FRONT COVER NATIONAL COUNCIL ON ALCOHOLISM & DRUG DEPENDENCE - GREATER DETROIT AREA NCADD GDA FALL ISSUE 2016
PROGRAM ESTABLISHES POSITIVE MENTALITY
ALUMNA STUDYING AT HARVARD, WORKING FOR FACEBOOK
SETTING STUDENTS UP FOR SUCCESS
REBUILDING A LIFE AFTER ADDICTION
INSIDE FRONT COVER AD
INSIDE FRONT COVER AD HELP IS A CLICK AWAY ncadd-detroit.org
CONTENTS To send a comment or question, write to: NCADD-GDA 2400 E. McNichols Rd. Detroit, MI 48212 INTERESTED IN MORE FROM NCADD-GDA? To learn more about our resources for living a healthy lifestyle, visit www.ncadd-detroit.org or call 313.868.1340
NATIONAL COUNCIL ON ALCOHOLISM & DRUG DEPENDENCE
GREATER DETROIT AREA
FEATURES 08 DETROITWAYNE MENTAL HEALTH AUTHORITY From the desk of the Substance Use Disorder Director Darlene D. Owens 12 SAFETY FIRST NCADD program manager promotes academic success 16 FORTHE PEOPLE Dedication to others creates lasting change in the community 46 FAMILYMAN NCADD client reconnects with his children
50 THUG AND DRUG-FREE NCADD program manager takes on many roles 54 SHINING EXAMPLE Former NCADD student continuing success at Harvard 58 BUILDING A FUTURE Student finds lasting success through NCADD program
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IN THE NEWS 24 BOOMING PROBLEM Elderly substance abuse issues expected to grow as baby boomers age 26 STARTING YOUNG Insight into adolescent addiction comes as new guidelines urge early prevention 28 FIGHTING FORTHE BRAIN DISEASEMODEL Model can complicate messaging in treatment plans 30 THEMISSING LINK Integrated treatment works best for victims of sexual abuse who are also addicts 32 RECOVERY U More college campuses are dedicating housing to students recovering from addiction
34 LEARNINGTODRINK Study finds alcohol changes the brain from the very first drink 36 ARE VACCINESTHE ANSWER? A new vaccine has been shown to prevent overdoses and stop opioid “designer drugs” from affecting the brain 38 FROM SMOKINGTODRINKING Marijuana users are five times more likely to develop an alcohol abuse disorder, according to a new study 40 THETURNING POINT New study looks to pinpoint transition from prescription opioids to heroin 44 GENERATIONAL BRAINDAMAGE Drinking during pregnancy presents parents with challenges beyond their own sobriety
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INTERVIEW 1 Detroit Wayne Mental Health Authority (DWMHA) Region 7 From the desk of the Substance Use Disorder (SUD) Director Darlene D. Owens One of our major concerns at DWMHA is addressing prescription drug abuse and heroin use in the Detroit Wayne County area. Our substance abuse admission data in Wayne County illustrates that our largest problem is heroin. • Mortality continues to increase steadily; 2015 saw a 15 percent increase from 2012 • Dominant primary drug of abuse in treatment admissions: 44 percent versus 5 percent for other opiates The Substance Use Disorder (SUD) Initiatives Department and Greater Detroit Area Health Council (GDAHC) co-hosted a Prescription Drug Abuse and Heroin Overdose Summit, Wednesday, February 10, 2016 at the Detroit Marriott Renaissance.The day began with a video conference from Lt. Gov. Brian Calley.The evaluations stated that the conference was on target, informative and educational.The conference highlighted medication assisted treatment, prevention and treatment efforts around the Detroit Wayne County area. DWMHA Region 7 established an SUD Team with Dr. Carl Christensen, WSU University Physician Group Tolan Center, LaJuana Scott, Nardin Park Recovery Center and Jackie Moore. Community Care Services presented to the 17th Annual Michigan Association of Treatment Court Professionals (MATCP) Conference held March 15th and March 16th at the Amway Hotel in Grand Rapids on medication assisted treatment in Wayne County and our efforts. DWMHA is expanding access to the lifesaving opioid overdose reversal drug naloxone, including equipping first responders with training and naloxone kits throughout Wayne County. 8 • Admissions are up, especially in the suburbs - doubling the number admitted with heroin as primary drug of abuse • However, there are still more admissions in Detroit versus suburbs DWMHA has launched several initiatives to address the deaths in our region.
We are distributing 2,500 free naloxone kits to Wayne County first responders. Naloxone blocks or reverses the effects of opioids, including extreme drowsiness, slowed breathing, or loss of consciousness. An opioid is sometimes called a narcotic. Naloxone is used to treat a narcotic overdose in an emergency situation. However, this medicine should not be used in place of emergency medical care for an overdose. DWMHA reassured law enforcement that they are covered by the Good Samaritan Law. Michigan law 28.543, sec. 3 states that a peace officer may possess any opioid antagonist distributed to that peace officer under section 2 and may administer that opioid antagonist to an individual if both of the following apply: The peace officer has been trained in the proper administration of that opioid antagonist. The peace officer has reason to believe that the individual is experiencing an opioid-related overdose.
