Tag Archives: treatment

Methamphetamine and Pregnancy

In Hawaii, at least 50 percent of methamphetamine abusers and addicts are women. It’s believed that the drug’s side effects, which include reduced hunger and weight loss, helps explain why so many women abuse the drug.

Most women who use methamphetamine are in their child-bearing years, which can result in meth-affected pregnancies. Using methamphetamine during pregnancy poses a significant risk to the mother and fetus.

Some of the risks to the infant include premature or early delivery of the infant as well as deformities such as club foot and limb abnormalities. Pre-natal meth exposure causes babies to be born with low birth weight, and it can cause the infant to have a stroke or bleeding in the brain.

Babies exposed to meth may also suffer neurological problems such as intolerance to light and touch, tremors, muscle coordination problems, and sleep and irritability problems. There is also an increased risk for these babies to be born with HIV, Hepatitis B, and Hepatitis C.

The developmental risks of infants exposed to meth include learning disabilities and growth and development delays. These babies also have higher rates of attention deficit and attention deficit hyperactive disorders. They also have higher rates for rage disorder and a greater risk of sudden infant death syndrome in infants—and even in children up to 7 years old.

Seeking treatment for drug addiction during a woman’s reproductive years can reduce the potential for harm to both the mother and child.

Mother Hiding Heroin in Her Body Is Spared Jail

A 23-year-old Wales mother who was caught with heroin hidden inside her body avoided jail yesterday when the judge gave her a chance to change her ways. Samantha Davies faced up to four years in jail.

Prosecutor Tony Trigg said police had told Davies they were going to search her when they stopped her car last April. “She volunteered to them that she had one wrap of heroin hidden in her bra and another eight wraps in a money bag concealed inside her body,” Trigg told the court.

“When she was interviewed she said she had been supplying heroin for about five weeks because she heavily addicted and needed as much as eight bags a day for herself,” he continued. Davies said her boyfriend was buying the drugs and sharing them with her.

Of every 20 bags she made out of her share, she sold on five or six because it was the only way she could afford her next purchase. Last year she was in court for drug possession and shoplifting.

Meirion Davies, defending, said, “Her situation is a cliché. This is what happens when you become hooked on a class A drug. It destroys your life and could ultimately end it.”

He said Davies’ mother and stepfather were still standing by her and that she had promised to cut herself off from her former boyfriend. The court was told she was now living away from her former boyfriend in a place where he couldn’t find her and was doing her best to recover from her addiction.

Judge Christopher Llewellyn-Jones QC gave her a two-year community order with drug rehabilitation, adding that she has a family who loves her and a little boy who needs her. He added, “We don’t expect miracles but we will expect you to become drug free.”

Drug Czar Looks to Baltimore’s Drug Court for Inspiration

Gil Kerlikowske, America’s drug czar, is looking to Baltimore’s 15-year-old drug treatment court to help set the nation’s strategy of emphasizing treatment over incarceration. The Baltimore Sun reports that Kerlikowske met with legislators and a drug court judge to discuss the program and collaborate efforts between city, state, and federal agencies.

During a news conference, Kerlikowske noted that released prisoners “almost invariably go back to the neighborhood from whence they came,” and that without treatment, “all we’re doing is recycling people throughout the system.”

It’s been suggested that the Obama administration will focus on drugs as a public health issue rather than a law enforcement problem, and in Baltimore, drug addiction is “the most significant public health crisis” there is, according to Greg Warren, president of the Baltimore Substance Abuse Systems Inc, which sets the city’s drug strategy.

Every year, 9,000 convicts are returned to Baltimore streets, and many of them return to the drug abuse that led them to incarceration. Most of the city’s criminal activity is drug-related, with 80 percent (or four out of five people) failing their initial drug tests.

The first drug treatment court was developed in Florida in 1989 when crack cocaine addiction was labeled an epidemic. The idea behind drug courts is to lessen the burden on courts and jails by attempting to treat drug-addicted individuals before imprisoning them.

Today there are more than 1,000 drug courts across the country, according to a 2005 University of Maryland report that studied the effects of Baltimore’s drug court, which was created in 1994 in response to a city Bar Association claim that 85 percent of Baltimore crimes were drug related.

In Baltimore, participants must live in the city and be at least 18, and they can’t have committed a violent offense. They are supervised and regularly drug tested during their treatment. However, Baltimore’s intensive probation supervision and the significant participation of the Division of Parole and Probation are atypical.

Baltimore’s drug court participants are about three times more likely to be employed after the program as other convicts, and are a third as likely to use drugs during treatment, according to Representative Elijah E. Cummings, who added, “We want Baltimore to be a model.”

