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Tuesday, May 25, 2010

Prescription Abuse - Why Begin? Special Issue on Women

Why? Why did this beautiful young person choose to risk addiction by taking illegal prescription drugs? That is the question that is repeated time and again by relatives and friends throughout areas of severe addiction. Nothing could possibly hurt worse than the unexpected loss of a loved one due to the evil control of addictive prescription drugs. The grief is unthinkable for those left in the wake. I believe no one answer to this question exists; however, we need to be vigilant and aware of danger signs.

A sobering reminder of the problem shows an analysis of 168,900 autopsies conducted in Florida in 2007 found that three times as many people were killed by legal drugs as by cocaine, heroin and all methamphetamines put together. According to state law enforcement officials, this is staggering evidence of the burgeoning prescription drug abuse problem.When will it peak or will it even peak at all?
"The abuse has reached epidemic proportions," said Lisa McElhaney, a sergeant in the pharmaceutical drug diversion unit of the Broward County Sheriff's Office. "It's just explosive."

"All this stuff is poison," Tuolumne County, Calififornia, Sheriff's Office Deputy Dan Crow Crow said. "Your body will fight all of this stuff." Tuolumne County Health Officer Todd Stolp agreed. A prescription drug taken recreationally is "much like a firearm in the hands of someone who's not trained to use them," he said. 

So, why do people subject themselves to this absolute form of Russian roulette played with pharmaceutical bullets?

Harvard Study

In recent research from a study involving 662 chronic noncancer patients taking opioid drugs for pain relief, Robert N. Jamison, PhD, a clinical psychologist at Harvard's Brigham and Women's Hospital, found misuse of prescription drugs by women seemed to be closely related to psychological distress while prescription pain drugs were more likely to be misused by men who had social and behavioral problems.

Jamison wrote that women in the study tended to display signs of emotional issues and affective distress, compared with men. For women, a history of sexual abuse was an issue in later misuse of prescription drugs. "These results are in agreement with past research that highlighted the importance of sexual and physical abuse history in predicting opioid misuse." said Jamison. "These same studies also showed that women with a significant history of anxiety and depression tended to do less well in properly managing opioids prescribed for pain, possibly because of the tendency to self-medicate a mood disorder using opioids." (Robert Jamison, The Journal of Pain, American Pain Society, vol. 11, April 2010)

The research also concluded that past studies had suggested that women might be more likely to be open and truthful about behaviors and more likely to seek psychological help than men.

Men who misused prescription drugs tended to show signs of worrisome behaviors, such as association with other people who abused drugs and alcohol and engaging in criminal behavior.

"Given the prominence of sex differences in a variety of pain-related processes, we may eventually arrive at a method for tailoring risk assessment and risk-reducing interventions in part as a function of gender," the Jamison and his fellow researchers said, adding that more research is called for by their study.

University of Michigan Study

Seven percent of college students have used prescription stimulants for non-medical purposes over their lifetimes and 4 percent have used in the past year, according to a study of students at 119 four-year colleges and universities nationwide published in the January issue of the journal Addiction. The study was supported by grants from the Robert Wood Johnson Foundation and the National Institute on Drug Abuse.

Science Daily (January 13, 2005) reported seven percent of college students have used prescription stimulants for non-medical purposes over their lifetimes and 4 percent have used in the past year, according to a study of students at 119 four-year colleges and universities nationwide published in the January issue of the journal Addiction. ("7 Percent Of College Students Used Prescription Drugs As Stimulants For Non-medical Purposes," ScienceDaily, January 13 2005)

This national study, led by a University of Michigan researcher and based on data from the Harvard School of Public Health College Alcohol Study, found that past year rates ranged from none to 25 percent at individual colleges and universities. Students attending three historically black colleges reported the lowest rate (none) of non-medical prescription stimulant use.

Reported use was higher among students who were male, white and members of fraternities. The study also showed that abuse of non-medical prescription stimulants was higher among women who are members of sororities.