Our kits contain the following:
Lastly, we must increase our use of medication assisted treatment, such as methadone, vivitrol, suboxone and buprenorphine and give our providers more tools for their tool box. (2) prefilled 2 ml naloxone/needle-less luer-lock syringes (2) mucosal atomization (nasal spray) devices (2) pairs of nitrile gloves (1) CPR face shield (2) use documentation cards (2) educational materials Other initiatives we continue to promote include encouraging providers to use the Strategic Prevention Framework for prescription drug use to raise awareness about the dangers of misusing prescribed medications and to work with pharmacy and medical communities to address the risks of overprescribing to youth and young adults with a special emphasis on 18- to 25-year-olds. We must increase the availability of prescription drug take back boxes in the Detroit Wayne County area, not just on National “Take Back Days,” as this will aid in the removal of unused prescription drugs from our communities.
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Individual Counseling: 1-2 times per week Group Therapy: 1 time per week Life Skills Family Counseling: As needed Case Management Referrals: As needed Recovery Coach: As needed HIGHLIGHTS
For a full list of programs and other information, please visit us online: ncadd-detroit.org
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NCADD program manager promotes academic success
Safety has always been paramount for children whether they’re playing in the park or simply walking down the street. But when it comes to fostering success both in and out of the classroom, NCADD is putting S.A.F.E.T.Y. first. S.A.F.E.T.Y. stands for the Successful Alliance for Educating Talented Youth, a youth program designed to promote academic success particularly for underserved and economically disadvantaged teens. The program includes an after-school component as well as prevention workshops staged throughout the community. Students get academic help in the after- school program as well as recreational opportunities, and NCADD staff use the workshops to talk to students and parents about important topics like drug and alcohol prevention. Organizers say they want to empower students to make positive choices and give them the tools to avoid becoming victims. “The parents are just ecstatic,” says S.A.F.E.T.Y. Program Manager Terry Phillips. “They like the exposure that we’re able to give them and bring their kids to an awareness about the dangers of drugs.” Phillips has been working with youth since she was 18 years old, and says the S.A.F.E.T.Y. program is a great way to keep kids motivated and moving in a positive direction. She says putting knowledge and power into a student’s hands is the best way to equip them for the future, and she feels the S.A.F.E.T.Y. program helps meet that goal. Phillips knows how important young people are to building and maintaining a strong and vibrant community, and has dedicated her life to helping kids succeed. “It has always been my heart’s desire to impress young people to make good decisions with their lives,” Phillips says. “If you give them information that can help empower them to make good decisions, they can make those decisions.”
“It has always been my heart’s desire to impress young people to make good decisions with their lives.” - Terry Phillips, S.A.F.E.T.Y. programmanager, NCADD
New direction, same leadership The S.A.F.E.T.Y. program was previously funded and run by the city of Detroit, but it was cut due to budget restrictions in 2013. NCADD picked up the program that year along with Phillips who had been facilitating the program since 2000. It was her experience that caught the eye of NCADD President and CEO Dr. Benjamin Jones, who praised Phillips’ leadership as well as the passion and commitment she brings to the organization. “You need to have that person who can make the connections and implement goals and objectives, not just develop them, but implement them and see them through to fruition,” Dr. Jones says. “She is a person who exudes confidence, she believes in what she’s doing and she believes that we can be successful.” “You’re in a position to become the best you can be.” - Terry Phillips Bright future N Th
Phillips says her message to students is always the same: “You’re in a position to become the best you can be.” And NCADD will be there to help them every step of the way. When the program was still part of the city, it offered college tours, a summer employment program, and other opportunities for student enrichment. Phillips, along with assistant coordinator Karl D’Abreu, has been working hard to develop new fundraising sources and is looking to relaunch many of the previous initiatives in the near future. But she says she is incredibly proud of the work the program has been able to accomplish with NCADD and is looking forward to building on that success in the future.
AGENCY AD 3 WE BELIEVE IN THE POWER OF RECOVERY TO TRANSFORM LIVES AND CHANGE OUR WORLD.
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INTERVIEW 3 Celebrating families Dedication to others creates lasting change in the community Helping people in need has always been part of Tonie Stovall’s life. So when it was time to choose a career, she knew she wanted to make people a priority. Now
As the prevention program coordinator, Stovall facilitates the Celebrating Families program, going out into the community, visiting schools and other organizations to promote healthy life skills.They speak to kids and parents about how to develop healthy communication skills, anger management, goal creation, and drug prevention. Stovall says she’s thankful to be part of a program designed to reunify families and break the cycle of addiction for people struggling with substance abuse. “We’re all in this together and my goal is just to help the community in any way I can to become a better, stronger community,” Stovall says. Stovall also oversees NCADD’s recovery support services, working alongside prevention specialists Lauren Stovall, Pat Jones, and peer support specialist Sheldon Hill.The team works with people who are in the early stages of recovery, directing them to resources and helping them to find housing, employment, and anything else they may need to be successful. While she’s pleased with the programming NCADD is able to offer, Stovall says they are continually looking to grow and evolve to meet the changing needs of those in the community. “We really want to make sure we are listening to those consumers, the ones we work with,” Stovall says. “We want to stay engaged and really know what’s going on.” “We’re all in this together and my goal is just to help the community in any way I can.” - Tonie Stovall prevention program coordinator NCADD
working as a prevention program coordinator at NCADD, Stovall says she may have found her “dream job.” “I love the people that I work with, it’s so much fun,” Stovall says. “They’re so genuine and so sincere, it’s never a dull moment.”
