Markham's Behavioral Health

Pulled From the Wreckage (Of Addiction)

On Sunday, September 30, 2007, Rev. Tamara Lebak, Assistant Pastor at All Soul's Unitarian Church, in Tulsa, OK gave a wonderful sermon on addiction and the need to sometimes surrender in life entitled "Pulled From The Wreckage." She even sings a couple of times during her sermon and she has a beautiful voice.

This sermon lasts about 25 minutes and its well worth listening to. Here is part of the blurb describing the sermon from the Digg web site.

Those of us who have been touched by substance abuse are familiar with this sort of interpersonal wreckage: when those we love cannot stop themselves from drinking or using drugs. I have yet to meet a person who has not been affected by substance abuse, whether directly or through a friendship or family member. Tragically, fear and misunderstanding â the stigma we are all so familiar with â keep people from seeking care, limit public support for expanded services, and make it difficult for individuals to rebuild their lives once they are well. I believe that addiction is a disease and that the human experience in modern culture perpetuates a desire to make real contact with others and only offers cheap substitutes for that meaningful contact: drinking, drugs, shopping, video games, television. The holes in our soul cannot be filled by the idols our culture offers to us. Join me this Sunday as I explore the stigma of substance abuse and our common need for contact.

You can access it by going to the Digg web site at the link below.

Link: Digg - Pulled From the Wreckage (All Souls Unitarian Church, Tulsa, OK).

Men who smoke risk erectile dysfunction

Hey guys, before you reach for the Viagra and Cialis maybe you ought to quit smoking. According to an article done by Reuters on September 26, 2007, on a study published in the October, 2007 American Journal of Epidemiology, men who smoke risk erectile dysfunction which means they can be impotent which means they can't get it up which means they can't get wood when they want to.

Otherwise healthy men who smoke risk developing erectile dysfunction -- and the more cigarettes they smoke, the greater the risk of erectile dysfunction, according to a new study.

Erectile dysfunction is the consistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. In a study of 4,763 Chinese men aged 35 to 74 years who were free of blood vessel disease and who reported that they had been sexually active within the last 6 months, the researchers found a significant statistical link between the number of cigarettes smoked and the likelihood of erectile dysfunction.

Link: MedlinePlus: Men who smoke risk erectile dysfunction: study.

New York State Office of Alcoholism and Substance Abuse initiates landmark policy banning tobacco products in its licensed facilities making it first in the nation

The New York State Office Of Alcoholism and Substance Abuse (OASAS), has announced in a press release issued on July 24, 2007, that all New York State licensed alcohol and drug treatment programs will be expected to be tobacco free by July 24, 2008. This means that no tobacco products or paraphernalia such as lighters, rolling papers, etc. will be allowed on agency properties or vehicles. Tobacco products will be considered and treated as contraband just as alcohol and street drugs are in OASAS treatment and prevention facilities. This is the first such policy in the United States and is labled as a "landmark initiative".

For the first time in professional substance abuse history a major regulatory and funding body has taken a sane and rational approach. Nicotine is the most addicting and deadly drug in America. 30,000 Americans die every year from street drugs, 100,000 from alcohol, and 430,000 from tobacco. What is America's drug problem.

Dr. Bob, and Bill W. the founders of Alcoholic Anonymous both died from tobacco.

Here is a brief snippet from the OASAS press release:

OASAS, which certifies and funds more than 1,400 prevention and treatment programs, today issued a proposed regulation that would take effect July 24, 2008, following final approval. It would require that all providers prohibit tobacco within facilities, on all grounds under their control and in program vehicles.

To read the whole press release, click on the link below.

Link: OASAS launches Tobacco Freedom Initiative.

Pathological gambling is an addictive disorder

There is an interesting article in the June, 2007 issue of the Journal of Addiction Medicine entitled, "Pathological Gambling: A Nonsubstance, Substance-Related Disorder?" which provides an overview of the history of diagnosing and treating pathological gambling.

Lifetime prevalence rates for pathological gambling are between 1% and 2% of the population. The co-occurance of pathological gambling and other substance using disorders is about 50% for gamblers who also have substance use problems, and about 9% - 16% for people with substance use disorders who also have gambling problems.

With minor variations current treatment for pathological gambling is very similar to treatment for substance use disorders. There is no know effective medications.

With the rise in gambling opportunities in all states but Hawaii and Utah, it is predicted that the prevalence of pathological gambling disorder will increase over the next few years. It is also important for substance use treatment providers to screen clients for gambling problems as well as substance use disorders because the rate of pathological gambling among the chemically dependent is about 10 times the rate in the general population.

Pathological gambling leads to financial ruin, divorce, depression, criminal justice problems, and sometimes suicide. It often requires professional treatment and other assistance.

Unfortunately, the article is not available on line for free.

