A Prescription For a New Attitude

Most of us adults take prescription medications daily for very good reasons. Especially as we age, we encounter health problems that require maintenance, and part of our ongoing regimen becomes taking prescriptions. Personally, I hate taking pills, but it seems the older I get, the more pills doctors prescribe to insure the relatively good health of my deteriorating body. As long as we follow the doctors orders and take the correct dosage of these medicines, the remedies help us live more comfortable, happy lives.

Today I want to talk about an attitude concerning prescriptions that adults have passed onto the younger generation. As grownups, we take our medications to help us heal and cope with our ailments; however, in doing this in a casual, offhand manner, our familiarity with and our dependence on prescription drugs confirms to youth that consuming rx drugs is all right.

This view is a very dangerous perception for young people who are now at great risk for dependency, addiction, and overdose. Mixing cocktails of drugs and alcohol (Drinking is also "no big deal" to most teens.), immature youth expose themselves to potentially lethal circumstances. Why, in part, do smart, attractive teenagers do this? This is the hard, sobering reality: Just look into the mirror.

We all -- not just the young -- we ALL need to change our attitude toward prescription drugs. To the dismay of many, we must treat potentially dangerous prescriptions in the same manner we treat guns because both of these household possessions represent the means of delivery for destruction.

We understand that carelessness and guns don't mix, especially around children . In 2009, there were 642 accidental deaths that resulted from accidental shooting. About two-thirds of accidental shooting deaths happen in the home, with the child shooting himself to death in 45 percent of the cases and friends or family members pulling the trigger in the remainder. (Ryn Gargulinski,"Top 5 Causes of Accidental Death in the United States,"listosaur.com, July 22 2011)

More than 50 percent of American households have a gun in the house, and, in one survey of evidently careless families, 10 percent said they had loaded firearms in unlocked locations that were easily accessible to kids. There is obviously a need to keep guns in locked, inaccessible and child-resistant locations and store them unloaded. Gun safety is still a major problem in America and a much-needed concern for all parents who possess firearms.

Let's compare gun risk with prescription drug risk. By 2004, opioid painkiller deaths numbered more than the total of deaths involving heroin and cocaine. Now, about 120,000 Americans a year go to the emergency room after overdosing on opioid painkillers. The number of overdose deaths from opioid painkillers — opium-like drugs that include morphine and codeine — more than tripled from 1999 to 2006, to 13,800 deaths that year, according to Center of Disease Control statistics. (Liz Scabo, "Prescriptions Now Biggest Cause of Fatal Drug Overdoses," USA Today, August 10,2010)

Many health experts believe that number of rx drug deaths is grossly under reported. Many, many of these opioid deaths were teenagers.

In the past 10 years the rate of prescription drug abuse among teens has risen steadily. Nearly one in five — 4.5 million — admits to abusing medications not prescribed to him or her, reported the 2005 Partnership Attitude Tracking Study conducted by the Partnership for a Drug-Free America.

Accidental-poisoning deaths among youths ages 15 to 24 increased 113 percent between 1999 and 2004, mostly due to prescription- and illegal-drug abuse, reports the Centers for Disease Control and Prevention.

And what about teen attitude toward prescription drugs? By survey, almost 50% of teens believe that prescription drugs are much safer than illegal street drugs. What's more, nearly three out of 10 teens think these drugs are not addictive, according to the Partnership study. Kids trust prescription drugs because they're mass-produced, FDA-approved, familiar medicines. Even the nicknames teens give them — "jif," "Z-bar," "cotton" — suggest childhood treats and comfort food.
60% to 70% say that home medicine cabinets are their source of drugs. 57% of teens say they can get prescription drugs for free from a relative or a friend, and take them without asking. Data show that girls are more likely than boys to abuse prescription drugs. (Matt Lombardi, "Raising Awareness of 'Generation Rx," Couric and Company - CBS News, November 29 2011)

Sara Swanson, who grew up in suburban St. Paul, MN, the daughter of two recovering alcoholics. "My parents always warned me about alcohol abuse," explains Swanson, "but my mom had back problems and never dreamed I'd take her muscle relaxants." Swanson moved on from her mother's pills to other drugs, trading cigarettes to her friends for their Adderall. "I loved the pills, and they were so easy to get," she says. "I'd look at the recommended dose and then double it."

Why do teens, themselves, overwhelmingly report they experiment with drugs and expose themselves to all kinds of terrible hazards?

Teens say,

"It's (using prescription drugs) is no big deal."

Can we understand why?

 I think so.

Research indicates that using drugs can make youth feel more independent and grown-up. Teens who take alcohol or any kind of illegal drugs report feeling older than their real age, found a 2007 study from the University of Alberta in Edmonton. "One explanation: Kids are using drugs because they think of drug-taking as an adult behavior," says Kelly Arbeau, Ph.D., coauthor of the study. (Annemarie Conte, "Prescription Pills: The New Drug of Choice for Teens," MSN Lifestyle, 2012)

Adults think of prescription drugs purely as medicine, but young people have come up with ways to create effects similar to what they'd experience from street dope - from crushing pills to circumvent timed-release controls to doubling or tripling dosages or simply downing handfuls.

What teens actually do this? We should adapt our view of users and addicts. These teens are not the "stoners" of old or the "creeps" on the street. These days bright, motivated high achievers can be lured by prescription drugs. Some common threads do exist among users: Many of them have self-esteem issues. They start using the pills as a way of self-medicating for school or family problems and underlying depression and anxiety. But, "No big deal." Right?

In the past 10 years the rate of prescription drug abuse among teens has risen steadily. Nearly one in five -- 4.5 million -- admits to abusing medications not prescribed to him or her, reported the 2005 Partnership Attitude Tracking Study conducted by the Partnership for a Drug-Free America.

"I don't think it's bad. There's no particular reason I didn't do [prescription drugs]," says one recent New Jersey high school graduate. "It's not any worse than drinking or smoking pot. Yes, it's illegal, but taking pills doesn't make you a bad person by any means." The Partnership study found nearly one-third of teens (7.3 million) agree that there's "nothing wrong" with using prescription drugs without a prescription once in a while.

Pill popping has become so accepted as part of the weed-and-alcohol culture of high school parties, but now teens take them throughout the day as a routine part of life.

"School was really stressful, so kids would pop pills or snort Adderall during class to make it go faster," explains Anders Torgersen, 17, of Huntington Beach, California. Torgersen asserts that when he was an athlete and top student at a strict private middle school, pressure to excel led him to start taking prescription drugs. "I loved Vicodin because it made me feel like God," he says. "If I punched a wall, I couldn't feel it. I had more power and confidence on the pills." He began dealing the meds in his freshman year of high school. He estimates that 70 percent of his schoolmates used drugs." (Annemarie Conte, "Prescription Pills: The New Drug of Choice for Teens," MSN Lifestyle, 2012)

What Should We All Do?

We must change the attitude toward

taking prescription drugs from

 "It's no big deal"

to

"Rx drugs present 

a potential deadly health hazard.

Use only as directed by YOUR doctor."

That change in attitude must  be complete -- it must be done by young and old. Drug education must involve teaching the family that a pill can be deadlier than a bullet in a gun, and anyone taking the risks of prescription drug experimentation is playing Russian roulette with his/her life.