Creating change Recovery from drug and alcohol addiction can be extremely difficult, and Stovall knows that not everyone will be successful their first time through the program. But she says the stories of those who do find success stick with her and motivate her to continue working to help more people. While Stovall takes joy out of meeting new people and interacting face-to-face, she says the real fulfillment comes when she is able to see people succeed and change their lives for the better. “When you see the youth that you work with and they come out and they’re doing well, and they’re getting into college, and families have changed, it’s a good moment,” Stovall says. “It’s always just a proud moment to know that the program is successful and that it’s working.” With the programs creating positive change and benefiting the community, Stovall says she’s proud of the progress they’ve made so far. And while she may love meeting people one-on-one, she’s not limiting herself to just those she can meet in person. For both Stovall and the NCADD organization as a whole, the focus is on reaching as many individuals as possible to create a lasting impact in the community. “Detroit is changing a lot,” Stovall says. “We would love to be part of that resurgence in any way we can.”
“It’s always just a proud moment to know that the program is successful and that it’s working.” - Tonie Stovall
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“Everything we know about older adults and substance abuse probably doesn’t apply to Baby Boomers.” - Dr. Alexis Kuerbis, CUNY - Hunter College
overall numbers present a problem. “We’re grossly understaffed in being able to handle these problems,” says Dr. Dan Blazer, a psychiatrist at Duke University who has studied the issue extensive- ly. “It’s a problem. I think it’s a problem that’s going to get larger as time goes on and we’re probably already seeing evidence of that.” But there’s also an issue of attitude. Baby Boomers, in general, have a more relaxed view of substance use, and experts fear they may carry those behaviors later into life. “There’s no evidence that they’re going to automati- cally stop when they hit 65 years old,” Dr. Blazer says. “They’ve used them all their life, they say, ‘Why shouldn’t I use them now?’”
Even though elderly people show substance abuse issues in a much lower percentage than other age groups, the problem is more prevalent than many realize. And it appears it’s only going to get worse. Studies vary, but generally show between 2.2 and 9 percent of older adults have an alcohol use disorder, and experts say they’re already seeing a rise in marijuana and opioid abuse issues. With the large population of Baby Boomers aging, substance abuse numbers in the elderly population are expected to continue to rise, presenting serious problems for treatment providers and family members. Researchers say the problem is two-fold: part is sheer numbers, the other is attitude. With the number of older adults in the U.S. expected to increase from 40.3 million to 72.1 million between 2010 and 2030,
Experts say the lifestyle of elderly people presents a unique challenge for physicians and treatment providers. For example, because retired people don’t work, substance use doesn’t present a problem at their jobs, a HIDDEN DANGERS typical red ag for younger people. Experts also say too often doctors fall victim to their own prejudices and don’t ask the right questions that could lead to a diagnosis.
substance use. Although success rates in treatment can be better for older adults, the way they’re treated isn’t necessarily the same. Dr. Sacco says older adults respond better to more collaborative treatment programs that give them options. “For so long it was trying to t older adults into these programs, but now it might be changing these programs to t older adults,” Dr. Sacco says.
“People think this person doesn’t look like a substance user,” says Dr. Paul Sacco, an expert on substance abuse in older adults. “Sometimes physical problems associated with alcohol abuse are assumed to have a different cause in older adults.” Substance abuse can be even riskier for older adults as their bodies become less resistant to the stresses brought on by
different for an older adult.” But because Baby Boomers use substances more than previous senior groups have, experts say treatment providers may have to nd new ways to treat an old problem. “Everything we know about older adults and substance abuse probably doesn’t apply to Baby Boomers,” Dr. Kuerbis says. “All bets are off.”
To mitigate the expected problems as much as possible, experts say we need to train more counselors and physicians on how to best treat older adults, and how to spot potential problems in the rst place. “With just a little bit of education about older adults, I think you could make a very big impact,” says Dr. Alexis Kuerbis, a researcher who also works with older adults. “The rst step is awareness on what might be
“We’re grossly understaffed in being able to handle these problems.” - Dr. Dan Blazer, Duke University
INSERT 2 StartingYoung Insight into adolescent addiction comes as new guidelines urge early prevention
Treatment providers have known for years that adolescents are more susceptible to drug use and consequently, addiction. But now they might know why. Researchers recently discovered a specific pathway in the brain that makes adolescents more prone to problematic substance use, which could lead to stronger prevention efforts. By studying how cocaine affected the behavior of young and adult mice differently, researchers found that a mechanism in the brain which regulates specific protein production also controls addictive behaviors. By manipulating that mechanism, researchers were able to mitigate cocaine’s addictive effects. “Now we have a bidirectional switch that can turn on and off the cocaine-induced changes in the brain,” says lead researcher Dr. Mauro Costa-Mattioli of the Baylor College of Medicine.
