Battle Over 'Addiction' and 'Dependence'

The American Psychiatric Association's (APA) has finished the first draft of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The DSM-IV is used all over the world to diagnose behavioral and mental disorders, and to help provide patients reimbursement for medical bills from insurance companies. There will be several changes, many of which involve the areas of the DSM that deal with addiction and dependence. There has been a battle over 'addiction' and 'dependence' and how those words should be properly used. The first draft of the DSM-V no longer has disease categories for substance abuse and dependence, "addictions and related disorders" is the desired new wording.

In a press release on Feb, 2010, the APA explained that: "eliminating the category of dependence will better differentiate between the compulsive drug-seeking behavior of addiction and normal responses of tolerance and withdrawal that some patients experience when using prescribed medications that affect the central nervous system". "Substance-use disorders" will be classified by the particular substance type, i.e. "heroin-use disorder" or "cocaine-use disorder" will be the appropriate terminology when diagnosing. One difference in the new draft from the DSM-IV is the symptom of "drug craving"; the symptom would be added to the criteria; according to the APA "problems with law enforcement" would be eliminated from the criteria "because of cultural considerations that make the criteria difficult to apply internationally".


Gambling addiction looks like it will make the cut for the new DSM - finally. A new category of "behavioral addictions" would be created, but it will probably only contain one disorder (gambling) because other behavioral disorders have not had enough research. According to the APA, "Internet addiction was considered for this category, but work group members decided there was insufficient research data to do so, so they recommended it be included in the manual's appendix instead, with a goal of encouraging additional study". This is a big deal, for the first time, the term "addiction" would be tied to disorders other than drugs and alcohol. Charles O'Brien, M.D., Ph.D., chair of the APA's DSM Substance-Related Disorders Work Group, said, "There is substantive research that supports the position that pathological gambling and substance-use disorders are very similar in the way they affect the brain and neurological reward system". Although, in the DSM-V draft, sex and food disorders will still fall outside and not be included in the "behavioral addictions" category; instead, sex disorders will be included In the "hyper-sexuality" category and food problems will be classified as "binge eating" disorders.

The APA will be accepting comments on the proposed DSM-V revisions until April 20. The world has a much better understanding of the science of addiction, many breakthroughs in understanding have happened since the DSM-IV was released in 1994.

All of the proposed changes and information about submitting comments can be found on the DSM-V Website

Substance Abuse Emergency Detox Cost Over $1,300

How much is your life worth or the life of someone dear to you? The United States spends nearly $500 billion annually to help in the fight against addiction and sadly the money is poorly managed which leaves very little room for success. Alcohol and drug addiction is perhaps the hardest disease to treat and is certainly the disease that is the least understood. 105,000 Americans each year die as a result of complications directly related to drugs and alcohol, that number is higher than traffic accident related deaths in over 15 states. The cost of even attempting to start a new life, one free of addiction, is staggering; because of that it is very difficult for most addicts to get the treatment that they need. Sadly, treatments controlled by the state are not managed properly and their success rate is minimal; for those who can afford to go to private pay drug treatment facilities success rates are much higher. Substance Abuse Emergency Detox Cost over $1,300, and clearly most bottom of the barrel drunks do not have that kind of money lying around. With an annual bill of 500 billion dollars, one would think that the state organized treatment options would have better numbers - where is the money going?

The Times Union of Albany New York reported that, "of each dollar spent, 96 cents goes to the criminal justice system and health care costs, 'shoveling up the wreckage' in the phrase of a recent study by The National Center on Addiction and Substance Abuse at Columbia University. Less than 4 cents of every dollar goes to prevention, treatment and research, 'a reckless misapplication of public funds,' the study concluded". Unfortunately, the majority of state funds go towards a group of repeat offenders who have been to: detox, treatment, jail, and hospitals several times over. "In Albany County, about $12 million, mostly state funds, is spent each year where about 100 individuals chronically addicted to alcohol and drugs consume the bulk of services and funding. They typically also are homeless, mentally ill and suffer from a myriad of physical ailments", according to the Times Union. About have of that number, 43, people can be seen in emergency room detox units with blood alcohol content levels around .30% as much as two dozen times a month. If you do the math, at $1,300 a day per person, the bill could reach $26,000 a month.

