Addicts should realize that their life can never be the way it was before their addiction. This does not mean that a recovering addict cannot live a healthy and fulfilling life. Rather, addicts should be aware that recovery is a process that always will need to be maintained.

Posted August 28, 2009

From:

http://www.dol.gov/asp/programs/drugs/workingpartners/sab/recovery.asp#q3

Regardless of their impetus for participating in drug treatment—internal drive or external pressure—men had similar outcomes in the long term.

A group of men who completed court-ordered treatment for alcohol and drug problems reported lower intrinsic motivation at the beginning of treatment, but, 5 years later, reported the same rates of abstinence, employment, and rearrest as peers who sought help on their own. The findings from a NIDA- and Department of Veterans Affairs (VA) Health Services Research and Development Service-supported analysis of data on treatment outcomes affirm the results of shorter term studies that have shown similar therapeutic outcomes for voluntary and legally mandated patients. The new study also included an important, but largely unstudied, comparison group: people who had been in court, but were not mandated to enter treatment.

Mandated Treatment Works – Graphic
Click to enlarge

“Once in a therapeutic environment, mandated patients seem to reflect on their situation and accept the need for treatment,” says Dr. John Kelly, lead investigator of the study, conducted at the VA Palo Alto Healthcare System and Stanford University School of Medicine. “Our findings suggest that people can learn from the ‘teachable moment’ offered by a judicial mandate, even though the initial motivation for treatment is external. Judicial mandates may provide an opportunity for offenders to gain access to and benefit from needed treatment.”

Drs. Kelly, Rudolf Moos, and John Finney analyzed data, gathered by Drs. Moos and Finney and Dr. Paige Ouimette, on 2,095 men who were treated for alcohol and drug problems in 15 VA programs and followed for 5 years. About half the men (54 percent) were addicted to drugs; 80 percent were dependent on alcohol. Most (82 percent) had no criminal justice system involvement and entered treatment voluntarily (No-JSI); 7 percent were on probation or parole and were required to participate in treatment by order of a court or criminal justice official (JSI-M); 11 percent had been before a court, but not mandated to treatment (JSI). About half (49 percent) of the participants were African-American; 45 percent were White; and the remaining 6 percent were Hispanic, Native American, or Asian. Most (74 percent) were unemployed when they started treatment.

Arrest Rate Falls, Employment Rate Rises After Treatment – Graphic

The men completed 21 or 28 days of residential treatment, which took one of three therapeutic approaches: group psychotherapy and individual activities based on the 12-step approach, cognitive-behavioral therapy, or a mix of both. When they completed treatment, the men were urged to participate in outpatient programs and self-help activities.

At the beginning of treatment, each man completed a questionnaire that assessed characteristics considered important to recovery: motivation, self-efficacy, coping skills, 12-step participation, psychiatric symptoms, history of negative consequences of alcohol and drug problems, number of previous treatment episodes, and whether they considered themselves to be addicted. They also reported any prior year arrests and any judicial mandate for treatment. At the end of the treatment program, participants repeated the assessment and reported their perceptions of the therapeutic experience. Most also received a self-administered assessment in the mail at the 1- and 5-year follow up points, with the rest contacted by telephone or in person. Research assistants telephoned patients when necessary to complete or clarify information.

In the initial assessment, men in the JSI-M group reported experiencing fewer negative consequences of alcohol and drug consumption, fewer symptoms of depression and anxiety, and less desire to abstain than No-JSI or JSI participants. Fewer mandated (45 percent) than voluntary patients (58 percent) met the standard clinical criteria for drug addiction. Voluntary patients more frequently recognized their addictions, connected them to other problems, and reported a readiness to change.
REARREST RATES FALL , REMAIN LOW

At the end of treatment, all three groups of patients demonstrated enhanced coping skills and expressed more confidence that they could resist alcohol or drugs in high-risk situations. Symptoms of psychological distress improved for participants in all groups. At the 1-year followup, larger proportions of JSI-M participants reported abstinence, successful moderation in their use of alcohol, and freedom from drug-related consequences (for example, missing work or fighting with a family member because of drugs) than JSI and No-JSI participants (see chart). Arrest rates for the two JSI groups fell dramatically after treatment. Mandated patients showed arrest rates similar to those of their No-JSI peers (about 20 percent) and lower than those of their JSI peers (32 percent) at the 1-year followup. Five years after treatment, most outcomes among the three groups did not differ (see chart).