“ The excitement of this study is that now perhaps we have a signalling pathway that could be targeted for the treatment of addiction. ”
- Dr. Mauro Costa-Mattioli, Baylor College of Medicine
One size fits all What’s most exciting about the study is that the pathway does not appear to be specific to cocaine. A second study examining nicotine returned similar results, leading researchers to believe any treatments targeting the pathway would be effective for all substances. “In the case of nicotine, it’s exactly the same thing,” Dr. Costa-Mattioli says. “All the drugs of abuse, they reduce the activity, they hijack or change this mechanism.” Researchers say they’re still interested to see if the mechanism plays a role in the transition from social substance use to more problematic use. But they say simply identifying such a crucial link of the substance use chain could lead to significant prevention methods. “Of course, the excitement of this study is that now perhaps we have a signalling pathway that could be targeted for the treatment of addiction,” Dr. Costa-Mattioli says.
Total improvement Experts say the benefits of implementing early intervention efforts far outweigh the cost. Although limited data exists, studies show investing just one dollar can produce anywhere from a few dollars to $26 in cost savings down the road. “Thus a well-designed, well- implemented early childhood intervention can dramatically benefit the community and society as well as improve children’s and families’ quality of life,” Dr. Volkow says. But the benefits of early intervention go beyond substance abuse. Experts say many of the risk factors for substance abuse are the same indicators for other social, behavioral and academic problems. They say creating a prevention program to address and reduce the risk of substance abuse will pay big dividends across the board. “Interventions designed to reduce early risk factors show benefits in a wide range of areas,” Dr. Volkow says. “Including improved personal and social functioning, better performance in school, and less involvement with the juvenile justice system or mental health services.”
“ Early childhood intervention can dramatically benefit the community and society as well as improve children ’ s and families ’ quality of life. ” - Dr. Nora Volkow, NIDA director
First eight years To address adolescent drug use, experts say prevention efforts have to start earlier than most would expect.The National Institute on Drug Abuse (NIDA), the government’s top agency on substance use, recently released new guidelines suggesting prevention education should start in the first eight years of a child’s life. Officials acknowledge that early childhood is not a time period normally associated with drug use. But they say factors with family, school and community environments can shape development of certain emotional and behavioral issues that can manifest in substance abuse problems even decades later. “Central to intervening early is the idea of shifting the balance of risk and protective factors in a way that builds a foundation for optimal social development and resilience,” says NIDA Director Dr. Nora Volkow.
“The concept of addiction as a disease of the brain challenges deeply ingrained values about self-determination and personal responsibility.” – Dr. Nora Volkow, Dr. George Koob, Dr. AThomas McLellan
INSERT 3 Fighting for the Brain Disease Model Model can complicate messaging in treatment plans
Fighting public opinion can be an uphill battle, sometimes even a futile one. Despite years of progress and scientific advancements, researchers and treatment providers still find themselves having to convince the general public that substance use disorder is a disease. But it’s a message that can often complicate treatment plans as much as it seeks to inform.
Setting the Record Straight Earlier this year, three of the nation’s leading drug experts wrote a paper seeking to explain, once and for all, how substance use affects the brain in the same way as similar diseases. In an article published in the New England Journal of Medicine, NIDA Director Dr. Nora Volkow, NIAAA Director Dr. George Koob, and Treatment Research Institute founder Dr. AThomas McLellan say they hope to reaffirm the brain disease model while simultaneously addressing common misconceptions about addiction. “The concept of addiction as a disease of the brain challenges deeply ingrained values about self-determination and personal responsibility that frame drug use as a voluntary, hedonistic act,” the authors write. The authors argue that public skepticism about the brain disease model comes from researchers’ inability to articulately describe the relationship between changes in neurobiology and the behaviors associated with addiction. Although countless scientific studies have proven the brain disease model to be accurate and effective, the authors admit more work may be needed to change public perception. “A more comprehensive understanding of the brain disease model of addiction may help to moderate some of the moral judgment attached to addictive behaviors and foster more scientific and public health–oriented approaches to prevention and treatment,” the authors write.
