Addiction Blog

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Social Anxiety Disorder and Alcohol Use: I’m SAD! I need a drink!

Being sad is one thing, but suffering from social anxiety disorder (SAD) is a totally different ball game. This is the same way that “wanting” a drink differs from “needing” a drink. When joined with problem drinking, this forms a lethal combination.  For a long time, experts have witnessed that people with anxiety disorders are susceptible to substance abuse and vice versa, but determining which one is the preceding problem has been a stumbling block for diagnosis.

More than just shyness

An individual suffering from social phobia, also known as social anxiety disorder (SAD), has a distinct and sometime irrational fear or anxiety about specific circumstances. According to WebMD, some of these situations include:

  • Speaking in public
  • Eating or drinking in front of others
  • Writing or working in front of others
  • Being the center of attention
  • Interacting with people (i.e. dating, attending parties, etc.)
  • Asking questions or giving reports in groups
  • Using public toilets
  • Talking on the telephone[1]

What causes SAD? Many researchers believe that it might be related to the abnormal functions of the brain circuits that regulate fear and anxiety. Genetics is also thought to play a part in its roots, since social phobia occasionally runs in a family. Other factors include stress and environment.[2]

The fear of making a mistake or humiliating oneself in front of others can be debilitating to a person with SAD. Taking a drink to calm one’s nerves is often used as a coping mechanism.

More common and costly than you think

Anxiety disorders, which affect over 40 million adults (or approximately 18 percent of the population), are the common mental illnesses in the United States.[3] According to the Anxiety and Depression Association of America, an estimated 15 million Americans suffer from SAD.

The disorder often surfaces during the teenage years or early adulthood and is more prevalent in women than men. Although highly treatable, sadly, only one-third of those suffering seek professional treatment.[4]

The economic costs associated with anxiety disorders in the United States are overwhelming. In the 1990, the costs were estimated to be around $46.6 billion. The majority of the expenditures was tied to the loss and reduction of productivity and other indirect costs, instead of treatment.[5]

Symptoms and signs

The symptoms that a person who is suffering with SAD experiences can vary and be difficult to distinguish from other health issues, such as depression and obsessive compulsive disorder. These individuals tends to have negative thoughts about themselves and what will happen to them in social situations. According to the National Institute of Mental Health, some of the common signs are:

  • Anxiousness – especially about being with other people
  • Self-consciousness – worried about how they are perceived by others
  • Extreme fear of embarrassment
  • Excessive worrying – sometimes for days and weeks before an activity
  • Avoidance of places where people hang out in crowds
  • Difficulty establishing and maintaining relationships

Physical signs, which include:

  • Blushing
  • Heavy sweating
  • Increased heart rate
  • Trembling
  • Nausea
  • Hard time talking[6]

Self-medicating

Even after diagnosis, individuals are often leery about seeking professional help. They underestimate the seriousness of their condition and believe that they can fix the problem themselves. Instead of seeking mental health treatment, alcohol and other substance are often used for self-medicating an anxiety disorder. Researchers are investigating just how frequently people are using and abusing self-destructive alternatives to deal with SAD and other anxiety-based disorders.

Individuals self-medicating an anxiety disorder are two to five times more likely to develop an alcohol or drug problem within three years.

A 2011 longitudinal study that includes almost 35,000 U. S. adults revealed that 13 percent of those who had consumed alcohol or drugs during the previous year had done so in order to relieve anxiety, fear or panic. It also found that individuals with a diagnosed anxiety disorder who were self-medicating at the beginning of the research were two to five times more likely to develop an alcohol or drug problem within three years than people who did not self-medicate.[7]

Other results from the three-year study showed that the number of people with an anxiety disorder who developed a substance problem varied depending on the self-medicating substance:

  • With alcohol use – 13 percent developed an alcohol problem
  • With recreational drugs use -“ 10 percent developed a drug problem

A drink won’t help

One of the most frequent self-medicating techniques is alcohol consumption. Individuals turn to alcohol because it help them feel more in control of a given situation or encounter. It also lowers inhibitions and reduces self-consciousness.  In some social gatherings, such as parties and mixers, alcohol is available in abundance.

A 2012 study at Emory University investigated the relationship between SAD and the motives for drinking. The researchers believed that the reasons for drinking are based on the fact that people drink in order to achieve an outcome that is of value to them. The motives can be categorized as:

  • Social: Drinking to aid camaraderie
  • Enhancement: Drinking to have more confidence or to enhance the impact of another drug
  • Coping: Drinking to cope with or escape from stress

The results showed that 13 percent of the participants met criteria for SAD at some point during their lives. It was determined that SAD was a predictor of coping drinking motives, but was not a predictor for social or enhancement motives. The research also revealed that other mood disorders (i.e. depression, panic disorder, and generalized anxiety disorder) also lead to coping drinking motives. [8]

Short-term solution, long-term problems

Self-medicating anxiety with alcohol makes things worse in the long term.Drinking alcohol is only a short-term solution for suppressing anxiety. Initially, drinking may make an individual suffering from SAD have less tension and feel more confident in social situations. However, once the “buzz” wears off, the old anxiety returns. Dr. James M. Bolton, lead researcher in a 2011 study about the effectiveness of alcohol in treating anxiety, stated: “People probably believe that self-medication works. What people do not realize is that this quick-fix method actually makes things worse in the long term.” [9]

Alcohol is a depressant and has an overall detrimental effect on the central nervous system. According to the National Institute on Alcohol Abuse and Alcoholism, regular alcohol use can lead to long-term health problems such as:

  • Stretching and drooping of heart muscles (cardiomyopathy)
  • Irregular heartbeats (arrhythmias)
  • High blood pressure
  • Liver disease/inflammations
  • Certain cancers (mouth, esophagus, throat, liver and breast)
  • Weaken immune system [10]

Additionally, alcohol can interfere with the thinking process. Drinking a couple of glasses wine before a presentation may seem like a way to lessen tension. However, that consumption can lead to making errors and possibly fumbling through the talk, which could increase the anxiety for any future communications. Thus, this compels the anxiously-minded individual to drink even more alcohol and starts a vicious cycle that is difficult to break.

Alcohol is not the answer

If you suffer from SAD, don’t make the mistake of trying to eliminate your problems with alcohol SAD is a psychological disorder and should be treated by medical professionals.  Treating SAD with alcohol leads to additional problems that can destroy relationships with families and friends.

If you or a loved one has already started self-medicating with alcohol, the experts at Behavioral Health of the Palm Beaches can help. With nearly 20 years of experience, our doctors can develop a treatment program that gives you better options to deal with your anxiety issues. Alcohol is not a safe and healthy way to deal with anxiety. Call us at (888) 432-2467 for healthier possibilities.

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SMART/12-Step: It’s not a contest.

A few months ago we began to offer a weekly meeting of SMART (Self-Management and Recovery Training) at Seaside Palm Beach as another tool in the arsenal that a person in recovery can use to maintain abstinence from addictive behaviors.  Twelve-step recovery meetings continue as they always have. The weekly Smart meeting has become popular. I can say that a number of people have integrated SMART into their long range plan for continued abstinence.

