Laws Effective in Reducing Underage Drinking

Right now, all 50 states have a minimum legal drinking age of 21. Some states, though, have also implemented expanded underage drinking laws. Those additional laws were the focus of research done by a team at the Pacific Institute for Research and Evaluation (PIRE) in Calverton, Maryland, and published in the March 2016 issue of the Journal of Studies on Alcohol and Drugs.

Of the 20 expanded underage drinking laws that were identified, nine were found to be particularly effective in reducing the number of fatal crashes involving underage drivers who had been drinking.

The nine minimum legal drinking age laws associated with significant decreases in fatal crash ratios of underage drinking drivers were:

  1. Possession of alcohol
  2. Purchase of alcohol
  3. Use alcohol and lose your license
  4. Zero tolerance .02 blood alcohol concentration (BAC) limit for underage drivers
  5. Age of bartender 21+
  6. State responsible beverage service program
  7. Fake identification support provisions for retailers
  8. Dram shop liability
  9. Social host civil liability

It’s estimated that these particulaDoor_2323_715r laws are currently saving about 1,100 lives per year in states that have these laws. The researchers estimate that if all states adopted them, an additional 210 lives could be saved each year.

Research suggests that adolescents and young adults with substance use disorders have a good chance of becoming clean and sober, especially when two factors are present: first, when a drug and alcohol treatment center that knows how to address one’s needs is chosen, and when family members are involved in the drug and/or alcohol rehab process. Contact our Admissions Office at 800-785-2400 if you or your loved one needs help.



Many Studies Saying Alcohol Consumption is Healthy are Flawed

There have been many studies over the years acclaiming the potential health benefits of moderate alcohol consumption, particularly when it comes to the heart and longevity. But new research published in the Journal of Studies on Alcohol and Drugs indicates that many of these studies are flawed and that many of the purported benefits are likely overestimated.

Lead researcher Tim Stockwell, PhD, of the Centre for Addictions Research at the University of Victoria, Canada and colleagues analyzed 87 studies that measured the effects of moderate drinking on longevity.

Over the last decade, numerous studies have suggested that, in moderation, alcohol may lower the risk of heart attack and heart failure. However, this new research from Stockwell found that many of these studies are subject to biases that, when accounted for, eliminate the reported health benefits of moderate drinking. The team identified a number of flaws in the way the studies were designed.

“A fundamental question is, who are these moderate drinkers being compared against?” says Stockwell. When Stockwell’s team accounted for this bias and other flaws they identified related to study design, they found that moderate drinkers no longer showed any mortality benefits.

“There’s a general idea out there that alcohol is good for us, because that’s what you hear reported all the time. But there are many reasons to be skeptical” says Stockwell.

It’s the general consensus that for people with alcohol or drug problems, any use of alcohol is problematic. However, it now seems that moderate drinkers, who aren’t necessarily addicted, should also be mindful of the health risks associated with drinking as they seem to outweigh any benefits.

Guidelines for Prescribing Opioids for Chronic Pain

According to the Centers for Disease Control and Prevention (CDC), 259 million prescriptions were written for painkillers in 2012, enough for every American adult to have a bottle of pills. A national conversation has been taking place as people think about what’s good and what’s bad about this access to medications.

On one side of the debate are proponents of people in pain being able to access medication and treatment. On the other side of the debate are the groups worried that this explosion of prescriptions is covering a very serious drug problem here in the US brought on, in part, by doctors having no protocols for how people take pain meds, how long they should be on them or how to come off.

No matter what “side” you’re on, the CDC has published the following statistics about painkiller use here in the US:

  • Each day 46 people die from an overdose of prescription painkillers.
  • Many more men than women die of overdoses from prescription painkillers, although the rates of women’s deaths have quadrupled in the last decade.
  • Middle-aged adults have the highest prescription painkiller overdose rates.
  • People in rural counties are about two times as likely to overdose on prescription painkillers as people in big cities.
  • Whites and American Indian or Alaska Natives are more likely to overdose on prescription painkillers.

