Addiction is a complex disorder that results from a combination of genetic, lifestyle, and environmental factors. The role of genetics in addiction has been widely studied over the last few decades, and research has shown that certain genetic factors contribute to an individual's susceptibility to addiction.
One of the most studied genetic factors in addiction is the presence of specific variations in genes that encode proteins involved in the brain's reward system, such as dopamine and serotonin receptors. These variations may affect how these proteins function, leading to alterations in the brain's reward circuitry, which can result in addiction. Other genes linked to addiction include those involved in stress response, impulse control, and decision-making.
For example, researchers have identified specific genes that may influence an individual's response to drugs and alcohol, including genes that affect the metabolism of drugs, the neurotransmitter systems involved in reward and pleasure, and the stress response system. And while research in this area is still ongoing, some genes linked to addiction or protection against addiction include:
Moreover, family studies that include siblings, fraternal twins, identical twins, and adoptees suggest that as much as 50% of a person's risk of becoming addicted to alcohol, nicotine, or other drugs depends on their genetic makeup.
Research on the human genome reveals that humans are 99.9% identical on a genetic level. But the 0.1% variation is critical as it's responsible for the differences in their sequence of DNA bases. These differences contribute to visible variations like hair color and height and invisible traits like protection from or increased risk for diabetes, stroke, heart attack, and addiction.
Genetics is just one factor that contributes to addiction, and the influence of genetic factors can vary depending on an individual's environment and life experiences. Furthermore, not everyone with a family history of addiction will develop substance abuse disorder. People without genetic risk factors still have a risk of developing an addiction. Here are some other factors that contribute to addiction:
Genetic research has provided a better understanding of the complex interplay between genes and diseases like addiction. Today, mutations like BRCA 1 and 2 that predispose patients to a high risk of ovarian and breast cancer serve as crucial medical tools in assessing one's risk of severe diseases. Researchers can now unravel the genetics of single-gene disorders like breast/ovarian cancer, sickle cell anemia, cystic fibrosis, and addiction.
Understanding the genetic basis of addiction makes it easier to identify individuals who are more susceptible to addiction. By using genetic testing to identify these variations, healthcare providers can better evaluate a person's unique addiction risks. But this is an area that needs more research.
In addition to identifying individuals who are more susceptible to addiction, the knowledge of genetics can also inform addiction treatment approaches through pharmacogenetics. Pharmacogenetics studies how an individual's genetic makeup affects their response to medications. By tailoring addiction medications to an individual's genetic makeup, healthcare providers can improve treatment efficacy and reduce the risk of adverse side effects.
If you have a genetic predisposition to addiction, taking proactive steps to manage your risk and prevent addiction is essential. Here are some things you can do:
Remember that having a genetic predisposition to addiction does not mean that you will automatically develop an addiction. Taking proactive steps to manage your risk and getting help if needed can reduce your chances of addiction and help you live a healthy, fulfilling life.
Tranq, an animal sedative, is spreading through the United States illicit drug supply and is thought to be responsible for the surge in overdose cases. The drug is now posing a new threat in the country's ongoing battle against drug overdoses.
Tranq is appearing more frequently in synthetic opioids, particularly fentanyl, causing deaths and severe side effects. Although most jurisdictions don't routinely test for tranq in postmortem toxicology, the DEA estimates the drug was involved in at least 1,423 overdose deaths in the south and 1,281 in the Northeast in 2021. And while the full nationwide scope of overdose death involving the drug is unknown, surveys show deaths associated with tranq have spread westward across the US.
Tranq, also known as Xylazine or tranq dope, is a sedative used to tranquilize large animals during procedures and diagnostic testing. Initially, the drug was given for household pets, but it's now typically used for large animals like elk, cattle, sheep, and horses. The Food and Drug Administration (FDA) approved the drug in 1960 for animal use, but not humans.
Despite this, the drug has become increasingly common in the US illicit drug supply. It is now sold on the streets, usually mixed with other drugs like heroin, cocaine, alcohol, benzodiazepines, methadone, and fentanyl. According to officials, drug dealers and suppliers lace these drugs with Xylazine because it's powerful, cheap, and easy to get. So, in most cases, those who buy these street drugs may be using tranq dope unknowingly.
Now, drugs like heroin and fentanyl are dangerous enough on their own, but Xylazine is making them even more dangerous. Tranq is a powerful sedative meant for animals and can leave users unconscious for hours.
It also causes more complex and potentially more deadly overdoses. And the worst part is users cannot easily detect its presence in the drug supply. Fentanyl test strips that reliably measure fentanyl in street drugs can’t detect tranq presence.
In legal sales, Xylazine is sold directly through pharmaceutical distributors and online platforms for vets. It comes in solid and liquid form or preloaded syringes, with concentrations that match the weight and size of the species. It is not classified as a controlled substance, but people need a valid prescription from a licensed veterinarian to purchase it.
Those without licenses can still obtain tranq in powder and liquid forms through other online sites. These sites often have no association with the veterinary profession and do not require buyers to prove legitimate needs.
According to the DEA, a kilogram of tranq powder can go for as low as USD 6 to USD 20. At this low price, using tranq to lace other drugs may increase profit margins for drug dealers. And the psychoactive effects may also attract buyers looking for prolonged euphoric effects.
