Regular Pot Use Changes the Brain

By Richard Taite

shutterstock_70950535The existing literature on the long-term effects of marijuana on the brain is confusing, mostly due to methodological differences across studies. However, in a new study of cannabis users, scientists investigated the drug’s long term impact through brain scans, hoping to overcome methodological problems in previous studies. They found that marijuana use changes the brain.

The team studied 48 adult cannabis users aged 20 to 36 and compared data with a group of matched non-users. Researchers collected multimodal measures of chronic marijuana using adults with a wide age range that allows for characterization of changes across lifespan without developmental or maturational biases as in other studies.

Compared with controls, marijuana users had significantly less bilateral orbitofrontal gyri volume, higher functional connectivity in the orbitofrontal cortex (OFC) network, and higher structural connectivity in tracts that innervate the OFC (forceps minor) as measured by fractional anisotropy (FA). Increased OFC functional connectivity in marijuana users was associated with earlier age of onset. Lastly, a quadratic trend was observed suggesting that the FA of the forceps minor tract initially increased following regular marijuana use but decreased with protracted regular use.

The findings suggest that chronic marijuana use is associated with complex neuro-adaptive processes and that onset and duration of use have unique effects on these processes. In other words, if you start using marijuana at a young age and use it often, it affects the way your brain works, and not for the good.

Regular cannabis use shrinks the brain, but increases the complexity of its wiring. The loss of brain volume is balanced to some extent by more connections between neurons. This seems to be the brain’s way of trying to compensate for the changes made by marijuana use. Tests showed that regular users also had lower IQs than non-users and this did not appear related to abnormalities of the brain.

Brain scans disclosed that smoking cannabis every day was associated with shrinkage in the region of the brain involved in mental processing and decision making. Marijuana smokers who started taking the drug at a young age showed greater structural and functional connections between their brain neurons, the research showed. After six to eight years of continually smoking cannabis, the increases in structural wiring in the brain declined, but users continued to display higher connectivity than non-users. Again, this seems to show that the brain is trying to compensate for the damage being done to it by the marijuana use.

Dr Sina Aslan, from the University of Texas, Dallas, who co-led the research, said:

“The results suggest increases in connectivity … that may be compensating for grey matter losses. Eventually, however, the structural connectivity or ‘wiring’ of the brain starts degrading with prolonged marijuana use.”

Although the study does not conclusively address whether any or all of the brain changes are a direct consequence of marijuana use, the long-term effects on brain structure do suggest that these changes are related to age of onset and duration of use.  The younger you start using marijuana and the more often you use it, the worse off your brain will be.

Further work is needed to determine whether stopping cannabis use reverses the changes and if occasional users suffer similar effects. The best advice is not to use marijuana until your brain is fully developed, around the age of 25. The changes in the brain caused by early and prolonged marijuana use are serious and not worth the short term pleasure of the high.

Second, this goes on the bottom of all Rich’s external blogs:



Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.

Pot smoker image available from Shutterstock.

Veteran’s Day Message from Cliffside Malibu

By Richard Taite

Veteran’s Day Message from Cliffside Malibu

There are many things I’m proud of in this world. One is that I live in a nation with a volunteer military. Men and women from across our great land give their time, leave their families, and put themselves in harm’s way all so that we can live the lives we lead at home with relative safety and ease. Some don’t return. We remember them on Memorial Day. Most do come back, though sometimes they are damaged physically and emotionally by their service. They deserve our help.

Although not specifically a veteran’s service, Cliffside Malibu honors America’s veterans. Whenever we can, we help veterans find access to quality, evidence-based treatment for addiction and co-occurring psychological disorders, when benefits do not allow veterans to use VA services. We do our best to match veterans with services and treatment centers that are capable of meeting their specific needs, particularly those who have combat related psychological issues and require specialized treatment. Most often, we are able to secure low cost beds at nonprofit treatment facilities we respect. This is our way of paying it forward and supporting those who serve.

We believe that everyone deserves access to quality care for addiction and co-occurring disorders such as PTSD, depression, anxiety, and suicidal ideation. Please – if you or someone you love is suffering, do not wait to seek help. It can take months or years for VA benefits to come through. Meanwhile, our veterans are losing their lives. Call us. Call another treatment center. Call a 24 hour call center like (951) 676-2589 for a referral. Call the Wounded Warriors Project. Just call someone. We are losing too many good people. Get help now.

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Prescription Opioid Abuse: A Gateway to Heroin and Overdose

By Richard Taite

Prescription Opioid Abuse: A Gateway to Heroin and Overdose

Opioid-involved overdoses in the United States have dramatically increased in the last 15 years, largely due to a rise in prescription opioid (PO) use. Emerging evidence suggests the increase is linked to unintentional PO misuse that easily turns into addiction.