I cannot help but think that 4 cents on the dollar is not enough funding to make any head way in the prevention, treatment, and research of addiction. Perhaps if the state funding was allocating properly, the chances for individual success and less repeat offenders could be possible. The disease of addiction has been around since the dawn of civilization and is not going anywhere; if we use more money for research and less for imprisonment perhaps more lives could be saved every year from this terrible affliction. The tools are available for people to make a successful recovery, but, unfortunately people are not using those tools to their fullest potential or are not being properly taught how to harness the power of them. Until the United States figures out how to allocate spending appropriately, the longer unnecessary deaths will continue.

Pot Activists Filed A Ballot Measure On Tuesday In Oakland

The Marijuana battle continues in California, making huge strides yesterday towards legalization. Pot activists filed a ballot measure on Tuesday in Oakland, California in support of taxation of medical marijuana. If passed this would allow adults 21 and over to possess up to an ounce of pot. According to the Associated Press, "homeowners could grow marijuana for personal use on garden plots up to 25 square feet." Oakland is a microcosm of the larger picture in California, where earlier this year a Field Poll found that 56 percent of California voters supported legalizing and taxing marijuana. The debate over the pros and cons of legalization has been going on for a long time and it seems that recession was the missing ingredient to the marijuana activists' potential success. How this will work out and whether or not this is going to do more good than harm is very difficult to determine; both sides have shown great arguments to support their cause.

"It's one more pretty amazing element in the momentum toward ending statewide prohibition," said Stephen Gutwillig, California director of the pro-legalization Drug Policy Alliance. The statewide measure needs nearly 434,000 signatures to make the November 2010 ballot. This would be two years earlier than planned, but, as far as they are concerned the earlier the better. Two weeks ago several Northern California criminal defense lawyers filed an initiative, the "Tax, Regulate and Control Cannabis Act of 2010," that would set no specific limits on the amount of pot adults could possess or grow for personal use. The measure would repeal all local and state marijuana laws and clear the criminal record of anyone convicted of a pot-related offense. Basically this would make marijuana legal for everyone - medically or not! On the other side of the coin, El Cerrito Police Chief Scott Kirkland believes the health costs of increased statewide substance abuse would overpower the financial gain from legalization.

This is a very difficult subject where both sides seem to have very valid points to support their causes. I feel like the drug trafficking industry would not be inclined to pay any tax if marijuana were legalized since they have been getting away with it for so long. Obviously, the increased tax revenue in the state of California would do a lot of good, but we have to imagine that legalization will only bring the state more problems that cannot be controlled. I am interested in your thoughts on this subject, whether or not this would do more good than harm.

Brain Health - Depression

I Found this Article in My Save Section of my computer on Brain health and Depression I present this for your information 

Ernie orange county Calif

Twenty people out of 100 experience some form of depression during their lifetime.  With this high prevalence, we need to better understand this often misunderstood disease.  We have reviewed the chemical imbalance occurring in the brain of depressed people.  Low levels of essential chemicals necessary for brain cell function, such as serotonin, can result in depression.  In addition to chemical imbalance, the brains of depressed people demonstrate decreased blood flow through the frontal lobe, further impairing normal brain activity. 

Several lifestyle factors can worsen or improve the illness of depression.  Nutrition is one factor.  However, diet is not the only way to increase serotonin in the brain.  Exercise raises brain serotonin and increases blood flow through the brain.  Multiple research studies show exercise helps to reduce mild to moderate depression.  Muscle movement (motor activity) increases the stimulation rate of serotonin neurons, increasing the release and synthesis of serotonin.  Also, Remember the brain cannot produce serotonin unless the protein tryptophan is available.  Exercise increases the presence of tryptophan in the brain.  The increased presence of tryptophan persists even after exercise is completed.r

The most consistent effect of increased serotonin and increased blood flow through the brain is seen when regular exercise includes aerobic exercise.  Aerobic exercise requires the use of large muscle groups in a rhythmic motion, such as walking, jogging, swimming or cycling.  The recommended minimum length is 30 minutes at least three times a week.

