Understanding addiction as a disease has its roots in work by doctors and theorists in the late 1700s. In fact, one of the signers of the Declaration of Independence, a Dr. Benjamin Rush called alcoholism a "palsy of the will" and argued for it to be treated medically. Other competing theories of addiction have essentially relegated the behaviors to lack of will power, laziness, or other negative personality traits.

At present, the medical world – rehabs, clinics, detox centers, and even some self help groups – have for the most part adopted the medical model. Addiction is seen as a disease requiring treatment, and treatment involves receiving a diagnosis, possibly medication, and other medically necessary care. Much of this care is billed to and paid for by insurance companies or if eligible, Medicaid. What are the pros and cons of viewing addiction through this lens? What are alternatives to this point of view?

The Downsides

The downsides, or cons, of understanding addiction as a disease include the assertion that by declaring addiction a disease, you actually disempower people to change and remove the motivation or will to do so. "If it is a disease, then I can’t help it," is often how this argument goes. And thus, for some people, this becomes an argument supporting the notion that addiction is a choice and a matter of will power or self-control. Again, the idea behind this is that asserting that the behavior (drinking or using drugs) is a choice underlines the potential to make a different choice and be effective in making changes. Labeling the behavior a disease does nothing to empower the person to change, according to critics.

There is, however, another serious downside to considering addiction a disease: if it is a disease requiring medical treatment, then it must be covered by health insurance, or Medicaid. The expense involved in treating addiction is huge. The New York Times reported that in one year New York (state, not city) spends more than $300 million on detoxification services alone.

Of course there are counter arguments, most importantly the assertion that if services were not available, the cost in suffering and loss of life would be higher, and that people suffering from addictions would end up costing society (and thus tax-payer money) elsewhere in the system – if not receiving treatment then via jails, other law enforcement costs, or unemployment and social services.

The Benefits

The "upsides" of regarding addiction as a disease include

• Reduction of stigma, thus making it easier for increasing numbers of people who otherwise might not seek help
• Availability of help via treatment centers
• The development of a field of treatment professionals and para-professionals and the creation of jobs, sometimes even for recovering addicts or alcoholics, who then become involved in helping others
• Thorough assessments often reveal underlying or co-morbid conditions that require treatment, such as depression or bipolar disorder
• Medical treatment can be brief and episodic and include linking the patient to other self help groups and community-based services

Other models of addiction and/or treatment of addiction include the harm reduction approach, and the life process model of addiction. Both of these models focus on other aspects of addiction and rather than counter the disease model directly, they simply downplay its importance.

However, the federal government actually supplies four citizens with marijuana cigarettes to be used for medicinal purposes, so theoretically, these are the only four Americans allowed to smoke marijuana for medical reasons.

Sixteen states have passed laws that allow citizens to use marijuana if their doctors "recommend" it for chronic pain relief, movement disorders and muscle spasticity, to alleviate nausea while undergoing chemotherapy, and/or as an appetite stimulant. This means that the federal statutes are in conflict with the laws in sixteen states.

In some of the states that have laws allowing for the medical use of marijuana, "clinics" have sprung up where it is relatively easy to obtain a "medical recommendation" to use the drug. In some of these states, such as California, you can even grow your own marijuana if you have a medical recommendation. Many people believe they now found a legal way to use marijuana for recreational purposes. However, this is not the case, because no one is sure when or if federal authorities will crack down on the sixteen states that have laws allowing people to use medical marijuana.

To further complicate the matter, several medications that contain the active ingredient in marijuana are already on the market. These medicines have undergone rigorous testing for safety and effectiveness as part of a formal approval process through the Federal Food and Drug Administration. They come in the form of pills, patches, and even mouth sprays, but not as cigarettes. Although there is an ongoing government study about the effect of smoking marijuana to relieve posttraumatic stress syndrome among veterans of the Middle East conflicts, most doctors will not prescribe any form of smoking because of its link to cancer.

Marinol and Casamet are two kinds of tablets containing a synthetic version of the active ingredient in marijuana. These pills are used to ease the side effects of chemotherapy in cancer patients. Marinol is also prescribed to AIDS victims as an appetite stimulant. The FDA was also testing an anti-obesity drug called Acomplia, which blocks the chemical receptors associated with marijuana, but stopped the tests once Acomplia was linked to an increased risk for suicide.