The investigators believe that, in addition to the other positive effects of treatment, mandated patients may acquire motivation to change. “The high level of camaraderie in VA residential treatment, where these individuals interacted with self-motivated peers, may have contributed to a shift in attitude,” says Dr. Kelly.

The implications of Dr. Kelly’s findings go beyond the criminal justice population, says Dr. Beverly Pringle, formerly of NIDA’s Division of Epidemiology, Services and Prevention Research. “The idea that patients must want to change seems to permeate current practice, but the drug abuse treatment field may need to reexamine its definition of motivation,” she says. Clinical measures of motivation mostly indicate intrinsic drive to change, but extrinsic motivators as well as rewards can increase treatment entry and improve long-term outcomes.

SOURCE

Kelly, J.F.; Finney, J.W.; and Moos, R. Substance use disorder patients who are mandated to treatment: Characteristics, treatment process, and 1- and 5-year outcomes. Journal of Substance Abuse Treatment 28(3):213-223, 2005. [Abstract]

Posted August 27, 2009

Original article by Lori Whitten, NIDA NOTES Staff Writer

From:

http://www.nida.nih.gov/NIDA_notes/NNvol20N6/Court.html

What is Drugged Driving?

“Have one [drink] for the road” was, until recently, a commonly used phrase in American culture. It has only been within the past 20 years that as a Nation, we have begun to recognize the dangers associated with drunk driving. Through a multipronged and concerted effort involving many stakeholders, including educators, media, legislators, law enforcement, and community organizations such as Mothers Against Drunk Driving, the Nation has seen a decline in the numbers of people killed or injured as a result of drunk driving. It is now time that we recognize and address the similar dangers that can occur with drugged driving.

In 15 states (Arizona, Georgia, Indiana, Illinois, Iowa, Michigan, Minnesota, Nevada, North Carolina, Ohio, Pennsylvania, Rhode Island, Utah, Virginia, and Wisconsin), it is illegal to operate a motor vehicle if there is any detectable level of a prohibited drug, or its metabolites, in the driver’s blood. Other state laws define “drugged driving” as driving when a drug “renders the driver incapable of driving safely” or “causes the driver to be impaired.”

The principal concern regarding drugged driving is that driving under the influence of any drug that acts on the brain could impair one’s motor skills, reaction time, and judgment. Drugged driving is a public health concern because it puts not only the driver at risk, but also passengers and others who share the road.
How Many People Take Drugs and Drive?

The National Highway Traffic Safety Administration (NHTSA) reports that more than 17,000 people were killed in alcohol-related crashes in 2006.1 Studies also have found that drugs are used by 10 to 22 percent of drivers involved in crashes, often in combination with alcohol.

According to the 2006 National Survey on Drug Use and Health, an estimated 10.2 million people age 12 and older reported driving under the influence of illicit drugs during the year prior to being surveyed.2 This corresponds to 4.2 percent of the population age 12 and older, similar to the rate in 2005 (4.3 percent), but lower than the rate in 2002 (4.7 percent). In 2006, the rate was highest among young adults age 18 to 25 (13.0 percent).2 In addition:

* In 2006, an estimated 13.3 percent of persons age 12 and older drove under the influence of an illicit drug or alcohol at least once in the past year. This percentage has dropped since 2005, when it was 14.1 percent. The 2006 estimate corresponds to 32.8 million persons.2
* Driving under the influence of an illicit drug or alcohol was associated with age. In 2006, an estimated 7.3 percent of youth age 16 drove under the influence. This percentage steadily increased with age to reach a peak of 31.8 percent among young adults age 22. Beyond the age of 22, these rates showed a general decline with increasing age.2
* Also in 2006, among persons age 12 and older, males were nearly twice as likely as females (17.6 percent versus 9.3 percent) to drive under the influence of an illicit drug or alcohol in the past year.2