There have been so many deaths due to prescription opioid overdose that the government has declared it an epidemic. In response, the CDC has issued new recommendations for prescribing opioid medications for chronic pain, excluding cancer, palliative, and end-of-life care. “The CDC Guideline for Prescribing Opioids for Chronic Pain, United States, 2016 will help primary care providers ensure the safest and most effective treatment for their patients.”

CDC Director Dr. Tom Frieden recently stated: “Overprescribing opioids – largely for chronic pain – is a key driver of America’s drug-overdose epidemic. The guideline will give physicians and patients the information they need to make more informed decisions about treatment.”

By using the guideline, primary care physicians can determine if and when to start opioids to treat chronic pain. The guideline also offers specific information on medication selection, dosage, duration, and when and how to reassess progress and discontinue medication if needed.

Some of the keys to the 12 recommendations in the guideline, encourage doctors to prescribe opioids at the lowest possible effective dose to reduce the risks of addiction and overdose and they also encourage prescribing healthcare providers to “exercise caution” when prescribing and to monitor all patients closely.

The CDC developed user-friendly materials to assist providers with implementing the recommendations, including a decision checklist. There are many treatment options for people with pain killer addictions including drug and alcohol treatment centers, both residential and outpatient however, it should be noted that someone addicted to painkillers will likely need a safe detoxification which could include inpatient detox or ambulatory (outpatient) detox. If you’re unsure, call your insurance provider for covered programs near you.

Everything You Need to Know About DXM

Dextromethorphan (DXM) is one of the main ingredients in many over-the-counter (OTC) cough and cold medications. It’s legal and easily bought from pharmacies and grocery stores, so typical users are teenagers and young adults.

In fact, 1 in 11 teens have admitted to getting high on cough medicine. DXM use is referred to by teens as “robo-tripping,” “skittling,” and “tussin toss.” According to the 2015 Monitoring the Future study, 4.6% of 12th graders reported recreational use of cough syrups in the past year.

At recommended doses, DXM is quite safe. However, because abusers regularly take 10 times the “normal” dose, and often take it with other substances, DXM abuse can lead to serious side effects, including death.

DXM is a dissociative anesthetic, synthetically produced and chemically related to codeine. It produces a high similar to another dissociative anesthetic, Ketamine (or “Special K”). When consumed in high doses, DXM can cause a hallucinogenic, trance-like euphoria. The typical high lasts 6-8 hours.

Most DXM abusers ingest the drug orally as a liquid syrup, capsule or pill. Other forms can be snorted and even injected. Pure DXM powder can be bought online and is often mixed with alcohol to mask its taste. 

Street names for DXM include: Dex, Dextro, Drix, Gel, Groove, Mega-perls, Poor man’s PCP, Red devils, Robo, Rojo, Rome, Sky, Syrup, Tussin, Velvet, Triple C, Skittles, Drank and Vitamin D. 

Commercial names for DXM include: Robitussin and Delsym. Common combination products containing DXM include Coricidin HBP Cough & Cold Tablets, TheraFlu, Triaminic, Robitussin DM and NyQuil Nighttime Cold Medicine, as well as many other brand and generic names.

When the recommended dose is exceeded, side effects of DXM may include: confusion, nausea and vomiting, sweating, dizziness, accelerated heartbeat, stomach pain, hyperexcitability, paranoia, slurred speech, seizures and vivid auditory and visual hallucinations. The use of high doses of DXM in combination with alcohol or other drugs is particularly dangerous and deaths have been reported. Chronic abuse of the drug has also been associated with psychosis.

DXM has been noted as a drug of abuse since the 1960s. If you or someone you know is abusing DXM, this is a dangerous activity and some form of intervention should be attempted. Call a local drug and alcohol treatment center or call New Bridge Foundation at 510-548-7270 for more information on treatment options.


How Long Should My Loved One Be in Treatment?

SONY DSC“So, how long should my son stay in treatment?” a worried mother asked me yesterday. For those of us who work in drug and alcohol treatment, this is probably the question we hear the most from anxious husbands, wives, parents, siblings and friends. How long should your loved one stay at alcohol or drug rehab?