“You have to emphasize the responsibility on the part of the person, but you also have to explain why the behaviors are happening.” – Bob Rohret, MARRCH executive director
Scientific studies attest that a person’s brain chemistry can be altered as a result of addiction.This fact can provide a needed explanation as to why continued use can still be a problem for people who clearly desire to get clean. “When you start to apply an explanation of why certain behaviors occur,” Rohret says, “it provides people some comfort in understanding why they’re doing what they’re doing.” Mixed Messages But as confident as many in the medical community are about the nature of substance abuse disorder, the idea that addiction is a disease presents something of a double-edged sword for treatment providers. “The messaging has to be sort of finessed,” says Bob Rohret, executive director of the Minnesota Association of Resources for Recovery and Chemical Health (MARRCH). “You have to emphasize the responsibility on the part of the person, but you also have to explain why the behaviors are happening.” Rohret says treatment providers have to inform those in recovery about the nature of their disease, while also making sure knowledge of that disease doesn’t become a crutch or an excuse for inaction. When presented correctly, Rohret says patients should understand their addiction and responsibility toward it in much the same way someone with heart disease may understand their affliction. Although they cannot change the biological makeup of their body immediately, they can make behavioral changes and take actionable steps that lead to more positive outcomes.
Integrated treatment works best for victims of sexual abuse who are also addicts. Researchers have found a dramatic link between the
“ 1 out of every 6
INSERT 4 occurrence of sexual abuse and substance abuse. According to alcoholrehab.com, “sexual abuse victims are three times more likely to suffer depression, six times more likely to suffer PTSD, 13 times more likely to abuse alcohol and 26 times more likely to abuse drugs than those who have not been sexually abused.” They go on to say that one out of every six women and one in 33 men in America have been the victim of sexual assault or rape in their lifetime.
women and one in 33 men in America have been the victim of sexual assault or rape in their lifetime. ” -alcoholrehab.com
Treatment centers are beginning to recognize the need for integrated treatment techniques for victims undergoing substance abuse recovery. Since there’s such a high prevalence of sexual abuse among addicts, integrated treatment offers a fuller recovery for sexual abuse victims. Trauma-focused Cognitive Behavior Therapy (CBT) is one common form of treatment. In CBT, individuals are offered psychoeducation, therapy instructing and empowering them to deal with their condition in an optimal way. Stress management tools are also helpful. Individuals can be taught to change their situations or their reactions and how to maintain appropriate personal boundaries. The regulation of emotions can be a challenge for a person who has been sexually abused. In CBT, clients learn what emotions are socially tolerable and they learn how to be flexible enough to permit some spontaneity. Survivors are also taught how to delay emotional reactions as necessary.
Individuals can be taught to change their situations or their reactions, and how to take good care of themselves.
Integrated treatment for those suffering from substance abuse addiction and sexual abuse greatly increases the chance that this person will remain sober for the long haul.They can also experience greater joy and healing than if they were treated for substance abuse alone. Telling their story One effective aspect of CBT is for the person to do a “trauma narrative.” In addition to telling their story by the spoken word or writing it down, they can also use drawing, painting or other art forms to communicate the trauma.The narrative can then be shared with a safe person, like a trained therapist or substance abuse counselor.The hope is that the survivor will be able to let go of some of the trauma. Healing can then take place. Another facet of CBT is behavior management training. Clients are encouraged to stay calm in an emotionally charged situation, manage their own responses, learn what limits are appropriate, handle challenging questions and learn how to prevent physical confrontations with others. According to the Rape, Abuse and Incest National Network (RAINN), survivors are also encouraged to do what they can to heal themselves. Good sleep and nutrition, exercise, and regular routines like starting and ending the day in a peaceful way are a good place to start for people from this background. Those in recovery are also urged to write down leisure activities they find enjoyable and engage in those activities regularly. Clients are also encouraged to use journaling and inspirational reading to further grow in their recovery. Finally, having a supportive group of friends and family will help an individual recover emotionally from this kind of trauma.
INSERT 5 More college campuses are dedicating housing to students recovering from addiction
House parties, keg stands and spring break. The stereotypical images of American college life may revolve around drinking and party culture, but that image may be changing as more universities look to make campus a welcoming space for recovering addicts to live and learn. In the fall of 2016, a growing number of colleges will debut new Living-Learning Communities (LLCs) specically for people in recovery. While LLCs typically occupy a oor of a dormitory and center on a
shared interest or academic eld, these new student housing sections will provide a safe and positive environment for recovering students.
“It’s something I’ve always wanted to see implemented at the university,” says Dr. Gerard Love, a drug and counseling professor at Slippery Rock University in Pennsylvania where a new eight-person LLC will open in the fall of 2016. Slippery Rock ofcials hope to offer recovery-related programming at least once a week with topics such as nutrition, team building and spirituality. The hope is that the apartment-style living space will provide students a network to help them focus on both academics and recovery.
“I see them as being leaders here on campus.”
– Kris Barry, University of Minnesota - Rochester
“It’s really just about being around like-minded people and developing that ‘we’ as a support system.”
INSERT 5 – Dr. Gerard Love, Slippery Rock University
“Universities are supposed to be about dialogue, and having this is a great opportunity for dialogue,” Dr. Love says. “Bringing this whole notion of addiction out of the shadows and increasing understanding, I think will be a good byproduct of this.”
“It’s really just about being around like-minded people and developing that ‘we’ as a support system,” Dr. Love says. Dr. Love says simply having a recovery space on a college campus could help change perceptions about recovery and remove the stigma surrounding addiction.