The first cases of Xylazine misuse were reported in Puerto Rico in the early 2000s through DEA reporting and lab analysis. But it's unclear when tranq first appeared in the illicit drug market in Philadelphia. Still, public health officials say that the drug seems to be concentrated in Philadelphia, making it the ground zero for tranq dope in the US.
Its uptick in the city's drug market is primarily due to its ability to enhance the potency and duration of a fentanyl high. This has a substantial effect considering fentanyl ranked first ahead of heroin as the city's opioid of choice.
According to researchers, tranq is in 91% of the fentanyl and heroin supply in Philadelphia, and the prevalence is heading west. Reports have also shown that the state of Michigan had an 87% increase in Xylazine-related deaths between 2019 and 2020. Other affected states include Maryland, Delaware, New Jersey, and New York, all of which have seen an increase in drug overdose deaths in 2021.
Tranq is a central nervous system depressant, so it slows down the process in the body's nerve cells. It causes drowsiness and lowers blood pressure, slows the heart rate and breathing to dangerously low levels. Mixing Xylazine and opioids like fentanyl can induce hours of sleep, making it harder to determine whether the user is experiencing an overdose. The risk of life-threatening overdose is also higher when tranq is mixed with other CNS depressants like benzodiazepines or alcohol.
Besides, tranq is highly addictive and can cause physical and psychological dependence. Regular use of the drug can lead to open wounds and skin ulcers. These wounds may result in dead tissue or necrosis and, eventually, amputation of affected limbs.
That's why it's essential for anyone using tranq to seek help before the addiction worsens. Medical experts provide wound care and emergency services to counter the effects of tranq use.
According to experts, tranq is unsafe for humans, and even a small amount can be deadly. Humans are 10-20 times more sensitive to the drug than animals. And as mentioned earlier, tranq is not an opioid and therefore does not respond to naloxone.
Those who overdose on the drug may need breathing assistance in addition to naloxone. Naloxone is given because Xylazine is often mixed with opioids like fentanyl or heroin.
Tranq use can range from mild to severe and cause fatal and non-fatal overdoses. The following are some of the signs and symptoms of Xylazine use:
Tranq addiction presents a different form of challenge to medical professionals. Experts have raised concerns about the limited treatment for tranquilizer withdrawal for those who want to quit using the drug. According to the experts, some medical examiners have no idea what to look for or what to do if they recognize tranq withdrawal.
They may start to treat opioid withdrawal, but other unpleasant symptoms like agitation, anxiety, restlessness, and sweating start to show. Currently, there aren't any FDA-approved treatments specifically for tranq withdrawal, but there are protocols in development to help ease patients' symptoms.
In response to the influx of tranq overdoses, many government and health agencies are taking action. Local health departments are offering public education programs to help people understand the dangers of using tranq. They advocate for the safe and proper disposal of the drug and harm reduction efforts such as needle-exchange programs.
Medical examiners are also working to increase their understanding of tranq overdose to better recognize and respond to its signs and symptoms. Furthermore, The US House of Representatives is looking into ways to schedule the animal tranquilizer. However, this may hinder efforts to study the drug's effects and find a solution to help patients who are overdosing.
Mental health and addiction issues often go hand in hand, and many people suffer from both. When you have a mental health disorder and substance use disorder at the same time, it is referred to as co-occurring disorders. Co-occurring conditions can be very difficult to manage, as each disorder often significantly impacts the other.
The Substance Abuse and Mental Health Service Administration estimates that about 9.2 million adults in the United States have a co-occurring disorder. Yet, only 7% of those individuals receive treatment for both issues. A whopping 60% of individuals with co-occurring disorders do not receive treatment for either issue. This is a growing concern when it comes to overall public health.
Co-occurring disorders, also known as dual diagnosis or comorbidity, refer to the simultaneous presence of a mental health disorder and a substance use disorder in an individual. This means that an individual may struggle with drug addiction and an underlying mental health condition such as bipolar disorder, depression, anxiety, PTSD, trauma, etc.
Research has shown that people with mental health disorders are more likely to develop a substance use disorder, and people with substance use disorders are more likely to develop a mental health disorder. In fact, roughly about 50% of people with severe mental illnesses are affected by substance abuse and vice versa. This is because individuals may turn to substances as a form of self-medication to cope with their mental health disorder symptoms. Substance use may also worsen existing mental health symptoms or lead to new mental health problems.
Self-medication is one of the main issues surrounding co-occurring disorders. People self-medicate to attempt to numb or cope with the symptoms of their mental health disorder, such as feelings of sadness or worthlessness. However, this is a risk factor for substance abuse and addiction.
Self-medication can also mask the underlying mental health issue, making it difficult for individuals to access the appropriate mental health services. This further perpetuates the cycle of substance abuse, making it even harder for individuals to break free from addiction.
The signs and symptoms of a co-occurring disorder vary depending on the abused substance and mental condition. For example, marijuana abuse and depression could look very different from the signs of alcohol abuse and schizophrenia.
That said, here are some questions you can ask yourself to help determine if you or a loved one may be struggling with comorbidity:
If you answered yes to any of these questions, you may have a dual diagnosis and should consider seeking professional help.
Co-occurring disorders can be challenging to diagnose and treat because the symptoms of the mental health disorder and the addiction tend to overlap. This makes it difficult to determine which condition is causing which symptoms. In some cases, the symptoms might vary in severity, making a patient receive treatment for one disorder while the other disorder remains untreated. People may also be less likely to seek help if they struggle simultaneously with both issues.