Individuals who regularly use opioid analgesic medications do not often recognize that they are using a medication that can be a gateway to heroin use.

“According to the National Survey on Drug Use and Health, the number of individuals reporting past year heroin use almost doubled between 2007 (373,000) and 2012 (669,000). Emerging evidence suggests the increase may be linked to prescription opioid (PO) users who transition from oral and/or intranasal PO use to heroin use, with POs providing the entryway to regular opioid use, and ultimately, heroin injection.”

Switching from POs to heroin is only one problem. Overdose is another concern. New York University’s Center for Drug Use (CDUHR) and HIV Research and the NYC-based National Development Research Institutes (NDRI) published a recent study examining the overdose knowledge and experience of nonmedical PO users. Researchers found that people who abuse POs fail to educate themselves on the risks of overdose.  Dr. Pedro Mateu-Gelabert, lead investigator with CDUHR and NDRI, said in a statement:

We found that despite significant overdose experiences, nonmedical prescription opioid users were uninformed about overdose awareness, avoidance, and response strategies.”

Most of the users in this study were generally uniformed about the benefit of naloxone treatment for overdose recovery. Naloxone comes in pre-filled auto-injection devices and is used along with emergency medical treatment to reverse the life-threatening effects of opioid overdose. Having this medication on hand can save lives when PO or heroin users overdose.

PO users in the study tended to see themselves as distinct from traditional heroin users. Today the average PO abuser is more likely to be young, white and middle class. They are also unlikely to utilize harm reduction services that address drug users’ health and safety. This is because PO abusers don’t usually see themselves as substance abusers or addicts. PO misuse often leads to long-term opioid dependence, as well as transition to less costly heroin.

Nora D. Volkow, M.D. at a hearing of the US Senate Caucus on International Narcotics Control stated:

“To address the complex problem of prescription opioid and heroin abuse in this country, we must recognize and consider the special character of this phenomenon, for we are asked not only to confront the negative and growing impact of opioid abuse on health and mortality, but also to preserve the fundamental role played by prescription opioid pain relievers in healing and reducing human suffering. That is, scientific insight must strike the right balance between providing maximum relief from suffering while minimizing associated risks and adverse effects.”

The US is seeing an increase in the number of people who are dying from overdoses, predominantly after abuse of prescribed opioid analgesics. This disturbing trend appears to be associated with a growing number of prescriptions in and diversion from the legal market. People from all walks of life are being prescribed addictive painkillers.  This trend must stop.

Mindfulness and Meditation: Two Steps Toward Better Health

By Richard Taite

Regular meditation along with a mindful lifestyle path can help individuals control and recover from many mental health disorders. Meditation is a practice of training the mind to induce another state of consciousness or bring attention to a particular point. Mindfulness refers to a psychological quality that involves bringing one’s complete attention to present experience on a moment-to-moment basis, in a specific way and nonjudgmentally.

A recent study examined associations of mindfulness with mental health and the mechanisms of mindfulness in experienced meditators practicing various meditation styles. Researchers wanted to know if mindfulness and meditation helped people overcome anxiety and/or depression. This was a well-done study. All psychometric and structural analyses of mindfulness on depression and anxiety were based on two large, independent meditator sample groups. Results were cross-validated and allowed for cross-cultural comparisons, further broadening the generalizability of the results.

Researchers found that meditation and mindfulness did help individuals manage anxiety and depression. The success of decentering and nonattachment were the most important mechanisms of mindfulness and consistent with neuroscientific evidence on the same subject. Aspects of emotion regulation and awareness along with nonattachment helped explain the effects of mindfulness on depression and anxiety. In particular, positive effects on the ability to cope with stress were observed and described from a physiological point of view.

This research tells us that we can change the way the brain works by practicing mindfulness and meditation, for positive impact(s) on our mental health. Modifications of cerebral networks and neurobiological functioning are possible in relation to expertise in meditation practice. Published evidence on the neurobiological effects of meditation include information on:

(1) The deactivation of the default mode network that generates spontaneous thoughts and contributes to the maintenance of the autobiographical self and is associated with anxiety and depression;

 (2) Changes to the posterior cingulate cortex that helps to understand the context from which a stimulus emerges;

 (3) Improvement in the temporoparietal junction that assumes a central role in empathy and compassion;

 (4) Changed responses by the amygdala, which is implicated in fear responses.