In recent years, drugs other than alcohol that act on the brain have increasingly been recognized as hazards to road traffic safety. Some of this research has been done in other countries or in specific regions within the United States, and the prevalence rates for different drugs vary accordingly. Overall, the research indicates that marijuana is the most prevalent illegal drug detected in impaired drivers, fatally injured drivers, and motor vehicle crash victims. Other drugs also implicated include benzodiazepines, cocaine, opiates, and amphetamines.3

A number of studies have examined illicit drug use in drivers involved in motor vehicle crashes, reckless driving, or fatal accidents. For example:

* One study found that about 34 percent of motor vehicle crash victims admitted to a Maryland trauma center tested positive for “drugs only”; about 16 percent tested positive for “alcohol only.” Approximately 9.9 percent (or 1 in 10) tested positive for alcohol and drugs, and within this group, 50 percent were younger than age 18.4 Although it is interesting that more people in this study tested positive for “drugs only” compared with “alcohol only,” it should be noted that this represents one geographic location, so findings cannot be generalized. In fact, many studies among similar populations have found higher prevalence rates of alcohol compared with drug use.5
* Studies conducted in several localities have found that approximately 4 to 14 percent of drivers who sustained injury or died in traffic accidents tested positive for delta-9-tetrahydrocannabinol (THC), the active ingredient in marijuana.6
* In a large study of almost 3,400 fatally injured drivers from three Australian states (Victoria, New South Wales, and Western Australia) between 1990 and 1999, drugs other than alcohol were present in 26.7 percent of the cases.7 These included cannabis (13.5 percent), opioids (4.9 percent), stimulants (4.1 percent), benzodiazepines (4.1 percent), and other psychotropic drugs (2.7 percent). Almost 10 percent of the cases involved both alcohol and drugs.

Teens and Drugged Driving

* According to the NHTSA, vehicle accidents are the leading cause of death among young people age 16 to 20.1 It is generally accepted that because teens are the least experienced drivers as a group, they have a higher risk of being involved in an accident compared with more experienced drivers. When this lack of experience is combined with the use of marijuana or other substances that impact cognitive and motor abilities, the results can be tragic.
* Results from NIDA’s Monitoring the Future survey indicate that, in 2006, more than 13 percent of high school seniors admitted to driving under the influence of marijuana in the 2 weeks prior to the survey.8
* The 2004 State of Maryland Adolescent Survey indicates that 13.5 percent of the State’s licensed adolescent drivers reported driving under the influence of marijuana on three or more occasions.9

Why is Drugged Driving Hazardous?

Drugs act on the brain and can alter perception, cognition, attention, balance, coordination, reaction time, and other faculties required for safe driving. The effects of specific drugs of abuse differ depending on their mechanisms of action, the amount consumed, the history of the user, and other factors.

Marijuana

THC affects areas of the brain that control the body’s movements, balance, coordination, memory, and judgment, as well as sensations. Because these effects are multifaceted, more research is required to understand marijuana’s impact on the ability of drivers to react to complex and unpredictable situations. However, we do know that:

* A meta-analysis of approximately 60 experimental studies, including laboratory, driving simulator, and on-road experiments, found that behavioral and cognitive skills related to driving performance were impaired in a dose-dependent fashion with increasing THC blood levels.10
* Evidence from both real and simulated driving studies indicates that marijuana can negatively affect a driver’s attentiveness, perception of time and speed, and the ability to draw on information obtained from past experiences.
* Research shows that impairment increases significantly when marijuana use is combined with alcohol.11
* Studies have found that many drivers who test positive for alcohol also test positive for THC, making it clear that drinking and drugged driving are often linked behaviors.1

Other Drugs

* Prescription drugs: Many medications (e.g., benzodiazepines and opiate analgesics) act on systems in the brain that could impair driving ability. In fact, many prescription drugs come with warnings against the operation of machinery—including motor vehicles—for a specified period of time after use. When prescription drugs are taken without medical supervision (i.e., when abused), impaired driving and other harmful reactions can also result.