I was a little bit surprised at the impression a few people had of SMART even before we offered to first meeting. One person said “when I get to the point that I really want to drink I’m not going to do a cost-benefit analysis.” He’s probably correct. However, as I pointed out, “you’re not likely to call your sponsor either.” It doesn’t matter if a person is using 12-step recovery, SMART, or some combination, the reason we use meetings for support is so we don’t get to that point.

It is true that where 12-step recovery is based on spiritual principles SMART is based on Cognitive Behavioral Therapy (CBT). A SMART facilitator may tell the group that “spirituality is not part of the SMART program.”

I’m a SMART facilitator and a long time believer in 12-step recovery. I’m good at manipulating. So, if a person brings up “spirituality’ at one of my SMART meetings I will ask “what are the needs you are looking to fulfill?” I will then gladly put items such as belongingness,” “rootedness,”  “the desire to be a part of something bigger than oneself” on the agenda for the evening.

It also occurs to me that if there’s no need for a Higher Power, what do you call a group of people supporting each other?

On the other hand, “came to believe….” seems fairly cognitive to me.

There are clearly people who object to 12-step’s religiosity. Probably the worst thing someone can do is tell another that 12-Step is not religious.” It is! I’ve often wanted to tell non-believers to “get over it.”  Most of the time they don’t. So for some people SMART may be the only social support for recovery. That would be great if SMART was as geographically available as is 12-step recovery. It’s not even close.  Fortunately, SMART has a great website (www.smartrecovery.org).

Great websites are also available to support 12-step recovery (www.intherooms.com ).

Bottom line is that SMART is not something that is offered instead of 12-step recovery. It’s “in addition to.”

Is an addiction a disease? SMART recovery does not take a position. Alcoholics Anonymous (AA) makes reference to an allergy to alcohol. Does it make a difference when it comes to maintaining abstinence? Probably not. In any case, it’s unlikely that a group of recovering people is going to settle an issue. It takes a lot of energy to maintain abstinence. Leave the argument to scientists.

The goal of SMART recovery is abstinence from addictive behaviors. It does not advocate moderation. It is true that SMART meetings are open to people who have not yet decided to abstain from addictive behaviors. People who have yet to make that decision are welcome providing they are not disruptive.

AA is open to anyone with a “desire not to drink.”AA is open to anyone with a “desire not to drink.” AA is likely to attract some people still engaged in the addictive behavior. They need to have the desire. That’d not a stipulation of SMART recovery.

Point is that both SMART and 12-step recovery may attract people who are still using. I think that SMART attracts a few more. Whether that’s a positive or a negative is debatable.

What’s not debatable is that SMART is less shaming. People who find labeling (“my name is …….., I’m a…..”) will feel much more comfortable at SMART.

In 12-step recovery there’s an emphasis on “powerlessness.”  SMART emphasizes being “empowered.” The difference may not be as great as it seems. It can be argued that accepting “powerlessness” over an addictive behavior actually frees you up. A good number of people will reject this argument.

I see pluses and minuses regarding SMART’s use of trained facilitators. The thirty hour on-line certification process is very well done. My experience has been that SMART facilitators are very professional. I’m not sure that the thirty hour process screens out people who shouldn’t be facilitating groups.

I believe that participants in a SMART group attribute skills to a facilitator that go beyond what the facilitator is trained to perform.

However, sponsors in 12-step programs are frequently seen as having magical powers.

The thing to remember about 12-step and SMART is that they are both support groups, not professional help.

So what does it come down to? My belief is that when a person is ready to give up an addiction petty arguments about whether one support group being spiritual and another cognitive will go away. That being said, a person has to start somewhere. Whether it’s 12-step or SMART it really doesn’t mater. A person working a strong recovery will find comfort in both.

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The Myth of Drugs and Creativity: Mental Illness’ Role in the Using Artist

Drugs and CreativityThe writer sits at his table, a drink in hand and ready for the downing. The painter stands at her canvas, having recently smoked a bliff, and contemplates the pigments on the surface of her latest work. The musician runs on stage, revved up on coke and ready to wow the crowd.

Whether touted as an emblem of counter-cultural freedom from the restrictive thinking of mainstream society or reputed to stimulate the imagination, drugs and alcohol have been linked with the artistic process for some time now. Both celebrated and aspiring creatives often dabble in drugs at one point or another in their lives. Though emerging from different walks of life, many artists fall into a tradition that began well before the 20th century and that has been maintained by legends like Pablo Picasso, The Beatles, and most recently Prince. Cocaine, methamphetamines, marijuana, alcohol – these are all part of the artist’s toolkit, right?

Not exactly.

A Myth That Enables Addiction

This common trope of drugs as elixirs of creativity is misleading and, when taken too far, irrevocably harmful. America’s favorite horror author Stephen King, who famously struggled with alcoholism and a number of drug addictions throughout his life, has no patience for those who claim that drugs inspire creativity.[1] As he states in On Writing: A Memoir of the Craft, “The idea that the creative endeavor and mind-altering substances are entwined is one of the great pop-intellectual myths of our time.” The mystique that drugs hold in society is just that — an illusion.

the idea that the creative endeavor and mind-altering substances are entwined is one of the great pop-intellectual myths of our time.

When it comes down to it, King goes on to argue, artists who claim to use illicit substances to stir their creative juices are more-or-less trying to justify their inclination toward such self-destructive behavior. “But I need it to write!” or “I can’t express myself artistically without it” are not valid excuses but are instead symptomatic of a larger problem at hand: abuse and/or addiction. Drugs don’t make artists — they break them.

Stress and its Many Sources

Connection between drugs, alcohol and creativityThough those who abuse and become addicted to drugs are not one in the same and range in socioeconomic status, race, gender and other qualities, what they often do share is stress. Unstable households, physical pain or the pressures from school or work are stressors that can drive individuals to self-medicate through available drugs.

However, mental illness is one of the most prominent sources of stress that pulls people toward abusing substances in attempt to relieve or cope with their conditions. In fact, approximately a third of all individuals who experience a mental illness and about half of people living with severe mental illnesses also have substance abuse issues, according to the National Alliance on Mental Illness (NAMI).[2]

For reasons not yet fully understood, rates of mental illness are also high among artists, and understanding this link may help explain why so many artists are drawn toward drugs.

Mentally Ill or Creatively Inclined? The Two Often Go Hand-in-Hand

bipolar disorder and creativityWhile the belief that creativity is dependent on drugs is, as King put it, just a “pop-intellectual myth,” the stereotype of the tortured artist does have some credence (though is certainly not all-defining). A body of research suggests that there is a strong link between mental illness and creativity. In 2012, Sweden’s Karolinska Institute found that, “People in creative professions are treated more often for mental illness than the general population.” [3]

In one of the most comprehensive studies conducted in this field, the researchers used a registry of psychiatric patients listed for over the past 40 years, containing data on nearly 1.2 million Swedes and their relatives. Analyzing patients with a variety of diagnoses, ranging from schizophrenia and depression to ADHD and anxiety syndromes, they saw that bipolar disorder was the most prevalent among people with artistic and scientific professions, including dancers, researchers, photographers and authors.