What Youth Is Taking

(Annemarie Conte, "Prescription Pills: The New Drug of Choice for Teens," MSN Lifestyle, 2012)

Depressant : Xanax

• Nicknames: Z-bar, bricks, Benzos
• Generic: alprazolam
• Legitimate uses: Treats anxiety and sleeplessness; is an anticonvulsant
• Kids take: Orally, or occasionally by crushing and snorting
• Effects: Wooziness, floating feelings, mind-and-body numbness

Depressant: Valium

• Nickname: blues
• Generic: diazepam
• Legitimate uses: Treats anxiety and sleeplessness; is an anticonvulsant
• Kids take: Orally, or occasionally by crushing and snorting
• Effects: Euphoria and sleepiness

Stimulants:Ritalin, Concerta

• Nicknames: Rid, vitamin R, jif, R-ball, Ritty, Rits
• Generic: methylphenidate
• Legitimate use: Treats attention deficit hyperactivity disorder (ADHD) in children and adults
• Kids take: Orally, or by crushing and snorting
• Effects: Intense feeling of energy and increased concentration

Stimulant: Adderall

• Nicknames: beans, black beauties, Christmas trees, double trouble
• Generic: amphetamine and dextroamphetamine
• Legitimate use: Treats ADHD
• Kids take: Orally; crushing/snorting
• Effects: Intense feeling of energy and increased concentration

Painkillers:Vicodin, Vicoprofen, Tussionex, Lortab, Norco

• Nicknames: Vike, Watson-387, Tuss
• Generic: hydrocodone
• Legitimate use: Treats pain
• Kids take: Orally; crushing/snorting
• Effect: Intense euphoria

Painkillers: OxyContin, Percodan, Percocet

• Nicknames: OC, cotton, Percs
• Generic: oxycodone
• Legitimate use: Treats pain
• Kids take: Orally; crushing/snorting
• Effect: Intense euphoria

Painkillers: Avinza, Kadian, MS Contin, MSIR, Oramorph SR, Rescudose, Roxanol

• Nickname: Morph
• Generic: morphine
• Legitimate use: Treats pain
• Kids take: Orally; crushing/snorting
• Effects: Euphoria and hallucinations

Are We Living In a Cult of Pharmacology or a Cult of Personality?

Richard DeGrandpre holds a doctorate in psychopharmacology, was a fellow of the National Institute on Drug Abuse, and wrote the 1999 book Ritalin Nation. In his next book (2007), The Cult of Pharmacology: How America Became the World's Most Troubled Drug Culture, DeGrandpre tells the story of how, as one legal drug after another fell from grace, new pharmaceutical substances took their place.

Whether Valium or OxyContin at the pharmacy, cocaine or meth purchased on the street, or alcohol and tobacco from the corner store, drugs and drug use proliferated in twentieth-century America despite an escalating war on “drugs.”

DeGrandpre denies that drugs are chemically predestined to be either "angels" or "devils." He states “drug use and drug outcomes are ultimately artefacts (things made by man) of culture, not of the inherent pharmacological properties of drugs.”

DeGrandpre argues that the determination to treat the medically sanctioned use of drugs such as Prozac or Seconal separately from the illicit use of substances like heroin or ecstasy has blinded America to how drugs are transformed by the manner in which a culture deals with them.

DeGrandpre points out, during the last century or so, there have been radical shifts in the substances subjected to differential prohibition. Once you could get cocaine in Coca-Cola at the corner drugstore (in trace amounts). You could buy heroin from the same company, Bayer, from which you purchased aspirin. Heroin itself was originally introduced as a “cure” for morphine addiction: it began its life as an "angel" but fell from grace

In De Grandpre's own words:

"As a drug ideology derived from the eternal notion that psychoactive compounds contain a unique spirit or essence, the cult of pharmacology legitimized the belief that these spirits bypassed all social conditioning of the mind and by themselves transform human thought and action. Unlike other worldly modes of influence on mind and human experience, and despite many advances in the pharmacological sciences in the twentieth century, psychoactive substances continue to be treated in the main as spirits that could enter into a body and take possession of it. Yes, soul was transformed into mind and spirit into biochemistry, giving the appearance that science and medicine had done away with the myths surrounding what had come to be called 'drugs.' Drugs were not demythologized, however, but rather remythologized. Psychobabble and biobabble replaced magical explanations of drug action, creating what had become by the end of the century a new, molecular pharmacologism."

The "cult of pharmacology" can be seen as an attack on government authorities responsible for drug regulation and the policies formulated with respect to so-called illicit drugs. DeGrandpre argues that various powerful interest groups hoodwinked the public into accepting the orthodox view. These interests include: “the pharmaceutical industry, the tobacco industry, modern biological psychiatry, the biomedical sciences, the drug enforcement agencies, and the American judicial system."

Any battle against an American industry," DeGrandpre writes in his chapter on Big Tobacco, "even in the name of public health, [is] also a battle against those in Washington who protect that industry, regardless of the public health."

DeGrandpre sees addiction as a matter of setting, the user’s personality and background, and the meaning assigned to certain substances by powerful, self-interested, sinister groups.

My Take On Addiction

Of course, I believe addiction can't be defined strictly in terms of the addicted human organism and a chemical substance. Research supports that compulsive drug use can never be isolated from cultural and other contextual factors and from the situation of the actor. (DeGrandpre, R. J., & White, E. 1996. Drugs: In the care of the self. Common Knowledge.)

Reseach also supports that environmental factors ultimately determine drug use, including the very addictiveness of a drug's appeal and the urge to continue compulsively consuming the substance. (Peele, S. 1985. The meaning of addiction: Compulsive experience and its interpretation. Lexingtron, MA: Lexington.)

But, also one must consider that people don't plan to become addicted. Alan Leshner, PhD, director of the National Institute on Drug Abuse, calls this the "oops phenomenon." It happens when occasional use of a drug turns into weekly use, then daily use, and then eventually into a surprising realization: "I'm addicted."

"Every drug user starts out as an occasional user, and that initial use is a voluntary and controllable decision," Leshner writes. "But as time passes and drug use continues, a person goes from being a voluntary to a compulsive drug user. This change occurs because over time, use of addictive drugs changes the brain--at times in big dramatic toxic ways, at others in more subtle ways, but always in destructive ways that can result in compulsive and even uncontrollable drug use." Leshner, A. "Oops: How casual drug use leads to addiction." National Institute on Drug Abuse web site,www.drugabuse.) 

The fact is, drug addiction is a brain disease.  Leshner says. "While every type of drug of abuse has its own individual trigger for affecting or transforming the brain, many of the results of the transformation are strikingly similar regardless of the addictive drug used. The brain changes range from fundamental and long-lasting changes in the biochemical makeup of the brain, to mood changes, to changes in memory processes and motor skills."

These changes refer to specific alterations in the structure and function of the brain. In simple terms, drugs (a) change brain structure, (b) alter brain function, and (c) hijack the brain's reward system.

Recently, scientists have discovered new insights into the role heredity plays in addiction. These findings may actually identify people at risk for addiction and prompt them to learn behaviors that prevent the disease.

