What is a “Drug”?
The human animal has sought out drugs for thousands of years. As far as we know, since Homo Sapiens first appeared on the planet! In highly developed ancient cultures, psychoactive plants played important economic and religious roles. There is evidence that humans have always overused, misused or abused substances. Remember humans, like other animals, do not live by logic alone. We, like other sentient beings, are pleasure-seeking animals who enjoy impressing each other.
In the broadest sense a drug can be defined as “any chemical entity or mixture of entities, after administration of which alters biological function and possible structure”. I include food in this definition although the World Health Organization (WHO) omits “those substances” required for the maintenance of normal health, i.e. food. In fact, some processed foods have the same exact amount of sugar-fat and salt that in combination increases our own endorphins. Sometimes, okay… often times I have strong opinions, so besides including food as a drug (since there are several foods which have been abused throughout history, i.e. plants and spices), I will also be grouping alcohol and drugs together because alcohol is a drug. Saying alcohol and drugs would be redundant. Currently alcohol and nicotine are by far the most abused drugs. They contribute to more overall health problems, increased health care costs, and alcohol produces wide spread damage to our bodies whereas nicotine seems to have more specific areas of damage.
The Dangers of Alcohol Abuse
Although I enjoy red wine, I feel compelled as a health care provider to let you know that alcohol, when taken in, travels throughout the body (including the blood stream). However, it does not distribute much into fatty tissue – therefore a 180 pound ‘lean’ person will have a lower blood alcohol concentration (BAC) than a 180 pound ‘fat’ person, even though they both drank the same amount. Chronic alcohol abuse/dependence does more widespread damage to our bodies systems including the brain, cardiovascular, endocrine, gastrointestinal, and the immune system. It also puts us at an increased risk of some cancers. So remember if you do drink, do so in moderation and make sure you are boosting your immune system and taking thiamine, folic acid, and a multivitamin!
The Myth Concerning Alcohol Dependence
There is a myth that alcohol dependent people are not productive members of society. It can take a long time for the accumulative effects of drug misuse to damage the bodies. Ninety-five percent of alcohol dependent individuals are employed, married, and not distinguishable from the general population by any socioeconomic factors! On the down side, alcohol is the # 1 drug associated with violence (cocaine running a close second), as well as the # 1 drug associated with suicide. As I mentioned in episode 7: “Substance Abuse”, a combination of alcohol and benzodiazepines (anti-anxiety medication) have been found to be the most common drugs found in the blood stream of “murder suicide” cases.
Knowledge About Substance Abuse Relapse
Substance abuse/dependence relapse happens frequently and can happen to anyone! Knowledge about the possible causes and ‘triggers’ of a relapse may help to avoid this, or at least decrease the severity of it. NOTE: According to the National Institute on Drug Abuse, RELAPSE RATES can be comparable to RELAPSE of other common ‘MEDICAL’ diseases i.e. Addiction relapse (30-70%) can be compared to Type 1 Diabetes (30-50%), Hypertension (50-70%), or Asthma (50-70%)! Substance addiction/dependence SHOULD be treated like any other disease, with relapse indicating the need for renewed interventions.
Substance Abuse: Nicotine
The # 1 cause of death in the U.S. is cardiovascular disease and the # 1 cause of cardiovascular disease is cigarettes! Nicotine is a biphasic drug, i.e. at low doses it is a stimulant – at higher doses it has a depressant effect. Nicotine’s ‘calming’ effects seem to be the main reason for its use. Health damage from cigarette smoking in 1990 cost the U.S. economy approximately 72 billion dollars – can you imagine what the cost is today?
Western Europeans discovered tobacco when they saw Native Americans in the New World smoking dried tobacco leaves. A bit of history – from the times of Columbus until about 1860, tobacco, like many other drugs, has widely been thought to be a panacea for medical problems. Acting with almost as much speed as cyanide, nicotine is one of the most toxic drugs known in existence. In humans, 60mg of nicotine is a lethal dose and death follows within a few months. A cigar contains enough nicotine for 2 lethal doses (I made a mistake on my video), but with the way a cigar is smoked, not all the nicotine is delivered to the smoker or absorbed in a short enough period of time to kill a person. Remember, inhalation is an extremely effective drug delivering system, with ninety percent of inhaled nicotine being absorbed. Smoking one cigarette delivers approximately 1mg of nicotine intravenously.