Ofcials at the University of Minnesota – Rochester will also be opening a new recovery LLC for the fall 2016 semester. Ofcials say it’s necessary to provide recovering students with the tools they need to succeed academically and in their personal lives. “Historically, students who are in recovery really struggle to come back to campus without that [supportive housing] program,” says Kris Barry, the school’s health and wellness advocate. The LLC will house six to 10 students and feature evidence-based recovery programming. Ofcials say the LLC speaks to the school’s mission as a health-focused university. But more than that, they say they hope to foster a culture of personal growth among all students, particularly those in recovery. “I see them as being leaders here on campus and then taking that and changing the dialogue about addiction,” Barry says. “We know that the traditional college experience can be hostile to the goals of anyone in recovery, and we want to support them as much as possible.”
Boyd Austin says student communities centered on recovery provide a welcome relief for students to explore their university in a supportive and positive way. “It oers a space, it oers a culture, it oers a community of people who are engaging in college in the same way,” Boyd Austin says.
Experts say universities are increasingly adding recovery programs focused on creating a community among students, but ones incorporating housing are still few and far between. “This started about 30 years ago, but it has really taken off in the last 10 years,” says Amy Boyd Austin, president-elect of the Association of Recovery in Higher Education.
INSERT 6 Learning to Drink
Study finds alcohol changes the brain from the very first drink
“ Drugs of abuse basically hijack the normal learning and memory processes. ” - Dr. Dorit Ron University of California - San Francisco
The NIAAA-funded study did not establish a relationship between initial use and addiction, or even problematic drinking. But the hope is that further understanding of how alcohol affects the brain initially could lead to better treatment and prevention efforts down the road. “If we can control that step, we may be able to prevent further escalation,” Dr. Ron says. More research is needed to determine which other components of the brain are affected by initial alcohol exposure. Dr. Ron says she believes the changes that occur during first exposure could be reversed with prolonged abstinence from alcohol. But she said the more a person drinks, the harder it is to reverse those changes as the brain forms stronger connections to drinking.
One drink is all it takes. That’s what one research team found when studying how even the first exposure to alcohol can affect a person’s brain. A team from the University of California - San Francisco exposed mice to alcohol and then studied the synapses (connections) in their brains.The team found that even the first drink produced significant changes in the brain’s biological structure, calling the changes a “learning event.” “This is basically the first step,” says Dr. Dorit Ron, one of the chief researchers. “You are basically placing a memory trace.” Dr. Ron says the entire study was based on the idea that “addiction, and not just alcohol addiction, is thought to be a maladaptive form of learning and memory.” In essence, the study showed that first exposure to alcohol primes the brain for further use and lays the foundation for future “learning.” “Drugs of abuse basically hijack the normal learning and memory processes,” Dr. Ron says. “The behavior becomes habit.”
INSERT 6 A new study also suggests that the earlier a person starts drinking, the stronger those connections may become. Researchers recently set out to identify which substance people use first in their lives and found the majority of people try alcohol before any other substance.The team also looked at how a person’s age when they start drinking affects substance use later in life. Researchers say the earlier someone starts drinking, the more likely they are to use more than one illicit substance, and they’re also more likely to develop an addiction. “It’s a very nice predictor for polysubstance use,” says Dr. Adam Barry, the study’s chief author. “The later you delay, the closer you are to 21, the less likely you are to be alcohol dependent or dependent on other substances.”
“ Alcohol consumption among youth doesn’t occur in a vacuum. ” - Dr. Adam Barry, Texas A&M University
Curbing use Researchers acknowledge there’s a difference between a first sip and a first binge drinking event. But they say age at first use of any kind is still a good predictor of behavior later in life. To combat problematic drinking, Dr. Barry says educators need to address all factors of a child’s life, not just the substance itself. In keeping with new guidelines from the National Institute on Drug Abuse, Dr. Barry and his team recommend beginning substance education as early as third grade. “Alcohol consumption among youth doesn’t occur in a vacuum,” Dr. Barry says. “It’s really just trying to find evidence-based strategies that prevent drug use and then applying those in an alcohol setting.”
Treating addiction with vaccines is a relatively new idea with many unanswered questions
INSERT 7 ARE VACCINES THE ANSWER
that arise out of a lack of research. But a new study suggests vaccinating against illicit drugs is not only possible, it could be extremely effective. At the Scripps Research Institute in California, researchers were looking for a way to guard against the lethal and addictive effects of synthetic opioid “designer drugs.” A potentially deadly opioid, fentanyl, is often used as a heroin substitute or mix-in by drug dealers, so researchers developed a vaccine to try to mitigate its effects. Researchers injected mice with three rounds of the vaccine and then exposed them to doses of fentanyl. They found the vaccinated mice did not display any “high” behaviors even months after the last series of vaccine injections. Researchers say the immune systems of the mice developed antibodies that successfully blocked the drug from reaching the brain. “The results were the best we’ve ever seen for any drug vaccine,” says Paul Bremer, a graduate student at Scripps Research Institute who worked on the study.