Despite all the mystery and opinions surrounding this question, the answer is actually surprisingly simple, because this question has been researched for about 25 years now.

According to the National Institute on Drug Abuse (NIDA), “Research has shown unequivocally that good outcomes are contingent on adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes.”

So, why 90 days? Research has shown that drug abuse results in changes in the brain that persist long after a person stops using drugs. These changes in brain function often have many behavioral consequences, including an inability to control the impulse to use drugs and alcohol, despite negative consequences. Ninety days is the general length of time it takes for important neurotransmitters to reset, thus allowing the individual to override cravings and impulses, often referred to as Post Acute Withdrawal Syndrome (PAWS).

 There are actually two stages of withdrawal.

  1. The first stage is the acute stage, which lasts from three days up to three weeks, depending on the type of addiction. During this stage, there are usually physical withdrawal symptoms. But every drug is different, and every person is different.
  2. The second stage of withdrawal is called Post Acute Withdrawal Syndrome (PAWS). During this stage there are often fewer physical symptoms, but increased emotional and psychological withdrawal symptoms. Post-acute withdrawal occurs because the brain’s chemistry is gradually returning to normal. As the brain improves, the levels of brain chemicals fluctuate as they approach the new equilibrium, and this causes post-acute withdrawal symptoms.

PAWS symptoms, including irritability, difficulty sleeping, changes in appetite, anxiety, mood swings, and fatigue, tend to occur around 30 and 60 days of sobriety, often the time when people are leaving treatment. This is why it’s crucial, whenever possible, to stay involved in some form of treatment for at least 90 days.

Two of the important questions to ask any drug and alcohol treatment provider are: “What does your discharge planning include?” and “Do you have Aftercare?” You want to make sure that there’s a comprehensive discharge plan including follow-up visits scheduled before discharge with mental health and other providers, specific 12-step or other support meetings, and weekly aftercare for at least six months. Aftercare is typically free and is a weekly therapy group with a certified or licensed counselor, and usually includes random urine screens. These level of supports are crucial to support long-term sobriety and stop the cycle of addiction.

The Sex Addiction Cycle

redtulipsClients at drug and alcohol treatment centers often have more than one issue when they come into rehab including problems with depression, anxiety and food. A lesser known and discussed issue is that of sexual addiction. Although sex addiction isn’t listed in the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-5) it is still a serious and often debilitating set of behaviors.

Sex addiction can refer to a range of sexually-related behaviors that are in excess and significantly and negatively impact a person’s life. Research shows that adverse sexual behavior is similar in development to chemical addictions.

Sexual addictions can come in a variety of forms including:

  • Pornography
  • Prostitution
  • Masturbation or fantasy
  • Sadistic or masochistic behavior
  • Exhibition/Voyeurism
  • Other excessive sexual pursuits

It can have profound psychological effects, like generating feelings of shame, inadequacy, and emotional distress.

In his book “Out of the Shadows” author Patrick Carnes, Ph.D. outlines a four-step process for sexual addiction including: 

  1. PREOCCUPATION: the addict’s own special routines, which lead up to the sexual behavior. The ritual intensifies the preoccupation, adding arousal and excitement.
  2. RITUALIZATION: the addict’s own special routines, which lead up to the sexual behavior. The ritual intensifies the preoccupation, adding arousal and excitement.
  3. COMPULSIVE SEXUAL BEHAVIOR: the actual sexual act, which is the end goal of the preoccupation and ritualization. Those who engage in obsessive/compulsive sex are unable to control or stop the behavior.
  4. DESPAIR: the feeling of utter hopelessness “addicts” have about their behavior and their powerlessness.

Sexual addiction can also be a relapse trigger for chemical addiction so must be watched closely.

Top 6 Mental Health Tips for 2016

According to the World Health Organization (WHO): “Mental health is an integral part of health; indeed, there is no health without mental health.” From many studies they’ve conducted, as well as other studies from around the world, we now know that poor mental health is linked to increased risk of death from heart disease, stroke and cancer. In addition, studies have shown that poor mental health is associated with gender discrimination, social exclusion, increased risk of violence and crime and an unhealthy lifestyle. With this in mind, WHO defines good mental health as a “state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.”