The creative figure of the author, however, seemed to be especially burdened by mental disorders more-so than other individuals, artistic or otherwise. The study stated that ‘authors suffered from schizophrenia and bipolar disorder more than twice as often as the general population.’ [4] They were also more likely to be diagnosed with depression and anxiety disorders, and they also had a greater tendency to commit suicide.

Abusing Drugs to Cope with Mental Illness

emotional pain and artSo, we know the facts: a considerable number of artists experience mental illness. Since those who are mentally ill often abuse substances or have substance use disorders, according to the NAMI statistics, it stands to reason that many artists also have drug problems. Though some try to convince themselves that their lingering, preoccupying desire for another hit is a testament to their creative genius, the real story is that many artists cling to substances for a false sense of stability. They want to relieve the distress of their mental disorder left untreated, and too often they turn to drugs as a way of coping. But this only harms them in the long run.

What starts out as a casual experiment can quickly turn into abuse when an illicit substance temporarily dulls emotional pain or provokes euphoric feelings of delight in the user. Eventually, the body and mind can become so dependent on the drug that the user continues to abuse it in order just to function. This is when addiction sets in.

Case Study: Eminem’s Descent into Drug Addiction and His Sober Awakening

Take Eminem, one of the most versatile and provocative artists of the rap and hip-hop world. Though only revealed later in his career in 2008 that he has been grappling with bi-polar disorder for most of his life, his feelings of raw anger and emotional instability were exceedingly clear in his lyrics.[5] He also suffered from prescription pill addiction and even nearly died from an overdose at one point, according to MTV News.[6]

“It’s no secret I had a drug problem,” he was quoted admitting. “If I was to give you a number of Vicodin I would actually take in a day? Anywhere between 10 to 20. Valium, Ambien, the numbers got so high I don’t even know what I was taking.”

Eminem drug addictionAnd how did he get so hooked? Through the psychological and physical relief that the substances instilled in him, countering the near-constant emotional instability that he experienced from his mental illness. “When I took my first Vicodin, it was like this feeling of ‘Ahh.’ Like everything was not only mellow, but [I] didn’t feel any pain,” Eminem says in the documentary How To Make Money Selling Drugs, quoted by MTV News.[7]

“I don’t know at what point exactly it started to be a problem. I just remember liking it more and more. People tried to tell me that I had a problem. I would say, “Get that f____g person outta here. I can’t believe they said that sh_t to me.”

As Eminem’s addiction worsened, his motivation, physical health, and even his ability to string words together deteriorated. MTV News writes that at his lowest the drugs shut off his brain and made him so lazy he preferred watching TV to making new tracks.[8]

After seeking treatment and remaining sober for a year, Eminem came back to the recording studio. In 2009, he released Relapse: an album that openly discussed his struggle with addiction. But he comments that during Recovery, an album released a year later, is when he really began to repair the damage that the drugs took on him despite how impossible it felt at times.

“I had to learn to write and rap again, and I had to do it sober and 100 percent clean,” Eminem told MTV News. “That didn’t feel good at first. I mean it in the literal sense. I actually had to learn how to say my lyrics again; how to phrase them, make them flow, how to use force so they sounded like I meant them. I was relearning basic motor skills. I couldn’t control my hand shakes. I’d get in the [recording] booth and tried to rap, and none of it was clever, none was witty and I wasn’t saying it right.”

Yet he did it, creating an award-winning album that stands as a testament to how only sobriety can unlock the true potential of an artist.

Let Our Treatment Help You Find Your Creative Flow Again

Eminem\’s Recovery is dedicated, “Anyone who’s in a dark place tryin’ to 2 get out. Keep your head up… It does get better!”[9] We couldn’t have said it better ourselves.

I actually had to learn how to say my lyrics again; how to phrase them, make them flow, how to use force so they sounded like I meant them.

Though the confusion, frustration and emotional agony that can come along with an untreated mental illness and drug addiction can seem insurmountable, there is a way out. Behavioral Health of the Palm Beaches’ dual diagnosis program is sensitive to the hardships unique to both mental health and substance use disorders, and our professionals are experienced in treating both conditions simultaneously.

At our facilities, artists can also continue creatively expressing themselves as a way of working through their conditions. We offer art therapy, music therapy, and expressive writing therapy for those who want to discover what it means to be creative while sober.

Don’t let drug addiction get in the way of what’s important in your life. Contact us at 888-432-2467 to learn more about our addiction help and mental health treatment options and how we can help you or a loved one find the courage to recover.

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How Worried About Fentanyl Should You Be?

If you had never heard about fentanyl before the results of Prince\’s autopsy were revealed, you are not alone. The drug has been around for more than 30 years, but has managed to fly below the radar of most everyday Americans. Unless you are suffering from excruciating pain after surgery or from advanced cancer, fentanyl has probably been completely invisible to you. With the news now popping up about the number of fentanyl-related overdose deaths, how worried should you be?

Journey to the U. S.

Fentanyl is currently a Schedule II synthetic opioid used to treat chronic pain.[1] But this drug did not get its start in this country. It was first synthesized by Dr. Paul Janssen in 1960 in Belgium.[2] He and his group of chemists were attempting to develop analgesics (pain relievers) that would easily migrate into the central nervous system (CNS). The initial batches of fentanyl, which were produced for intravenous uses, were 100 – 200 times more potent than morphine in the animal subjects tested. Initially, Dr. Janssen would not get U. S. Food and Drug Administration (FDA) approval for fentanyl because of its potency. After a merger with Johnson and Johnson and the agreement to only use fentanyl in combination with other drugs, it was introduced to the U. S. in 1968. In 1972, fentanyl was approved for standalone use.[3]

A Patch, a Pill, a Snort and a Squirt

Initially, fentanyl was introduced as an injectable under tradename Sublimaze® in 1968. Since this introduction, it has been modified and reformulated. Currently, pure fentanyl and numerous analogs, which are developed by slight maneuvering of the basic chemical structure, are available. One of the most deadly analogs is acetyl fentanyl, which has been connected to a number of overdoses deaths in the United States.[4]

Pharmaceutical versions include tablets, pills, lozenges, nasal sprays, skin patches and even lollipops.