But the good thing is that many treatment facilities and professionals (like psychiatrists, psychologists, and therapists) specialize in treating comorbid conditions. These healthcare professionals are experienced in diagnosing and treating substance use and mental health disorders. They will perform a comprehensive assessment that includes physical exams, psychological evaluations, mental health screenings, and substance use assessments to determine the primary and contributing conditions.
Once a dual diagnosis is established, the healthcare provider will create a treatment plan that integrates both mental health and substance abuse treatment co-currently. Addressing these comorbid disorders at the same time ensures the best outcome.
With integrated treatment plans, the same practitioner offers both substance and mental health interventions in an integrated manner. The goal is to treat the person as a ‘whole,’ not just two separate issues. This treatment addresses the underlying causes of addiction, such as depression and anxiety, while providing strategies to help deal with cravings and overcome the physical aspects of addiction.
Integrated treatment often involves specialized therapies such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational therapy, and trauma-informed psychotherapy. Each type of therapy helps address the underlying issues contributing to addiction while promoting healthy coping skills and emotional regulation. These therapies can be offered in individual or group settings.
According to SAMHSA, co-occurring disorders are treated in a stage-wise fashion with different services provided at different stages: engagement, persuasion, active treatment, and relapse prevention. At each stage, a team of professionals provides services that address mental health and substance use disorder.
After treatment, the patient is encouraged to attend support groups, such as Narcotics Anonymous (NA) and Alcoholics Anonymous (AA), to maintain sobriety. Additionally, they are encouraged to use the skills and techniques they learned in therapy, such as mindfulness and stress management, to help them cope with triggers and handle cravings.
Co-occurring disorders are complex conditions that require integrated and comprehensive health services. With the right combination of therapies, medications, and peer support, individuals can recover from mental health disorders and addiction.
Needle exchange programs (NEPs) or syringe services programs (SSPs) are public health initiatives that provide clean needles and other injection equipment to people who inject drugs. They aim to reduce the transmission of blood-borne infections, such as HIV and hepatitis C, among drug users. NEPs also often offer other health services, such as:
Needle exchange programs provide needles and syringes to people who inject drugs. The program allows injection drug users to safely dispose of used needles and access new sterile ones. This helps reduce the spread of HIV/AIDS, hepatitis B and C, and other blood-borne diseases that can be transmitted through sharing or reusing needles. NEPs also provide additional services mentioned above.
NEPs are usually located in pharmacies, clinics, and organizations that provide health or community services. But the services can be delivered at fixed sites, outreach programs, mobile programs, and syringe vending machines.
Studies have shown that NEPs are extremely beneficial to public health. The Centers for Disease Control (CDC) shared a summary of information on the safety and effectiveness of SSPs, which included data from 30 years of research on the matter.
According to the report, comprehensive NEPs are safe, effective, and economical and don't promote crime or illegal drug use. In fact, new program users are 3x more likely to stop using drugs and 5x more likely to join addiction treatment than those who don't use SSPs. The report also points to the effectiveness of NEPs in reducing the transmission of HIV and other blood-borne diseases.
Beyond the CDC report, other bodies, including the United States Department of Health and the National Institute of Health, endorse the program's effectiveness in reducing HIV transmission and saving lives without losing ground in the battle against illegal drugs.
In addition to harm reduction, NEPs are cost-effective. They have reduced healthcare costs by preventing HIV, hepatitis, and other infectious diseases, including endocarditis. A 2014 analysis revealed that each dollar spent on syringe exchanges saves the government about $7 in HIV-related healthcare costs.
The programs have also effectively reduced dangerous conditions in the communities where they are implemented. They do this by providing addicts with a safe, healthy place to dispose of used needles, thus eliminating the need to discard them on streets or playgrounds. This helps keep neighborhoods cleaner and reduces the risk of injury from discarded needles.
NEPs are designed to reduce the spread of HIV/AIDS and other blood-borne diseases by providing a safe place for injection drug users to access sterile needles and dispose of used ones. This can help break the chain of transmission through sharing or reusing needles, as well as connect these individuals with substance abuse services.
Some argue that NEPs encourage substance abuse. But evidence from reputable sources, including the CDC, NIH, and Department of Health, shows that NEP does not promote drug use. The few cases indicating increased drug use should be analyzed to establish the circumstances under which negative effects might occur.
However, these scattered cases should not be used as a basis for discrediting the overall effectiveness of NEPs. These programs have reduced public health risks and provided a much-needed entry point into treatment and support services for people struggling with addiction.
Syringe services programs save lives by training drug users to prevent, quickly identify, and reverse opioid overdoses. Many NEPs give drug users and community members "overdose rescue kits" and educate them on how to recognize an overdose, give rescue breathing, and administer naloxone. Based on measures like hospitalizations for drug overdoses, there is no proof that community norms change in favor of drug use. For example, there were no increases in new drug users after the introduction of NEP in New Jersey, Hawaii, California, etc.
According to studies, NEPs protect the public and first responders by offering safe needle disposal and reducing the presence of needles in the community.