The so-called "cult of pharmacology" theory that Richard DeGrandpre presents begs many questions. The composition of a drug does not, inherently, make it a "devil" or an "angel." I agree. However,  people place the primary blame for the damage done by a drug on the last stop in the delivery of the product -- the people who abuse it.. Of course, they are ultimately responsible for their own dependency, addiction, or overdose. But, are there times when the addicts, themselves, have been abused? And, are the biggest abusers of drug dependents working in the fields of pharmacology and health?

For example, in the case of OxyContin abuse, the public sees firsthand the tremendous availability of the drug and the deadly effects of misuse, so their primary blame falls upon the visible, continuous, illegal activity between the dealer and the addict. They cry, "Just say no!" and "Lock up the criminals on the street!"

They have been conditioned to believe in the good of doctors, pharmacies, pain clinics, and any other of the sanctioned, traditional players in the Oxy pain relief business. Pain is bad; the pain patients trust the professionals' concern for their health, so the public thinks that "angelic" professionals administer only "angelic" medications with "angelic" care.

To most folks, drug addiction is a consequence suffered by expendable souls who live on the fringes of damnation and eventually take the plunge into the chemical "pit." Why? Most believe that drug abusers are pathetically weak and totally devoid of moral upbringing.

How does the public assume the process works? The means of delivery in the eyes of the public is the dealer. Since the "devil" dealer sells the "devil" product to the "devil" addicts, the consumption of the "devil" pill delivers the final "devil" destruction. Case closed and lesson learned -- "Stay away from the devil druggies, boys and girls."

Unfortunately, people begin to see Oxy, a once-advertised rx "angel" pill for pain, as a "devil" drug only on the streets. Instead of tracing the problem with the drug all the way back to its roots and questioning the true intentions of the company and the professionals who support it, the masses choose to say, "It's not the pill, so blame the people who take it."

Damn it, people, wake up! We know the abusers are ultimately responsible for their addictions. A fool could understand that. The concern is elsewhere. As rx drugs kill in increasingly greater numbers than illegal drugs, something must be done. It must be done now, without hesitation, because rx drugs are currently killing 15,000 people a year. (Centers for Disease Control and Prevention, 2011)

Let's all pressure the FDA and the drug manufacturers to stop Pharmageddon. Illicit drug is just a term used to describe chemicals that are illegal under present policy. In fact, many of today's prescription drugs need to be more tightly regulated. Some (oxycodone varieties) need to be taken from the market until the true damage they cause is properly studied as it relates to the rx epidemic in the United States.

I don't care which drugs are "angels" or "devils" according to an outdated historical perspective. I know what is happening in America in the 21st century -- Big Government and Big Pharma are reacting far too slowly and, thus, contribuing to a terrible killing field. Please, pray for better protection of future generations.

Gonna Get In Trouble, Just You Wait and See: "Why's Everybody Always Picking On Me?"

What causes bad child behavior?

It happens because children 

don’t yet know how

to solve problems effectively.

- James Lehman, behavioral therapist

and the creator of The Total Transformation Program for parents

To put it another way, they're trying to handle many of the situations that life throws at them by acting out. They do this because it's working for them. Lehman says,

"But here's the truth:

If you don't find out what problem

your child is trying to solve with his behavior

and offer him a new solution,

the acting out will most likely continue

or even get worse over time."

Lehman believes if your child can learn to master three tasks with your help, he will be well on his way to functioning successfully as an adult. Three of the most important skills for children to learn as a foundation for good behavior are:

1. How to read social situations

Can your child walk into a social environment, gauge what is going on, and decide how (or if) he is going to interact in an appropriate way?

He must be able to (a) identify how other people may be feeling and (b) try to identify other people's emotions.

2. How to manage emotions
 
Can you give your child appropriate consequences for bad behavior in order that he will know that if the inappropriate behavior happens again, he will be held accountable?

Consequences for bad behavior alone are not enough. Rather, it’s the learning process associated with the consequences that changes a child’s behavior. Why? The problem is actually not the behavior -- the problem lies in the way kids think. This faulty thinking then gets externalized into how they behave.

If you punish them for the behavior and neglect to challenge the way they think about the problem -- or discuss what their options are for dealing with that problem effectively in the future -- then really, what are you doing? Punishment without learning is not effective.

When you have this talk with your child, it should be a pretty businesslike conversation and not all smiley and touchy feely; it shouldn’t be abusive or negative, either. Stick to the facts and ask, “What can you do differently next time?”

3. How to solve problems appropriately

Do you help your child to continually adjust his problem-solving skills and learn new ones to solve ever-tougher problems while managing his behavior and social life?

There is no such thing as "good kids" and "bad kids." A child is often labeled “the bad kid” when he’s developed ineffective actions to solve the problems that other kids solve appropriately. So this child may turn to responses that are disrespectful, destructive, abusive, and physically violent.

Talk to your child about the problem at hand and how to solve it --not just about the emotion your child is feeling at the time.

Lehman On "Out of Control" Teens And Calling the Police

In a frank interview in "Impowering Parents," James Lehman tackles the tough question about when parents should call the police on their abusive child. The interview is very thought provoking. (James Lehman, "Is It Time To Call the Police on Your Child?" nomoreoutofcontrolteens.com, July 8 2010)

Here are some points from the article:

Lehman states, "To parents who tell me 'I’m afraid of my teen, I say, 'I believe you. These kids can be very scary and threatening. But I think if your child doesn’t respond to your authority, there’s another authority you can call upon if you choose to.'”

Lehman believes the important thing is to understand that teens make choices. For example, the teen made the choice to hit a parent, take drugs or destroy the neighbor’s property. Lehman urges that the parents should hold him accountable for that by using whatever appropriate means they have at their disposal.

Calling the police involves a a social stigma: many parents are embarrassed by what their neighbors will think if they see the police at their house. They also may feel ashamed of themselves; they question themselves and wonder why they can’t handle their own teen.

Lehman emphasizes, "I want to be very clear here: it’s tough for parents to call the police and it’s a very personal decision. It’s not for everyone, and if this option does not work for you or your family, then I think you should listen to your gut feeling. I really think everybody has to honor the choice of the parents. After all, you have to live with yourself for a long time. 30 years from now, your child’s teachers and counselors won’t remember him, but you will, and you want to act in a way that you won’t regret later."

So, when does Lehman believe it is imperative that parents call the police? He says, "I think you call the police when safety is an issue or when the behavior crosses the line and becomes criminal. This includes when things are getting broken and when people are getting threatened or hurt. To be more specific, if your child grabs a book and throws it across the room, I don’t think you call the police. But if he punches holes in the wall or breaks something on purpose, I think you tell him “Next time you lose control like that, I’m going to call the police.'”

Lehman stresses that if a teen does it again, parents must follow through. Lohman explains,"To put it another way, I think you should consider calling the police when you see a pattern of behavior that’s unsafe and threatening to others. Make it clear to your child that 'This is the consequence for abusive, destructive or criminal behavior.' And hopefully he will learn from that consequence and make a different choice next time."