A distinction should be made between pharmaceutical fentanyl and non-pharmaceutical fentanyl (NPF), which is illicitly-produced and often mixed with heroin and/or cocaine to heighten its effects. Forms of the pharmaceutical versions include tablets, pills, lozenges, nasal sprays, skin patches and even lollipops. They are prescribed for pains associated with cancer, when other opioid medicines have proven ineffective, HIV- associated neuropathy and as an analgesic during and after various surgical procedures, including heart.[5]

Some of the specific brands include:

  • Actiq® – Transmucosal lozenge (Placed between the cheek and lower gum then sucked)
  • Abstral® – Sublingual tablet (Dissolved on the floor of the mouth)
  • Duragesic®- Transdermal patch (placed on a healthy, unbroken skin location)
  • Fentora® – Buccal tablet (placed between the cheek and gums)
  • Lazanda® – Nasal spray

The U. S. Drug Enforcement Administration (DEA) recently issued a warning to law enforcement officials about the handling procedures. The deadly effects of fentanyl can be easily absorbed through the skin or accidentally inhaled if the powder becomes airborne.[6]

NPF comes from many sources and can be just as deadly as pure fentanyl. On the street, it has been sold as fentanyl, an additive in street heroin or completely camouflaged as another drug.[7] The Centers for Disease Control and Prevention (CDC), working with other agencies, developed a definition for an NPF-related death. It is defined as one in which:

  • Fentanyl caused or contributed to it
  • No evidence of pharmaceutical fentanyl was presented
  • Toxicology testing confirmed fentanyl in the body[8]

Even pharmaceutical fentanyl can be used for illicit purposes. When patches are not properly disposed, leftover fentanyl gel can be extracted.[9] Guidelines have been established for the correct procedures for fentanyl disposal.[10]

The Path across the U. S.

Fentanyl has taken a circuitous route across the world and the nation since its inception in Belgium over 50 years ago. Abuse of the drug began recreationally in the 1970s,[11] appearing on the streets under names such as Apache, China Girl, China White, Murder 8 and TNT, to name a few.[12] It was initially just stolen from pharmacies, but was eventually used to lace cocaine and heroin to increase profits for illicit drug dealers. According to the CDC, one gram of pure fentanyl can be broken down into 7,000 doses for street sales.[13] The DEA estimates that a kilogram of fentanyl powder can be bought for $3,300 by drug traffickers and sold at 300 times the amount.[14]

Throughout the 80s and 90s, the DEA occasionally discovered illicit fentanyl labs, but the turn of the century and millennium ushered in an explosion of the drug’s popularity.[15] From 2005 – 2007, the CDC reported over 1,000 fentanyl-related deaths.[16] After a spike in fentanyl seizures in 2007, it appeared that the drug had faded away, but it made a strong comeback in 2014, leading the DEA to issue a nationwide alert in March of 2015.[17] Seizures of fentanyl have spiked in New Jersey, Maryland, Ohio, Massachusetts, Pennsylvania, Virginia, Florida, New Hampshire and Indiana.[18]

While illicitly produced fentanyl is being brought into the U.S. primarily by Mexican-based drug cartels, they are purchased directly from China, according to DEA reports.14 The drug is so potent that it is prescribed in micrograms instead of milligrams. When a drug with this level of potency is cut into heroin and prescription opioids, the results are often deadly. From 2013 to 2014, there were more than 700 fentanyl overdose deaths in the U.S.18 While Prince’s tragedy may appear to be unique, rising statistics show that it is anything but.

Protect Your Family from Opioid Addiction

One of the biggest differences between an addiction to a prescription opioid and an illicit drug is that a person can develop an opioid addiction by following doctor’s orders. When a person is using prescription drugs for pain over a long period of time, eventually tolerance sets in and stronger drugs and higher doses are needed. It appears this was the unfortunate case with Prince.

If you’ve been taking more and more painkillers to find relief, or you’ve noticed someone close to you taking more prescription meds than seems necessary, it may be time to seek treatment. A tragic overdose is always a possibility when increasingly taking powerful opioids.

Our opioid addiction experts at Behavioral Health of the Palm Beaches are fully versed in the dangers of fentanyl and other opioids and will create a personalized addiction treatment for you or an important person in your life. One of the biggest mistakes people make when dealing with addiction is waiting too long before seeking help. Make sure you and your family don’t make the same mistake by contacting our professionals today at  888-432-2467.

 

 

 

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Does Mandatory Addiction Treatment Work?

Drug and alcohol addiction treatment in the United States has evolved considerably in the last 50 years. Our nation has slowly moved away from the philosophy of incarcerating people with addictions to providing treatment. While it has been shown that treatment is much more successful in helping people with substance use disorders (SUDs) than punishment, the question of whether or not mandatory rehabilitation can be effective remains unanswered.

Many subscribe to the belief that an addicted individual must “hit rock bottom” before he or she can get better, thus making mandatory treatment inherently flawed. The “rock bottom” theory implies that a person must get to a certain low-point in his or her life (either professionally or personally) in order to make the decision to get help and be treatable. This theory would make mandatory treatment useless, because the addicted individual did not choose to get help. Others argue that a person with a drug or alcohol addiction is unlikely to voluntarily seek treatment and needs to be pushed into it, making mandatory rehab a viable option.

Boston Medical Center’s global analysis of mandatory drug treatment programs determined there was no evidence that these programs were effective.

The Boston Medical Center is the most recent group to offer its two cents. In June 2016, the organization conducted a global analysis of the efficacy of mandatory drug treatment programs and determined there was no evidence that these programs were effective.[1] In addition, the medical center found that these programs violate human rights principles laid out in the Covenant on Economic, Social and Cultural Rights, a U.N. treaty signed by 160 states.[2]

Not All Mandatory Treatment is the Same

For the purposes of the global analysis (which did not include drug courts in America), mandatory treatment was defined as, “Any form of drug treatment that is ordered, motivated, or supervised by the criminal justice system.” But within this broad definition lies differing degrees of severity:

  • Quasicompulsory: Person is offered a choice between incarceration and treatment.
  • Compulsory: Authorities mandate treatment without allowing the person the option to give consent, decline treatment or choose the type of treatment received.[3]

mandatory addiction treatment programMost mandatory drug treatment programs within the U.S. and around the world fall somewhere in between these two extremes. In this global analysis, mandatory detention was a part of many of the programs observed by the Boston Medical Center, where hundreds and even thousands of people are detained for periods ranging from a couple of months to multiple years. These facilities are run by police officers and members of the military, rather than by medical and addiction care professionals.

This is an oppressive form of addiction rehabilitation and is not allowed in the United States or in many other developed nations. Instead, our country has relied on drug courts as a diversionary programs since the late 1980s. The first drug court was established in Miami-Dade County, FL in 1989.[4] The program was created in response to growing frustrations over repeatedly seeing the same faces in court for non-violent drug offenses. As of June 30, 2014, there were 2,968 drug courts in the United States, with programs operating in every U.S. state and territory.[5]

Specifics about U.S. Drug Courts

mandatory addiction treatment planDrug courts combine drug treatment with the structure and authority of a judge and court system. The programs provide nonviolent people with substance abuse problems with intensive court supervision, mandatory drug testing, addiction treatment and other social services in an effort to keep them out of jail or prison. When faced with the alternative of incarceration, many happily choose drug courts. Ideally, these programs help participants break the cycle of substance abuse and addiction.

It’s important to note that these programs are optional. Drug offenders must agree to all of the program’s requirements and successfully meet all obligations in order to avoid jail, have their sentences lessened or have charges reduced or dismissed. While there could be some debate as to how ‘optional’ these programs are in reality, the fact that U.S. Congress has continuously supported its development is a sign that drug courts are considered to be effective.