SSPs do more than improve health. Because they're so practical and far cheaper than the lifetime cost of treating HIV and viral hepatitis, they save taxpayers money. There have been a lot of politics surrounding the programs, with most states and local governments limiting or prohibiting SSPs. However, some restrictions have been lifted, providing further opportunities to assess their effects.
NEPs are effective at reducing the spread of HIV and other infectious diseases, promoting safe needle disposal, and providing access to evidence-based addiction treatments and support services. They are cost-effective and have been shown not to encourage drug use in the communities they serve. With proper implementation, NEPs can help reduce the burden of infectious diseases, drug use, and overdose-related deaths in communities worldwide.
Drug overdose is a significant public health issue that affects all age groups. However, it is particularly concerning among seniors, who are dying at an alarming rate due to drug overdoses. In recent years, there has been a significant increase in the number of seniors who have died from drug overdoses, and this trend shows no signs of slowing down. According to the Centers for Disease Control and Prevention:
This data reveals a frightening trend in drug overdose deaths among older adults. In a single decade, alcohol and drug use among the elderly has skyrocketed, and as a result, more and more seniors are dying of an overdose. It begs the question, is it that more people from the 60's & 70's counterculture movements (hippies, beatniks, etc.) are now approaching their golden years? Or, is it simply that illicit and prescription drugs are more dangerous nowadays?
Many factors contribute to the high overdose rates among the baby boomer population. Along with regular health care procedures and recreational drug use, more and more seniors are becoming a significant part of the drug overdose epidemic in the United States.
Prescription medications, particularly opioid painkillers, significantly contribute to drug overdose among seniors. According to the CDC, seniors are more likely to be prescribed opioids and other medicines for pain relief that can be misused or overdosed on. They are also more likely to experience adverse side effects from these medications, such as respiratory depression, which can be life-threatening.
There are several reasons why seniors may be at increased risk of overdose from prescription medications. One reason is that they are more likely to have chronic pain, terminal illness, dementia, etc., that require multiple medications, increasing the risk of drug interactions and overdose. Additionally, age-related changes in the body, such as decreased kidney or liver function, can affect how medications are metabolized, increasing the risk of overdose.
Prescription drug abuse is also an issue among seniors. Many people mistakenly believe prescription medications are safer than illicit drugs, so they may be more willing to abuse them.
Another major factor underlying drug overdose deaths in seniors is a history of substance abuse. Many individuals reaching their golden years were part of the "hippie" or "free love" counterculture movement in the 1960s and 1970s. During this era, the use of psychedelic drugs such as LSD was popular, as was the use of marijuana.
Unfortunately, many of these individuals have carried their substance abuse habits into old age. They are now more vulnerable to overdosing on substances due to decreased tolerance and physiological changes that come with aging.
Today's drugs are more powerful and, therefore, more dangerous than in the past. For example, the synthetic opioid fentanyl is 50 to 100 times more potent than morphine and can cause death in even small doses. Fentanyl has been linked to a dramatic increase in overdose deaths over the past few years and is particularly deadly for seniors due to their decreased tolerance.
Alcohol use has also increased among seniors, and heavy drinking is becoming more common in this age group. Binge drinking is a particular concern, as it can increase the risk of alcohol poisoning and other health problems. But in many cases, alcohol is pushed to the side in discussions about substance use and addiction.
Older adults are drinking alcohol, and this is driving deaths from overdose, accidents, and liver disease. Besides, mixing alcohol and other drugs, especially depressants, significantly increases overdose risk.
The National Institutes of Health points out that some seniors may turn to drugs or alcohol to cope with significant life changes. Retirement, the death of a spouse, or illness can all be difficult for seniors to handle and can increase their risk of substance abuse. The COVID-19 pandemic has also had a significant impact on seniors, who are more likely to experience isolation and loneliness due to social distancing measures. These feelings can lead some seniors to abuse drugs or alcohol as a way of coping with their situation.
Mental health issues, such as depression, anxiety, or trauma, are a major risk factor for substance abuse and overdose in seniors. According to the World Health Organization, older adults are more likely to have mental health problems than their younger counterparts due to ongoing loss in capacities, the decline in functional ability, life-changing events, a drop in socioeconomic status with retirement, etc. These stressors can result in isolation, loneliness, or psychological distress in older people, leading to increased substance use and overdose.
Given the unique challenges that seniors face, it is important for caregivers, loved ones, and even healthcare providers to be aware of the warning signs of substance abuse and addiction and the available treatment options. Substance abuse is a serious issue that can lead to life-threatening consequences, and seniors need to get the help they need.
But in many cases, older adults have difficulty accessing treatment due to transportation, financial issues, and stigma. As such, they may need extra support and encouragement from family, friends, and the community.
If a senior is struggling with substance abuse, they must get professional help as soon as possible to lessen the risk of overdose and other health problems. By recognizing the unique challenges seniors face and addressing substance abuse issues early on, we can help to reduce the number of overdose deaths in this age group.
Methadone has been used to treat people with extreme pain for decades and has been approved by the Food and Drug Administration to treat opioid addiction. According to SAMHSA, methadone can help people with opioid use disorder reduce their cravings and withdrawal symptoms, stay in treatment longer than those who are not taking it, and lower their chances of using illegal opioids.