How Do I Know If I’m Addicted?
Tolerance and withdrawal – but even if you don’t feel you have these symptoms you may be overusing a substance and causing damage to your body. Interesting note, cocaine initially has weight loss effects, though long-term use increases prolactin levels eventually causing Gynecomastia (enlarged breasts in men). Cocaine also has a kindling effect, i.e. with repeated use of the drug you may actually lower your brain seizure threshold, thereby causing a seizure!
Opiates: A Quick Look
Opiates – I didn’t want to spend too much time on opiates because the current treatment has become more widely available with maintenance, i.e. suboxone or methadone – both of which have demonstrated decreased cravings. Many health care providers and individuals who suffer from the disease of substance abuse/dependence believe (but not always) that there may be an underlying untreated medical or psychiatric condition or disease present, i.e. endocrine, neurological, gastroenterological, cardiovascular or psychological among others. Of note, long-term opiate/opioid use, whether medically or misused can cause low testosterone – ouch! Also of note, you ‘learn’ to be addicted to opiates because most often it takes 2-3 times of using to produce euphoria. The two most dangerous detoxes which should be medically supervised (alcohol and the anti-anxiety benzodiazepines i.e. Xanax, Klonopin, Valium, etc.) are both legal substances!!
During the psychedelic revelation in the 1960’s in Europe and from coast to coast in the U.S., humans unwittingly gave scientists free clinical trials as they used themselves as laboratory animals. I for one thank all of you for sparing those animals!
A Positive Light On Ketamine
In Russia, where there was no psychedelic revolution in the 1960’s, the use of Ketamine to experiment with altered states of consciousness, specifically for working through personal issues, parallels the use of Ketamine in sanctioned experimental psychotherapies. Controlled clinical trials of Ketamine-assisted psychotherapy have demonstrated Ketamine’s significantly superior efficacy over standard psychiatric treatments for alcoholism. Russian psychiatric researchers report success, defined as abstinence for more than one year, in over sixty-five percent of Ketamine Psychedelic Therapy (KPT) groups compared with twenty-four percent rate of success among conventional treatment control groups. Since 1985 more than one thousand cases of alcoholism have been treated with the Ketamine-psychotherapeutic method. Ketamine may promise to be a powerful tool in Russia for alcoholism, where as you know, Ketamine is currently under research for psychiatric disorders in the US, especially depression.
So remember, substance dependence is a disease not a weakness in character! There’s an old saying among those of us who have worked with psychiatry and treated individuals with co-occurring substance dependence… in every other aspect of medicine when one becomes symptomatic we offer more care, yet when the substance abuse/dependent individual becomes symptomatic (i.e. relapses), we offer LESS care!
The Most Positive Outcomes According to The Smithers Institute Were Seen With Supportive Family Involvement.
Here’s a list of Do’s and Don’ts for family members of substance abusers during the recovery process. These may help to prevent a possible relapse.
DO remember that alcohol and other drug abuse is a disease – not a disgrace.
DON’T blame yourself: You didn’t cause it, you can’t control it, you can’t cure it.
DO allow the chemically dependent person to feel the consequences of his or her own actions. Stop making excuses for drunken or drugged behavior.
DON’T try to control the chemical use. Don’t search for drugs or alcohol and don’t throw them out. The person will just get more, and you’ll still have the problem.
DO stop denying the problem. If you accept it you can begin to deal with the problem realistically.
DON’T play roles like martyr, caretaker, savior, victim or villain. Stop trying to protect the chemically dependent person – this only enables destructive behavior to continue.
DO get off the other person’s back. Stop nagging, scolding, pleading, managing and lecturing. It only gives the chemically dependent person an excuse to continue using alcohol or other drugs.
DON’T ever make idle threats.
DON’T treat the chemically dependent person as bad. He or she is sick, not bad. The strange behavior, including lying, is a result of the illness and is not directed at you personally.
DO try to get the focus on yourself. Try not to be so preoccupied and involved with the other person’s drinking/drugging behavior.
DON’T get caught up in the constant crises, but DO allow your love to show.
DO detach from the disease, but not the person.
DO offer support, understanding and encouragement in the recovery process. Try very hard to avoid unrealistic expectations.
DO learn all you can about chemical dependency, its effects on you and your family and what you can do about it. Attend the Smithers Family Education Workshop.
DO get professional guidance in this difficult period.
