mental health conditions, called the DSM-V, does list Internet gaming disorder as a potential behavioral addiction warranting more study, but all of the other ways in which we can get hooked to our electronics have been officially overlooked. There is no formally recognized smartphone addiction or Facebook addiction. China, on the other hand, has recognized Internet disorder, largely because that country has 20 million addicts. This epidemic has led to interesting and controversial treatment camps, mostly designed to treat young people.

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The Lifetime Burden of Methadone, Buprenorphine Treatment

Posted on May 13, 2015 in Stimulants

Can you fight fire with fire? The use of methadone and buprenorphine to treat heroin addiction can be looked at as an attempt to do just that—giving opioid dependent individuals more opioids as “treatment” for their addiction. However, the reality of the situation is a little more nuanced, with evidence suggesting that the substitute drugs reduce risky behavior and keep individuals off heroin. Doctors around the country are now struggling with the question of whether this seemingly contradictory approach is the best strategy or whether they are simply allowing addiction to continue.   Methadone, Buprenorphine for Opioid Addiction  With the prescription drug epidemic wreaking havoc across the U.S. and increasingly driving users onto the cheaper and more accessible opioid that is heroin, any medicines with the potential to reduce overdose deaths and the burdens of addiction need to be considered. Methadone and buprenorphine accomplish this goal in basically the same way: providing a different source of opioids in a less risky package.   Although both drugs give users a hit of opioids, when taken as directed they don’t lead to euphoric effects, and both drugs have a relatively long “half-life” (the amount of time taken for half of the substance to leave the body) in comparison to heroin. This means that their addictive potential is reduced because the effects last longer and don’t lead to a spike in feel-good neurochemicals. By providing opioids in this way, the medicines reduce unpleasant withdrawal symptoms without producing euphoric effects. In addition, buprenorphine is often combined with naloxone (in the brand-name medication Suboxone)—a substance that blocks the effects of opioids—which becomes active if the medicine is crushed in an attempt to get a faster-acting hit.   Harm Reduction vs. Beating Addiction  The debate about using methadone and buprenorphine to treat heroin addiction ultimately comes down to the choice between reducing harm and beating addiction entirely. These medicines reduce harm because they mean that users don’t need to inject (which, when done with dirty needles, carries risks of conditions such as HIV), and users often replace heroin entirely with the medicines, thereby reducing the risk of overdose and death, as well as reducing criminal activity. According to the CDC, the death rate for opioid-dependent people on methadone maintenance therapy is 70 percent lower than for those not on the therapy. They also appear to reduce risky sexual behaviors and may be cost-effective, but the evidence on these points is conflicting or unreliable.    The big issue, though, is that you’re simply switching addiction from one type of opioid to another. It’s generally recommended that people be on methadone maintenance therapy for a year before attempting to wean themselves off the drug, for example, but in practice this can easily turn into several years. In addition, most patients either drop out, are encouraged to leave or are barred for failing to comply with program regulations within the first year, and the majority of these people relapse to heroin use. Other evidence suggests that most who end up trying to kick the medicines relapse within two years, and high numbers die from suicide or overdose.  Withdrawal may also be a factor even when taking the medicines, according to reports. A Minneapolis StarTribune reader who was addicted to pain meds talks of his burprenorphine-assisted withdrawal: “I was literally in the fetal position for the first week, and [had] the worst flu/hangover feeling for the next two weeks. Only after going back to the doctor for meds to help me withdraw from the Suboxone did I finally start to feel better.”   The Best Way to Get Clean Is Abstinence  There is a place for medicines like methadone and buprenorphine, but it’s a very confined one. They can reduce harm, but they also come with a big downside of continued addiction, so the drugs seem appropriate only when abstinence-based methods have proven to be unsuccessful, and even then the drug therapy should be combined with psychological support. If there is literally no other way to help someone, then allowing the addiction to continue in a less risky way is the most humane approach.   However, the key point is that the best way to get clean is by becoming abstinent. Yes, the withdrawal symptoms will be very unpleasant, but they will pass. Most importantly, abstinence-based approaches help people understand the underlying reasons they choose to use substances, promoting self-understanding and providing them with tools to overcome their triggers and cues to use drugs. In short, abstinence-based approaches treat addiction itself and reduce harm in the process, whereas methadone and buprenorphine reduce harm but allow addiction to continue.