HAS BEEN SHOWN TO PREVENT OVERDOSES AND STOP OPIOID “DESIGNER DRUGS” FROM AFFECTING THE BRAIN vaccine
The results were the best we’ve ever seen for any drug vaccine. - Paul Bremer, Scripps Research Institute
“ WE WERE ABLE TO BLOCK EXTREMELY LARGE - Paul Bremer DOSES OF FENTANYL TO PROTECT AGAINST OVERDOSES
SAFE AND POWERFUL Not only was the vaccine able to stop intoxication (something researchers suggest could aid in opioid addiction treatment), the vaccine also proved extremely effective in blocking the potentially lethal effects of fentanyl as well. While the chemical is not necessarily toxic in itself, it does produce psychoactive effects that can shut down breathing and stop a person’s heart. Researchers say mice injected with the vaccine could withstand doses of fentanyl up to 30 times the normal rate. “It was just a rst generation vaccine, but it did prove to be very potent,” Bremer says. “We were able to block extremely large doses of fentanyl to protect against overdoses.” A SINGLE PURPOSE Researchers say the vaccine would not protect against heroin or oxycodone, and a mixture of vaccines would be needed to protect against all opioids. But that was somewhat by design. To make sure the vaccine would not interfere with any medications a person may take responsibly later in life, researchers targeted specic molecules so the vaccine would only block fentanyl and its derivatives.
“For unrelated drugs that you would be taking, there would be no effect from the vaccine,” Bremer says. LOOKING TOWARD THE FUTURE Although still in the early stages of development, researchers say the vaccine represents an exciting step forward in drug vaccine research. The lab is beginning more advanced trials on a similar heroin vaccine which should give them a better idea of how successful the fentanyl vaccine could become. But until more testing can be completed, researchers say they were pleased with the progress and excited for the future of vaccines in the treatment of addiction. “This concept of using a vaccine for addiction isn’t just an academic pursuit, it could really be used in practice,” Bremer says. “I think it’s really promising.”
Marijuana users are five times more likely to develop an alcohol abuse disorder, according to a new study
When it rains it pours. The old idiom may be familiar to many drug users who often find themselves battling more than one addiction. While previous research has shown multiple substance abuse disorders often go hand in hand, a new study suggests simply using marijuana can lead to a much higher risk of developing an alcohol use disorder.
Finding the Link Researchers at Columbia University analyzed data from 27,461 people who had used marijuana at the time of first testing, but had no history of alcohol related disorders. When researchers checked back three years later, they found marijuana users were five times more likely to have developed an alcohol abuse disorder.
Researchers said they were surprised the link wasn’t between marijuana use disorder, but simply marijuana use itself. “I think it’s important for people to be aware that there are certain behaviors that come with specific risks,” says Dr. Renee Goodwin, one of the lead researchers. “It would be particularly useful for youth.” Because youth are at a higher risk of experimenting with both drugs and alcohol, researchers said educating them about the total scope of risk is not only important, but could help curb problematic behaviors. “Preventing or delaying the onset of marijuana use could prevent or delay the onset of alcohol use disorder,” Dr. Goodwin says. “Statistically it should.”
“I think it’s important for people to be aware that there are certain behaviors that come with specific risks.” -Dr. Renee Goodwin
“Preventing or delaying the onset of marijuana use could prevent or delay the onset of alcohol use disorder.” -Dr. Renee Goodwin
Uses In Treatment For those already struggling with marijuana or alcohol use disorders, researchers said the knowledge that the two behaviors are linked could help people see the bigger picture of their addiction, and could prove useful in their journey toward recovery. “In some ways it may seem self- evident, but it may not be,” Dr. Goodwin says. “If you’re trying to quit drinking, it’s good to know that quitting marijuana could increase your chance of being successful.”
Zero relationship to mood and anxiety disorders As marijuana use has increased in the U.S., with some states even voting for legalization, some have wondered what the psychological cost will be to users. To investigate the question further, other researchers at Columbia University also conducted a recent study to determine if a link exists between increased marijuana use and psychiatric disorders. Although the results, published in the journal JAMA Psychiatry, mimicked previous research in showing a strong relationship between marijuana use and other substance abuse disorders, the findings in regards to psychiatric disorders were much different. The study showed no relationship between marijuana use and increased instances of mood and anxiety disorders, only substance abuse disorders. But despite the lack of a connection, researchers still cautioned against public policy that could lead to increased marijuana use. “The lack of association between more frequent cannabis use with increased risk of most mood and anxiety disorders does not diminish the important public health significance of the association between cannabis use and increased prevalence and incidence of drug and alcohol use disorders,” the authors wrote.
New study looks to pinpoint transition from prescription opioids to heroin
Stopping heroin use before it begins may be the best remedy for the country’s growing epidemic. A new study looks to pinpoint the times and ways that young people rst use the dangerous drug in hopes of strengthening prevention efforts. For three years, researchers at Wright State University tracked nearly 400 18- to 23-year-olds in Columbus, Ohio, who used illicit prescription opioids but were not opioid-dependent. Of the 362 participants, 27 eventually transitioned to heroin, a rate of 7.5 percent. “We were surprised at the number of people who transitioned to heroin,” says Dr. Robert Carlson, the study’s lead researcher. “We had really no idea of what exactly we’d be able to predict.”
