Thursday, November 24, 2011

Higher Childhood IQ Linked With Higher Risk of Drug Use

Rahul always used to remind me that addiction was nature's way of harm reduction by blunting the intellect of the super-intelligent. He believed that this was how evolution kept things from getting too good for one's own good. Given that fact that I saw much of my life story as a chronicle of stupidity, I could not agree with him. However, recent findings do seem to prove his point, and add another page of erroneous views to my autobiography.

The Journal of Epidemiology and Community Health has published a new study that studied more than 8,000 people over 30 years and found that young children were more likely to experiment with weed, speed, smack and coke later in life than the ones with lower IQ. This correlation was stronger in women than in men.

This also explains in some why addiction issues tend to persist among successful people and creative artists and performers in the face of absent attendant consequences.

Read more about it at the Hip Chick's Guide to stuff.

Wednesday, November 16, 2011

The Clinician's Illusion: A Prescription for Relapse

Addiction is a disease of relapse, and it is our way or the highway, and the highway here is jails, institutions or death. This is one of the most commonly heard declarations in the field of addiction treatment. If you look up substance dependence recovery rates with and without treatment, you will come across a very interesting fact. 75% of people who have overcome addiction or alcoholism have done it without resorting to medical treatment (for addiction) or attending self help anonymous groups. It is a known fact that the client population in treatment centers is largely a revolving one, thereby strengthening the belief that addiction is a disease of relapse. I have always worried about the fact that a group of people who self-declare themselves to be physically, mentally, emotionally and spiritually unwell can pronounce that the only alternative to “their way” is jails, institutions or death for the addict. Let us look a little closer at this belief that addiction is a disease of relapse, where it comes from, and what it does to the addict seeking recovery from proponents of this belief.
There are two reasons, in my opinion, that this belief flourishes. The first is the fact that those in the helping profession find meaning in their lives from being needed by those in search of help. Transference and counter-transference in the psychotherapeutic process are ideas that have been beaten to death, but what a lot of people do not pay attention to is the fact that a large number of people in the helping profession are people who are “recovering” from their own devils, and more often than not, the “helping” is a component of their recovery program, as it is in most self help anonymous groups. In addition, there is a catch-22 situation in this belief. If addicts were to not relapse, then the addiction equals relapse model would not hold true, and that would bring into question the entire belief system about addiction being a manifestation of a spiritual bankruptcy, reinforced by an obsessive-compulsive acting out. Therefore, unconsciously, every recovering person in the helping, while “praying” for the wellbeing of fellow addicts would be unconsciously praying also that all that is written in the holy books of recovery be proven untrue, which is something that even artificial intelligence routines would find challenging.

Saturday, September 17, 2011

The RAPS4 Rapid Screening Test

The hallmark of addictive behavior is denial. However, every addict has insight into his or her problem at a subconscious level. There are periodic moments of clarity and honesty during which they may open out to others, or seek help for themselves. These moments are few and far between, and often very brief.

One of the most effective short tests to diagnose an addiction problem is the RAPS4 test, a test made up of four questions pertaining to remorse (R), amnesia (A), performance (P), and starter drinking behavior (S), with regard to the persons drinking or drug use over the last 12 months.

Initially the Rapid Alcohol Problems Screen (RAPS) was a five item test, but was later refined into its present form. It uses questions taken from other diagnostic tools to create a comprehensive and accurate screening test. The questions apply equally effectively to all addictive substances.

An yes to any one question is an indication of an addictive process that needs to be addressed urgently.

If you have questions about your own or a loved one's behavior, apply this short test and determine whether intervention is needed.

1. Have you had a feeling of guilt or remorse after drinking?

2. Has a friend or a family member ever told you about things you said or did while you were drinking that you could not remember?

3. Have you failed to do what was normally expected of you because of drinking?

4. Do you sometimes take a drink when you first get up in the morning?

Source: Drugdetox

Tuesday, September 13, 2011

Michigan Alcoholism Screening Test (MAST)

There are several self administered diagnostic tools that are available to determine whether your behavior falls into the category of addiction or dependence. The Michigan Alcoholism Screening Test is one that has stood the test of time. Though it addresses alcohol addiction, it can be adapted to almost any type of addiction by replacing the references to alcohol and drinking with the other type of addictive process.