However, some are still skeptical of its effectiveness in treating opioid addiction, citing the potential for misuse and abuse. They think that methadone can quickly become a replacement addiction and that it can still be used to get high. But proponents, who include top addiction professionals, argue broader use of methadone could help address the current opiate overdose epidemic in the US. They advocate for easier access to methadone treatment for opioid addiction, citing its potential benefits in helping people manage cravings and withdrawal symptoms.
This article will explore both sides of the argument and discuss the risks and benefits of using methadone as an addiction treatment.
Methadone is a powerful drug used for pain relief and opioid use disorders. It is a synthetic opioid, but unlike other opioids, it has been approved by the FDA to treat opioid addiction. It is one of the three medications approved in the US for opioid addiction treatment.
The drug works by binding to and blocking the opioid receptors in the brain, thus reducing cravings and preventing withdrawal symptoms. It is typically administered once a day at room temperature, though some people require more frequent doses. Methadone is available in liquid, powder, and tablet forms.
Methadone is extraordinarily effective if the standards of any epidemic are considered. A study found that those receiving the drug were 59% less likely to die of an overdose than those who did not receive it.
Methadone is used as part of a treatment program for opioid use disorder. Those receiving the drug to treat opioid addiction must receive it under the care of a qualified healthcare provider.
This provider prescribes the medication and supervises its use. After a period of stability, some people may be able to take the medication home and administer it themselves. However, this is an option only after they've gone through frequent tests and counseling sessions.
The duration of methadone treatment varies depending on the individual and the severity of their addiction. But the National Institute on Health recommends a minimum of 12 months. Some patients may need long-term maintenance. But those who are getting off the drug should work with their healthcare provider to gradually taper off the medication to avoid any life-threatening methadone withdrawal symptoms.
Methadone has long been controversial in the addiction treatment world. While advocates are proposing a significant expansion in access to the drug, the providers of methadone for addiction treatment are warning that caution should be used when prescribing the medication.
The primary concern for those who oppose expanded access to methadone is its potential for misuse and abuse. While methadone is effective for treating opioid addiction, allowing doctors to prescribe it to anyone could lead to low-quality care, abuse, and overdose on methadone itself.
At the moment, patients need to visit a methadone clinic each day for a single dose. They also need to be a part of an opioid treatment program and go through frequent drug tests, take part in counseling sessions, and prove that they've had opioid addiction for over a year.
Opponents of expansion strongly believe it's essential that methadone treatment is accompanied by counseling and other services that opioid-trained professionals are qualified to offer. They also point to worrying statistics about methadone-related overdose. A recent estimate by NIDA found that methadone is involved in 3% of opioid-related overdoses.
On the other hand, advocates argue that methadone can be prescribed responsibly, with adequate monitoring and oversight. They point out that the benefits of broader access to methadone outweigh the potential risks. And that the risk of overdose is too high and that methadone can help treat addiction, reduce cravings and prevent long-term health problems caused by opioid addiction. According to the proponents, the opioid crisis has reached a level where any measure taken to reduce the number of overdoses is worth exploring.
Those in favor of expansion don't see why increasing access should be a problem considering any healthcare provider can prescribe methadone for chronic pain treatment. They argue that strict regulation is only imposed on addiction treatment, which makes little sense and is a sign of the discrimination and stigma faced by OUD patients. Currently, no other drug is as restricted for approved use (opioid addiction), yet it has few restrictions when prescribed for pain management.
It is worth noting there have been fewer methadone-related deaths even after significant restrictions were lifted during the COVID-19 pandemic. The lift allowed "stable" patients to bring home their weeks' worth of methadone doses instead of going to a clinic every day for an amount.
Methadone is a safe and effective treatment when taken as prescribed. Patients should work closely with their healthcare provider to find the correct dose and frequency of administration that works for them. Patients should also take precautions when taking methadone, such as:
Some common side effects of methadone include:
Methadone is generally considered safe to use during pregnancy. However, it will likely cause harmful side effects to a developing fetus and should only be used when the benefits outweigh the risks. Breastfeeding women should consult their doctor before taking methadone, as it can be passed to the infant through breast milk.
For people with opioid addiction, many facilities offer comprehensive drug addiction treatment programs. These treatment plans include counseling, support groups, medical monitoring, and other therapies designed to help patients gain control of their addiction and begin the journey toward recovery.
California Sober is a trending term that was popularized by singer-songwriter Demi Lovato. The singer released her song, California Sober, after a near-death opioid overdose in 2018. In her interview with CBS News, Lovato said she best identifies with the term California Sober.
But what exactly does the term California Sober mean?
While traditional sobriety is defined as abstaining from any drug or alcohol, the California Sober approach is about using certain drugs in moderation.
California Sober, or Cali sober, refers to abstinence from all substances except smoking weed or ingesting marijuana. People interpret the exceptions differently, but marijuana is the most commonly cited "acceptable" substance for those who consider themselves California Sober. The term, California Sober, is associated with Michelle Lhooq, who wrote an article on Vice.com explaining how she streamlines her substance abuse to improve her health. The writer stopped using all drugs except marijuana and some psychedelics when she relocated to California from New York.
In their interview with CBS in her Los Angeles home, Demi Lovato said quitting drug use partially worked well for her. "I am cautious to say that, just like I feel the complete abstinent method isn't a one-size-fits-all solution for everybody, I don't think that this journey of moderation is a one-size-fits-all solution for everybody," she told CBS news. In their case, they replaced opioids with marijuana and alcohol.