In Lehman's eyes the decision is clear. He explains, "I think it’s very black and white. When you have a child who is willing to violate the rules of your household -- a child who’s willing to climb out the window and stay out all night, break his sister’s iPod, punch holes in the wall or push his father or mother or siblings -- you need to take very strong action. Believe me, you have a child who’s really in an awful lot of trouble as a person."

According to Lehman, it's imperative for parents to let a teen know what they're planning to do. When things are not going well, they can say, “The other night you pushed your mother. If that happens again, I’m calling the police.” He believes it's very important to have a plan in place.

He contemplates the alternative, "Let’s say you don’t have a plan and you wind up hitting your child in self-defense. You’re the one who will be arrested and penalized. And not only may you wind up in jail, but the courts are going to blame you for all your kid’s previous problems."

Lehman discusses the consequences of not following a plan: "I think you should tell your child you’re planning to do this and I think you have to be very clear. But remember, if you tell him you’re planning to do it, you better well do it. If you don’t, then it’s just another joke; it’s just another bluff. And every time that you bluff your child, he will get more contemptuous of your authority -- that’s just human nature."

But, what if abusive, destructive or criminal behavior continues? Lehman believes the main thing that parents should want is for their child to be held accountable on another level. One way the courts do that is by putting a teen on probation. Having a probation officer adds another dimension of accountability.

Lehman says, "Now if your child punches a hole in the wall, not only do you tell him to stop, but you call his probation officer. When your teen meets with him, the probation officer says, 'Your mom told me you punched a hole in the wall. I thought we said you were going to work on that. I thought you promised me you weren’t going to do that anymore.'" People should think of the probation officer as another level of authority.

Another issue that many parents have to think about is crime. This would include possession and selling of drugs or stolen property. Lehman says, "I think you can say ahead of time, 'I can’t stop you from using drugs and if you’re high, you’re high. I can’t tell the difference and I’m not going to play detective. But if I find drugs, I’m calling the police.'”

Calling the police should be something people consider, and either reject or accept. "Remember, you have the same right to protection from crime in your home as you do out of your home. It’s not as if the law is different. We should have the same expectations of our children, concludes Lehman.

 

Special Note: Mr. James Lehman

 

James Lehman was a remarkable man with a remarkable story. He went from being abandoned as an infant in a tenement building in New York City, to being a teen runaway and drug addict. By the time he was in his twenties, he had served seven years in prison. A judge sent him to an accountability- and responsibility-based rehabilitation program, where inmates were responsible for helping others beat their addictions.

It was there that James discovered he had a knack for helping teens. “Most people forget what it’s like to be a kid, but for some reason, I never have,” he would tell me. “I think I was given a gift in this life to be able to explain that to people, and to help parents and kids. I don’t take credit for it—it’s a gift.” And it was indeed a gift, one that has helped hundreds of thousands of kids and families, and will no doubt continue helping people for years to come.

Lehman went to several schools including Fordham University and Boston University where he graduated with a Master’s Degree in Social Work.

For three decades, behavioral therapist James Lehman, MSW, worked with troubled teens and children with behavior problems. He developed a practical, real-life approach to managing children and adolescents that teaches them how to solve social problems without hiding behind a facade of defiant, disrespectful, or obnoxious behavior. He taught his approach to parents, teachers, state agencies and treatment centers in private practice and through The Total Transformation Program--a comprehensive step-by-step, multi-media program that makes learning James' techniques remarkably easy.

The entire article used for the blog may be found here: http://nomoreoutofcontrolteens.com/drug-abuse/

They're Over-bored and Self-assured: What's a Parent to Do?

The Internet never ceases to amaze me. Maybe I see it as an extremely convenient and marvelous toy for old codgers like me who used to travel to the local library to absorb information. I employ the Internet on a daily basis to improve my knowledge base. I never cease to marvel at the quality of the material a thorough search can produce. Partnership for a Drug-Free America (2011) offers some great advice for parents on its web page "Why Do Teens Use Drugs."

Ironically, especially for many of my local cohorts, the national contributing sponsor for Drug-Free America is Purdue Pharma; however, despite the raised eyebrows of suspicion, the site features a great number of suggestions for those who are rasing young adults in a very "different" environment from the one those parents remember as adolescents. The world of  the teen today is filled with altogether different pressures. Technology and priorities have vastly changed. The site offers helpful information concerning some of the most common situations in which teens drink and use drugs.

The advice below is separated into divisions that address areas of concern for parents and adolescents. As children mature and gain new freedom, parents must attend to issues in each division -- cars, sex, etc. -- and apply their expertise in order that families may avoid potential problems or, if experienced, handle with care. To me, the advice seems logical, practical, and potentially life saving.

Cars

What Parents Can Do

• Make sure you have a key to the car
• Borrow it occasionally at the last minute – so they don't have time to clean it out
• Ask your teen where they will be
• If you are suspicious, show up where he said he would be
• Insist that her cell phone is charged and on before leaving the house so that she's reachable

Sex

What Parents Can Do

• Talk to your kids not just about the risks of sex, alcohol or drugs, but the link between them
• Tell your teen that because you love them, you want their first time to be special and memorable
• Despite how awkward you may feel, tell your kid the truth — alcohol can actually make sex a lot worse, not better. Drinking makes it difficult to maintain an erection and use a condom correctly
• Make sure that your child is aware of the physical and emotional consequences of unprotected sex (including sexually transmitted infections such as HIV and teen pregnancy) and, even worse, date rape

Emotional Pain

What Parents Can Do

• If you notice extreme and lasting changes in mood, behavior, grades, attention span, etc., take your teen for a professional health assessment to find out what's causing the problem
• Don't tell yourself it's "just a phase." If your teenager seems depressed or not herself, take him to a doctor or therapist
• Make yourself an expert on your child and what's happening in her life
• Know who is and isn't in your teen's social circle
• Stay on top of your teen's school issues
• Keep a close watch on the ways family matters affect your child
• Help teach your teen social coping strategies
• Be especially aware of your teen's plans when you know she's really down
• Keep in mind that even typical "happy" events may secretly make her sad. For example, prom or graduation
• Keep the lines of communication open, and let your teen vent to you regularly

Fitting In

What Parents Can Do

• Get to know your kid's friends and the friends' parents
• Encourage your teen's friends to hang out at your house: give them a private space if possible, feed them and leave them alone.
• Know the cell phone and house phone numbers of your child's closest friends
• Pay close attention when kids mention new names and find out who those kids are
• Tell stories (either from your own life or from history, books, movies, etc.) of people who chose not to go along with the crowd — and achieved great things because of it.
• Encourage and help your teen to sign up for a team, club, youth group, art class, or volunteer organization
• Explain to your child that real friends don't make you do things you aren't comfortable with
• Look at your child's selection of friends (the ones you disapprove of) as a potentially hidden communication to you. Possible meanings may range from a statement about his/her relationship with you, a declaration of revolt or anger (not just of healthy separation or individuation), a call for attention, or a request for intervention. Teenage relationship choices — like substance abuse — can be a symptom, not just an end product.
• It's important that teens feel that their parents trust them and do not invade their privacy. But trust must be mutual, and built upon open dialogue and discussion between parents and teens. Just as your teenager wants you to trust and respect his privacy, he must know that as a parent you need to be able to trust his decisions and know that he's following the family rules and being honest with you about anything that could endanger his health and possibly life.
• If you feel your child is risking his or her health or safety, let her know that you are concerned and may check her room, cell phones and computers. If you take that step, look for mentions of teenage drinking, drug paraphernalia or drug culture. Take a look at her internet browsing history for pro-drug websites as well as unusual e–mails, blog entries and instant messages. Keep an eye out for lingo such as "POS" (parent over shoulder), PAW (parents are watching), PIR (parent in room) and emoticons such as "%*}" (drunk).