Cummings stressed the need for more resources and the role the federal government has in providing them, which is the main reason he wanted Kerlikowske to become familiar with Baltimore’s system. “You want the federal government to be sensitive to things that are working,” Cummings said, to ensure that “the city has a better chance at getting the resources it needs.”

Kerlikowske said he “absolutely” plans to incorporate Baltimore’s efforts into the country’s policy.

Treating Alcoholism: Can Abstinence Be Replaced with a Pill?

Time magazine poses an important question this week regarding alcoholism treatment: Can a pill replace abstinence? Maia Szalavitz writes that alcoholics who take an anticraving medication called baclofen say the drug allows them to resist powerful relapse triggers such as a favorite bar, former drinking buddies, the sight of alcohol, and even having a single drink

She tells the story of Bob, 62, who battled alcohol dependency for several decades, regularly drinking at least 35 beers per week. Two years ago, after taking baclofen for two weeks, he found himself drinking soda water at a dinner party and, for the first time, not thinking about needing a drink.

“I realized I wasn’t having that nagging feeling in my head, ‘I should really get a drink,'” said Bob. “It never appeared during the dinner either so that was the eureka moment.” He continues to take baclofen and now drinks about two or three times per week, no more than a beer or two at a time.

Dr. Olivier Ameisen had a similar experience, which prompted him to write his memoir The End of My Addiction. A longtime alcoholic, Ameisen had been to rehab at least eight times and had attended nearly 5,000 Alcoholics Anonymous meetings without being able to maintain sobriety.

He began taking baclofen more than five years ago, and has since been able to abstain from drinking altogether. He occasionally drinks moderately in social situations but doesn’t have cravings or other addiction-related problems.

“I never understood how people could leave liquor in a glass,” said Ameisen. “Now you could give me a sip of champagne and I could leave it. That was impossible in my wildest dreams. And it’s effortless. Complete suppression, not reduction of cravings. I’m indifferent to it.”

But despite some anecdotal success, there is little scientific data to support the efficacy of baclofen. Previous animal studies have suggested that it does have a powerful anticraving effect, however, and two large studies are under way. But even if the apparent anti-addiction benefits of the drug—which is currently approved by the government to treat muscle spasms—are proven in human trials, it might do little to persuade most American addiction-treatment providers to use it.

For many people, successful treatment of addiction involves complete abstinence; for some, this includes abstaining from drugs that would help fight cravings. For decades, experts have debated whether drug addicts who cannot or will not quit should even be offered ongoing treatments that would reduce harm related to their drug abuse.

Baclofen might also be able to reduce cravings for nicotine, binge eating, or even heroin or cocaine, because it seems to intercept the drugs at their roots. Researchers think that by binding to the GABA-B receptors in the brain, the brain’s reward system is modulated, preventing the release of excess dopamine (the chemical that creates a sense of euphoria).

But not all research has been conclusive. A recently published multisite trial of the drug in cocaine addicts did not produce significant results, which could be due to the dose, according to Teri Franklin, a professor of neuroscience at the University of Pennsylvania. Franklin noted that most alcoholics who have reported success with the drug tend to take at least 80 mg per day, whereas the cocaine trial used 60 mg.

However, at high doses, baclofen can cause drowsiness and muscle spasms—though Franklin suggests that these side effects can be prevented with gradual exposure. Patients must also be gradually weaned off the medication to avoid muscle problems and anxiety. In addition, it seems that baclofen must be taken indefinitely, since cravings can return once the drug is stopped.

Regardless of the potential success of baclofen, most addiction experts would continue to encourage abstinence. “There are always some patients who can [cut down] to drink small amounts, but they are the exception,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse, which is funding several ongoing trials of baclofen.

Although Volkow thinks baclofen shows promise in helping patients quit drinking altogether, she says the idea of controlled drinking is unwise: “My advice to patients is, don’t risk it.”

Moral Reconation Therapy Helps Inmates with Drug Addiction

When Jeff Smith was 17, he was already an alcoholic and tried heroin for the first time. “It used to take me three hours to get high when I drank. I could do the heroin and be there in three minutes,” he said. When his drug addiction eventually lead him to forgery and he was sentenced to the Shelby County Correction Center in Memphis, TN in 1987, he took part in a new program called MRT, or moral reconation therapy.

At the time, the program wasn’t successful in treating Jeff’s drug problems. When he was released on parole and returned to his old habits, his parents changed their locks to keep him out of their lives. But while Jeff relapsed, the MRT program grew from a pilot program in Shelby County to one that is now used in 47 states and eight countries.

MRT was developed by Memphis psychologists Dr. Greg Little and Dr. Kenneth Robinson, and was first used in 1985 as part of the Shelby County Correction Center’s drug abuse program. Robinson says it is now the most widely used inmate rehab program in the world.