GW Pharma, a British drug company, is currently testing a mouth spray that would be used as a treatment for cancer pain. The drug is called Sativex, and contains Delta 9-THC and cannabidiol, the active ingredients in raw marijuana, and not synthetic versions of them.

Some people with multiple sclerosis have reported that smoking marijuana eases the pain of their muscle spasms. Timothy Coetzee, the chief research officer of the National Multiple Sclerosis Society, has said that no one knows for sure if marijuana is truly effective for this purpose, because available clinical studies are inconclusive.

Kris Hermes, a spokesperson for Americans for Safe Access, said his group believes the federal government should decriminalize marijuana. The FDA and its slow approval of drugs like Sativex may just be confusing the issue.

"To the extent that companies can produce effective medication that utilizes the components of the plant, that’s great," he said. "That’s the race against time in terms of how quickly can we put pressure on the federal government to recognize that the plant has medical use versus the government coming out with the magic bullet pharmaceutical pill."

A recent study examined the prevalence of drug use among aviation employees (Li et al, 2011). The federal government requires drug testing of certain employees in "safety-sensitive" occupations, including airline pilots. The study assessed whether use of illicit drugs is associated with a heightened risk of airline accidents.

About the Study

The researchers used aviation employer records to analyze results of drug tests for substances, including marijuana, cocaine, amphetamines, opiates and phencyclidine. The analysis involved employees at all major airlines, commuter air carriers and air taxis, and non-FAA air traffic controllers. It included flight crewmembers, flight attendants, flight instructors and aircraft dispatchers. The analysis covered a 10-year period from 1995 to 2005.

The researchers looked at both random drug testing and post-accident testing. The random testing comprised about 96 percent of the data, representing urine testing for a random selection of at least 25 percent of employees. Post-accident testing was conducted within 32 hours of an accident for employees who may have had an impact on the accident through job performance.

Drug Use Rare but Serious

The results of the analysis revealed that the occurrence of drug use was very low in random drug testing. However, it also showed that when an employee tested positive for drugs, they were nearly three times as likely to be associated with an accident when compared with an employee who tested negative for drugs.

Across all drug violations, marijuana accounted for 67.3 percent of all violations, while cocaine accounted for 23.9 percent and amphetamines accounted for 6.1 percent.

There were some limitations to the results that may affect their generalizability to other segments of aviation. For instance, the analysis did not include non-commercial aviation accidents, which account for 90 percent of all aviation accidents.

The results of the analysis reveal that drug use among aviation employees is rare, but the risk of accident goes up significantly if an employee does use drugs. Because of the limitation of the study to commercial air, the research on the topic is limited.

Later, feeling regret for food choices made, the individual will purge calories. Purging is usually done by self-induced vomiting or by the use of laxatives.

An article posted on Seattle PI discussed the possible removal of ipecac from store shelves in the state of New York. State legislators must decide whether the substance should be placed behind the pharmacy counter in order to prevent those with eating disorders from stocking up on it.

The legislation is being pushed through to Governor Cuomo by Debbie Begeny, of the Buffalo suburb of Kenmore. Begeny’s daughter died of cardiac arrest related to her anorexia nervosa after using ipecac for many weeks. Many with eating disorders use the substance to purge unwanted calories from their bodies.

Traditionally, ipecac has been used in the household as part of standard first-aid kits. When a child ingested a toxic chemical, parents were advised to use ipecac to induce vomiting. However, pediatricians now rarely advise the use of ipecac for this purpose. The legislation would place the substance behind the counter and require the documentation of the consumer using ipecac to prevent any individual from stocking up at home.

In what some call the ultimate symbol of the power of drug addiction, Dexter Manley, a football legend and 1983 Super Bowl ring holder, took his famed ring to a pawn shop to help fund his cocaine addiction. Years later, while preparing for the 2010 Super Bowl, Dexter’s wife phoned him with the news that she had re-acquired the ring, which became a symbol of Dexter’s new life that’s fully committed to drug addiction recovery.