In short, drugged driving is a dangerous activity that puts us all at risk.

1. National Highway Traffic Safety Administration. Traffic Safety Facts Research Note. Washington, DC, 2007. U.S. Department of Transportation Report No. DOT HS 810 821.

2. Substance Abuse and Mental Health Services Administration. 2006 National Survey on Drug Use and Health. Rockville, MD, 2007.

3. Soderstrom CA, Dischinger PC, Kerns TJ, Kufera JA, Scalea TM. Epidemic increases in cocaine and opiate use by trauma center patients: Documentation with a large clinical toxicology database. J Trauma 51:557–564, 2001.

4. Walsh JM, Flegel R, Cangianelli LA, Atkins R, Soderstrom CA, Kerns TJ. Epidemiology of alcohol and other drug use among motor vehicle crash victims admitted to a trauma center. Traffic Inj Prev 5(3):254–260, 2004.

5. Kelly E, Darke S, Ross J. A review of drug use and driving: Epidemiology, impairment, risk factors, and risk perceptions. Drug Alcohol Rev 23(3):319–344, 2004.

6. Ramaekers JG, Berghaus G, van Laar M, Drummer OH. Dose related risk of motor vehicle crashes after cannabis use. Drug Alcohol Depend 73(2):109–119, 2004.

7. Drummer OH, Gerostamoulos J, Batziris H, et al. The incidence of drugs in drivers killed in Australian road traffic crashes. Forensic Sci Int 134:154–162, 2003.

8. O’Malley PM, Johnston LD. Drugs and driving by American high school seniors, 2001–2006. J Studies Alcohol Drugs 68(6):834–842, 2007.

9. Maryland State Department of Education. 2004 Maryland Adolescent Survey. Available at: http://www.marylandpublicschools.org/NR/rdonlyres/852505C8-7FDB-4E4E-B34E-
448A5E2BE8BC/10500/2004_MAS.pdf.

10. Berghaus G, Sheer N, Schmidt P. Effects of Cannabis on Psychomotor Skills and Driving Performance–A Meta-Analysis of Experimental Studies. In: Kloeden CN and McLean AJ, eds. Proceedings of the 13th International Conference on Alcohol, Drugs and Traffic Safety. Adelaide, Australia: The University of Adelaide, NHMRC Road Accident Research Unit, pp. 403–409, 1995.

11. National Highway Traffic Safety Administration. Marijuana and alcohol combined severely impede driving performance. Ann Emer Med 35(4):398–399, 2000.

Posted August 26, 2009

From:

http://www.drugabuse.gov/infofacts/driving.html

A NIDA-funded study has demonstrated that the relapse rate for heroin addicts increases with time and that the probability of long-run abstinence depends on the age of first drug use. Those who start daily heroin use at a younger age are more likely to relapse than those who start later.

The study, conducted by Dr. Marnik G. Dekimpe of the Catholic University Leuven in Belgium and his colleagues in Belgium and at the University of California, Los Angeles, examined the treatment histories of 846 patients at methadone clinics in central and southern California. The researchers looked at males and females, whites and Chicanos, most of whom started using heroin between the ages of 17 and 25. Subjects were interviewed over a 4-year period during and after treatment to determine the probability of their relapse to heroin use.

The finding that relapse is connected to time suggests the need for long-term periodic monitoring of a former heroin user’s abstinence, Dr. Dekimpe says. The researchers also found drug relapse odds were significantly different across the sociodemographic groups studied, suggesting that prevention resources could be directed to groups at higher risk. No significant differences in relapse probability were associated with either gender or education.