Can you fight fire with fire? The use of methadone and buprenorphine to treat heroin addiction can be looked at as an attempt to do just that—giving opioid dependent individuals more opioids as “treatment” for their addiction. However, the reality of the situation is a little more nuanced, with evidence suggesting that the substitute drugs reduce risky behavior and keep individuals off heroin. Doctors around the country are now struggling with the question of whether this seemingly contradictory approach is the best strategy or whether they are simply allowing addiction to continue.

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Colorado May Ban Edible Pot

Posted on April 22, 2015 in Marijuana Addiction

Colorado May Ban Edible PotThe rollout of legal recreational marijuana in Colorado and Washington has largely been uneventful. In one respect, though, residents, lawmakers and health officials in Colorado still have serious concerns about edible marijuana products. Edible products, which can include enticing treats like cookies, brownies and candies, have sent kids to emergency rooms for accidental ingestion and have led to at least two deaths. As a result, the state of Colorado is reconsidering edible pot.

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Are Cocaine Addiction and Nicotine Addiction Related?

Posted on April 16, 2015 in Cocaine

Are Cocaine Addiction and Nicotine Addiction Related?Cocaine is an illegal/illicit drug of abuse that belongs to a larger class of substances known as stimulants. Nicotine is a legal recreational substance that produces both stimulating and depressing effects inside the brain and body. Repeated consumption of either cocaine or nicotine can trigger the characteristic changes in brain function that mark the onset of addiction. In a study published in 2014 in the journal Neuropsychopharmacology, a team of researchers from Virginia Commonwealth University looked at the common origins of cocaine addiction and nicotine addiction. These researchers concluded that both forms of addiction rely partly on access to the same pathway to the brain.

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Automated Care Helps Alcoholics Maintain Sobriety

Posted on April 13, 2015 in Alcohol Addiction

Automated Care Helps Alcoholics Maintain SobrietyAlcohol treatment programs can use a form of psychotherapy called cognitive behavioral therapy (CBT) to help people recovering from alcoholism establish drinking abstinence or substantially reduce their alcohol intake. However, individuals who initially benefit from CBT often eventually return to excessive drinking. In a study published in October 2014 in the journal Addictive Behaviors, researchers from the University of Vermont assessed the potential effectiveness of a phone-based automated system, called Alcohol Therapeutic Interactive Voice Response (ATIVR), in helping to extend the treatment benefits of cognitive behavioral therapy. These researchers concluded that ATIVR may help people who have successfully established alcohol abstinence by the end of active therapy involvement.