Exposure to bright light is a second possible approach to increasing serotonin without drugs.  Abundant evidence exists on the beneficial effect of bright light exposure in healthy individuals.  There is an interaction between bright light and the serotonin system.  A positive correlation exists between serotonin synthesis and the hours of sunlight.  Since outdoor light is more intense than normal indoor light, 30 minutes being outdoors in the sunlight is recommended.  Maybe you are concerned about the damage of the sun to the skin.  However, to reap the benefits of sunlight, the only body part that needs to be exposed is the eyes.  For example, you could sit on a patio or take a hike using protective clothing and still receive the benefits from sunlight.

Increasing evidence demonstrates what we choose to think about can also alter brain biochemistry.  Numerous studies have shown that alterations in though – such as self-induced mood changes, therapeutic counseling and meditation – can increase blood flow through the frontal lobe of the brain.

Happiness and well-being are important factors in protecting against mental and physical disorders.  Recent studies have shown negative emotions were associated with increased incidence of depression.  Positive emotions protected against depression.

A person’s mood also influences social relationships.  Positive emotions and agreeableness nurture social relationships with others, resulting in higher levels of social support.  Low social support is associated with higher levels of stress and depression, as well as increased illnesses and death from many medical illnesses.

Let’s end this discussion on depression by putting all the lifestyle factors together into a spiritual package.  Research has demonstrated an inner religious experience effective in recovery from depression.  However, an external religious activity was not as effective.

Spiritual food for the brain through Scripture study, meditation and prayer should be taken on a regular basis with the inner convicted purpose of knowing God better. These daily spiritual exercises need to be done with a true inner desire, rather than just going through the forms of religion.  Being exposed to the Light of the World will increase our self-worth and our sense of mission to others.


Anonymous

My Take #8 What is the best way to begin to normalize the dysregulated brain function and allow the person to regain some behavioral control over the use of the addicting substances?My Take #8

The best way to provide a successful result is a residential treatment program. The program begins with a medical assessment before the detoxification begins. The purpose of the detoxification to remove the drugs that are acting on the mesolimbic dopamine system (MLS). Slowly there is fleeting control changes giving back the power to the fore brain (thus the decision make become more normal). 

 Many treatment options are available, and are individualized to fit your recovery needs.  Stopping active addiction is just the beginning.  Recovery is a process of healing the mind, body and spirit.  Our program covers a wide variety of therapeutic areas and techniques designed to get you back into living a happy, clean, and sober lifestyle. For instance gym workouts and groups at the beach in the sunshine allow the nature body chemicals to begin to help take back the brain. Time is the great restorer. Slowly the forebrain gains mental clarity and the loving descent law abiding person returns. This is the beginning stages of getting “CHOICE” back into the equation relating to substance abuse. We use multiple disciplines to help the individual complete the process of early recovery. The process is healing the mind, body and spirit.

Our Goal is to resolve the core psychological problems that trigger the use of the substances. Thus, we provide psychological counseling in one-on-one and group settings through the utilization of the latest advances in Addiction Medicine, individual and group counseling, immersion in 12-Step recovery principles, long term continuing care planning, patients find that full recovery is more than just a possibility.

We teach an understanding of how and why the midbrain Hi-jacks the person away from “the seat of all that we are” in the fore brain. Teach techniques to control the ‘Cravings” that every addicted person has when they are becoming clean and sober. Time and good recovery tools leads to a less intense craving

Ernie @ Hope By The Sea

A Balanced Fulfilling Life After Addiction

-   

Hope By The Sea has developed one of the most powerful methods of helping clients learn how to make choices that create an effective, balanced and fulfilling life. We will help you clarify and authenticate you, so that you will have a loving, wise and passionate life.  Hope By The Sea is a place to heal from Substance Abuse, Alcoholism, Depression, Anxiety, Post Traumatic Stress Disorder and other symptoms that have taken over your life, affected your relationships, interfered with your ability to work efficiently, created distance and turmoil with the people you love, in general, caused you grief.  There is HOPE.  You can resolve these issues, as all these symptoms are treatable.                                                              

We understand the disease of addiction’s neurobiology and that the pathology is reversible. Our Program addresses the mid-brain (the survival brain) neurochemistry as well as restoring the dominance of the fore brain (the loving descent law abiding brain).   Various techniques are used to restore the fore brain dominance and to provide tool for the client to deal with the physical and psychological stresses that life brings. 

Ernie Co-Founder of Hope By The Sea