Since their creation, drug courts have been evaluated on the following three types of analyses:

  • Cost Savings: The amount saved in comparison to what would’ve been spent with incarceration, adjudication (court trying and sentencing) or criminal victimization.
  • Impact: Whether or not drug courts improved the lives of drug offenders compared to those who were incarcerated. Recidivism rate, employment and future substance abuse are among the factors evaluated and compared.
  • Process or Operations: This type of analysis focuses on the program’s details, such as the number of participants, referrals to treatment and the number of individuals successfully graduating from the program.[6]

How Successful Have Drug Courts Been?

While it’s widely believed that drug courts are certainly an improvement over the incarceration-focused policies of the past, there is some debate about their effectiveness in reducing substance abuse. According to the National Association of Drug Court Professionals (NADCP), drug court programs have been wildly successful in America. Here are some of their supporting facts:

  • mandatory addiction treatment requirementsNationwide, 75 percent of drug court graduates remain arrest-free for at least two years following the program’s conclusion.

 

  • mandatory addiction treatment resourcesDrug courts reduce crime by as much as 45 percent, compared to other sentencing options (probation, jail or prison)

 

  • mandatory treatment for drug addictionDrug courts produce cost savings ranging from $3,000 – $13,000 per client. These savings reflect reduced prison cost, lower recidivism and reduced victimization.

 

  • mandatory addiction treatment methodsParents who are in family drug court are twice as likely to go to treatment and complete it.[7]

Despite these supporting facts and figures, there have been many criticisms of the programs, namely in the evaluations themselves. Since funding is often dependent on a drug court’s ability to demonstrate effectiveness, many argue that the programs’ operators may be inclined to only report positive results or create evaluation methodologies that will ignore negative outcomes.

For example, the majority of drug court evaluation programs have no comparison group, such as offenders who refused treatment. This means that any success numbers reported by drug courts lack the context to put them in proper perspective.

“Drug court programs do not have much interaction with participants following graduation — meaning there are no long-term success or failure rates to examine.”

Another criticism is that treatment outcomes are only reported for those who graduate the program, meaning that it is not a true measure of the program’s overall effectiveness. Additionally, much of the drug court data is based on the self-reporting of participants (who are obviously motivated to report no drug use), adding another flaw. Lastly, drug court programs do not have much interaction with participants following graduation, meaning there are no long-term success or failure rates to examine.

Addiction Treatment is a Must

Though opinions vary on the efficacy of drug courts and the validity of their success-rates, there is little argument that they are more effective than incarceration. Many researchers believe that despite criticisms of drug courts, they are one of the most effective tools for combating addiction available.[8] This is because after centuries of research and observation, it has been shown that you can’t incarcerate a person’s addictions away. Drug courts allow addicted individuals to remain employed and to be productive members of their household and society.

At Behavioral Health of the Palm Beaches, we firmly support a treatment over punishment approach to addiction rehab. We offer an intensive DUI rehab alternative program and professional intervention services to help give your loved one the push he or she needs into treatment.

While it would be great if people addicted to drugs and/or alcohol took it upon themselves to get treatment, there are many who need extra motivation. We believe that the only thing stronger than addiction is love. If there’s a person in your life who needs help defeating an addiction, show how much you love and care for him or her by calling one of our representatives at 888-432-2467 to learn more about our treatment options.

 

[1] http://www.bmj.com/content/353/bmj.i2943
[2] https://treaties.un.org/Pages/ViewDetails.aspx?src=TREATY&mtdsg_no=IV-3…
[3] http://www.medicaldaily.com/drug-addiction-united-nations-human-rights-3902…
[4] http://www.nadcp.org/learn/what-are-drug-courts/drug-court-history
[5] http://www.ndcrc.org/content/how-many-drug-courts-are-there
[6] https://www.fas.org/sgp/crs/misc/R41448.pdf
[7] http://www.nadcp.org/learn/facts-and-figures
[8]http://www.americanbar.org/content/dam/aba/publishing/criminal_justice_sect…

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photo showing the words chronic diseases next to bottle of pills and drug needle

Where’s the chronic-care approach to this chronic disease?

Most of us know someone with a chronic disease. I think of my friend who has type 1 diabetes. He’s doing OK now, but he has been hospitalized on two occasions in the 25 years I’ve known him. After being discharged from the hospital, he had numerous outpatient appointments with his endocrinologist. The appointments became less frequent as his blood sugar stabilized. To this day, he monitors his blood sugar daily. My friend knows that he has to follow a daily plan to treat his disease. If he doesn’t, he could wind up in a hospital again or have to see his endocrinologist more often. In fact, this has happened on a few occasions.

My friend used to live in New York, and moved to Florida a few years ago. When he moved, he searched for and found another endocrinologist. He has regular checkups with his new
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photo of a person holding a smartphone with a special effect created to look like all the different social media icons floating above the smartphone in the air

Are Depression and Social Media Usage Linked?

The rise of social media sites like Facebook, Twitter, Instagram, Pinterest and others has changed the world we live in forever. People are now more connected than ever before and can personalize an online presence, conveying a digital persona of sorts. Social media has certainly led to a lot of very good things, but it’s undeniable that there have been some negatives associated with it as well.

A new study published in the journal of Depression and Anxiety found a link between high usage of social media sites and increased depression. The research, which was funded by the U.S. National Institutes of Health (NIH), involved nearly 1,800 individuals and tracked their usage of 11 well-known social media platforms:

  • Facebook
  • Instagram
  • YouTube
  • Twitter
  • Reddit
  • Google Plus
  • Snapchat
  • Tumblr
  • Pinterest
  • Vine
  • LinkedIn

The researchers found that the participants checked into social media an average of 30 times per week for just over an hour per day. Depression testing revealed that approximately one-quarter of the participants were at a high risk of depression. When social media patterns were compared with depression status, it was determined that those who used social media the most were about 2.7 times more likely to be depressed than participants who used social media the least. [1]

“One strong possibility is that people who are already having depressive symptoms start to use social media more, perhaps because they do not feel the energy or drive to engage as many in direct social relationships,” said senior study author, Dr. Brian Primack in a Health.com article. “However, there are also a few reasons why increased social media use may lead to more depressive thoughts. For example, people who engage in a lot of social media use may feel they are not living up to the idealized portraits of life that other people tend to present in their profiles. This phenomenon has sometimes been called ‘Facebook depression’.” [2]

The authors of the article, however, were careful to point out that they only discovered a connection, not a definite cause and effect relationship.

What we found were just overall tendencies for the entire population.

“What we found were just overall tendencies for the entire population. These findings do not suggest that every person who engages with more social media use is depressed,” Primack stressed. “In fact, there certainly are many groups of people who actually find solace and lessening of their depression through social media. However, the overall findings suggest that, on a population level, more social media use and more depression are correlated.”

Is Social Media Use a Danger to Mental Health?