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How Prozac Can Be Harmful

Posted on April 8, 2015 in Prescription Drug Addiction

Prozac, which is a brand name for the generic antidepressant fluoxetine, helps many people struggling with clinical depression, but it can also be a risky drug to take. Prozac abuse is common, although experts don’t consider the drug to be habit-forming. There is always the possibility of becoming dependent on a drug of abuse, and there is also the risk of dangerous side effects. If you have been prescribed Prozac or another brand of fluoxetine, know the risks and take the medication responsibly.  Is Prozac a Controlled Substance? One of the biggest concerns anyone should have when taking a prescription medication is whether it is a drug that is susceptible to abuse. Any drug that makes you feel good is one that you might abuse. If Prozac makes you feel relaxed and stifles your depressive symptoms, for instance, you might feel tempted to take more than the recommended dose. Or, once your doctor says you can stop taking it, you might ignore that and continue because of how the drug makes you feel. The Drug Enforcement Administration does not list fluoxetine as a controlled substance, which means it is not considered to be habit forming. However, it is a drug that some people feel compelled to abuse.  Is Fluoxetine Addictive? Experts would say that Prozac is not addictive, or in other words not habit-forming, which is why it is not listed as a controlled substance. However, you should be aware that whenever you abuse a drug, you put yourself at risk of becoming psychologically dependent on it. With Prozac you might feel as if you need it in order to feel relaxed or to sleep restfully at night. You may also feel afraid that if you stop taking it you will return to a depressed state. Your hesitation might lead you to feel that you absolutely need the drug.   Side Effects of Prozac Prozac addiction may be uncommon, but abuse of this drug is not. Abusing it means increasing the risk of experiencing side effects. It can also mean that the side effects you experience will be more severe. Possible side effects of Prozac include drowsiness, excessive sweating, dry mouth, sore throat, loss of appetite, weight loss, nervousness, nausea and loss of sex drive. The rare but more serious side effects include trouble breathing, a rash and hives, joint pain and swelling, confusion, fever, hallucinations and seizures.   You may also experience withdrawal from Prozac if you abuse it and then stop using the drug. The official name for this condition is called antidepressant discontinuation syndrome and it can be serious. Symptoms include anxiety, irritability, headaches, fatigue, flu-like symptoms and depression. If you are worried about withdrawal or think you have been abusing Prozac, talk to your doctor before you stop using the drug. You will need guidance to slowly stop using it to avoid the syndrome. Abusing any drug is risky, so know the facts before you make that choice. Prozac, which is a brand name for the generic antidepressant fluoxetine, helps many people struggling with clinical depression, but it can also be a risky drug to take. Prozac abuse is common, although experts don’t consider the drug to be habit-forming. There is always the possibility of becoming dependent on a drug of abuse, and there is also the risk of dangerous side effects. If you have been prescribed Prozac or another brand of fluoxetine, know the risks and take the medication responsibly.

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Synthetic ‘Spice’ Blamed for Deaths in Russia

Posted on April 2, 2015 in Stimulants

Synthetic ‘Spice’ Blamed for Deaths in RussiaSynthetic marijuana, otherwise known as “spice,” has been a problem in the U.S. for years, but now it’s spreading across the globe. A recent increase in deaths due to spice in Russia is the latest story relating to the “designer” drug. Like in the U.S., assumptions that spice is comparable to marijuana has led many Russian users to think it’s safe, and by the time they find out otherwise, it’s often too late. The government is hoping to take action to reduce abuse of the drug, but the rapidly changing formulas used by illicit chemists make legislating against spice a significant challenge. 

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The Facts about Crack Cocaine

Posted on April 1, 2015 in Cocaine

The Facts about Crack CocaineCrack cocaine, or crack, is a serious, highly addictive and extremely dangerous drug. It exploded on the illegal drug scene in the 1980s and became popular with drug users. Crack use and the resulting crimes during that decade spurred a number of laws related to the drug war, including mandatory minimum sentencing for drug offenses. Today, crack is not nearly as big of a problem as it once was, but it is still around and still causing serious harm. Addiction, overdose and health problems like crack lung are consequences of using this street drug.

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Is Internet Addiction Mania Leading to Irresponsible Treatment Practices?

Posted on March 26, 2015 in Internet & Video Game Addiction

Is Internet Addiction Mania Leading to Irresponsible Treatment Practices? Internet addiction has been described as “the illness of the future.” It’s easy to see why: more and more it seems like people in the modern world are perpetually glued to smartphones, laptops and tablets, stuck in the digital world at the expense of the real one. The social lure of the Internet and our brain’s drug-like response to the instant gratification provided by online communication mean that Internet addiction is a very real problem.