Posted August 25, 2009

From:

http://www.nida.nih.gov/NIDA_Notes/NNVol14N6/BBoard.html

We here at The Bridges Network are pleased to announce the launch of our interactive social media Extranet !!!! The Extranet will serve as the central network for all our clients. It will provide an efficient medium for our clients to communicate with one another, as well as with all of us at The Bridges Network. Through our established social network, we strive to maintain excellent customer service as well as provide essential resources that will promote a successful recovery program.

A solid body of research has shown that raising the taxes and price of alcohol leads to a decrease in consumption by youth, and reduces alcohol-related deaths and illness. Increasing the total price of alcohol has also been shown to decrease drinking and driving among all age groups.

The level of alcohol taxes and the rules for serving alcohol make a difference in underage and high-risk drinking. The taxes on beer, the drink of choice for the vast majority of underage drinkers, vary from $.02 per gallon in Wyoming to $1.07 per gallon in Alaska.

The five states with the highest beer taxes have significantly lower rates of teen binge drinking than the states with the lowest taxes.

Although raising alcohol taxes has proven to be effective, it is rarely used by states. According to the Center for Science in the Public Interest, most states’ alcohol taxes have not been raised in decades. With the effects of inflation taken into account, the current value of most state alcohol taxes is very low. For example, in California alcohol taxes have fallen 49 percent in inflation-adjusted dollars since the last increase in 1991, according to the Marin Institute.

Some states that have raised alcohol taxes dedicate the proceeds to public health programs, including substance use treatment programs, prevention campaigns, and other public education efforts.

Posted August 21, 2009

From:

http://www.jointogether.org/keyissues/taxes/alcohol-taxes-readmore.html

It used to drive me crazy early in addiction recovery when people would say ‘Bill you’re just not getting it’. I wanted to know how you are measuring my progress in addiction recovery, and by what standards are you judging me and saying that I’m not getting it. I’m doing just fine thank you; I would be petulant and angry. Clear as a bell to others, I was talking the game but not performing.

On the other hand, sometimes I would see no progress at all, be about to give up, and people would say ‘You’re doing great.’ or worse yet, ‘You’re doing exactly what you need to be doing at this time’. That would drive me nuts. I was so closed in my own head, you’re telling me I’ve got the answer, I don’t know what the heck the question is.

Looking for some signs of progress in addiction recovery, evidence if you will or a r yardstick that could compare myself to became a goal. Here are some concepts which I used and you may want to take a look at to measure your progress in addiction recovery:
# Have you cut off relationships with using friends for good?
# Have you begun to set clear and practical, attainable goals for your life?
# Does the idea of relapse scare you? What are you doing about it?
# Have you developed your own methods to deal with craving that work?
# Have you started to work hard at improving close personal relationships?
# Have you become invested in the recovery process, and are you doing what has been recommended?
# Is your opinion of yourself the same as others people’s opinion of you? Is your ego right-sized, neither too big or too small.
# Are you able to present yourself as you really feel without putting on masks and hiding behind defensive walls?
# Have you become open to growth, self improvement in recovery, and taken action to start that process?

These are just a few concrete indicators of progress in addiction recovery. At this point is not enough to be talking a good game. Our actions must be consistent with what we’re talking about. The above are just a few examples of the action steps that need to be taken, being in addiction recovery. Remember, self-esteem and the trust of others is acquired by consistently doing the right thing over an ever increasing length of time.

Posted August 20, 2009

From:

http://addictionrecoverybasics.com/2007/05/29/rate-yourself-on-these-measurable-signs-of-progress-in-addiction-recovery/#more-202

Drugs and alcohol have the capacity to provide short-term solutions to many of life’s problems. The difficulty of course, is that excess use of alcohol and drugs become the problem themselves.

I proposed the topic of what problems we’re trying to solve by the use of alcohol and drugs to a discussion group. We generated a list of items: 120 woman

Loneliness
Reducing stress
Handling anxiety
Coping with depression
I simply like to drink in drug, no problem.
My husband/wife – dysfunctional relationships
Low self-esteem
Feeling sorry for myself
Handling pain (both physical and emotional)

The list went on and on, I’m sure you get the idea. There is a reality here to be considered. Life is life, there are good times and bad times, we become frustrated with ourselves, other people, places and things.