Nearly everyone is familiar with some aspect of social media. Worldwide, there are over 1.96 billion users. Over three-quarters of the U.S. population currently has at least one social media profile, and 29 percent of U.S. social media users admit to logging on several times per day. [3]

Part of the potential negative impact of social media stems from the amount of time spent on various channels, which is time that could be spent exercising, meeting with friends and engaging in other activities that could benefit your mental health.

Individuals spend a staggering 4.7 hours per day on their smart phone checking social media sites. In the U.S., individuals check Facebook and other sites on their smartphones an average of 17 times per day and spend a staggering 4.7 hours per day using their phones. Considering that most of us are only awake for about 15 hours per day, this means that the average person spends a third of his or her time on the phone and checks social media at least once per hour. [4]

People spend hours at a time looking at other people’s lives; vacations, weddings, family updates and many other things that could incite envy. While social media can help people network for their careers and connect with distant friends and family members, it can also exacerbate negative feelings in individuals who are not happy with their lives.

The Problem of Bullying

cyberbullyingChildren have had to deal with bullying long before the advent and popularization of social media. The difference in years past is that kids could escape the bullying when they weren’t in school. With smartphones, tablets and laptops enabling adolescents to remain connected virtually 24/7, escaping from bullying is no longer possible. Children can be harassed at any time, day or night.

Cyberbullying is a growing problem that continues to receive attention in the mainstream media. In 2011, it was estimated that 2.2 million American students experienced some form of cyberbullying. [5] Other studies indicated that 7 percent of students from grades 6-12 experienced cyberbullying during the 2013-2014 school year, [6] and that 15 percent of high school students in 2013 were bullied electronically during the previous year. [7]

Potential Side Effects of Cyberbullying in Children

  • Substance abuse
  • Skipping school
  • More likely to be bullied in person
  • Unwilling to attend school
  • Experiencing mental health difficulties
  • Low self-esteem
  • Poor academic performance

Balancing Real and Virtual Relationships

addicted to the internetToday’s technological climate makes it nearly impossible for a person to avoid virtual or digital relationships. The vast majority of American teens and adults use social media and engage in blogging, texting and email regularly. There are many advantages to these types of communications and, when used correctly, they will not likely lead to any mental health difficulties. The problem comes when digital relationships exclusively take the place of personal ones.

Digital relationships may feel real, but they are limited and mediated by the technology we use. There is always something in between two people in a digital relationship and something is often lost in translation. Also, while all of the options available in electronic forms of communication may appear to give an individual more freedom, it actually may limit creativity and imagination. Never underestimate the value and effectiveness of face-to-face interaction.

There is also the very real issue of Internet addiction. Though there is no diagnostic criteria for identifying Internet addiction, a growing body of research surrounds the topic. Surveys estimate that up to 8.2 percent of U.S. citizens are currently addicted to the Internet, meaning they spend many hours in non-work technology-related computer/Internet/video game activities. Some research has shown prevalence rates as high as 18.5 percent. [8]

Help for Mental Health Difficulties

When people struggle with depression, anxiety, bipolar disorder, post-traumatic stress syndrome or any other psychological conditions, it can greatly diminish their quality of life. Living with these mental health issues can impact work, school, relationships and everything else in a person’s life, if they don’t receive proper mental health treatment.

If you are concerned about an older friend or family member, Behavioral Health of the Palm Beaches is ready to help. With nearly 20 years of experience, our doctors and other medical professionals can develop a treatment program that encompasses baby boomers’ needs. When you are ready to get back those good feelings without misusing alcohol and drugs, call us at (888) 432-2467.

 

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photo of a group of baby boomers sitting together at an outdoor party drinking alcohol

Substance Abuse on the Rise with Baby Boomers

Overlooking a Growing Dilemma

Substance abuse, particularly of alcohol and prescription drugs, among baby boomers is one of the fastest growing health issues facing our country. Yet, even as the number of older adults suffering from these disorders increases, the situation remains relatively hidden from the public’s eye. While substance abuse among the young is surveyed, categorized and analyzed, addiction problems of the parents and grandparents of these youths are virtually ignored.

Addiction problems of the parents and grandparents of these youths are virtually ignored.

The reasons for this oversight can be due to a lack of knowledge, limited available research statistics or even hurried doctor visits that overlook symptoms or attribute them to other health issues. As people age, medical issues, such as high-blood pressure, diabetes, dementia and others, can present symptoms that mirror the ones associated with addiction.  However, a better assessment of the problems associated with substance abuse among baby boomers is needed.

The Numbers are Rising

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), alcohol use among individuals aged 50+ is sustainably higher than illicit drug use. [1] The 2014 and 2015 SAMHSA’s Behavioral Health Barometer, which provides overviews of behavioral health in the United States, reported the following information on baby boomers: [2]

The use of illegal substances by older adults is on the rise. The generation who grew up in the “Age of Sex, Drugs and Rock & Roll” often see drugs as a way to combat loneliness and depression. Long-term recreational drug users, such as marijuana smokers, may now be facing increasing physiological problems associated with aging and drug use. Extended periods of isolation from retirement, “empty nest” or reduced interpersonal interactions tend to escalate substance use. Individuals who are hard-core drug users are at an even higher risks of serious physical decline, possibly leading to an early death. In 2013, more than 12,000 boomers died from accidental drug overdose. [3]Elements that contribute to higher alcohol use among older adults include significant changes in life, such as retirement, loss of family and friends and a decline in mental or physical health. Additional factors that make older individuals more vulnerable to inappropriate alcohol use include insomnia, family history of substance abuse, and having a psychiatric illness, such as depression or anxiety.

Misperceptions and Addiction

According to the American Society of Addiction Medicine (ASAM), addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. It is characterized by biological, psychological, social and spiritual symptoms. [4] Addiction, like Alzheimer’s disease, is a disorder of the brain that can affect both young and old. The lack of attention to this problem in older individuals may stem from the false beliefs that addiction results from a lack of willpower. So, this could result in a “shame” associated with substance abuse, which then leads to a reluctance to seek professional help and attempting to handle the issue privately and discretely. Their relatives, especially adult children, are often embarrassed by the problem and purposely choose to ignore it.

Ageism can also contribute to the silence associated with substance abuse in baby boomers. Young people often assign a different set of standards to older individuals. However, it is the belief that substance abuse can be overlooked in older individuals because of far-fetched reasons, such as: “It doesn”t make a difference since they are near the end of their lives anyway,” or “Grandma needs her ‘Happy Juice’ because she is so much easier to manage after she has it.” These attitudes are not only callous, they rely on false perceptions. Somehow, it becomes acceptable to ignore addiction problems with baby boomers. The same disorder that would have a family rallying around and staging an intervention for a teenager does not illicit the same sense of urgency for a grandparent.

Small Amounts, Big Effects

The reality is that the misuse and abuse of alcohol and drugs takes a greater toll on baby boomers than younger individuals. As people age, the way that their bodies metabolize alcohol and other substances slows. According to the National Institutes of Health (NIH), as the body goes through aging changes, alcohol and drugs cannot be broken down and eliminated from the body as easily.  Thus, they remain in the body longer and even a small amount can have a strong effect. [5] Some of the risks include increased number of falls, greater levels of confusion and higher potential to interactions with other medications.