The study also found that students who use prescription stimulants non-medically are more likely to abuse other substances such as alcohol, marijuana, ecstasy and cocaine. "They are also more likely to engage in other risky behaviors such as driving after heavy drinking," said Sean Esteban McCabe, lead author of the study and assistant research scientist at the University of Michigan Substance Abuse Research Center.

In a rather astounding finding, researchers said non-medical prescription stimulant users were over 20 times more likely to report cocaine use in the past year. They were also over five times more likely to report driving after heavy drinking than college students who had not used prescription stimulants non-medically.

The highest rates of non-medical use of prescription stimulants occurred on college campuses in the Northeastern region of the United States, schools with highly competitive admissions criteria and those college campuses with higher rates of binge drinking, the study finds.

The study concluded males were nearly twice as likely as women to report the non-medical use. (Notice, this is in contrast to findings by Jamison's 2010 study.)

White students were also more likely than Asian and African-American students to report non-medical use. Grade point was also associated with non-medical stimulant use.

Students with grade point averages of B or lower were two times more likely to use prescription stimulants non-medically than those earning a B-plus or higher grade point average.

Research About Women - Reasons For Psychological Distress In Gifted Women

1. Emotional issues become apparent to some women who have become nvolved in serious relationship in the college or graduate school years, or who had children later in their lives.

2. Older women resolve many personal issues relating to ability and social issues experience by younger girls. And some dilemmas shift or are resolved due to changes in a woman's life, such as maturation of their children, the dissolution of a relationship, the reemergence of their relationships, or a change in environments at work or at home. Some dilemmas simply cannot be resolved to the satisfaction of everyone involved.

3. Many young women believe they can "do it all" or "have it all," while many older women have learned they cannot -- ambivalence about their future caused hopes and career dreams to waver.

4. Almost from birth, females find themselves in a world of limiting stereotypes and barriers to achievement. Research has identified external barriers that seem to negatively influence the development of talents and gifts in some gifted girls and women. These barriers include the role of parents, school, and the environment in general, as well as the need to develop a set of philosophical beliefs that is essential to the development of creative and academic potential. In a male-dominated society, a female may have difficulty developing her own philosophical beliefs.

5. Parents' beliefs about children's abilities may have an even greater effect on children's self-perceptions than previous performance (Parsons, Adler, & Kaczala, 1982). Phillips (1987) confirmed this finding in her study of high ability students, and a recent study of parental influence on math self-concept with gifted female adolescents as subjects found consistently significant correlations between parent expectations and student math self-concept (Dickens, 1990). Messages about opinions sent by subtle and not-so-subtle verbal and nonverbal interactions may encourage or discourage girls for life.

6. Kramer (1985) found that teachers were usually able to identify gifted boys, but were often surprised to learn that a girl was considered smart. The gifted girls in her study were very successful at hiding their intelligence and in silencing their voices. In another analysis of research about adult perceptions of girls' intelligence, Myra and David Sadker (1994) stated that "study after study has shown that adults, both teachers and parents, underestimate the intelligence of girls" (p. 95). Kissane (1986) found that teachers are less accurate in nominating girls who are likely to do well on the quantitative subtest of the SAT than they were in naming boys who were likely to achieve a high score. Both male and female teachers regarded smart boys as more competent than gifted girls in critical and logical thinking skills and in creative problem-solving abilities, while they thought smart girls were more competent in creative writing.

7. Teachers have been found to believe and reinforce one of the most prevalent sex stereotypes-that males have more innate ability, while females must work harder. Fennema (1990), commenting on the role of teacher beliefs on mathematics performance, reported that, in a study she conducted with Peterson, Carpenter, and Lubinski, "teachers selected ability as the cause of their most capable males' success 58% of the time, and the cause of their best females' success only 33% of the time." Girls may internalize these lowered expectations very early in life.