Socializing

What Parents Can Do

• Encourage — and help — your child to socialize with friends in a public place instead of in someone's empty home
• Find activities for your teen to socialize in a healthy, safe supervised environment
• If your teen has a bunch of friends over, find excuses to be nearby or drop in frequently. (But don't overdo it, or they won't want to hang out at your house.) Teens are less likely to drink or use drugs if they know they can be caught at any minute
• If your child goes to a party, ask him to call you halfway through the night (and set consequences if he doesn't). Also, you can call him! He'll be less likely to get drunk if he knows he has to have a coherent conversation with you, or if he knows that you can and will call at any time
• Set curfews and enforce them
• When your teen arrives home after a night out with friends, look her in the eye, smell her clothes and hair and ask her about her night
• If your teen arrives home after you have gone to sleep, make them wake you up (or set your alarm at their curfew time), look him in the eye, smell is clothes and hair and ask him about his night
• If your teen is sleeping over at a friends house, call them on the house phone right before or after curfew
• If you sense your teen been drinking or using drugs, be sure to have a conversation the next morning when he's sober

Transitions

What Parents Can Do

• Pay even closer attention to your child's behavior during—and AFTER—transitions such as:
  • The move from grade school to middle school
  • A relocation to a different town
  • Parents' divorce
  • Serious illness in the family
• Amp up the monitoring and communication during such times
• Try not to get too lost in your own needs during transitions
• Encourage an open dialogue with your teen about his experiences
• Set aside regular one–on–one time with your teen to bond and have fun together

Take Charge!

Wow, this is a pretty comprehensive list, and applying it to a young person is sure to cause some heated family arguments, but the product of a parent's labor is so worth the effort. Doing these things involves showing a good mixture of "tough love" and the need for essential, open communication.

I honestly believe all teens (and even most older young adults) need solid structure, mentorship, and monitoring. Parents owe these commitments to the children they love. Some of the advice seems to be meddlesome, but most intrusion into the privacy of dependents can be lovingly modified to prevent a loss of trust. And, at times, parents have significant cause to deepen their routine investigations and assume authority to tighten rules and restrictions.

In a new report on drug, alcohol and tobacco use among teens in the U.S., the National Center on Addiction and Substance Abuse (CASA) at Columbia University finds 

that 75% of all high school students have used alcohol,

tobacco or either legal or illicit drugs

and that 20% of these adolescents are addicted.

(Alice Park, "Teens and Drugs: Rite of Passage or Recipe for Addiction?"

Time Healthland, June 29 2011)

The data also supports previous studies that link early substance use to addiction later in life. Science confirms that the earlier children start to use, the greater they risk becoming addicted. Adolescence is the critical period for starting to use drugs and acquiring addictions.

 90% of Americans who are currently addicted

started smoking, drinking or using drugs before age 18.

A quarter of those who begin using addictive substances

 at these early ages become addicted as adults,

while only one in 25 who start using these substances after age 21 does.

(Alice Park, "Teens and Drugs: Rite of Passage or Recipe for Addiction?"

Time Healthland, June 29 2011)

Adolescent health experts say that part of the reason for the upward trends has to do with the mixed messages that both parents and society send to adolescents about drug use.

 

 

“One of the things you hear is that every teen

is going to [try some addictive substance],”

says Dr. Leslie Walker, president of the

Society for Adolescent Health.

 (Many parents say)
"So what’s the big deal?

This is normative,

and it’s fine."

 

 

 But the data shows that "NO,

parents should NOT accept this 

as normative for adolescents

 to use and there’s a reason

 young people SHOULDN'T be using,

 and there are things parents CAN DO about it."

Walker says that arents must educate themselves about the harm that using substances such as tobacco, alcohol and marijuana can have on their child’s cognitive development, affecting their ability to form proper judgments and mature emotionally. If parents excuse use of these substances because they’re preferable to “harder” drugs such as cocaine, then teens won’t learn the important lesson that any exposure to these substances can be harmful to them.

Parents must be "parents" and take responsibility for their children. Psychologists and successful parents agree, and the court system "seals the deal" with laws concerning parental requirements for the proper care of minors. Those in charge must help their children develop good habits and good ethics early in life and continue fulfilling this charge forever. Taking control is not easy because it involves administering untold doses of love.

Safeguarding and loving children is not the same as manipulating them with overbearing oppression. John Grohol, author and mental health expert says, "No matter how much you may try and control it, you will end up losing (successful parenting) if that is your only goal — control. Children and teens learn through example and the morals you instill in them from day one." (John M. Grohol, PsyD. "Parents Spying On Teens," PsychCentral, 2012)

The entire Drug Free America article: http://timetoact.drugfree.org/think-why-teens-use.html

Born To Be Wired: Passing Down the Risks

You understand that people at risk

of drug dependence typically have deficits

 in self-control. But, did you know 

that the brain vulnerabilities had a family origin

 that may pave the way for addiction

to develop from occasional use?

A study conducted by Dr. Karen Ersche, Department of Psychiatry, University of Cambridge, England, and published in Science, reveals that one sibling who is addicted to drugs, and the other who is not, have similar brain abnormalities.

These abnormalities come from the fronto-striatal systems, an area of the brain that is vital for aiding people in exhibiting self control. (Ersche K, Jones P, Williams G, Turton A, Robbins T, Bullmore E. "Abnormal Brain Structure Implicated in Stimulant Drug Addiction." Science 3 February 2012:Vol. 335 no. 6068 pp. 601-604.)

Dr. Ersche and her researchers compared 50 healthy participants' brain scans with the brain scans of 50 pairs of siblings. In the pairs of siblings, one was addicted to cocaine, and the other sibling did not use alcohol or drugs at all. The siblings, all with a family history of substance use, grew up in abusive homes.

The brain scans revealed abnormalities among both the addicts and their siblings in the prefrontal cortex, an area of the brain that’s responsible for self-control. Also, the putamen, a structure involved in forming habits, tended to be larger in drug users and their siblings, while structures in the brain that manage responses to cravings tended to be smaller.

This research should help people understand why it is more likely for people who have a history of drug abuse in their families to develop the addiction, than those without any family history of drug addiction or abuse.

The findings determined that the person addicted to the cocaine and their sibling both possessed the same brain abnormalities in an area of the brain called the frontal-striatal system, yet somehow some siblings of addicts were able to resist addiction.

Ersche says, “It has long been known that not everyone

 who takes drugs becomes addicted, and that people

at risk of drug dependence typically have deficits in self-control.

 

 

"Our findings now shed light on why the risk

of becoming addicted to drugs is increased in people

with a family history of drug or alcohol dependence:

parts of their brains underlying self-control abilities work less efficiently.