Manley’s football career is marked with periods of relapse and recovery from drug addiction, beginning with a position on the Oklahoma State University team and then an eleven-year span with the NFL Washington Redskins. Three decades ago, Manley experienced a long-remembered moment in his drug addiction story, when he faced an NFL ban in 1991 for unsuccessful drug tests. Reports indicated jail time and multiple arrests for substances including crack cocaine.

Manley had a chance in 1999 to regain possession of his Super Bowl ring when his family attorney presented it to him – but the football star gave it back, saying he needed to be in full recovery before reclaiming his prized possession. A few years following the event, Manley saw more jail time for cocaine offenses. When his wife, Lydia, gave him the ring again in 2010 Manley accepted, marking his progress along the drug addiction recovery path.

The football legend’s bouts with drug addiction are believed connected to the pressures of the occupation and to the athlete’s personal struggles, including dyslexia. Manley has said in emotional speaking engagements that he has the disorder and struggled to read, even though he is a college graduate. Positive personal relationships along Manley’s addiction journey are also highlighted in reports, including with recovering alcoholic and high-profile attorney John O’Quinn, who passed away in 2009. Manley requested the return of the Super Bowl ring previously from O’Quinn, but the attorney did not return it for fear that Manley had not yet conquered his addiction.

Headlines addressing the famed Super Bowl ring continue to describe Manley as coming full circle with drug addiction. Today, Manley’s personal focus on recovery includes active speaking engagements at high schools. Students who have attended have commented on the athlete’s obvious passion toward a life free of drugs as he recounts all that the drugs have cost him, including relationships, finances and career accomplishments. His presentations are said to be strikingly bold and honest as he talks to students about overcoming addiction – and avoiding drugs altogether.

Refusing to hide from the addiction is also a key factor in his success, says Manley, and it’s part of the message he brings to the public as he strives to help others learn from his story.

For the study, researchers examined prairie voles, rodents that form lifelong bonds with their mating partners. The researchers, led by Zuoxin Wang, PhD, of Florida State University, found that the males that had a life-long mate were less interested in amphetamine, compared with "single" males. Amphetamine exposure led to changes in the nucleus accumbens, part of the brain’s reward system, that also differed depending on the voles’ relationship status.

The researchers discovered that brain cells in both paired and single voles released a similar amount of the neurotransmitter dopamine, which plays an important role in the brain’s reward system, when exposed to amphetamine. However, the dopamine may have different effects on the voles, depending on their relationship status.

In single voles, amphetamine use increased the binding of dopamine to the D1 receptor in the nucleus accumbens, but the binding was decreased in paired moles. This suggested that single and paired voles have opposite reactions to amphetamine.

When given drugs that blocked dopamine from binding to the D1 receptor, single voles were less attracted to amphetamine. On the other hand, paired voles became more attracted to dopamine when given the blocking drug.

Wang said this suggests that the long-term relationships may change the neurobiological response to drugs like amphetamine, which may make the drugs less appealing.

Previous studies by Wang showed that single voles sought out the rewarding effects of amphetamine, and that repeated exposure to the drug made them less driven to seek a lifelong mate. The current study looks at whether relationships formed in adulthood could make substance abuse less appealing and rewarding.

Larry Young, PhD, and expert in social behavior at Emory University, who was not involved in the study, said that although this study’s findings are very interesting, more research needs to be done to determine whether paired voles would be less likely to seek drugs if they were given unlimited access to them. He added that understanding how social relationships affect substance abuse could inform new treatments for addiction.

Source: Science Daily, Steady Relationships Reduce Amphetamine’s Rewarding Effects, Animal Study Suggests, May 31, 201

“Honesty is the first chapter in the book of wisdom.” – Thomas Jefferson, 3rd President of the United States, author of the Declaration of Independence (1762-1826)

Separated by more than two centuries, William Shakespeare and Thomas Jefferson both knew the value of honesty. Shakespeare equated honesty with honor, while Jefferson liked honesty to wisdom. Fast-forward to today and how should we interpret honesty as it relates to our daily lives in recovery? Actually, some things never change. Honesty is just as important today as it ever was.