Researchers found several predictors of increased risk of heroin use, starting with the ways in which the opioids were being used. Those who crushed or snorted the prescription drugs were far more likely to transition to heroin. “It increases the speed at which the drug is hitting the system and makes people much more liable to becoming dependent,” Dr. Carlson says. “If people can become aware that if they even think about starting to use via a non-oral route, they are heading off on a very dangerous path.”
“We were surprised at the number of people who transitioned to heroin. ” - Dr. Robert Carlson, Wright State University
The new NIDA-funded study targeted 18- to 23-year-olds because they are arguably at the highest risk for substance abuse. The study did not look at other age groups. But when considering the factors that may move a person from prescription opioids to heroin, Dr. Carlson believes age is just a number. “I wouldn’t think the risk factors for transition to heroin would be much different regardless of age group,” Dr. Carlson says. While the risk factors may be the same across age groups, the most deadly effects of heroin use are not. Research has shown that those most at risk of a heroin-related overdose fall in the 25 to 44 age range. It’s important to keep in mind that the vast majority of prescription opioid users will not move on to heroin. And signicant research is still needed to determine the social, environmental and biological factors that contribute to a person transitioning to heroin. But Dr. Carlson says he’s encouraged by the progress being made and believes the groundwork has been laid to develop effective treatment and intervention programs. “The really exciting thing to come out of this is it really gives us a rm foundation of some variables that could be targeted to prevent transition to heroin and transition to dependence,” Dr. Carlson says. Targeted approach The study also saw a difference in race among those who eventually turned to heroin. Despite roughly half the participants being African-American or Hispanic, all of the individuals who ultimately used heroin were white. Although the study could not determine the reasons behind such a strong racial divide, Dr. Carlson suggests that social networks, generational use and other circumstances could be signicant factors. National data shows the heroin epidemic has increasingly hit white males the hardest. The Centers for Disease Control estimates that between 2002 and 2013, heroin use among non-Hispanic whites increased 114 percent. Age is just a number
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Drinking during pregnancy presents parents with challenges beyond their own sobriety
Since its first diagnosis in 1973, Fetal Alcohol Spectrum Disorders (FASD) have shown how devastating drinking during pregnancy can be for an unborn child. Despite this fact, at least one in 10 pregnant women drink in the U.S. every year, according to a recent study by the Centers for Disease Control and Prevention. The CDC says children with FASD have physical issues like low birth weight and growth, problems with organ systems and damage to parts of the brain.These issues lead to behavioral and intellectual disabilities, hyperactivity, difficulty with attention, and poor communication, reasoning and judgment skills. The incurable situation can produce lifelong issues with school and social problems, mental health and substance abuse issues, difficulty keeping a job, living independently and having trouble with the law. In 2010, drinking while pregnant cost the U.S. $5.5 billion, says the CDC.
“ In 2010, drinking while pregnant cost the U.S. $5.5 billion. ” — Centers for Disease Control
“ I don’t know how I’m going to tell her. It was something I could have prevented. ” —mother of an FASD infant
Dysfunction in the family tree FASD can be multi-generational. Besides the common familial curse of addiction, the disability itself can contribute to bad impulse decisions, making it more likely for one to drink in the present moment and ignore the possible consequences. For that reason, a mother who has FASD herself may not recognize the symptoms of FASD in her child, because she views her own symptoms as normal. A mother in Tucson, Ariz., who was in recovery before realizing her drinking had caused FASD in her child, says the guilt was tremendous. Having to explain to her daughter why she had FASD was going to be the hardest thing she had ever done. “I don’t know how I’m going to tell her. It was something I could have prevented,” she says. Early diagnosis is key Diagnosing fetal alcohol syndrome can be difficult. A simple blood test will not suffice. Doctors typically look for abnormal facial features, such as a smooth fulcrum (the ridge most of us have between our nose and lips), lower than average height and weight, a small head and the birthmother’s admission of alcohol use during pregnancy. There are many treatment options, including medication for certain symptoms, behavioral therapies, education and training for parents. It is most helpful for children to be diagnosed before the age of six, be in a nurturing family environment and have access to special education and social services. Having FASD is not a hopeless situation. Implementing treatment strategies at a young age can help a child thrive despite the disorder.
Regardless, it is never too late to quit drinking. Since brain growth takes place throughout a woman’s pregnancy, the sooner a woman quits drinking, the better off her baby will be. Prevention is best To prevent FASD, the best scenario is for a woman to refrain from drinking any amount of alcohol during pregnancy. Ideally, women should quit drinking the moment they go off birth control. “About half of all pregnancies in the United States are unplanned, and even if planned, most women won’t know they are pregnant for the first month or so, when they might still be drinking,” says Anne Schuchat, principal deputy director at the CDC.
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