Telling Mom and Dad That They Need Help

It is a difficult situation when a child has to tell Mom or Dad that they need help for a substance problem.

Increased mood swings, difficulties making decisions, disorientation and just not seeming like themselves can be symptoms of a substance abuse problem and not just general characteristics of the aging process. However, it is a difficult situation when a child who has always relied on his or her parents to make wise choices, now has to tell Mom or Dad that they need help for a substance problem.

Unfortunately, our society does not fully recognize the seriousness and extent of substance misuse in older adults. As the number of older individuals with addiction problems grows, better methods for early identification of the signs are needed. In an article in Today’s Geriatric Medicine, some of the steps are:

  • Improving quality of care, including training and broadening dissemination of effective practices;
  • Integrating substance abuse, health, mental health and aging services to provide comprehensive care tailored to the needs of the individual consumer who presents with co-occurring, multiple needs;
  • Building a clinically and culturally competent workforce through education and training of providers, increasing the supply of competent providers, especially those who are bilingual and culturally competent and using older adults in peer-to-peer service roles more extensively;
  • Increasing support for family caregivers, including education about medication management and signs of alcohol and drug abuse;
  • Providing public education to address ageism, stigma, ignorance and fears about treatment and its effectiveness;
  • Improving research on effective prevention, intervention and recovery support strategies
  • Developing governmental and private sector readiness including leadership, planning and program development. [6]

Too Much Time On Your Hands

The generation that grew up in an era that romanticized drug use and rebellion is now preparing to retire. Uninhibited by work responsibilities and parental duties, many of the baby boomers are using the extra time to relive their youth and return to a favorite pastime. If you are concerned about an older friend or family member, Behavioral Health of the Palm Beaches is ready to help. With nearly 20 years of experience, our doctors and other medical professionals can develop a treatment program that encompasses baby boomers’ needs. When you are ready to get back those good feelings without misusing alcohol and drugs, call us at (888) 432-2467.

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photo of bartender pouring alcohol into a row of shot glasses

Alcohol Still One of The Nation’s Deadliest Drugs

While much of the national discussion about substance abuse and addiction has been focused on the rising death tolls surrounding prescription opioids and heroin use, alcohol-induced deaths remain perched near the top.

New data from the Centers for Disease Control and Prevention (CDC) showed that the alcohol-induced death rate has increased nearly 23 percent since 1999. It also revealed that almost 31,000 people died as a result of alcohol abuse in 2014, surpassing the death toll from opioid overdoses. When accounting for deaths from drunk driving, other accidents and homicides committed under the influence of alcohol, the death toll spiked to 88,000 in 2014, making alcohol the second deadliest drug in America, only behind tobacco. [1]

Why Americans Are Drinking More and More

Given the various factors that lead an individual to alcohol consumption and abuse, pinpointing an exact reason why alcohol-related deaths have increased is extremely difficult, if not impossible. But one of the simplest reasons is that Americans are drinking more. The number of Americans who reported having a drink in the previous month has increased along with the rising death toll. [2]

The most significant increase is in the female demographic, who reported more drinking and binge drinking than in the past. In 2006, 45.2 percent of women reported drinking within the past month, and 15.2 percent admitted to binge drinking (five or more drinks in one occasion). In 2014, those numbers climbed to 48.4 percent and 16.4 percent, respectively.

Another factor is that alcohol is more affordable than it has been in six decades, according to a study published in the American Journal of Preventive Medicine. The study attributed this to rising incomes and stagnant alcohol taxes. [3]

What’s Leading to More Deaths?

A rise in alcohol consumption does not necessarily lead to an increase in alcohol-related deaths. In fact, while more and more people are drinking alcohol, binge-drinking and heavy alcohol use have not increased population-wide, according to the National Survey on Drug Abuse. Many industry experts have pointed to the opioid painkiller and heroin epidemic as a reason why.

It’s extremely dangerous to mix prescription painkillers and alcohol. When taken together, opioids and alcohol intensify the effects of the other drug. Additionally, approximately one-third of opioid deaths now involve benzodiazepines, such as Xanax. Benzodiazepines can enhance the effects of alcohol, which may explain why death rates from alcohol have risen at the same time as death rates from prescription drugs.

What Can Be Done?

Leading researchers are pointing to the need for legislative action. It is impossible to completely eliminate all substance use and abuse, as was shown during the nation’s failed attempt at prohibition in the 1920s. But just because alcohol abuse and the resulting deaths can’t be eliminated doesn’t mean that they can’t be reduced. Many leading researchers are pointing to the need for legislative action and federal policy changes.

One of the loudest calls is for an increase on alcohol tax, as written by David Roodman, senior adviser for the Open Philanthropy Project: [4]

“Higher prices do correlate with less drinking and lower incidence of problems such as cirrhosis deaths. And I see little reason to doubt the obvious explanation: higher prices cause less drinking. A rough rule of thumb is that each 1 percent increase in alcohol price reduces drinking by 0.5 percent. Extrapolating from some of the most powerful studies, I estimate an even larger impact on the death rate from alcohol-caused diseases: 1-3 percent within months. By extension, a 10 percent price increase would cut the death rate 9-25 percent. For the US in 2010, this represents 2,000-6,000 averted deaths/year.”

A 10 percent increase, put in context, amounts to only a few extra cents and dollars on a bottle of wine, spirits or on a six-pack of beer, but could save thousands of lives.

Parents Must Set Better Examples

One of the greatest predictors of a person’s future drinking habits is their parents’ patterns. It has been shown that children of alcoholics are approximately four times more likely to develop alcohol abuse problems than the rest of the population. [5] It has also been shown that children may mirror their parents’ drinking habits when they become adults. [6]

Even further than parents directing the future substance abuse habits of their children, they are also often the easiest place for kids to acquire alcohol. According to a study published in the Journal of Studies on Alcohol and Drugs, children who had sipped alcohol by the time they were in sixth grade were about five times more likely to have a full drink by high school and four times more likely to binge and get drunk. [7]

Quite obviously, the most likely place for an underage person to get alcohol is from his or her parents:

  • Nearly half of kids between ages 12 and 14 who drink got their alcohol for free from a family member or at home. [8]
  • Approximately 709,000 U.S. kids between ages 12-14 have had at least one alcoholic beverage in the last month. [9]
  • Of this group, 93.4 percent said they got their alcohol for free last time they drank.
  • 44.8 percent of kids who got free alcohol said it was from a parent or in their home.
  • 19.6 percent got alcohol from another underage person
  • 13.5 percent from an unrelated adult
  • 6.8 percent from someone else’s home.
  • 8.7 percent got alcohol from other miscellaneous source
  • 6.6 percent paid for their alcohol
  • People who begin drinking alcohol before age 15 are six times more likely to develop alcohol problems than those who wait till they are 21. [10]

By working to reshape the thoughts and attitudes children have about alcohol use and abuse, parents can sow the seeds for a better future with fewer alcohol-induced deaths. This begins with parents setting examples with their actions as well as their words.