The use of addictive drugs such as cocaine

further exacerbates this problem,

paving the way for addiction to develop from occasional use.”

The Huge Question

"Presumably, the siblings must have some other resilience factors

 that counteract the familial vulnerability to drug dependence," says Ersche.

Of course, the most important question remains unanswered: "How were the siblings of the addicts able to resist addiction?" Although biologically predisposed to develop dependency, these people do not. Science must engage itself in further study to find answers to this nagging question.

Interventions that focus on improved self-control is one avenue researchers are exploring. Using information about why siblings didn’t succumb to compulsive or addictive behavior is another important key in battling addiction.

A critical next step for substance abuse researchers is understanding what causes a person to spiral out of control. Ersche believes if they are able to identify high-risk people and utilize early intervention that reinforces self-control, addiction could stop attacking a family tree.

Ersche concludes,

"Our findings now shed light

on why the risk of becoming addicted

to drugs such as cocaine further exacerbates this problem,

paving the way for addiction to develop from occasional use...
These brothers and sisters who don't have addiction problems,
what they can tell us is
how they overcome these problems and 
how they manage self-control in their daily lives"

Social Decision -- Is It OK To "Wing It"?

“Most schools and colleges spend too much time

preparing students for careers

and not enough preparing them to make social decisions….

In short, modern societies have developed

vast institutions [that] have an affinity

for material concerns and a primordial fear

 of moral and social ones.”

- David Brooks, New York Times columnist

David Brooks believes higher education is structured to distract people from the decisions that have a huge impact on happiness in order to focus attention on the decisions that have a marginal impact on happiness. Believing that most people vastly overestimate the extent to which more money would improve their lives, he recommends that college should teach good decision-making and social skills rather than simply focusing on landing a high-paying job at the end.

Brooks believes media talk shows do not fill the obvious need for a serious social education. He sarcastically says,"To get information on private affairs, you have to go down-market to Oprah or Dr. Phil. Why are they the ones who have access to information on meeting life’s vital needs?"

So what does Brooks believe are the most pressing educational gaps? Here are some conclusions he makes. (David Brooks and Gail Collins, "Advice For High School Graduates," The New York Times Opinionator, June 10 2009)

The needs according to Brooks:

1. The need for instruction on choosing a lifelong marriage companion. (a decision)

2. The need for instruction on the ability to make and keep friends. (a talent)

3. The need for instruction to develop the ability to control one's impulses. (a skill)

Many would conclude that most moral and social formal education now begins in pre-school, peaks in grade school, and becomes much more subject-related in high school. The assumption that values and social skills are formed early in life is accepted by most. Of course, parents in the home setting are responsible for the majority of such instruction. The question is "Are young people getting it?"

Traditionally, high schools offer mandatory health classes that stress information needed to maintain physical and mental wellness and a limited number of nonrequisites such as home economic courses that focus on family concerns and sociology classes that focus on the origins and development of social behavior. The high school college preparatory curriculum usually requires so much attention to academic core requirements that students have little opportunity to enroll in these "extra" classes.

I believe many parents assume that their children, by the time they reach high school, already possess the necessary knowledge and abilities to confront the needs Brooks cites. After spending decades as a high school teacher and a father, I agree with Brooks. The 21st century young adult is not getting enough quality instruction on higher order skills such as critical thinking, analysis, and problem solving. However, this is nothing new -- schools have been struggling with this understanding forever.

The problem is that teaching these higher order thinking skills requires much more time, energy and devotion than teaching facts and simple recall information. For example, grading a multiple choice test of recall is much easier than grading a 500 word essay of thoughtful composition. Teachers and students are under tremendous strains of class loads and time limits. To consistently teach critical thinking and problem solving, instructors must establish in their students the need for independent study and for adequate "digestion" of theories, skills, and applications. This in-depth teaching and learning is a Beast many instructors and students resist or merely leave to chance.

Simple instruction is "read it, post homework on it, review it, and test it." Higher order instruction is more. It offers models and strategies to deal with related application in the highly complex real world which is chock full of problem solving challenges. The key to "buying into" this more rigorous learning is to successfully engage students' need for the skills in independent living. Lord knows that requires a lot of future projection since most young adults remain significantly dependent until post-college years. Most young people have the Larry the Cable Guy attitude about studies, the "Get' 'er Done" heads on approach. They do not see the purpose of retaining skills for tomorrow, much less for a lifetime.

David Brooks is really saying a happy life requires constant education, readjustment of thinking, and lifelong development of strategies to cope with relationships, friends, and personal emotions. That may sound relatively simple to employ -- too simple to require instruction in critical thinking.
However, consider the difficulties that constantly arise in our lives. So many complications involve how we relate to our companions, how we relate to our friends, and how we handle our irresolute emotions. Do we adequately educate our children about these things? I doubt it.We still subscribe to the "Go to college and get a job" happiness formula. Don't get me wrong here. I definitely believe in acquiring the needed education to qualify a person to land a satisfying, good-paying job. Today we are just considering what may be lacking -- BIG TIME.

None of Us Are As Smart As All of Us

Anyone who reads this blog may already understand what I about to say, but it must be written so that some permanent confirmation exists.

A movement dedicated to rehabilitating

the personal experience of human beings

 must place all common work and achievement 

above politics and above individual desires.

Failure to do so allows selfish interests to flourish by using the good cause as a mouthpiece for personal gain. The probability that the movement will become a shifting sea of "I's" instead of a united surge of "we" becomes great as people concern themselves only about a segment of the cause. This preference encourages prejudice, creates division, and feeds individual egos. Instead, full and consolidated commitment to the good of society produces advancement toward crucial reclamation.

As the movement to stop drug abuse in Scioto County gained momentum, we naturally celebrated and treasured each step of progress. After the pill mills shut down and the drug-related statistics improved, it was satisfying to say, "Congratulations, team. Work well done." Yet, in truth, we have just begun our sworn commitment to "work." No one person has accomplished anything, but the team has made substantial progress. Without the full roster of players, we could not have made these initial strides. And, in order to continue the work, the group must resist the pressures that can potentially sidetrack individuals and draw them away from common goals.

Mahatma Gandhi said, "Every good movement passes through five stages, indifference, ridicule, abuse, repression, and respect." I truly believe we are beginning to achieve respect. But, as we do, we must understand that any measure of esteem the local public grants the group is much more important than media coverage or political comment. Needed change is slowly progressing but lasting change occurs when all people, themselves, see that the transition will make their individual lives more fulfilling than the lives they live now.

I know that "we all must work together" sounds like pre-game speech mumbo jumbo. As cliche and trite the simple bidding sounds, it is true. Division has pervaded our county over decades for reasons largely unsubstantiated -- rumors spread like wildfire in an environment where distrust and rivalries superceded the desire to achieve the common good. Factions bent on personal agendas doomed efforts to make the citizens a cohesive, formidable unit. However, when the human resources here became united, new alliances began to work wonders. I believe, we are just beginning to "taste" the rewards of such unions.

Let me stress, the cooperation and newfound dedication could collapse without sufficient growth and continued achievement. Nothing brings people together like a disaster. In the case of Scioto County, the initial response to the drug abuse epidemic has been phenomenal; however, some tend to see the beginning of progress as an acceptable destination for improvement instead of a temporary pause on the track to permanent and complete change. Defeating drug abuse is going to be a "long haul" that requires substantial energy and smooth interaction to insure continued motion. We have merely started a movement that must be continued into future generations.