But the singer now has a different outlook on things and believes that traditional sobriety is the way to go.
Harm reduction seeks to provide users with safer and healthier options to reduce the harm associated with substance abuse. The approach follows principles like:
By most definitions, Cali sober isn't harm reduction. This approach is primarily about replacing substances, like opioids and alcohol, with marijuana as a "softer" alternative. While this may work for some people, it doesn't necessarily change their relationship with drugs. It just shifts it from one substance to another, potentially a more accepted one.
When considering California Sober as a form of harm reduction, it's essential to speak with a medical professional or addiction specialist. They can guide how to safely reduce drug use and provide resources to those who wish to pursue abstinence.
The main benefit of Cali Sober is that it allows individuals to reduce the risk associated with certain drugs while still getting some of the pleasure they seek. For example, a person who has struggled with alcohol abuse may find that using marijuana in moderation is a less risky alternative. The switch is also common among those who experience hangovers or sleeplessness.
The California Sober approach allows users to escape the strict abstinence-only models of traditional sobriety and gives them more leeway to experiment. This is especially important for those with no behavioral addictions or behavioral health issues like opioid or alcohol abuse.
Marijuana is an addictive substance but carries fewer risks than drugs like opioids, heroin, cocaine, or fentanyl. It doesn't cause overdose or blood-borne disease and is legal in most states.
There are some potential risks associated with the California Sober approach. Some common ones include:
Finding the right balance between safe drug use and substance abuse can be tricky. According to the CDC, marijuana use can lead to addiction, especially for those who start using at a young age or use it frequently. Other factors like family history, mental health issues, peer pressure, social isolation, and lack of family involvement can also contribute to cannabis use disorder. And like any other substance use disorder, CUD can hurt one's physical and mental health.
Semi-sobriety involves setting limits on intake and gradually decreasing the frequency and amount of substance use over a period of time. It is often done with other strategies like lifestyle changes, alternative therapies, and counseling. But since the definition of moderation varies greatly, it's easy for some people to go overboard. For those who have a hard time controlling use, it can be a good idea to cut use completely.
While marijuana is the most commonly used drug in the California Sober approach, some individuals may use other substances like alcohol, tobacco, or even prescription drugs instead. Some may modify it further to use marijuana during the week and hard drugs over the weekend. The lack of rationalization of this approach can increase the chances of relapse. In contrast, the abstinence recovery model requires total abstinence from all mind-altering substances to ensure sobriety.
When following the California Sober approach, one must constantly decide what is acceptable drug use and what isn't. For example, they'll need to figure out things like:
This can become exhausting and can lead to burnout, which has the potential to create a slippery slope back into addiction.
Ultimately, to ensure lasting recovery, people should be guided toward a holistic approach that looks at the underlying cause of addiction. This might include addressing mental health conditions and developing healthier coping strategies for stress or trauma. Treatment options like cognitive behavioral therapy, yoga, and meditation can also help build resilience to cravings.
To summarize, Cali Sober is an increasingly popular approach to sobriety that allows individuals to consume marijuana in moderation while giving up other drugs. However, it's essential to keep in mind that there are some risks associated with this approach, and it should be done thoughtfully. This approach can help individuals find a healthier balance between abstinence and drug use when used responsibly.
If you or someone you know is struggling with addiction, seek help from an addiction specialist. Recovery is possible, and taking the first step can make all the difference.
The number of drug overdose deaths in the United States has skyrocketed in recent years, with opioids leading the way as one of the most deadly and addictive substances. Many even consider it a drug overdose epidemic. According to the CDC, there were approximately 107,000 overdose deaths in 2021. In the same year, SAMSHA identified 141,529 unweighted drug-related ER visits from its analysis of 52 hospitals.
If these numbers are anything to go by, it's evident that addiction is a major problem in the US.
And yet, despite this alarming trend, many US hospitals and emergency departments lack dedicated addiction specialists who can help those suffering from substance or opioid use disorder. This is a glaring omission, especially given how critical an early intervention can be for someone in the throes of addiction.
Without access to addiction specialists on staff, people with substance abuse problems may not get the help they need at a crucial juncture. As a result, they may go through multiple hospitals or ER visits. A lucky few will be connected with a treatment facility while they're still at the hospital.
For everyone else, they walk out with a phone number to call, or often, nothing at all. Once they leave, many of these people go back to their old habits and never make the effort to call the number they've been given.
There's a clear need for hospitals to do better when it comes to addiction treatment. So why is it that so many don't have addiction specialists on staff?
If you go to a hospital with a kidney problem, you'll likely be seen by a nephrologist. If you have a heart condition, you'll be seen by a cardiologist. But if you're struggling with addiction, chances are you won't see an addiction specialist.
Only a few hospitals have someone who specializes in addiction medicine on staff. A majority of hospitals focus on primary care. Addiction is left untreated.
This is a problem because addiction is a disease requiring specialized care. Without access to an addiction specialist in ERs, people with substance use disorder are often left at the mercy of whoever happens to be on call. This could be a general practitioner, an ER doctor, or even a social worker, most of whom have very little training in physiology, medications, and other aspects of treatment.
For years, addiction prevention and treatment services have been delivered separately from other general and mental health care services. Drug and alcohol abuse has traditionally been viewed as a criminal or social problem. As such, prevention services were not typically considered a responsibility of health care systems. For this reason, those struggling with substance use disorders have had access to only a limited range of treatment options that were generally not covered by insurance.
