Showing posts with label drug abuse. Show all posts
Showing posts with label drug abuse. Show all posts
Monday, August 22, 2011
DEPENDENCE vs ADDICTION in Cannabis Users
Is Pot Addictive?
The answer to this question has eluded mankind for nearly one hundred years!
Prior to that, marijuana was not illegal, nor considered an addictive or harmful substance; at least, not by the U.S. government’s standards. Alcohol was the bane of society in the early 1900’s as prohibitionists marched in the streets, many of them quietly addicted to Opioid Tonics freely available from the corner druggist.
As with anything, the answer to the question depends on the presumed definition.
Addiction is a psychological state in which the object of addiction can be any number of drugs, actions, or substances. Calling cannabis addicting in this context is NOT telling the truth, but is a trick of semantics in a society where food has become the most common and dangerous addiction.
Dependence is a physical state in which the object of dependence causes enough physical distress as to make the user continue their addiction even through obvious deleterious consequences. Nicotine has been cited as causing the greatest dependence in humans.
Cannabis does not cause physical addiction or create a physical dependence. There are no dependency-causing chemicals in Cannabis. Any physical discomfort felt by a cannabis user on cessation is psychological.
Although Cannabis can cause psychological addiction, so can any substance or human action: Prohibiting marijuana for a psychological addiction is like criminalizing dice for gambling disorders.
Unlike opiates (Heroin, Morphine), cocaine (Crack), benzos (Xanax), nicotine, and alcohol, Cannabis carries no risk of physical addiction, and has no substances that create a physical addiction. A psychologically addicted user may report anxiety upon "withdrawal"; any "withdrawal" symptoms are purely psychological. Although many studies have proved this, the argument of addiction is one of semantics and medical terminology, as well as ICD-9/10 (Diagnosis) coding.
Cannabis cannot create the condition of "drug dependence"; however, cannabis can create "drug abuse", as can a can of hairspray and a package of bath salts.
Prohibition has not stopped the use, recreational or medical, of marijuana. Cannabis is freely trafficked into the United States from Mexico by violent, dangerous and warring cartels. Although billions have been spent, US Federal forces such as the DEA, INS, and ICE have been unsuccessful in stopping the influx of low-grade cannabis into the United States. This “Schwag” has no medicinal value, and is cheap and widely available and easy to get, especially for the young. Even IF the Feds got their way, and all of the progress in medical cannabis was reversed, the cartels will assure that their brand of blood stained pot is on American streets. Wouldn’t it be better if the sick, suffering, and dying had access to clean, quality Cannabis, safely and transparently available, and prescribed specific to symptomology?
The Green Association for Sustainability
K. Rojas,
BLS, MLS, CPC
Saturday, December 12, 2009
LIFT ON SEP PROGRAM FUNDING BAN
See also: http://www.mapinc.org/alert/0419.html and 1000 Feet
ADVOCACY AND ACTIVISM DO WORK: The Media Awareness Project, Drug Policy Alliance, and other advocacy groups can claim success in their recent campaign that disclosed the restrictive fine print in the original spending bill to appropriate federal funds to needle exchanges, including a letter writing campaign.
StoptheDrugWar.org posted breaking news just after 2:00 today that in a Saturday morning Subcommittee vote, the Senate Committee endorsed a spending appropriates bill that would lift a 21-year old ban on federal funding of Needle Exchange Programs, WITHOUT the restrictive language preventing SEP's within 1000 feet of "just about anywhere" --see Drug Policy Alliance news release ; See Dave Borden's take here.
In a second major victory, Congress also lifted their restriction on a medical marijuana bill that was passed by D.C. voters 10 years ago, but held from becoming law by Congress. This is a two-fold victory, in that it also sets a precedent for Congress to ease on the "micromanagement" of the District residents. After a long wait, DC residents will finally have access to medical marijuana.
ADVOCACY AND ACTIVISM DO WORK: The Media Awareness Project, Drug Policy Alliance, and other advocacy groups can claim success in their recent campaign that disclosed the restrictive fine print in the original spending bill to appropriate federal funds to needle exchanges, including a letter writing campaign.
StoptheDrugWar.org posted breaking news just after 2:00 today that in a Saturday morning Subcommittee vote, the Senate Committee endorsed a spending appropriates bill that would lift a 21-year old ban on federal funding of Needle Exchange Programs, WITHOUT the restrictive language preventing SEP's within 1000 feet of "just about anywhere" --see Drug Policy Alliance news release ; See Dave Borden's take here.