For those of us in recovery, honesty is critical. Without honesty, we will never come to grips with the falsehoods we’ve told ourselves and others. If we fail to be truthful, we will seek to justify our actions and shirk our own responsibility for what we’ve done and continue to do. Without being honest, we will not reach our goals that we’ve set for ourselves in sobriety. Sooner or later we will bump up against a brick wall that’s largely of our own making. By seeking to avoid the truth, by shading and distorting what’s real, we will be doing ourselves and our loved ones a tremendous disservice.
In short, we have to be honest if we hope to continue to make progress in recovery.

How do we know if we are being honest? It is really quite simple. We have to face the truth about who we are and what we’ve done. We have to tell the truth without resorting to lies, deception, half-truths or omissions. And we need to act the truth – doing the things we know we must to embrace and strengthen our recovery.

Is honesty easy? Is it always the only right way to go? If honesty were easy, everyone would always do it. The truth is that honesty requires integrity, and some of us don’t have that in too much supply early in recovery. It is, however, something that we can develop. We learn how by doing, by not taking short-cuts or looking for the easy way out. Maybe we could only tell half-truths and get away with it. But over time, those half-truths will come back to haunt us. We’ll find out soon enough that going part-way in recovery means we’re sabotaging our efforts and putting our sobriety in jeopardy.

Yes, being honest is sometimes painful. Yes, it means that we may be fearful of what will happen when we tell the truth. But honesty is absolutely critical if we hope to make continued progress in recovery. In that respect, honesty is always the best policy.
 

One recent study compared amounts of tar emitted from a traditional packaged cigarette to amounts emitted from a rolled cigarette, assembled at home, and found that cigarettes rolled by the user had significantly higher levels of chemicals known to be addictive.

The study, conducted at Victoria University, also showed that ingredients in cigarette smoke cause higher levels of a protein to be produced in the body, and this protein aids in boosting the addictive properties of nicotine.

It is estimated that about 50 percent of people who smoke for long periods of their life will die from smoking-related illnesses. Chemicals found in cigarettes that are linked to cancer include arsenic, formaldehyde, chromium and acrolein. Nitrogen oxides, ammonia and forms of cyanide are also present in cigarettes. Cigarettes rolled at home, say researchers, have much larger amounts of tar than retail cigarettes – contributing to even stronger addictive properties.

This may explain why, say researchers, smokers who try nicotine replacements – which don’t include smoke – have a harder time quitting and sticking to their resolve. Some statistics show people may attempt to quit as many as 14 times before becoming successful.

The appeal of rolling-your-own cigarettes may come in price. Smokers purchase a package of rolling papers, which can come in a variety of flavors, and a can of loose smoking tobacco for less cost than traditional cigarettes. However, though perhaps lower in price, smokers are still exposed to the same list of cancer-causing chemicals no matter which type they use, says another study published in Addiction Biology.

The study compared the urine from people who smoked retail cigarettes with samples from people who rolled their own cigarettes to determine levels of two types of carcinogens. Results showed that levels of toxic chemicals in both smokers’ urine were essentially the same, even when participants’ variances in weight, smoking behaviors and ages, along with other considerations, were factored in.

Females, say the researchers, showed more levels of carcinogens than men, no matter which variety of cigarettes they used. Researchers hope the study, conducted at the Health Behavior Research Centre, part of Cancer Research UK, may help dispel the false belief of smokers that rolling-their-own presents a more nature-based and less destructive cigarette.

The conclusion researchers arrived at brings a straightforward message to smokers, says Elspeth Lee of Cancer Research UK. When it comes to smoking, Lee says, no type of cigarette should ever be considered safe. She adds that while rolling-your-own cigarettes may be more appealing to people in lower-income areas, the practice is just as deadly as smoking retail cigarettes.

Lee, along with other members of large-scale anti-smoking initiatives, is calling for new legislation to keep smoking away from young persons and to reduce marketing campaigns for tobacco. Across the globe, experts believe making the deadly habit less appealing and less accessible may help prevent millions of new addictions.