In a nutshell, most hospitals don't have specialists because:
For a long time, addiction has not been seen as a medical problem but rather a social or psychological one. Some medical staff still see it as a moral issue and not something that requires formal medical treatment. This attitude can make it hard to justify dedicating staff and resources to addiction treatment.
Additionally, many hospitals are already understaffed and overstretched, so it could be difficult to add another specialist.
And finally, there's the question of reimbursement. Addiction treatment is notoriously underfunded, and many insurance companies don't cover the cost of specialized care. Hospitals can find it hard to recoup the cost of hiring an addiction specialist.
NPR shared a story of a 63-year-old heroin addict, Marie, who was admitted to Salem Hospital, north of Boston, for COPD. The next day, she was told she was ready for discharge after the doctor had confirmed that her oxygen levels were good. But the woman was experiencing heavy withdrawal symptoms and could not move. She didn't want to leave the hospital but felt like she had no choice.
Sadly, most hospitals would still let her go despite her pain and condition. Sometimes, she'll be issued a list of detox programs or rehab centers to call. But more likely, she'll be sent on her way with no real plan or hope for recovery.
This is a typical story of what's happening in many US hospitals. Marie was lucky to have found a doctor who administered her some medications that helped. But every day, people with addiction walk into ERs across the country only to be discharged without real help or support.
This is dangerous because it increases the likelihood of patients relapsing and overdosing. In fact, research shows that patients have a higher chance of overdosing within a few days or weeks of being discharged from the hospital.
An addiction specialist is a medical professional specifically trained to diagnose and treat patients with substance use disorders. These specialists can provide critical support to patients who walk into the ER for various reasons but have an underlying addiction problem. Salem Hospital is one of the few hospitals that has succeeded in naming addiction as a specialty and hiring people with training in the disease.
And despite reservations from some staff, the addiction specialists get overwhelmed many days with referrals - a clear sign of the need for their services. The trend is similar in five other Massachusetts hospitals that added addiction specialists in the last three years. These facilities are funded by HEALing Communities study. Addiction specialists can help patients in several ways, including:
Addiction specialists are vital in helping patients get the treatment they need. They can also refer them to a reputable treatment facility for specialized care. Hospitals can provide a much-needed service to their communities by having these professionals on staff.
According to the National Institutes of Health, effective integration of addiction prevention, treatment, and recovery solution across healthcare systems can help address drug abuse and related issues. This is also the most promising way to improve access to and quality of treatment.
People try drugs or alcohol for a variety of reasons, ranging from curiosity or boredom to social pressure or mental health issues. For some people, trying drugs or alcohol is a one-time event that doesn't lead to further use. For others, though, drug or alcohol use can become a substance use disorder, defined as a chronic and relapsing brain disease that is characterized by compulsive drug seeking and use despite harmful consequences.
But what drives people to try drugs and alcohol in the first place? There are several reasons, but some are more common than others.
Peer pressure is one of the leading causes of drug use among young people. Whether it takes the form of subtle suggestions or outright coercion, peer pressure from family and friends can exert a powerful influence over our decisions and behaviors.
Teens are especially susceptible to this type of social pressure, and many will start using drugs at an early age to fit in or feel accepted by their friends. Many young people will try out drugs or alcohol without fully understanding the risks involved.
Mental health issues like anxiety disorders, schizophrenia, eating disorders, bipolar disorders, and depression, can also lead people to start using drugs or alcohol. Numerous studies have listed mental health issues as one of the main drivers of substance use disorders, and vice versa.
Many people with mental health disorders self-medicate in an attempt to numb the pain or ease the symptoms like excessive fear, worry, mood changes, or even suicidal ideation. Others may use drugs or alcohol as a way to cope with difficult life experiences. This can lead to a spiral of drug addiction and mental health problems that is very difficult to break free from.
Trauma, especially early childhood trauma, is a major risk factor for developing substance abuse problems later in life. Traumatic experiences like abuse, neglect, witnessing violence, or losing a loved one can have a profound effect on one's mental and emotional health.
For many people, childhood trauma can be long-lasting and far-reaching, and it's often difficult to overcome the damage done in childhood. They may struggle with mental health issues like Post Traumatic Stress Disorder, anxiety, and depression, and turn to may use substances to try to cope with these problems.
Boredom is another common reason people first try drugs or alcohol. Teens and young adults often have a lot of free time and can be easily bored. They may start using drugs or alcohol to pass the time or to make their lives more exciting. This can lead to addiction, as people continue to use drugs or alcohol to escape the boredom of their everyday lives.
Many young adults first try drugs or alcohol out of curiosity. They may have seen their friends using these substances and want to try them for themselves. Others may be curious about the effects of drugs or alcohol and want to experience them firsthand. It's estimated that over 52% of all high school students try illicit drugs, while over 70% drink alcohol by the time they graduate.
Popular culture often glamorizes drug use, and this can influence young people to start using drugs or alcohol. TV shows, movies, music, and video games often depict drug use in a positive light, and this can make it seem like a harmless or even exciting activity. Constant exposure like this normalizes drug use in entertainment culture. As a result, teens assume using illegal, and prescription drugs is a normal lifestyle.