I hope that many, many more people decide to rethink dependency and addiction. If skeptics allow themselves to view the problems with a different perception, I am certain they will join the efforts to reduce the present unacceptable state of drug abuse in Scioto County. The fact that abuse affects so many other vital concerns in the area makes it such an excellent place to begin thorough community improvement. With swelling ranks of active supporters so much can be accomplished.

"Teamwork is the ability to work together toward a common vision.
The ability to direct individual accomplishments toward organizational objectives.
It is the fuel that allows common people to attain uncommon results."
- Andrew Carnegie

This is a vital lesson we must teach our children: "Common people, especially in mass, can attain uncommon results." They probably do not believe this in the light of their media-skewed perspective in the 21st century. Yet, ask any of the members of the Scioto Drug Action Team about the veracity of this statement. I believe, to the person, they will shake their head "yes" and profess that enough tiny flames coordinated tightly together can ignite a hell of a fire -- even if the "tall timber" seems impenetrable to the heated change.

Soldiers and Heroin: Good Morning, Vietnam!

 "The only person to blame for a drug death 

is the person who actually took the drugs."

I hear this often as I talk with others about drug abuse. We all want to blame one cause in order to narrow our target and apply the panacea needed to stop the madness. Unfortunately, the network of abuse involves many different means to reach its final destination -- the point of ultimate delivery. If the public ignores any of these stops along the way to dependency, addiction, and death, they will only contribute to extending the life of unrelenting drug operations.

Depending on the circumstances, the cause of each drug-related death is unique. The public must come to grips with this broad view in order to comprehend the complexity and extent of the epidemic. No longer will repulsion and the "you got what you deserve" view suffice for acceptable attitudes toward addicts, and these reactions certainly won't help recovery efforts.

Would you look at some fairly recent American history 

to discover widespread heroin addiction in a group 

you have learned to respect and admire 

for their outstanding service to the nation? 

Of course, I am speaking of the Army veterans of the Vietnam War. Maybe this review will help change the mindset of those with the "dirty junkie" mentality. In fact, during the '60s and '70s service personnel in Vietnam became heroin addicts at an astounding rate. These addictions also contributed to myriads of psychological problems suffered by large numbers of Vietnam veterans. 

First of all, let me qualify the following information with a personal note. I did not serve in Vietnam and experience the terrible realities of combat. So, I have no conception of the stress and the pressures endured by Vietnam vets; however, studies confirm that most Vietnam veterans addicted to heroin reported first using the drug during their military service in Vietnam to relieve the fear and tensions of war. (Mintz J., O'Brien CP, and Pomerantz B. "The Impact of Vietnam Service on Heroin-addicted Veterans," Am J Drug Alcohol Abuse. 1979; 6 1:39-52)

 Lee Robins

A Revealing Study About Vietnam Veterans: 

Many Used Heroin,  

Lots Kicked an Addiction,

Some Remained Addicted,

Many Found Other Routes

In 1971, under the direction of Dr. Jerome Jaffe of the Special Action Office on Drug Abuse Prevention, Dr. Lee Robins of Washington University in St. Louis undertook an investigation of heroin use among young American servicemen in Vietnam. He surveyed a representative sample of enlisted Army men who had left Vietnam in September of 1971—the date at which the U.S. Army began a policy of urine screening. The Robins team interviewed veterans within a year after their return, and again two years later. (Robins, LN. "Lessons From the Vietnam Heroin Experience." Harvard Mental Health Letter. December 1994)

Dr. Robins found that almost half—45 per cent—had used either opium or heroin at least once during their tour of duty. 11 per cent had tested positive for opiates on the way out of Vietnam. Overall, about 20 per cent reported that they had been addicted to heroin at some point during their term of service overseas.

To put it bluntly, one out of every five soldiers in Vietnam

 had logged some time as a junkie. 

In fact, soldiers under the age of 21 

found it easier to score heroin 

than to hassle through the military’s alcohol restrictions. 

In Vietnam, soldiers who drank heavily almost never used heroin, and the people who used heroin only rarely drank. 

The “gateway drug hypothesis” 

didn’t seem to function overseas. 

What is the "gateway hypothesis"? In the United States, the typical substance abuse progression was assumed to be from “soft” drugs (alcohol, cigarettes, and marijuana) to the “hard” category of cocaine, amphetamine, and heroin.

The mystery of the gateway drug was revealed to be 

mostly a matter of choice and availability. 

One way or another, addicts found their way to the gate, and pushed on through. (Dirk Hanson. "Heroin in Vietnam: The Robbins Study." Addiction Inbox. July 24 2010)

“Perhaps our most remarkable finding,” 

Robins later noted, “was that only 5% of the men 

who became addicted in Vietnam relapsed 

within 10 months after return, 

and only 12% relapsed even briefly within three years.” 

 

How could this be? Heroin is a deadly, highly addictive substance. Those who don’t consider heroin addiction to be a serious problem should consult the work of researchers at UCLA. Between 1962 and 1964, researchers began following a group of heroin addicts who had recently completed a substance abuse rehabilitation program. 

 

The researchers discovered, according to a news bulletin put out by Emory University, something tremendously depressing. In 1997, when the researchers contacted participants, 49 percent of the original participants, 284 to be exact, were deceased. The 40 percent that were still living admitted to abusing heroin within the past 12 months.The abusers’ death rate was 50 to 100 times that of the general population. Most of these people died of a heroin overdose. As this study so clearly demonstrates, heroin addiction can truly be fatal if left untreated.

 

Why Were So Many Vietnam Vets Recovering?

 

What accounted for this surprisingly high recovery rate from deadly heroin addiction? Once the men were back in the U.S., treatment and/or institutional rehabilitation didn’t make the big difference: besides, heroin addiction treatment was close to nonexistent in the 1970s. “Most Vietnam addicts were not even detoxified while in service, and only a tiny percentage were treated after return,” Robins reported. 

 

Was it solely a matter of easier access of the substance causing addiction? This was not likely since roughly half of those addicted in Vietnam had tried smack at least once after returning home. But very few of them stayed permanently readdicted. Easy access of heroin in Vietnam certainly played a part in the addiction of vets but that doesn't explain the high "kick" rate. A heroin addict in the U.S. could access the substance.

 

Somehow, the bulk of addicted soldiers 

toughed their way through it, 

without formal intervention, 

after they got home.

 

The Robins Study found that a majority of soldiers kicked it on their own, without formal intervention. Some of them could “chip” the drug at will—they could take it or leave it. And when they came home, they decided to leave it.

Yet, how about the 5 to 12 per cent of the servicemen in the study for didn't recover? This group of former users could not seem to shake it, except with great difficulty. And when they did, they had a very strong tendency to relapse. Frequently, they could not shake it at all, and rarely could they shake it for good and forever. 

It is important to recognize the unique environment 

in which the soldiers were using heroin in Vietnam. 