Start Setting a Better Example by Seeking Help

No matter how long you’ve been abusing alcohol or to what extent alcoholism has taken hold, it’s never too late to ask for help. If you’ve allowed alcohol and drug abuse to take over your life and dominate your habits, set an example your kids won’t soon forget by admitting you have a problem, acknowledging the need for treatment, completing rehab and turning around your life.

Behavioral Health of the Palm Beaches will guide you through each step of the process, from a medically administered detox all the way to a year’s worth of aftercare services. Contact us today at 888-432-2467 to learn more about our treatments, family-themed therapies and nationally recognized facilities.

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photo of former Florida Governor Jeb Bush at recent republican debate talking about the problem of addiction in the U.S.

Jeb Bush: A Daughter’s Drug Addiction Leads to a Father’s Strategy

Addiction Crosses All Barriers, All Lines, All Races, All Incomes

With a lineage that consists of two U. S. presidents, a U.S. senator, two governors, president of major industrial manufacturer and several successful businessmen, one would not expect to find a drug addict on any branch of the respected Bush family tree. However, Noelle Bush, the only daughter of Republican Presidential candidate John Ellis “Jeb” Bush, has endured a long and trying struggle with drug addiction.  In today’s society, substance abuse knows no boundaries. Regardless of gender, race and socio-economic status, the allure of illicit substances continues to have a strong magnetic pull over a significant portion of the population.

Jeb Bush recently addressed the challenges that he and his family have encountered while dealing with his daughter’s disease. As the potential holder of the highest U. S. governmental office, he has outlined steps to fight the drug epidemic in this country. He recognizes that this is a long-term dilemma that needs a long-term solution. According to Bush, “It will take real leadership that makes solving the problem a top priority.” [1]

An Uncontrollable Spiral

Noelle did not wake up one morning and decide to use heroin. However, she did become a statistic in the opiate crisis that is overwhelming this country. In 2012, 259 million prescriptions for opioid pain medication were written, which is enough for every American to have a bottle of pills. [2]

Opioid abuse serves as a key to unlocking dormant compulsions within a person’s brain. The resulting addiction is defined as a chronic, relapsing disease that alternates the brain’s mechanisms due to sustained drug use. [3] Some of its symptoms are:

  • Persistent desire or unsuccessful effort to stop or reduce the use of substance
  • Lack of behavioral control, i.e. overwhelming cravings, taking undue risks, etc.
  • Inability to recognize significant behavior and relationship problems
  • Inappropriate emotional responses

Without proper treatment, addiction often involves spiraling between relapse and remission. This never-ending cycle places an enormous amount of stress on a family. But, when your family is in the public eye, the additional pressures are unimaginable. Noelle’s struggle serves as an eye-opening experience for the man who may become the next U.S. president.

A Slippery Slope

The transition from a prescription for OxyContin to heroin is not a difficult one. According to the Journal of American Medical Association, approximately 75 percent of patients addicted to opioids will switch to heroin as a cheaper substitution. [4]

The ease-of-access and lower costs were cited as the two major reasons for the conversion.  This also introduces even greater dangers. Because heroin is illegal and unregulated, it can be laced with anything. Users are virtually unaware of exactly what they are putting in their bodies.

One Vision

In 1989, a group of concerned professionals came together to address the drug epidemic by forming the first drug court. The idea was simple;  to stop treating substance abusers as criminals and to recognize that they were facing a disease that require more help than just jail time. [5]

The concept of combining medical professionals with the judiciary system to create a treatment program that could break the continual recovery-relapse loop was revolutionary. While drug courts have proven to be very effective, the exponential growth of substance abuse in the U. S. requires additional methods of combat.

Tackling the Problem from Many Angles

Noelle is currently in recovery after successfully graduating from the drug court system. In a recent post, Jeb Bush not only addressed Noelle’s substance problems, but he also identified tactics for dealing with the drug epidemic in this country. His versatile strategies included:

  • Preventing drug abuse and addiction before it starts
  • Strengthening criminal justice
  • Securing the border to stop the flow of illicit drugs
  • Improving drug abuse treatment and recovery programs.

Never Too Early to Start

With drug addiction starting at younger ages, the best time for discussion is during early childhood.  Children need to develop strong coping mechanisms so that drugs don’t appear as the only viable option for handling pressure. The National Institute on Drug Abuse (NIDA) developed a list of the 16 principles for developing a prevention program. Some of the key factors are:

  • Enhance protective factors and reverse or reduce risk factors
  • Address all forms of drug abuse
  • Deal with the drug abuse in the local community
  • Tailor program to address risks specific to population or audience characteristics
  • Enhance family bonding and relationships
  • Design the package to intervene as early as preschool
  • Target improving academic and social-emotional learning to address risk factors for drug abuse (Elementary school students)
  • Increase academic and social competence in various areas (Middle/High school students)
  • Aim initiatives at general populations and key transition points, such as the transition to middle school
  • Combine two or more effective programs, such as family-based and school-based programs
  • Present consistent, community-wide message in multiple settings, including schools, clubs, faith-based organization and the media
  • Retain the core elements (Structure, Content and Delivery) when adapted to meet the needs of the community
  • Should be long-term with repeated interventions
  • Include teacher training on good classroom management
  • Employ interactive techniques
  • Should be cost-effective [6]

Adding Support to the Justice System

The justice system is littered with addicts and the mentally ill. Many statistics reveal the overall ineffectiveness of incarceration. Recently, a report revealed that over half of the federal prisoners are serving time for drug crimes. [7]

While drug courts are helping, other options for dealing with addiction in the judicial system are needed.

Drug courts provide an additional mechanism for dealing with the effects of addiction. Since their initial introduction in 1989, they have expanded to include courts dedicated to families, adults, veterans, DWI-related and juveniles. Courts have also been established to deal with parolees’ reentries into the community after incarceration. These specific courts help with jobs, housing and any other services that will keep the individuals drug-free. As of June 2014, 2,968 drug courts are in operation in the United States. [8] While drug courts are helping, other options for dealing with addiction in the judicial system are needed.

Developing a Solid Line

Drug seizures at the U. S. borders are constantly making headlines. While there are many governmental departments that handle drug interdiction, Bush suggests that direct intervention from the highest offices would have the most impact on improving border control.

He affirms that the establishment of better relationships with the nations responsible for the majority of illicit substances will lessen the drug flow. Whether it’s better border patrol, guidelines or coordination, stopping drugs before they enter this country is one of the best ways to reduce drug abuse.

Better Drug Recovery Program

The last part of Bush’s strategy called for improvement in treatment and recovery programs for drug addiction. Behavioral Health of the Palm Beaches (BHOPB) offers a comprehensive program designed to deal with the addiction disease. In a warm and welcoming environment, we empower our patients with the tools that they need to manage and overcome their affliction.

With intervention, detox and holistic programs, we can design a strategy that will help you become a better you. Noelle did it and so can you. For more information about a drug rehabilitation plan for you, call BHOPB at (888) 432-2467.

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