Many teenagers first start using drugs or alcohol as a way to rebel against their parents or authority figures. They may see drug use as a way to defy the rules and take risks. For example, they may smoke cigarettes to show their independence or hallucinogens to escape to a world they deem more idealistic.
Many people start using drugs or alcohol without knowing much about them. They may believe myths and misconceptions about these substances, which can lead them to underestimate the risks involved. For example, teens might be led to believe that marijuana is medicinal and carries a host of benefits. So, they may be more inclined to start using it without understanding the risks.
People who lack confidence or have low self-esteem are also more likely to start using drugs or alcohol. They may use these substances as a way to boost their confidence or make them feel better about themselves. For example, someone who feels shy in social situations may start drinking alcohol to loosen up and feel more confident.
The above are some of the main reasons people start using drugs or alcohol. It's important to note that not everyone who tries these substances will become addicted. However, drug and alcohol use can lead to addiction, and it’s often hard to break free from this cycle of abuse.
As a parent or guardian, there are a few things you can do to help protect your loved one from addiction:
If you suspect your child is using drugs or alcohol, don't hesitate to reach out for help. There are many physical and mental health care resources available to families struggling with addiction. Early intervention is essential to helping your child get on the path to recovery.
Sleep disorders and addiction share a complex and bidirectional relationship. People who suffer from a sleep disorder may be more likely to abuse drugs or alcohol to try and self-medicate and achieve better sleep. For instance, they may use stimulant drugs to compensate for daytime fatigue caused by lost sleep.
In other cases, they may use drugs because of issues like cognitive impairment. Conversely, people addicted to drugs or alcohol may also suffer from sleep disorders due to the negative effects these substances can have on the body and mind.
There is a strong link between sleep disorders and addiction. A review by the Addiction Science & Clinical Practice found that about 70 % of patients admitted for detox had sleep issues before admission, and 80 % of those with sleep problems connect them to alcohol or illegal drug use.
According to the review, the relationship between the two seems to be bidirectional, with chronic or acute substance use disorders increasing the risk of developing sleeping problems. The review also adds that there's evidence indicating that long-term abstinence from chronic drug or alcohol use can reverse some sleep problems.
One of the most common ailments related to lack of sleep is depression. If you’re wondering whether or not you or someone you know suffers from depression, one way to learn more is to take a depression test.
Addiction is a brain disease. Chronic alcohol or drug use interferes with the brain, changing its chemistry and circuitry. These changes result in compulsive drug use and sleeping problems. Drug and alcohol use disorders can cause short- and long-term sleep issues like insomnia and sleep apnea.
Substance abuse also alters how a person through their sleep stages - messing up the rapid and non-rapid eye movement (REM and NREM). Generally, substance abuse can lead to:
Marijuana interacts with the endocannabinoid system (ECS) by binding to the cannabinoid receptors responsible for many roles, including regulating the sleep-wake cycle. This explains why more than 40% of those trying to quit marijuana experience sleeping problems. Many others experience sleep difficulty, strange dreams, and nightmares too.
Opioids like heroin bind to mu-opioid receptors, a body system that’s also responsible for sleep regulation. In fact, the name morphine or morphia, a medical derivative of opium, comes from Morpheus, the Greek god of sleep and dreams. Opioid drugs can induce sleepiness but also derange sleep by increasing transitions between different sleep stages.
Those going through withdrawal from heroin addiction can experience terrible insomnia. Opioids can also regulate respiration and, when taken in high doses, can severely impede breathing during sleep.
Depressants like alcohol may help people fall asleep, but they often lead to disruptions in sleep patterns and can make it difficult to stay asleep. Chronic alcohol use causes:
Stimulants like cocaine can make it difficult to fall asleep and cause people to wake up frequently at night. The sleep disturbances like insomnia and hypersomnolence mostly happen during cocaine intoxication and withdrawal. Other stimulants like amphetamine trigger dopamine release.
During acute administration, they can decrease total sleep time and sleep efficiency and increase sleep latency and the number of awakenings. In the withdrawal phase, there's a drop in sleep latency and a rise in total sleep time and efficiency.
Withdrawal from drugs can cause sleep disorders like insomnia, or other sleep problems, including restless legs syndrome, strange dreams, or broken sleep. These issues can take a toll on one’s physical and mental health, making a recovery harder. Sleep problems are common when withdrawing from:
Sleep disorders can also lead to substance abuse. Many people with sleep disorders turn to substances as a way to self-medicate or try and improve their sleep. For example:
As discussed earlier, people with sleep may take stimulants like caffeine, cocaine, or nicotine to stay awake during the day and then use alcohol or other drugs to fall asleep at night. Also, those struggling with addiction may disrupt their circadian system and end up with sleep disorders that lead them to use more substances to self-medicated. This can create a dangerous cycle in which they use substances to try and manage their sleep, but the substances themselves make it difficult for them to get the rest they need.
People who stop using drugs and alcohol often have better sleep. This happens because they are no longer disturbed by the side effects of those substances. When people get good sleep, they feel better and can concentrate more easily on their addiction recovery.
At the same time, people who sleep better don't need to use substances to cope with their fatigue. So, improving sleep can help break the cycle of addiction.
If you or a family member or someone you know is struggling with a sleep disorder and substance abuse, help is available. There are many treatment options that can address both issues at the same time. With treatment, it is possible to recover from both a sleep disorder and addiction.