The MAST Test
The MAST Test is a simple, self-scoring test that helps assess if you have a drinking problem. Answer yes or no to the following questions:
1. Do you feel you are a normal drinker? ("normal" is defined as drinking as much or less than most other people)
___ Yes ___ No
2. Have you ever awakened the morning after drinking the night before and found that you could not remember a part of the evening?
___ Yes ___ No
3. Does any near relative or close friend ever worry or complain about your drinking?
___ Yes ___ No
4. Can you stop drinking without difficulty after one or two drinks?
___ Yes ___ No
5. Do you ever feel guilty about your drinking?
___ Yes ___ No
6. Have you ever attended a meeting of Alcoholics Anonymous (AA)?
___ Yes ___ No
7. Have you ever gotten into physical fights when drinking?
___ Yes ___ No
8. Has drinking ever created problems between you and a near relative or close friend?
___ Yes ___ No
9. Has any family member or close friend gone to anyone for help about your drinking?
___ Yes ___ No
10. Have you ever lost friends because of your drinking?
___ Yes ___ No
11. Have you ever gotten into trouble at work because of drinking?
___ Yes ___ No
12. Have you ever lost a job because of drinking?
___ Yes ___ No
13. Have you ever neglected your obligations, family, or work for two or more days in a row because you were drinking?
___ Yes ___ No
14. Do you drink before noon fairly often?
___ Yes ___ No
15. Have you ever been told you have liver trouble, such as cirrhosis?
___ Yes ___ No
16. After heavy drinking, have you ever had delirium tremens (DTs), severe shaking, visual or auditory (hearing) hallucinations?
___ Yes ___ No
17. Have you ever gone to anyone for help about your drinking?
___ Yes ___ No
18. Have you ever been hospitalized because of drinking?
___ Yes ___ No
19. Has your drinking ever resulted in your being hospitalized in a psychiatric ward?
___ Yes ___ No
20. Have you ever gone to any doctor, social worker, clergyman, or mental health clinic for help with any emotional problem in which drinking was part of the problem?
___ Yes ___ No
21. Have you been arrested more than once for driving under the influence of alcohol?
___ Yes ___ No
22. Have you ever been arrested, or detained by an official for a few hours, because of other behavior while drinking?
___ Yes ___ No
Scoring the MAST Test
Score one point if you answered "no" to the following questions: 1 or 4. Score one point if you answered "yes" to the following questions: 2, 3, 5 through 22. A total score of six or more indicates hazardous drinking or alcohol dependence.

This test can help you come to a decision to seek professional help. Keep in mind that a large number of so called professionals in the field of addiction treatment, especially in countries with poor regulation of mental health care services, are often recovering people who choose to set up therapeutic communities or treatment facilities either because they are unemployable otherwise or because they find it difficult to stay sober in or fit into mainstream social life and might have unresolved treatment issues themselves.

Familiarize yourself with the credentials and track record of any addiction professional you may want to go to for help. In India, you can direct your queries regarding the credentials of addiction professionals to the International Alcohol and Drug Counselor Certification Trust For India.

Source: NCADD

Friday, September 9, 2011

National Recovery Month

In 1989, the US government decided to observe September as Treatment Works Month in an effort to recognize and encourage the work being done in the field of addiction treatment. In 1998, this was officially changed to National Alcoholism and Drug Addiction Recovery Month. With the growing realization that substance abuse and mental disorders had much in common, September this year is being observed as Recovery Month, a month that promotes the societal benefits of treatment for substance use and mental disorders, celebrates people in recovery, lauds the contributions of treatment providers, and promotes the message that recovery in all its forms is possible.