However, it’s also attracted a lot of attention in the media, and the furor surrounding it has led to the proliferation of specialized treatment centers in the absence of detailed understanding. The addiction itself is one problem, but one that gets a lot less attention is how treatment programs for it are currently unregulated, opening the door to a whole host of problems.

The Rise of Internet Addiction Treatment

The U.S. is actually quite a late-comer to Internet addiction treatment. The first centers opened in China in 2004 and in Korea shortly after, with Tao Ran’s initial Chinese program operating out of a military hospital. This set the tone for Internet addiction treatment, with Korea continuing the trend with boot camp-style programs. In Korea, Internet addiction is an especially widespread issue, with online gaming serving as a national sport and Internet cafes as social hubs for young people in particular. Because of this, it’s not surprising that the condition was first addressed in Asia.

The first U.S.-based Internet addiction treatment program (reSTART) was established in 2009, but it wasn’t until 2013 that condition was first mentioned in the appendix of the Diagnostic and Statistical Manual of Mental Disorders (the DSM). Internet addiction rehabilitation centers are now becoming more popular in the U.S., and many existing treatment providers are also offering Internet addiction-specific programs to meet the growing demand. Many of these programs have a focus on troubled teens, and reSTART has since developed its own youth program too but, as with all addictions, it can strike at any age.

The Lesson from China

There are hundreds of residential Internet addiction treatment programs in China, and many of these follow legitimate practices. Tao Ran’s own program (the first in China) was featured in the documentary “Web Junkies,” and shows the positive work that can be performed at such centers. Ran himself has a master’s degree in medicine, but not everybody who operates these programs in China is so well-qualified.

Like in the U.S., parents in China are worried about their kids’ extensive use of the Internet, and are eager to pay anybody offering treatment, even if it comes in the form of unlicensed electrotherapy or outright abuse. There have been two widely reported deaths at these less than reputable centers. The first occurred in 2009, where 15-year-old Deng Senshan was beaten to death at a treatment center, and even though this led to guidelines for banning physical punishment (as well as pointless surgeries and other dangerous interventions) at the centers, another virtually identical incident followed the next year.

Lack of Regulation in the U.S.

We may be inclined to think that such incidents wouldn’t occur in the U.S., but there are many boot camp-style programs being set up all around the country dedicated to troubled teens, and some have extreme approaches. As one example, “escort services” (more like private bodyguard-initiated kidnappings) are being used to take teens to such programs, often waking them in the middle of the night and using handcuffs to restrain them. When they arrive, along with the risk that comes with the wide variation in treatment style used, they risk being involved in a case of abuse. In 2005, 33 states had 1,600 staff members or more employed in these residential programs who were involved in cases of abuse.

It seems that regulation is a necessity to ensure that concerned parents don’t send their children somewhere ineffective or dangerous. However, when a bill was introduced to Congress to pursue this goal in 2013, it only reached the committee stage. The documentary film “Kidnapped for Christ” aims to draw some attention to the dangers of the “troubled teen” industry sweeping the U.S., and it seems only a matter of time before regulation takes place.

Does Korea Have the Best Approach?

Many other countries are just getting involved with Internet addiction treatment much like the U.S., but Korea’s attempt to help their own addicted teenagers may offer the most successful model to date. The government runs the treatment programs, ensuring a consistent approach not incorporating counter-indicated or downright dangerous treatment methodologies, and taxpayer-funded counseling is available. In addition, education about the dangers of Internet addiction starts in preschool and runs right through to high school graduation.

Korea has an amplified version of the problem, and elements of their approach may not translate directly to the U.S., but the core message is essential. Parents are eager to get their kids into treatment and we need to make sure they aren’t sold a “snake oil” program, particularly one dependent on barbaric practices. Government regulation of providers is vital, and much like drug education has been used in schools, Internet addiction education should be a regularly revisited issue. Korea may have a bigger problem with Internet addiction right now, but it’s just a window into our future if we don’t head off the problem while we can.

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