 

Service members were using extremely pure heroin (drug) in Vietnam, in a very different environment (setting), and under very stressful and different emotional situations (set) than they were presented with back in the U.S.  And, of course, the level of heroin use was somewhat controlled by the nature of military life. 

 

To illustrate this, consider that soldiers could use heavily while on leave, but they could not use chronically like street addicts while on active duty. Otherwise, their drug use would become obvious and be readily brought to the attention of their superior officers.

 

Joe Spillane, Associate Professor of History at the University of Florida, explains, "This early awareness would have precipitated early intervention, thereby partially mitigating the development of physiological addiction and the entrenchment of the brain’s reward reinforcement pathway, which is the key to physiological addiction and psychological habituation. However, the unique protective factors of the military environment were countered by a number of critical risk factors, especially the pervasive availability of potent heroin in the Golden Triangle and the traumatic environment of war." (Spillane J. "The 'Lee Robins Study' and Its Legacy: Part II." Blog of the Alcohol and Drugs History Society. pointsadhsblog.wordpress.com. January 18 2012)

A Deeper Examination

A. Comprehensive Screening

 

Joe Spillane delves deeper into the reasons so many Vietnam vets recovered. Spillane explains, "The setting for Lee Robin’s research was the gateway out of Vietnam, which encompassed heroin addiction screening for every soldier before they were allowed to return home. 

 

"Robin’s research was based on a newly implemented and relatively comprehensive screening system in which every soldier was tested for heroin addiction before he was allowed to return home to the U.S.  She found a 20 percent rate of heroin addiction among returning soldiers using the subjective self-identification criteria for being psychologically addicted to heroin coupled with the more objective criteria of testing positive for opiates through urine screening." (Joe Spillane. "The 'Lee Robins Study' and Its Legacy: Part One." Blog of the Alcohol and Drugs History Society. pointsadhsblog.wordpress.com. January 16 2012)

 

B. Early Intervention and Treatment

 

If service personnel tested positive for opiates in their urine and/or reported that they were psychologically addicted to heroin, the soldiers were required to complete a military drug treatment program before they were eligible to return home to the U.S. 

 

However if the soldiers were able to stay clean for three days before their urine screen and did not-self-report psychological dependence, they would screen negative for heroin addiction and would not have been included in the relapse cohort for Robins study. 

 

Spillane says, "Knowledge of this “work around” may have separated the novice users from the experienced users, thereby capturing the group we often ignore in secondary prevention and treatment – the more novice regular or experimental users. If this was the case then what the Robins study may actually demonstrate is the effectiveness of early intervention and drug treatment among those who are early in their drug use process."

 

C. Population Differences -- Military Newly Addicted and High Risk Already Addicted With Triggers

 

This was a study of an active military population. The environment in which the soldiers were living during their year of deployment was conducive to heroin use – high rates of undiagnosed PTSD, access to cheap, pure, and readily available heroin. Many of the soldiers who used heroin while in Vietnam would not have done so otherwise. 

 

Spillane points out an important difference in the populations studied: "Whereas comparative research studies are based on high-risk populations that are already heroin addicted.  Contrasting Robin’s extraordinarily low relapse rates, contemporary research on addicts treated in the U.S. who return home to their communities following in-patient treatment shows relapse at a rate of around 65 percent -- largely because the vast majority of addicts from the general population return to their communities and the environments in which they were previously using– environments flush with cues for drug craving and triggers for relapse."

 

 

But, Were the Vietnam Vets Really Able to Stay "Clean"?

 

Did these Vietnam vets really stay clean? Whereas the Robins study did show that the vast majority of veterans were not using heroin one year out from their return from Vietnam, it did not demonstrate abstinence from alcohol and other drugs altogether. 

 

Although a substantial number of soldiers 

successfully stopped their use of heroin, 

many continued with, or switched to amphetamines, 

barbiturates and/or marijuana.

Still, the facts do speak about the success that many Vietnam heroin addicts had while "kicking" their disease, or, at least, the facts speak to the successful strategies that helped them manage it. Remember, many tragedies did occur even in this unique group, so the picture is not extremely "rosy." But, there are important lessons in this history lesson. These lessons must be analyzed and now applied to new groups of heroin dependents and addicts.

Joe Spillane emphasizes, 

"What all service personnel and veterans did have 

was immediate access to services to support 

their full recovery from heroin addiction. 

This is precisely what the treatment community

 advocates for today – early and immediate access

 to comprehensive treatment."

The systems put in place for Vietnam veterans encompassed:

• Treatment on demand
• Replacement therapy – Methadone maintenance
• Support network of peers
• Ongoing medical care and long-term follow up
• Change of environment, people and places that trigger relapse

These resources, coupled with early intervention contributed to the low rates of relapse and high rates of success that Robins observed.
For many years now (surely since the 1980s), America has moved away from prioritizing treatment and recovery. The focus has been the legalistic, militaristic and judicial aspects of drug use.

I agree with Joe Spillane when the says,

"The Robins research and the early days 

of the war on drugs show us

  that addiction can be overcome –

when all hands are on deck and 

when addiction is treated 

as a scientific medical issue first and foremost, 

rather than as an opportunity for 

ideology-mongering and punishment."

Although the physical environment changes when veterans return home, memories and psychological trauma persist. These traumatic memories can lead to a desire to use alcohol and other drugs, including prescription drugs, to reduce anxiety and block unpleasant thoughts and feelings. The use of these substances are significant contributing factors to addiction among veterans.

The true lesson learned from the Robin's study 

is that abuse problems veterans experienced 

did not dissipate when they returned home. 

Post-traumatic stress disorder is a persistent problem that escalates overtime, particularly without treatment. And, a disproportionate percentage of the addicted and homeless populations in the U.S. are veterans from Vietnam, Iraq and Afghanistan.

Tolerance, Compassion and Understanding

I want you to understand that wonderful men and women, boys and girls, and even babies are heroin addicts. When you use a wide brush to paint all addicts, you do them a disservice. And, actually, you do yourself a disservice as well. We must use tolerance, compassion, and understanding to solve any problem. Unfortunately, the problem of drug abuse, at its very core, is black and disgusting to most. We have to change attitudes and policies to combat drug abuse effectively and to insure positive change.

I am sure all of you would do anything within your power to help a vet -- WWII, Vietnam, Gulf War, Iraq, Afghanistan, Kosovo -- overcome a debilitating, potentially deadly addiction. And, please remember, the addiction can be caused by alcohol, drugs, tobacco, or many other stimuli. What difference does it really make?

Are many of us going to continue to say, "They did it to themselves" and  refer to addicts as worthless refuse? Please, look into your own soul and discover your own shortcomings. And then, do one more thing -- think of all the mistakes and hell you have caused in your past. Are you a better person today because a significant number of individuals and groups helped you with your problems? I know I am. I want addicts to be.


Information will be found here:
Dirk Hanson Article: http://addiction-dirkh.blogspot.com/2010/07/heroin-in-viet-nam-robins-study.html
Joe Spillane Article I: http://pointsadhsblog.wordpress.com/2012/01/16/the-lee-robins-study-and-its-legacy-part-one/
Joe Spillane Article II: http://pointsadhsblog.wordpress.com/2012/01/18/the-lee-robins-study-and-its-legacy-part-two/