In a second major victory, Congress also lifted their restriction on a medical marijuana bill that was passed by D.C. voters 10 years ago, but held from becoming law by Congress. This is a two-fold victory, in that it also sets a precedent for Congress to ease on the "micromanagement" of the District residents. After a long wait, DC residents will finally have access to medical marijuana.
Tuesday, July 14, 2009
“RECENTLY, I DID SOME CLINICAL WORK AT A METHADONE CLINIC”
This comment was a response to a posted blog in the Addictions Recovery Professionals group at Linked In (http://www.linkedin.com/). The original blogger is an addictions counselor discussing working at Methadone clinics. Please review the many comments at: http://www.linkedin.com/groupAnswers?viewQuestionAndAnswers=&gid=862107&discussionID=4887361&goback=%2Eanh_862107
Mr. Jenkins, others,
Thank you for concisely and clearly stating the facts regarding the unique physiology of opiate addiction. Pure science dictates the intractability of opiate addiction in the malfunction of opiate receptors. It has nothing to do with “will power”, but rather with changes that occur in the brain and neurological synapses.
For many years I advocated for medicated recovery, specifically Methadone, and was deeply involved and invested in the passage and implementation of the Drug Abuse and Treatment Act of 2001 (DATA). In addition to changing methadone rules, this Act allowed for the private physician use of Suboxone for opiate withdrawal and maintenance. In my research and advocacy since then, I have come to believe that Suboxone/ Buprenorphine/Naltrexone may be a better choice in many circumstances. Methadone is very effective for long term treatment of heroin addiction. Still, it has many drawbacks, specifically, the difficulty in withdrawal; however, the stigma of Methadone also cannot be underestimated in its effects on the clients social wellness. As such, Methadone should be used as a last resort, only after other avenues have failed, including abstinence programs.
True stabilization and reorientation into a non-drug seeking lifestyle can take many years, and even then, it is not unusual for heroin addicts to relapse, often after many years of abstinence. True, intractable heroin addiction may best be treated with life-long Methadone, in terms of the client’s well being and social harm reduction. Too many times, though, clients are accepted into Methadone clinics before other treatments have been attempted. Often, these patients may be opiate naïve in comparison to long-term heroin addicts seeking methadone maintenance. The methadone may get them off of their “drug of choice”, but only addicted to one that is even more difficult to overcome. In these cases, if abstinence is not an option, then Suboxone should be used. Using methadone in anything but the most severe cases, i.e., the patient is at risk of IV related disease and social degradation, is like swatting a fly with a sledgehammer.
I also agree that your “Counselors-in-relapse” is a valid paradigm, and one seen much too often in recovery. While some addicts in treatment may prefer to have a counselor that is also a recovering addict, the value of learning the pathology and physiology underlying opiate addiction an educated cannot be understated, nor can the value of certification. The best of both worlds, of course, would be ideal, and fortunately many recovering addicts have gone on to receive certification and/or college graduation. When I hear of recovering counselors who have been clean for less than two years working in methadone clinics, I worry that they are not only ineffective, still fighting their own battles, but they are also putting their own recovery at risk by being in a drug-centered environment before they have had a chance to put that environment behind them, and think themselves “well”.
Mr. Jenkins, others,
Thank you for concisely and clearly stating the facts regarding the unique physiology of opiate addiction. Pure science dictates the intractability of opiate addiction in the malfunction of opiate receptors. It has nothing to do with “will power”, but rather with changes that occur in the brain and neurological synapses.
For many years I advocated for medicated recovery, specifically Methadone, and was deeply involved and invested in the passage and implementation of the Drug Abuse and Treatment Act of 2001 (DATA). In addition to changing methadone rules, this Act allowed for the private physician use of Suboxone for opiate withdrawal and maintenance. In my research and advocacy since then, I have come to believe that Suboxone/ Buprenorphine/Naltrexone may be a better choice in many circumstances. Methadone is very effective for long term treatment of heroin addiction. Still, it has many drawbacks, specifically, the difficulty in withdrawal; however, the stigma of Methadone also cannot be underestimated in its effects on the clients social wellness. As such, Methadone should be used as a last resort, only after other avenues have failed, including abstinence programs.
True stabilization and reorientation into a non-drug seeking lifestyle can take many years, and even then, it is not unusual for heroin addicts to relapse, often after many years of abstinence. True, intractable heroin addiction may best be treated with life-long Methadone, in terms of the client’s well being and social harm reduction. Too many times, though, clients are accepted into Methadone clinics before other treatments have been attempted. Often, these patients may be opiate naïve in comparison to long-term heroin addicts seeking methadone maintenance. The methadone may get them off of their “drug of choice”, but only addicted to one that is even more difficult to overcome. In these cases, if abstinence is not an option, then Suboxone should be used. Using methadone in anything but the most severe cases, i.e., the patient is at risk of IV related disease and social degradation, is like swatting a fly with a sledgehammer.