So, if you want to improve your mental health in 2016, here’s where you want to start:

  1. EATING WELL: Just like your mother told you, eating well is the cornerstone of a healthy physical life. What we know now, is that it’s also integral to a healthy mental life. There are many ways to eat, but many proponents such as the Mental Health Foundation, recommend the Mediterranean diet which incorporates a high consumption of beans, nuts, cereals, seeds, plant-based foods and fruits. The diet is also low in saturated fat, includes moderate consumption of fish, poultry and dairy, and low consumption of meats and sugary foods. Studies have found that people on this diet not only live longer, but they also have better cognitive function and mental health.
  2. EXERCISE: Here’s another one that can seem obvious but so many people don’t do. One of the top reasons for exercise avoidance is the misconception that it will take hours or be too hard. Studies from the University of Michigan have shown that you don’t have to go to grueling gym sessions. They found that such enjoyable activities as group nature walks could promote good mental well-being. “Our findings suggest that something as simple as joining an outdoor walking group may not only improve someone’s daily positive emotions but may also contribute a non-pharmacological approach to serious conditions like depression,” said study leader Dr. Sara Warber, associate professor of family medicine at the University of Michigan.
  3. SLEEP: It’s common knowledge that sleep problems can affect our mental well-being making us grouchy, judgmental and poor problem solvers. A 2010 study by researchers from the George Institute on Global Health in Australia found that people who have less than 5 hours sleep a night may be at a higher risk of mental illness.
  4. MANAGING STRESS: In 2014, researchers from the University of California-Berkeley found that stress can make the brain more susceptible to mental illness. There are many, evidence-based ways to reduce stress including things like yoga, mindfulness-meditation, exercise, grounding techniques, biofeedback and EMDR.
  5. VOLUNTEER/FIND A HOBBY: According to the Mental Health Foundation, volunteering or starting a hobby is an effective strategy to promote and improve mental health. “Caring for others is often an important part of keeping up relationships with people close to you. It can even bring you closer together,” say experts from the organization. “Concentrating on a hobby, like gardening or the crossword, can help you forget your worries for a while and change your mood.” Having interaction with friends and family is also important for good mental health.
  6. DECREASING/ELIMINATING DRUG AND ALCOHOL USE: Alcohol and illicit drugs such as methamphetamine, marijuana and illegally obtained prescription medications are all toxins, and your body treats it as such. There are many negative effects from sustained drug and alcohol abuse. In addition, drugs and alcohol can exacerbate mental health symptoms such as depression and anxiety. If you think you have a problem, seek help at a local drug and alcohol treatment agency. You can generally call for a free assessment and get some education and information so you can make decisions that help you reach your goals.

So there you have it. The top 6 tools for improving your mental health in 2016.

Drug Overdose Deaths Hit Record High

According to the Centers for Disease Control and Prevention (CDC), the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin) since 2000.

According to new data published in CDC’s Morbidity and Mortality Weekly Report, nearly half a million Americans died from drug overdoses from 2000 to 2014 and they’re calling this an epidemic. Opioid overdose deaths (which include everything from heroin to opiate pain killers) hit record levels in 2014. In fact, there was an shocking 14% increase in just one year. Increases in prescription pain reliever and heroin deaths are the biggest driver of the drug overdose epidemic. Deaths from heroin increased in 2014 and, since 2010, heroin overdoses have tripled.

“The increasing number of deaths from opioid overdose is alarming,” said CDC Director Tom Frieden, M.D., M.P.H. “The opioid epidemic is devastating American families and communities. To curb these trends and save lives, we must help prevent addiction and provide support and treatment to those who suffer from opioid use disorders. This report also shows how important it is that law enforcement intensify efforts to reduce the availability of heroin, illegal fentanyl, and other illegal opioids.”

Interestingly, there is no one group affected by this epidemic. Drug overdose deaths are up in both men and women, in non-Hispanic whites and blacks, and in adults of nearly all ages. Drug addiction, as always, is a great equalizer.