The converging evidence shows that mindfulness-based interventions are effective in the treatment of psychological disorders, the reduction of stress, and for improving overall well-being.

Several of the proven therapies based on mindfulness meditation are:

  • Acceptance and Commitment Therapy
  • Functional Analytic Therapy
  • Behavioral Activation
  • Metacognitive Therapy
  • Mindful Based Cognitive Therapy
  • Dialectic Behavior Therapy
  • Integrative Behavioral Couples Therapy
  • Compassionate Mind Training      

All therapy models may be use alone or combined in a personal plan developed to meet individual needs.

These treatments offer concepts and techniques that may enhance therapeutic efficacy by teaching individuals a new way to focus attention in order to diminish cognitive reactivity and to enhance psychological flexibility. Mindfulness can be learned by anyone to foster clear thinking and open-heartedness. It requires no particular fitness level, age, religious or cultural belief system, but only the desire and effort required to practice regularly. Give it a try. Meditation and mindfulness practice are easy to learn, free to use and can make a great positive impact on overall mental health.

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As Seen on TV: Advertising’s Influence on Alcohol Abuse

By Richard Taite

As Seen on TV: Advertising’s Influence on Alcohol Abuse

Excessive alcohol consumption is a leading cause of premature death in the U.S. and responsible for one in every 10 deaths. The statistics that describe the ways in which we drink ourselves to death are staggering. A study published in the journal Preventing Chronic Disease found that nearly 70% of deaths due to excessive drinking involved working-age adults. The study also found that about 5% of the deaths involved people younger than age 21.  Moreover, excessive alcohol use shortened the lives of those who died by about 30 years. Yes, 30 years.

One strong factor that reinforces the popular culture surrounding drinking is the glamour of advertising. Researchers at the Johns Hopkins Bloomberg School of Public Health examined alcohol-advertising placements to determine whether the alcohol industry had kept its word to refrain from advertising targeting young people. This included television programs for which more than 30% of the viewing audience is likely to be younger than 21 years, the legal drinking age in every state.

The study found that alcohol related advertising increased by 71% in the last decade; this is largely attributed to exposure on cable television. That increase coincided with a reported upsurge of alcohol consumption by high school students. In conclusion, the study suggested that if the National Research Council/Institute of Medicine’s proposed threshold of 15% exposure to advertising was implemented, young viewers would see 54% fewer alcohol ads and society would see a correlating decrease in alcohol related deaths.

What about those “drink responsibly” admonitions on so many commercials? Federal regulations do not require responsibility statements in alcohol advertising. The alcohol industry’s voluntary codes for marketing and promotion emphasize responsibility, but they provide no definition for responsible drinking. So when you see the admonition to “drink responsibly” at the end of an alcohol-related television commercial, there is no idea given as to exactly what that may mean, particularly to someone under the legal drinking age.

David Jernigan, PhD, director of the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health said:

“The contradiction between appearing to promote responsible drinking and the actual use of ‘drink responsibly’ messages to reinforce product promotion suggests that these messages can be deceptive and misleading.”

Youth who start drinking before age 15 years are five times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21 years according to the Centers for Disease Control and Prevention.

Alcohol advertising influences many people across a wide range of demographics. Regardless of the warning labels on alcohol containers, community prevention programs and general public knowledge of the risks of excessive alcohol consumption, people continue to drink in health-damaging ways. Drinking in public, at sporting events, in parks, during celebrations, etc., is firmly embedded in society as acceptable behavior. At the same time, the large number of alcohol related deaths among all age groups is a concern, especially when this drinking behavior is generally developed while individuals are underage.

Alcohol use is a major public health problem that can lead to social, financial, and health related setbacks and premature death. Talk to health care professional if you or someone close to you is struggling with excessive alcohol consumption.


The Ineffectiveness of Opioids for Chronic Pain

By Richard Taite

The Ineffectiveness of Opioids for Chronic Pain                                                                                      

Let me first say that I am not a medical doctor. However, as the founder and CEO of a leading addiction treatment center, I sit on the front-lines of the prescription painkiller epidemic. From this vantage point, by working with addicts and their families and the physicians who treat addiction, I have come to learn a great deal about opioids, both when they are useful and when they may cause more harm than good. In reading the recent research on the efficacy of opioids for treating non-cancer related pain, I am dismayed at the ease with which these medications are prescribed.

The use of opioids for chronic non-cancer pain has increased dramatically over the past several decades. This has been accompanied by a major increase in opioid addiction and overdose deaths. The evidence does not support the safety and effectiveness of opioids for chronic pain and is causing an epidemic of tragic drug overdoses. The consequences of this abuse have been devastating and are on the rise.