In India, however, both mental disorders and addiction continue to be largely seen in poor light, in spite of government initiatives and the growing community of able treatment professionals. The tragedy lies not only in the fact that society misunderstands the challenges faced by those afflicted by these conditions, but also that these poor understanding permits a large number of people and organizations to market treatment that is inhuman, unethical, and outright harmful. For a population already grappling a life-threatening and debilitating mental condition, this is a double whammy. In spite of governmental regulations specifying that only certified and qualified professionals will be allowed into this field, these organizations are often run by addicts themselves, with their own unresolved treatment issues that manifest themselves in ways that are damaging to the therapeutic communities that they set up.

Given the trauma that active addiction imposes on the addict and those in the addicts lives, these practices are often overlooked as they offer temporary respite from the pain of active addiction. The long term damage to the addict's psyche, the reduced probability of long term recovery, and the permanently destroyed fabric of trust and relationships are marketed by these organizations as reasonable price for this respite. Typically, these organizations take refuge behind religious beliefs, fearful superstition and the threat of things getting worse if the families do not comply to get away with this mode of functioning. A sad comment on our times, indeed.

Wednesday, August 31, 2011

Recovering from Eating Disorders

Food addiction consists of two broad but distinct behaviors, compulsive overeating and the pathological complex of bulimia-anorexia. Both of these are driven by an unnatural identification of pleasure with the act of eating beyond the normal impulse to satiate hunger. The physical consequences of compulsive overeating are obesity, heart disease, hypertension, diabetes and sleep disorders. The psychological consequences can include depression, guilt, shame, poor self worth, isolation, and even suicidality.

There has been a great deal of scientific study in the field of eating disorders and food addiction, and the reader is advised to peruse them. This blog is a layman’s guide to addictive behaviors, and views addiction from the perspective of a basic understanding of the mind. This post attempts to explain the phenomenon of food addiction in simple and basic terms, largely from the standpoint of those faced with food addiction in themselves or in a loved one, or those dealing with the process of recovery from food addiction, again, either in themselves or in a loved one. It is not a substitute for professional treatment. As a recovering addict myself who has gone through professional treatment at various points in time, I would hesitate to recommend much of what is proffered as professional treatment, but that is another story altogether.

Sunday, August 21, 2011

Internet Addiction: When Gaming, Internet and Computers Become Drugs

Obsessive and uncontrolled use of the computer, gaming, internet, or other computer related activity in the face of negative effects on one’s physical, psychological, and social wellbeing is considered internet addiction.  The computer/internet addict replaces real life contact with other human beings with seeking a satisfying relationship in the cyberspace, be it with other people online, or with the act of using the computer or internet itself.

While this was dismissed as a passing fascination in earlier years, with computers and internet being a relative novelty on the scene, with the coming of age of a generation that has not seen a pre-computer, pre-internet life, and with the advent of online social media and role playing games, this has become a serious concern.  The dynamics of internet addiction is simple.  The most common ways that people use the internet are through technological interfaces that were originally meant to bring people closer, to foster connection and relationships, email, instant messaging and chat, bulletin boards, the foundations of a new socialization, the online social network.  However, in time, these have tended to replace real socialization, and ended up creating alienation, isolation, and eaten into the skillsets needed for real life social interactions.

The internet allows the addict to seek emotional gratification through what he believes to real human relationships, feeling love, friendship, gratitude, hate, fulfillment without having to undertake the journey of a real relationship.  The consequences of this alienation are an inability to function in real relationships.

The tangible effects of this addictive behavior are most commonly seen in activities like surfing for pornography, online gaming and role playing, and online gambling.  Apart from this is the anxiety that many people experience about being cut off from internet access even though there may not be any obvious reason for it.  The compulsive need for checking mail, status updates, and feeds have led to an entire industry that addresses internet distractions and behavior modification.  Digital sabbaticals (often for a day only) are becoming common.  

In the thousands of years prior to the internet, knowledge was shared among people in a socially binding manner.  If one needed to learn something, they would be able to think of someone they could go to and ask, and even if that person were not able to give you the answer, he would by and large be able to guide you to someone who would.  With the internet, this social activity has dried up, and we no longer need to depend on society to provide us answers, we can go to the internet.  While this is not an addictive behavior in itself, the reason I include it here is to illustrate the point that the internet has robbed many of us of the very activity it was meant to promote, bonding.