Three Ways to Stop or Slow the Epidemic: Four main routes have been pointed out to prevent and reduce deaths by overdose:

  1. Pain killer prescriptions have quadrupled since 1999. It’s time to review how many prescriptions are written and to better monitor what education and information is being given to both prescribing doctors and their patients. Health care professionals need safer prescribing guidelines and more education so they can make more informed prescribing decisions.
  2. Expand drug and alcohol treatment options while also making drug and alcohol inpatient rehabs, outpatient and medications more accessible.
  3. Education on every level needs to improve. From schools, to public service announcements to prescribing doctors. Evidence-based information needs to be disseminated to the public in a way it can be understood and utilized.

And the Real Gateway Drug is….

There have been many claims, for many years, about marijuana being a gateway drug and this has been an accepted “fact” for a long time but it’s been found that some of the research this is based on is faulty. So, a team of researchers at Texas A&M and the University of Florida decided to ask this question again. Using data from the Monitoring the Future Study, they looked to see which substances teens typically used first. The findings, recently published in the Journal of School Health, were somewhat surprising.

They found that “the vast majority of respondents reported using alcohol prior to either tobacco or marijuana initiation.” In addition, of the three main substances, adolescents were more likely to try alcohol or cigarettes before trying pot. The researchers found that of all substances, alcohol was the most widely used and started the earliest.

So, understanding that alcohol is a gateway drug is critical as parents allow kids to “drink safely” in their homes or think “Kids are going to do it anyway, you really can’t stop them.” “Alcohol acts like a sledgehammer on kids’ brains” according to researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and prevention is key to raising teens into healthy adults.

The findings from previous research, into this same issue concur with this later research. “Alcohol should receive primary attention in school-based substance abuse prevention programming, as the use of other substances could be impacted by delaying or preventing alcohol use. Therefore, it seems prudent for school and public health officials to focus prevention efforts, policies, and monies, on addressing adolescent alcohol use.”

The researchers of the latest study point out that, in the end, what drugs kids are using first isn’t as big an issue as how early they start using anything. In the study they state, “Overall, early onset substance initiation, whether that is alcohol, tobacco, or other drugs, exerts a powerful influence over future health risk behaviors.”

Sober and Clean in 2016

greensnakeFor many, New Year’s Eve is a day filled with friends, family, fun and parties. For people in early sobriety from drug and alcohol abuse, New Year’s is generally the last day of a stressful season filled with uncomfortable situations and the need to be vigilant at all times since temptations are, seemingly, never-ending.

The secret for a successful (meaning clean and sober) New Year’s Eve and Day is preparation. As the Boy Scouts have long said: Be prepared.

Here are our top 4 tips for a Sober and Clean 2016:

1. Put yourself first. You need to be your top priority. This means getting plenty of rest and sleep, eating healthy foods, saying “no” to as much as possible and not over-committing. Take care of yourself and your own needs before any else’s.

2. Stick to Your Schedule: With everyone off from work and school, stores and restaurants closed or holding different hours, and new people around your environment and life can feel unpredictable and chaotic. To counteract this, keep, as much as possible, to your schedule. Go to bed and wake up at the same time (or near the same time) as you usually do; go to your 12-step meetings or other appointments, the gym and whatever else you normally schedule. Try to make sure your day has touchstones of normalcy so you can feel more like yourself and not completely off-kilter.

3. Have an Exit Strategy: Decide how long you’re going to stay at a party or event and have an exit plan at the ready in case things don’t go as you thought. Follow your instincts. If something starts to feel bad, leave immediately. Make sure you have a ride or an Uber account set up so you’re not trapped anywhere.

4. BYOS: Have a non-alcoholic drink with you at all times. This way people aren’t constantly offering you a drink at parties or events and you don’t have to keep resisting temptation over and over. Bring Your Own Soda (BYOS) to wherever you go – you’ll be able to feel social while still keeping yourself safe.

If you think you or someone you know has a drug or alcohol problem call a local drug and alcohol treatment center for help or contact New Bridge Foundation and ask for a free assessment.