I also agree that your “Counselors-in-relapse” is a valid paradigm, and one seen much too often in recovery. While some addicts in treatment may prefer to have a counselor that is also a recovering addict, the value of learning the pathology and physiology underlying opiate addiction an educated cannot be understated, nor can the value of certification. The best of both worlds, of course, would be ideal, and fortunately many recovering addicts have gone on to receive certification and/or college graduation. When I hear of recovering counselors who have been clean for less than two years working in methadone clinics, I worry that they are not only ineffective, still fighting their own battles, but they are also putting their own recovery at risk by being in a drug-centered environment before they have had a chance to put that environment behind them, and think themselves “well”.
Tuesday, May 19, 2009
WHY DO ADDICTS RELAPSE? Enterhealth (T) poll on LinkedIn
EnterHealth of Dallas Fort Worth posted this poll and discussion on Linked-In, in April, 2009. To review all comments, click on link.What have you noticed to be the biggest cause of an addict's relapse? We started a poll and would love your votes and feedback! http://polls.linkedin.com/p/33383/cbfam
EnterHealth of Dallas Fort Worth posted this poll and discussion on Linked-In, in April, 2009. To review all comments, click on link.What have you noticed to be the biggest cause of an addict's relapse? We started a poll and would love your votes and feedback! http://polls.linkedin.com/p/33383/cbfam
Thursday, April 16, 2009
METHADONE LIFE
METHADONE LIFE
One of the properties of methadone that make it ideal for heroin addiction recovery is that is has a half-life of 24 hours, and can last as long as 36-48 hours in stabilized patients. Yet methadone can be a fickle lover, and there are many things that can cause an early detox, or aberrant metabolization. Too much coffee, extreme stress, not enough sleep, certain medications…the list is as individual as the person. This is one methadone client’s post of a “sleepless methadone night”.
“The plaintiff stood nervously at her lectern, shuffling papers, smacking her lips to smooth her lipstick after combating her nervous dry mouth with a sip of water. The well dressed young woman came before this court to recover a cell phone debt incurred by the defendant, a flamboyant Hollywood boy-toy dressed in a colorful poncho and carrying a designer alligator bag, or brief case, or whatever you want to call it. But the braggart placed it on the table next to his lectern and microphone with a sly and better than thou attitude, shifting his weight from one hip to the other, in that very L.A. metro-sexual way of saying, “oh honey, let’s just get this over with!”
And I heard, “…but the defendant says that she was riding his coattails to the best bars, and normally he wouldn’t have even bothered with someone with only one broken Gucci bag, but he felt sorry for her.”
Huh? Suddenly my attention was piqued for one unbelieving moment and I immediately became disgusted and the phoney wannabe-ness of this ignorantly and narcissistically damaged person (of male persuasion). The plaintiff, smiled in her sweetness in a ‘what can I say?’ sorta way. And for the brief moment it takes to regain consciousness from a restful sleep, I forgot that it was just three o’clock in the morning and that I had only passed one half hour of this endless night.
I try to go back to sleep…sometimes if I close my eyes, when I open them again, an hour or so may have gone by without my knowledge while in this predetoxification state. It is a feeling that I have gotten used to, but that I will never be able to accept. I start to kick my legs as they cramp up on me, and a horrible feeling like a wash of chemicals runs through my esophagus and I can FEEL the taste and smell of the drug that is in every functioning cell of my body.
Getting up and moving around gets rid of that dope sick feeling for a time, and I take advantage of this fact to keep the promise I made myself when I first started this journey on Methadone: I would never dose before 4:30 a.m. An arbitrary time, an arbitrary rule, kind of like many of the clinic rules: just something to keep me in control of these insidious orange disks.
Stop the War: Begin the Healing
One of the properties of methadone that make it ideal for heroin addiction recovery is that is has a half-life of 24 hours, and can last as long as 36-48 hours in stabilized patients. Yet methadone can be a fickle lover, and there are many things that can cause an early detox, or aberrant metabolization. Too much coffee, extreme stress, not enough sleep, certain medications…the list is as individual as the person. This is one methadone client’s post of a “sleepless methadone night”.
