Investigators at Massachusetts General Hospital have determined that stimulant medication misuse increases the risk of conduct problems, substance abuse, and ADHD among college students when compared to peers who did not misuse stimulant medication. The investigators also discovered that the extended versions of this class of drug was misused less often than the immediate release versions. The investigative results of the study can be found in the Journal of Clinical Psychiatry. According to the report corresponding author Timothy Wilens, M.D., “Our data suggest that college students who misuse prescription stimulant medication are more likely to exhibit clinically relevant psychiatric dysfunction. In addition to higher levels of ADHD, conduct disorder, and alcohol or drug use disorders, the majority of those misusing stimulants met or approached criteria for stimulant-use disorder.”
The fact that stimulant medications are typically used to treat ADHD is ironic because stimulant medication misuse can actually cause this disorder, as well as making the person more likely to engage in other forms of substance abuse and to develop conduct disorders. Dr. Wilens explained that “Someone may report on a survey that they misused stimulants on ‘a handful of occasions’ and have never been diagnosed with a substance-use disorder. While that misuser may deny having a stimulant-use disorder, when systematically queried, it may be found that he or she met or approached the criteria for a full disorder. Some misusers may be pressured to use a friend’s prescription if they believe it will improve academic performance, which is not likely if combined with alcohol or other drugs. We know that untreated ADHD is associated with increased risk of alcohol- and drug-use disorders, so it is not surprising that we found high rates of co-occurring ADHD and of stimulant-use and overall substance-use disorders in those misusing stimulants. It’s possible that pre-existing cognitive deficits may lead some individuals to develop stimulant misuse as they try to self-medicate.”
Opioid use disorder is a form of substance abuse that involves opioid drugs and medications. This is a pattern of problematic opioid use that leads to distress or impairment, making it impossible for the user to perform daily tasks or function normally. Between 2012 and 2013 the National Institute on Alcohol Abuse and Alcoholism reports that around 10 million adults in the United States misused prescription opioid medications. This does not take into account individuals who used heroin, which is also an opioid but which is never legally prescribed because of the addiction risks and other problems associated with this specific drug. Someone who is under continuous medical supervision and who only uses the opioid drugs as needed and prescribed can build up a tolerance and even have withdrawal symptoms when the drug is stopped but these individuals do not have opioid use disorder.
Some signs that opioid use disorder is a problem can include some symptoms of other forms of substance abuse. Some things to watch for include:
Taking legally prescribed opioid drugs in larger amounts, for longer than intended, or more often than prescribed.
Efforts to cut down on opioid use are unsuccessful.
A considerable amount of time, effort, or money is spent trying to find and get the drugs.
Cravings for the opioid drugs.
Failing to fulfill responsibilities at work, home, or school because of the substance abuse.
Lost interest in friends, social activities, hobbies, and recreation so that the drug can be used.
July 4th is Independence Day in the USA, a holiday that celebrates the hard won freedoms that Americans enjoy today, but it could be independence day for anyone who has a substance abuse problem as well. Don’t let drugs or alcohol make you dependent and ruin your life. There is help available and you can finally become a strong and independent person who does not have to rely on substances any more. If you or a loved one needs help then the first step is recognizing that there is a substance abuse issue and deciding what type of rehab would work best. Government run facilities have a lower cost but they can be crowded, and the treatment methods used by these programs may not be the most effective because of cost constraints.
Substance abuse can have a devastating impact on your life, and without rehab things will usually continue to spiral out of control as the drug or alcohol abuse gets worse over time. An effective rehab program can be the answer but only if the right program is determined before an intervention is attempted. If you try to have an intervention without finding a substance abuse treatment program then if the individual agrees to treatment you will not have anywhere to send them. A professional intervention can be the best approach, with an intervention specialist who can arrange for immediate treatment. Take your life back on Independence Day, and declare your independence from drugs and alcohol once and for all. Don’t let addiction stop you from living your life to the fullest.
There is still a social stigma associated with substance abuse even today, but just how harmful is this stigma and can it finally be eliminated once and for all? Many people view alcohol and drug abuse as a personal failing instead of an addiction, and this can be very harmful because it places all of the blame on the individual. Another model is the medical model, which views substance abuse as a medical condition like heart disease, high blood pressure, or diabetes. The problem with this model is that it takes all personal responsibility away from the user and can offer the viewpoint of “It’s not my fault, I can’t help myself, I have a disease”. Neither extreme model is effective but the medical model does try to remove some of the social stigma associated with drug and alcohol abuse.
Instead of entirely blaming the individual for the substance abuse, which only increases the social stigma attached to this problem, or blaming everything on a disease a balance needs to be struck. The individual must take some responsibility for their actions while society needs to adapt and accept the fact that substance abuse does have a genetic component and tends to run in families. When this is achieved we will be able to offer effective treatment for substance abuse and those who have a problem and need treatment will be more willing to admit that they have a problem and need help. Right now many people do not admit they have a substance abuse issue for fear that the social stigma could ruin their career or even their life. This need to change.
Substance use and substance abuse are not always the same thing, and there are varying degrees of alcohol and drug use that need to be considered to determine whether treatment or rehab is needed. The main types of alcohol and drug use include:
Experiment- Many people experiment with various substances throughout their lives. Many adolescents have experimented with alcohol or marijuana, but experimentation does not necessarily mean that the substance use has reached abuse or that help and treatment is necessary.
Social Use- Social use does not mean substance abuse. The individual may use alcohol or drugs only in social settings where the substance is used to help them relax and lessen any social anxiety that they may feel. This is the person who may have one or two drinks at a social gathering but who may not consume alcohol at all otherwise.