8. Personality factors that influence women include: dilemmas about abilities and talents; personal choices about family; choices about duty and caring and nurturing the talents in oneself as opposed to putting the needs of others first; religious and social issues which consistently affect women across their lifespans; poor planning; hiding abilities and differences; perfectionism; attributing success to luck rather to ability; poor choice of partners; and confusing messages from home about politeness (Reis, 1998).

9. Some research and reviews of research (Arnold, 1995; Bell, 1989; Cramer, 1989; Hany, 1994; Kramer, 1991; Leroux, 1988; Perleth & Heller, 1994; Reis & Callahan, 1989; Subotnik, 1988) have indicated that some gifted females begin to lose self-confidence in elementary school and continue this loss through college and graduate school. These girls may grow to increasingly doubt their intellectual competence, perceive themselves as less capable than they actually are, and believe that boys can rely on innate ability while they must work harder to succeed.Thus, they lose their enthusiasm for learning and speaking out.

10. Some research indicates that gifted girls believe it is a social disadvantage to be smart because of the negative reactions of peers. Fearing their peers' disapproval, bright young women may deliberately understate their abilities in order to avoid being seen as physically unattractive or lacking in social competence. In other words, they may "play dumb." (Bell, 1989; Buescher, Olszewski, & Higham, 1987; Eccles, Midgley, & Adler, 1984; Kerr, Colangelo, & Gaeth, 1988; Kramer, 1991; Reis, 1987, 1995; Reis, Callahan, & Goldsmith, 1996)

11.Perfectionism can cause talented women to set unreasonable goals for themselves and to strive to achieve at increasingly higher levels. It also can cause women to strive to achieve impossible goals and spend their lives trying to achieve perfection in work, home, body, children, wardrobe, and other areas. (Hamachek;1978) They developed a fixation about making mistakes. Unlike the healthy female perfectionists, they viewed their parents' perfectionism negatively, and perceived parental expectations as demands to be perfect in everything they did.

Sources Used by Dr. Sally M. Reis, SENG Newsletter, 2 (3)1-5 2002

"Social and Emotional Issues"
Dr. Sally M. Reis

Arnold, K. D. (1995). Lives of Promise. San Francisco: Jossey-Bass Publishers.

Bell, L. A. (1989). Something's wrong here and it's not me: Challenging the dilemmas that block girls' success. Journal for the Education of the Gifted, 12(2), 118-130.

Buescher, T. M., Olszewski, P., & Higham, S. J. (1987). Influences on strategies adolescents use to cope with their own recognized talents. (Report No. EC 200 755). Paper presented at the biennial meeting of the Society for Research in Child Development, Baltimore, MD.

Callahan, C. M., Cunningham, C. M., & Plucker, J. A. (1994). Foundations for the future: The socio-emotional development of gifted, adolescent women. Roeper Review, 17, 99-105.

Cooley, D., Chauvin, J., & Karnes, F. (1984). Gifted females: A comparison of attitudes by male and female teachers. Roeper Review, 6, 164-167.

Cramer, R. H. (1989). Attitudes of gifted boys and girls towards math: A qualitative study. Roeper Review, 11, 128-133.

Dickens, M. N. (1990). Parental influences on the mathematics self-concept of high achieving adolescent girls. Unpublished doctoral dissertation, University of Virginia, Charlottesville.

Eccles, J. S., Midgley, C., & Adler, T. F. (1984). Grade-related changes in the school environment: Effects on achievement motivation. In J. Nicholls (Ed.), Advances in motivation and achievement (Vol. 3, pp. 283-331). Greenwich, CT: JAI Press.

Fennema, E., Peterson, P.L., Carpenter, T.P., & Lubinski, C.A. (1990). Teachers' attributions and beliefs about girls, boys and mathematics. Educational Studies in Mathematics, 21, 55-69.

Hamachek, D. E. (1978). Psychodynamics of normal and neurotic perfectionism. Psychology, 15, 27-33.