“The plaintiff stood nervously at her lectern, shuffling papers, smacking her lips to smooth her lipstick after combating her nervous dry mouth with a sip of water. The well dressed young woman came before this court to recover a cell phone debt incurred by the defendant, a flamboyant Hollywood boy-toy dressed in a colorful poncho and carrying a designer alligator bag, or brief case, or whatever you want to call it. But the braggart placed it on the table next to his lectern and microphone with a sly and better than thou attitude, shifting his weight from one hip to the other, in that very L.A. metro-sexual way of saying, “oh honey, let’s just get this over with!”
And I heard, “…but the defendant says that she was riding his coattails to the best bars, and normally he wouldn’t have even bothered with someone with only one broken Gucci bag, but he felt sorry for her.”
Huh? Suddenly my attention was piqued for one unbelieving moment and I immediately became disgusted and the phoney wannabe-ness of this ignorantly and narcissistically damaged person (of male persuasion). The plaintiff, smiled in her sweetness in a ‘what can I say?’ sorta way. And for the brief moment it takes to regain consciousness from a restful sleep, I forgot that it was just three o’clock in the morning and that I had only passed one half hour of this endless night.
I try to go back to sleep…sometimes if I close my eyes, when I open them again, an hour or so may have gone by without my knowledge while in this predetoxification state. It is a feeling that I have gotten used to, but that I will never be able to accept. I start to kick my legs as they cramp up on me, and a horrible feeling like a wash of chemicals runs through my esophagus and I can FEEL the taste and smell of the drug that is in every functioning cell of my body.
Getting up and moving around gets rid of that dope sick feeling for a time, and I take advantage of this fact to keep the promise I made myself when I first started this journey on Methadone: I would never dose before 4:30 a.m. An arbitrary time, an arbitrary rule, kind of like many of the clinic rules: just something to keep me in control of these insidious orange disks.
Stop the War: Begin the Healing
Monday, December 24, 2007
Houston Pain Clinics
With great urgency, the Houston news machine has been churning out stories about the area’s pain management clinics. First “breaking” with “Are Some Houston Pain Clinics Prescription Pill Mills?” , (See www.click2houston.com) the rest of the media jumped on the bandwagon. Is this “breaking news” or is it free publicity for these clinics?
Pain management clinics have been operating in Houston for years, and they will continue to operate, for as long as there is a demand, and there will always be a demand. And those that didn’t know about them before, now know not only that they exist, but the media has kindly shown us, step by step, how to obtain drugs through these clinics. Should parents of experimenting young adults be thanking the media or cursing it?
According to click2houston.com, the DEA is now investigating these clinics, and have suspended ONE physician license. Yet thousands have now learned of these clinics, and see them as a legal way to get illegal drugs and make some money, too.
The problem is that pain treatment is a necessary and integral part of medical management, and is a legitimate, respected, and essential field of medicine. Millions of people suffer with intractable chronic pain, preventing them from working. Many end up in poverty, on disability, and still in pain. Pain management can allow many to return to work and lead a more normal life.
The media’s focus on these pain management clinics may create awareness of a problem; however it is the wrong problem. Some of these clinic doctors may be mildly concerned about the DEA, and it is true that there are doctors that line their pockets at the expense of their patients’ health. Knock them down and another doc-in-the-box will just pop up.
Rather than stigmatizing and prejudicing all pain management practices, the media should give equal time to those clinics that are legitimately practicing chronic pain medicine, that combine state of the art medicine with social support.
Pain management clinics have been operating in Houston for years, and they will continue to operate, for as long as there is a demand, and there will always be a demand. And those that didn’t know about them before, now know not only that they exist, but the media has kindly shown us, step by step, how to obtain drugs through these clinics. Should parents of experimenting young adults be thanking the media or cursing it?
According to click2houston.com, the DEA is now investigating these clinics, and have suspended ONE physician license. Yet thousands have now learned of these clinics, and see them as a legal way to get illegal drugs and make some money, too.
The problem is that pain treatment is a necessary and integral part of medical management, and is a legitimate, respected, and essential field of medicine. Millions of people suffer with intractable chronic pain, preventing them from working. Many end up in poverty, on disability, and still in pain. Pain management can allow many to return to work and lead a more normal life.
The media’s focus on these pain management clinics may create awareness of a problem; however it is the wrong problem. Some of these clinic doctors may be mildly concerned about the DEA, and it is true that there are doctors that line their pockets at the expense of their patients’ health. Knock them down and another doc-in-the-box will just pop up.
Rather than stigmatizing and prejudicing all pain management practices, the media should give equal time to those clinics that are legitimately practicing chronic pain medicine, that combine state of the art medicine with social support.
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