One thing I believe to be a commonality among people with chemical dependency, or of users of drugs and alcohol, is a tendency to not know how to deal with life’s issues in a positive, not destructive way. Perhaps somewhere long the way the skills were just never learned. Another possibility is that the skills we learned in childhood were dysfunctional and we still use them as adults with little success.

I believe that one thing that absolutely must be done in recovery is to scratch off the option of returning to drug and alcohol use as a means of solving life’s problems. How am I going to handle the death of loved one, the loss of a job, celebrating the birth of a new baby?

I really don’t know, I’ll deal with it to the best of my ability when it happens. But one thing that is absolutely certain is that the option of returning to drug and alcohol use and abuse is no longer on the menu of options in my life.

That emotional and intellectual commitment to abstinence is only so much rhetoric if it is not backed by a plan of action. The intellectual decision to stop drinking is about 2 percent of the game. The other 98 percent involves having a concrete plan of recovery in growth in place, a relapse Prevention Plan, and an absolutely huge support network.

Posted on August, 19 2009

From:

http://addictionrecoverybasics.com/2008/12/15/if-drugs-and-alcohol-are-the-solution-then-what-is-the-problem/#more-663

EzineArticles.com Bill Urell Platinum AuthorThere is an old adage that states quitting drug and alcohol use is easy, staying quit is the hard part. I’m not sure if I agree with the easy part, but it is a fact that many people have difficulty maintaining abstinence from drug and alcohol use and suffer a relapse. There are certain attitudes and behaviors that can be developed that will decrease the likelihood of returning to drug and alcohol use.

Here is a list of the top five sobriety tools:

1. Motivation level – maintaining abstinence from mood altering drugs is definitely doable, but in most cases difficult. In order to achieve difficult goals it makes sense that the motivation has to be very high. People who rank their sobriety as a number one priority often have better results than those who put maintaining recovery on their ‘to do’ list. There should be an absolute commitment not to drinker drug ‘no matter what’.

2. Handling cravings – as sure as the sun will rise tomorrow, thoughts and cravings of using drugs or alcohol will occur to anyone in recovery. The skill that needs to be developed is to stop these thoughts and cravings from becoming an actual using incident. The good news here is that cravings generally decrease in frequency and intensity over time. It helps to have a concrete plan of action in place prior to the occurrence of the craving for using thought.

3. Coping skills – often people in early recovery rely on coping skills that were developed to protect their drug and alcohol abuse. This might include becoming isolated and pushing people away, becoming dishonest in cheating, or becoming self-centered in the extreme. In other cases coping skills are either undeveloped, or underutilized. Some examples of life skills that may need some work are the ability to communicate, basic social skills, knowing how to develop and maintain interpersonal or intimate relationships.

4. Identifying, owning, and processing emotions – there is often stated rule in relapse prevention that advises people in recovery to avoid “people, places, and things” that could be dangerous to the recovery. In reality, is may not be the situations or triggers that are more dangerous, but our rather our inability to handle the emotions that these things generate. Our actions are often generated by our feelings.

5. Self-esteem and self-confidence – if a person does not have the self-confidence in their ability to remain abstinent, certainly undercuts the motivation to keep working at it. If a person does not start feeling better about themselves in recovery and gain self-esteem, then the idea of returning to drug and alcohol use can become very attractive. There needs to be some internal reward for going through all the effort of maintaining sobriety.

Relapse back into drug and alcohol use happens with alarming frequency for great number of people. It is therefore only prudent to develop plans that decrease the possibility of relapse. However, relapse not a part of the recovery process, many people stopped using drugs in our overall never to return to it. In my experience, however, these people have put a great deal of proactive planning into use. They have made recovery their number one priority and have been ferocious in their commitment.

by Bill Urell

Posted August 18, 2009

From:

http://addictionrecoverybasics.com/2009/05/13/drug-and-alcohol-relapse-prevention-neglecting-these-five-key-issues-can-lead-to-relapse/#more-980