The program was refined into a formal treatment method in 1987, and involves theories from psycholgists Carl Jung, Jean Piaget, and Lawrence Kohlberg. Little and Robinson formed a company called Correctional Counseling, Inc., and states on their website that MRT “seeks to move clients from hedonistic (pleasure vs. pain) reasoning levels to levels where concern for social results and others becomes important.” Put simply, MRT seeks  to make inmates think about the way they make decisions. The term “reconation” comes from the archaic term “conation” and means getting offenders to re-evaluate their choices.

Robinson says most people who experiment with drugs and alcohol are like Jeff Smith, starting in adolescence. “You see those people making poor decisions,” he said. “It changes your ability to live.”

Little says that logic doesn’t apply to offenders. “The bulk of offenders, 60 to 90 percent, have diagnosable antisocial personality disorders, and most people with antisocial personality disorders abuse drugs or alcohol.”

Smith, now 53, says he was a good example of this. When he was on parole, he worked, but mainly to support his drug habit. “I made decisions to do what I wanted to do regardless of consequences. I lost several jobs because of alcohol and drugs,” he said.

After violating parole, Smith was sentenced to another 13 years in prison and was released after 6-and-a-half years. He then enrolled in the Salvation Army Adult Rehabilitation Center and entered MRT group therapy.

“I missed out on 35 years of my life with my family. I had always known the difference in right and wrong, but I didn’t always do right. MRT helps you realize those things are conscious decisions,” Smith said.

When he completed therapy, Smith became an MRT trainer. He now works as a carpenter, furniture refinisher, and antique pricer for the Salvation Army and is living with and helping care for his aging parents.

“MRT is very easy in the beginning,” said Little. “We ask them to buy into the program. Soon, they are slowly swimming upstream. We ask them to stand up and tell what they know is the absolute truth. … It’s that they are liars. We try to have them clear the air by telling us they’re liars.”

After admitting their weaknesses, inmates are then confronted with choices, which grow more and more complex. For example, they may be asked whether it’s right to steal if you can’t afford a prescription for your sick wife who might die without the medication. As they consider their answers, they have to think about the way they make decisions.

Shelby County Sheriff Mark Luttrell says that the MRT program works, but that it doesn’t perform miracles. Standard rates for repeat offenders in the United States are 65-85 percent, and the recidivism rate in Shelby County is about 85 percent. But Little says MRT fares better nationally, with a recidivism rate of 60 percent in the short term and going down to 20 percent after 10 years.

New Insights into the Brain’s Role in Drug Addiction

New animal research is enabling a deeper understanding of the neurobiology of drug addiction in humans, and this knowledge may lead to more effective treatment options to weaken the powerful cravings that cause people to relapse.

The findings were released today at Neuroscience 2009, the Society for Neuroscience’s annual meeting and the world’s largest source of emerging news about brain science and health.

Drug addiction is known to change the structure and function of the brain, affecting a person’s self-control and decision-making ability. According to the Substance Abuse and Mental Health Services Administration’s latest survey, 23.6 million persons aged 12 or older needed treatment for an illicit drug or alcohol abuse problem in 2006.

These new studies have identified brain mechanisms that help explain how addictions form, as well as the cognitive problems associated with them. Additional research findings discussed could also offer hope against addiction relapses.

Today’s new findings show that:
1.) Chronic alcohol consumption reduces the number of new brain cells that form in the hippocampus of primates. The hippocampus plays a key role in memory, perhaps explaining the association between chronic alcoholism and memory problems (Chitra Mandyam, PhD).

2.) After exposure to cocaine, rhesus monkeys developed impairments in learning, cognitive flexibility, and memory. This finding suggests that cognitive problems associated with cocaine addiction in humans result directly from the cocaine abuse (Charles W. Bradberry, PhD).

3.) An amino acid already in the body was found to reduce cravings in addicted rats and appears to restore normal functioning in a brain circuit associated with cocaine addiction (Khaled Moussawi).

Other research findings being discussed at the meeting show that:

1.) Advanced neuroimaging technologies and behavioral research suggest that addiction disrupts the fine balance underlying reward, motivation, memory, and cognitive control. This research has important implications for developing therapies to treat addictive disorders (Nora D. Volkow, MD).

2.) Increasing evidence suggests that chronic drug use may alter the brain’s reward circuits on a genetic level, contributing to addiction. Focusing on the genetic effects of addiction may open new avenues for improved treatment (Eric J. Nestler, MD, PhD).
“The brain is the body’s most complex organ and chemical alterations caused by drug abuse have significant overarching impact on neuroplasticity,” said press conference moderator George F. Koob, PhD, of The Scripps Research Institute, an expert on addiction and stress.

“Today’s findings offer a better understanding of the impacts of this disease and provide a clearer approach toward treating addiction and guarding against relapse.”