Pain medicine use has nearly doubled

The Associated Press reported on August 20, 2007 that pain medicine use has nearly doubled between 1997 and 2005. The use of OxyContin manufactured by Purdue Pharma has jumped six fold between 1997 and 2005. Pharma executives were recently pled guilty to lying to patients, physicians, and federal regulators about the addictive nature of the drug.

While the use of opiate pain killers has a legitimate place in the treatment of pain, they also have been increasingly abused and people have become addicted such as Rush Limbaugh and Bret Favre.

At the substance abuse agency where I work we are seeing a big increase in prescription pain medicine abuse and addiction. OxyContin gained notoriety in the Appalachian states of West Virginia, Kentucky, and Tennesee where it was called "hillbilly heroin."

Studies have shown that emergency room visits for painkiller abuse has increased by 160% since 1995. In the last four years the DEA has prosecuted 108 physicians for the inappropriate prescribing of pain killing drugs. Of the 108, 83 pleased guilty or no contest while 16 others were convicted by juries. 8 cases are still pending and 1 physician is a fugitve.

Be careful with the pain killers. The pain they cause can be worse than the pain they alleviate.

Link: AP: Pain medicine use has nearly doubled - Yahoo! News.

Suboxone stepped treatment helps heroin addicts

Reuters reported on June 1, 2007 on a study in the May, 2007 issue of the American Journal of Psychiatry which found that treatment of heroin addiction with Suboxone and if necessay, with Methadone, kept 78% of the heroin addicts in the study in treatment for for six months and opiate free.

One of the most encouraging findings, said Heilig "is how well heroin addicts, even with long histories of addiction, can do in a well designed combination of optimal pharmacological and behavioral treatment. I believe these results are among the best published in controlled studies."

Link: MedlinePlus: Suboxone stepped treatment helps heroin addicts.

Party Host Mom Set for Va. Jail Term

On June 9, 2007, the Washington Post has an interesting article about Elisa Kelly and her ex-husband, George Robinson, who were sentenced to 27 months in a Virginia jail for providing alcohol a few years ago to her 16 and 15 year old sons and their friends. Elisa and George were charged with nine counts of contributing to the delinquency of a minor and were found guilty. Elisa and George appealed their convictions and went all the way to the U.S. Supreme Court which refused to hear the case allowing the convictions to stand.

Is this penalty too severe for the offense?

We live in a society which sees nothing wrong with the abuse of alcohol and yet alcohol contributes to over 17,000 deaths a year from DWI crashes, hundred of thousands of injuries, millions of dollars in property destruction, hundreds of thousands of rapes and assaults, and we continue to see commercials on TV and in magazines which promise us joy, excitement, pleasure if we drink this beer, or that alcopop beverage, and imbide fine whiskey.

When parents allow young people to abuse alcohol you have to wonder about the judgment of such people. Whether they belong in jail is another question. I would much rather see them on probation where their behavior can be monitored to encourage better judgment and healthier decisions when it comes to the parenting of their children.

As a public health issue, underage drinking and adult alcohol abuse is a huge concern with high mortality and injury consequences. Elisa Kelly and George Robinson don't deserve to be exploited to be made examples of in an attempt to change societal norms and attitudes, and yet societal norms and attitudes do need to change if the public health is to improve. The breweries and distilleries lie continually to the public about the benefits of their products and they spend millions of dollars a year creating expectations that using their products leads to pleasure and fun and to some extent this may be true, but the use of their products also leads to destructive, tragic, and very expensive consequences as well. Children are in no position to use good judgement in making good decisions without parental and adult guidance and when the parents let the kids down it is right for the broader community to be concerned and hold such parents accountable.

Link: Party Host Mom Set for Va. Jail Term - washingtonpost.com.

I Am a Promise: The Children of Stanton Elementary School, the film

I Am A Promise: The Children of Stanton Elementary School is an award winning documentary released in 1993 about an inner city school in Philadelphia which won the the 1994 Academy Award for Best Documentary.

The film depicts the challenges and difficulties of trying to educate kids in poverty who come from single parent, drug addicted neighborhoods. I doubt that much has changed in the last 13 years.

This film is well worth watching and I highly recommend it.

Link: I Am a Promise: The Children of Stanton Elementary School (1993).

Where do drug abusers get their prescription pain killers? From family

Where do prescription drug abusers get their drugs? The internet? No. On the street? Sometimes. From the family medicine cabinet and from friends? Usually.

Reuters Health Day  reported on February 9, 2007 on a couple of recent studies which have been done.

"About 60 percent are getting their drugs from friends and family for free, while another 15 percent go and buy them from friends," Clark said in reference to numbers from SAMHSA's 2005 national survey of drug use, which also confirmed that opioid analgesic use is on the rise among teens. "So, in the case of a general population, drug dealers aren't the biggest problem either, although it's certainly no surprise that hard-core addicts are getting it that way," he said.

Link: MedlinePlus: Dealers, Family Biggest Sources of Illegal Prescription Painkillers.

Drunk driving doesn't always kill. Sometimes it injures

Drunk driving crashes don't kill everybody. They maime and injure as well.