Hany, E. A. (1994). The development of basic cognitive components of technical creativity: A longitudinal comparison of children and youth with high and average intelligence. In R. F. Subotnik & K. D. Arnold (Eds.), Beyond Terman: Contemporary longitudinal studies of giftedness and talent (pp. 115-154). Norwood, NJ: Ablex.

Hess, R. D., Holloway, S. D., Dickson, W. P., & Price, G. G. (1984). Maternal variables as predictors of children's school readiness and later achievement in vocabulary and mathematics in sixth grade. Child Development, 55, 1902-1912.

Kimball, M. M. (1989). A new perspective on women's math achievement. Psychological Bulletin, 105, 198-214.

Kissane, B. V. (1986). Selection of mathematically talented students. Educational Studies in Mathematics, 17, 221-241.

Kline, B. E., & Short, E. B. (1991). Changes in emotional resilience: Gifted adolescent females. Roeper Review, 13, 118-121.

Kramer, L. R. (1991). The social construction of ability perceptions: An ethnographic study of gifted adolescent girls. Journal of Early Adolescence, 11(3), 340-362.

Leroux, J. A. (1988). Voices from the classroom: Academic and social self-concepts of gifted adolescents. Journal for the Education of the Gifted, 11(3), 3-18.

McGillicuddy-De Lisi, A. V. (1985). The relationship between parental beliefs and children's cognitive level. In R. Sigel (Ed.), Parental belief systems (pp. 7-24). Hillsdale, NJ: Erlbaum.

Parsons, J. E., Adler, T. F., & Kaczala, C. (1982). Socialization of achievement attitudes and beliefs: Parental influences. Child Development, 53, 310-321.

Perleth, C., & Heller, K. A. (1994). The Munich longitudinal study of giftedness. In R. F. Subotnik & K. K. Arnold (Eds.), Beyond Terman: Contemporary longitudinal studies of giftedness and talent (pp. 77-114). Norwood, NJ: Ablex

Phillips, D.A. (1987). Socialization of perceived academic competence among highly competent children. Child Development, 58, 1308-1320.

Reis, S. M. (1987). We can't change what we don't recognize: Understanding the special needs of gifted females. Gifted Child Quarterly, 31, 83-89

Reis, S. M. (1995). Talent ignored, talent diverted: The cultural context underlying giftedness in females. Gifted Child Quarterly, 39(3), 162-170.

Reis, S. M. (1998). Work left undone: compromises and challenges of talented females. Mansfield Ctr., CT: Creative Learning Press.

Reis, S. M., & Callahan, C. M. (1989). Gifted females: They've come a long way-or have they? Journal for the Education of the Gifted, 12(2), 99-117.

Reis, S. M., Callahan, C. M., & Goldsmith, D. (1996). Attitudes of adolescent gifted girls and boys toward education, achievement, and the future. In K. D. Arnold, K. D. Noble., & R. F. Subotnik (Eds.), Remarkable women: Perspectives on female talent development (pp. 209-224). Cresskill, NJ: Hampton Press, Inc.

Reis, S. M., Hébert, T. P., Diaz, E. I., Maxfield, L. R., & Ratley, M. E. (1995). Case studies of talented students who achieve and underachieve in an urban high school. Manuscript in preparation.

Sadker, M., & Sadker, D. (1994). Failing at fairness: How America's schools cheat girls. New York: Charles Scribner's Sons.

Schuler, P. A. (1997). Characteristics and perceptions of perfectionism in gifted adolescents in a rural school environment. Unpublished doctoral dissertation, University of Connecticut, Storrs.

Stevenson, H. W., & Newman, R. S. (1986). Long-term prediction of achievement in mathematics and reading. Child Development, 57, 646-659.

Subotnik, R. (1988). The motivation to experiment: A study of gifted adolescents' attitudes toward scientific research. Journal for the Education of the Gifted, 11(3), 19-35.

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