Binge Use- Binge substance use may or may not be considered substance abuse. The issue with a binge is that large amounts of alcohol or another substance is used in a short time period, while the individual may be a teetotaler the rest of the time. Binge episodes do indicate a need for treatment.
Abuse/Addiction- Substance abuse may also be referred to as addiction. This occurs when the use of a substance interferes with normal life and daily activities. The individual becomes dependent on or addicted to the use of the substance and a normal and healthy life is not possible until substance abuse treatment is successfully achieved.
The fact that there is a link between substance abuse and suicide attempts is not disputed, but the mechanics are more complicated than this and the link may change depending on age, race, gender, and other factors. The latest study in this area involves examining the suicidal emergency department records for hundreds of patients, and it shows that when cocaine and alcohol are used together this includes a very strong link to a higher risk of suicide attempts in the future. According to the study authors “One unexpected finding was that, when examined independently, alcohol use had no significant association and cocaine use had a borderline significant association. However, reporting both alcohol misuse and cocaine use was significantly associated with a future suicide attempt.”
Brown University Alpert Medical School researcher Sarah Arias discussed the study on substance abuse and suicide attempts in view of the study findings, writing “These disparate findings emphasize the complex interaction of sex, substance use, and suicide attempts. They also suggest women may be differentially at risk depending on whether they report substance use or past suicide attempts. It’s not a clear-cut, straightforward association. Even though substance use is often touted as a very strong predictor of suicidal intentions and behaviors, when we look at individual substances we’re seeing that there’s not that consistency in the future association with behavior.” Arias also explained that “We’re on our way to trying to identify factors that can be used to better assess and identify people who are at risk for suicide, and ultimately I think this is a step in the right direction to get a better picture. Patients who have potentially comorbid alcohol and cocaine use may be at a higher risk. Findings like these can be useful for informing suicide risk assessment.”
There has been a lot of controversy over whether marijuana use can lead to other forms of substance abuse, and a new study has shed new light on the topic. Researchers looked at national surveys which were taken 3 years apart, and they found that the adults who reported using marijuana in the initial survey were also between two and nine times more likely to have developed a problem with substance abuse when they took the second survey. Researchers are hoping that the risks of marijuana use will be considered by everyone, from patients and doctors to lawmakers and policymakers who consider whether to approve marijuana for medical or recreational use. These risks may not be as small or inconsequential as some believe.
Dr. Mark Olfson, the senior author of the study and a researcher associated with both the New York State Psychiatric Institute in New York City and Columbia University Medical Center, explained the results of the marijuana use and substance abuse survey study. Olfson stated in an email to Reuters Health that “Patients who may be considering using cannabis should know that by using cannabis they are approximately doubling their risk of developing a drug use disorder over the next few years. Patients who already use cannabis should be aware that increasing their use may further increase their risk of developing a substance use disorder, while reducing or stopping their cannabis use is likely to reduce that risk.”
Olfson continued by explaining “Policymakers who may have to vote on legalization of marijuana should consider potential adverse effects of marijuana use on the risks of developing other drug and alcohol abuse problems. In states with marijuana laws that permit recreational marijuana use, regulators and public health officials should develop means of monitoring and communicating this risk. By studying the effects of existing state-to-state variation in marijuana laws in relation to key outcomes, such as cannabis-related traffic injuries and fatalities, emergency department mentions, poison control calls, and admissions to addiction facilities, it might be possible to increase our understanding of the public health effects of marijuana legislation.”
Recent research has determined that simply smelling alcohol can have an impact on substance abuse and behavior, causing individuals to have more difficulty in controlling their behavior. Researchers at Edge Hill University in England gave study participants a face mask, with some receiving a face mask that was alcohol laced while others received a mask that was laced with a citrus scent instead. The study participants had to press a specific button when they saw either a beer bottle picture or the letter K on the computer screen. Study participants who were wearing the face mask laced with alcohol tended to have a higher number of false alarms.
Edge Hill University psychology senior lecturer Dr. Rebecca Monk explained the study on alcohol and substance abuse, saying “We know that alcohol behaviors are shaped by our environment, including who we’re with and the settings in which we drink. This research is a first attempt to explore other triggers, such as smell, that may interfere with people’s ability to refrain from a particular behavior. For example, during the experiment it seemed that just the smell of alcohol was making it harder for participants to control their behavior to stop pressing a button.” Edge Hill Professor Derek Heim, a fellow researcher, noted that “Our hope is that by increasing our understanding of how context shapes substance-use behaviors, we will be able to make interventions more sensitive to the different situations in which people consume substances.” More studies are needed, and this study must be replicated in a real world environment for further validation.
A recent study has determined that more than 33% of the lawyers who practice in the USA have substance abuse struggles, and more than 1 in 4 of these lawyers also deal with depression according to the National law Journal. The study researchers performed a survey which included around 13,000 lawyers, and this is one of the biggest and most comprehensive studies that has been performed to date. The study determined that lawyers deal with higher rates of substance abuse and even some other mental health disorders including depression at a rate that is higher than what is seen in the general population. The study found that 36% of attorneys in the USA are considered problem drinkers based on how much and how often they drink, while only 15% of medical professionals met the criteria for this condition.
The study title is The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys, and it will be published in the Journal of Addiction Medicine February edition. One co-author on the study of lawyers and substance abuse. Patrick Krill, also operates a program offering substance abuse treatment for judges and attorneys who need help. Krill explained “Any way you look at it, this data is very alarming. It paints the picture of an unsustainable professional culture that’s harming too many people.” The study results showed that almost 29% of attorneys who were in their initial 10 years of practice were problem drinkers, while only 21% met this classification when they practiced between 11 and 20 years. For lawyers under the age of 30 over 32% had a substance abuse problem with alcohol, for those between 31 and 40 years old 26% were considered problem drinkers.