The study, which was conducted by researchers at Dartmouth Medical School in New Hampshire found that those whose parents were stricter with viewing habits early on reduced the onset of adolescent drinking. Researchers polled 3600 children in middle school regarding what types of movies they were allowed to watch. Two years later, the same children were again surveyed to see how that correlated with drinking habits.

Researchers reported that of those who were never allowed to watch R-rated movies, only three percent stated that they were consuming alcohol. This compares to 19 percent of kids who were occasionally allowed to watch R-rated movies and 25 percent of kids whose parents let them watch R-rated movies whenever they wanted.

The study goes to show that parental involvement and rules do have an impact in controlling behavior. Sometimes parents think that kids are going to do what they want and there is no stopping them. That clearly is not the case for all kids, especially when certain boundaries are set from the very beginning. The study illustrates the importance of monitoring children’s viewing habits from a young age.

Dr. James Sargent, author of the study says that the results of this analysis confirm that of prior studies on the subject. He adds that the effects of R-rated movies go beyond early alcohol abuse. Kids see actors and try to imitate what they do. Those who watch this type of adult content often have sex earlier, smoke sooner, and may even exhibit violent behavior.

And, Sargent claims that risky adolescent behaviors such as sex, smoking, and drinking go hand-in-hand. Once a teen has decided to try one, they are more likely to engage in another. This can be harmful as these youngsters are not mature enough to know the full impact of their decisions. Those in middle school are prone to binge drink in high school, which has been associated with poor academic performance and legal problems. Additionally, early use of alcohol has been linked to addiction in later years.

Sargent believes that the content in R-rated movies has the ability to change the personality of youngsters. He states that it can make them more prone to be risky and thrill-seeking. He estimates that about 90 percent of R-rated movies portray the use of alcohol, which could be a contributing factor as to why watching the movies increases the chances for early-onset drinking.

The study has implications for not just R-rated movies but also video games and television programs with questionable content. Parents who want to avoid these types of behaviors in their children have to be firm with what their children are allowed to watch. Sargent concludes by saying that monitoring what children watch is as essential as ensuring they finish their homework or eat their vegetables.

Several prescription medications can cause problems with patients’ sex life, but it can be difficult to pinpoint which medication is responsible, or if life factors are part of the problem. Factors like stress, emotional disturbances and anxiety can all interfere with sexual performance or complicate the side effects from medications.

Medications like antidepressants are long-known to cause sexual side effects like erectile dysfunction and decreased sexual interest, a problem estimated to affect up to 50 percent of patients who are receiving treatment for depression. This is especially true with SSRI antidepressants, which can also prevent a patient from reaching orgasm. Tricyclic antidepressants cause similar problems. Because patients may stop taking these important medications due to sexual side effects, physicians are encouraged to talk with patients about sexual problems and modify the dosages if needed, but only under a doctor’s supervision.

For people with high blood pressure and heart problems, certain medications, such as lisinopril or enalapril can cause impotence. Even some eye drops in the beta-blocker family of drugs can cause sexual problems. For male patients fighting high cholesterol who are taking medications like fibrates or statins, the inability to become aroused may also be a problem.

A range of other conditions – including acid reflux, epilepsy, anxiety, chronic pain or ulcer treatments – also have prescription treatments that are linked to a lack of interest in sex and the inability to perform sexually. Many patients may not be aware that these side effects can occur, making patient education a critical component whenever a prescription is started. If patients suspect their medication may cause sexual dysfunction, they may stop taking it and put their health or lives at risk.

Instead, patients can be switched to a different medication or their dose can be adjusted. Taking medications at different times of the day may also help with sexual problems. In some cases, medications for erectile dysfunction are not recommended to treat sexual problems caused by other medications because additional side effects can occur.

For some patients, just giving the medication time can help ease sexual problems. The problems may lessen as the medication is taken for longer periods. Sometimes patients can set aside times to engage in sexual activity, based upon when they took their medications, in order to help offset some of the side effects.

As physicians and patients work together to discuss and explore side effects and options, a right combination of medications with decreased sexual problems can often be reached, preventing dangerous self-adjustments to prescriptions and helping ensure successful treatment for illnesses without compromising the benefits of a healthy sex life.