An estimated 2.1 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin.

The high risks associated with long-term opioid use are clearly shown by the climbing numbers of reported overdoses. Over 100,000 individuals have died, directly or indirectly, from prescribed opioids in the United States since the late 1990s. People aged 35–54 years have higher poisoning death rates involving opioid analgesics as compared with those in other age groups. Furthermore, substance abuse rates in those over the age of 55 are predicted to double in the next few years according to research predicting future trends from past and current research data.

A major reason why opioids are over prescribed is the misinformed belief that addiction is a rare consequence of long-term opioid therapy. The limited data supporting this outdated belief is of poor quality. Dependence arises in virtually all patients who are treated with long-term opioid therapy, and serious addiction occurs in up to one-third of patients.

The long-term use of opioids may not be beneficial even in patients with more severe pain conditions, including sickle-cell disease, destructive rheumatoid arthritis and severe neuropathic pain. The American Academy of Neurologists in a newly released position statement claimed :

Studies show that roughly half of patients taking opioids for at least three months are still on opioids five years later. Research shows that in many cases, those patients’ doses have increased and their level of function has not improved. In addition, the premise that tolerance can be overcome by dose escalation is now seriously questioned.

A relationship between prescribed opioid dose and overdose events was verified in three separate high quality studies. A nine time increased risk of overdose was noted in amounts exceeding 100 mg/d compared to doses below 20 mg/d in patients. Unfortunately, prescribed doses are common at 120-200 mg/d. Many patients suffer serious opioid-related harm, including death, despite never misusing an opioid prescription.

Addiction withdrawals from opioids, when not treated by a detoxification specialist, are extremely unpleasant lasting several days, and sometimes compared to severe influenza, including abdominal pain, nausea, diarrhea, and generalized malaise. The emergence of these symptoms following abrupt reductions in the dose of opioids, and their resolution following re-administration of the drug is common. This makes it difficult for even highly motivated individuals who are dependent on opioids to reduce or eliminate use without careful medical oversight and support.

If a patient’s pain is not under control, they should seek the help of a pain specialist and consider more successful alternative therapies than opioid medication on its own. Evidence now supports several holistic treatment options that are effective to help alleviate pain. We are able to promote mental, physical and spiritual healing without the need for what are now being regarded as generally ineffective opioid medications. Talk to a medical professional specializing in pain management for help with a long-term personal plan for managing pain.


Addiction Changes the Way We Learn

By Richard Taite

Addiction Changes the Way We Learn

When I look at my children at play, I am fascinated by the ways in which they learn. Learning is a brain event and there are times I imagine I can almost see my kids’ brains working and developing as they play and learn. Everything that we do, whether motor, sensory or cognitive, requires networks of neurons to generate new activity patterns in our brains. These new patterns are how we experience learning.

A team of researchers from the Center for the Neural Basis of Cognition at Carnegie Mellon University and the University of Pittsburgh were able to provide a theoretical representation for brain limitations during learning. In other words, they may be able to show us what prevents individuals from learning. This could give scientists a better understanding of how addiction changes the brain and affects the recovery process.

In the recent study, animals were shown to be able to control specific neural activity patterns that were from previously learned activities. Consider these non-study-related examples as an illustration. If animals knew how to open a door by pushing a lever, they would be easily able to learn similar activities. However, animals were less able to learn to control activity patterns that were not previously learned. An animal that could push a lever to open a door would have no idea how to put a ball into a basket – a completely unrelated activity – and would not learn that task as quickly as it would an activity related to a lever. These results suggest that it is difficult to learn to generate neural activity patterns that are not consistent with the existing network structure. Think of it like this; if you’ve never been introduced to math, astrophysics will be incomprehensible; but if you speak three languages, learning a fourth will be relatively easy. The brain develops by adding on to existing structures and learning patterns.

The research findings explain the observation that we are better able to learn new skills when they are related to the skills that we already possess. The researchers speculate that the results provide a basis for a neural explanation for the balance between adaptability and persistence in action and thought.

Dr. Aaron P. Batista, one of the researchers of the study explained:

We knew from experience that some things are learned more readily than others. We now understand a bit on why some things are learned easier than others.”

What does this mean for addiction? Addictive behaviors consist of a compulsion to engage in an action repeatedly, regardless of negative consequences to the person’s physical, mental, social, and/or financial well-being. Dopamine, a neurotransmitter, takes a role in the learning and sustaining of many acquired behaviors. Addiction causes the addict to repeat a particular behavior due to the dopamine reward system – a system that in some ways can be described as being haywire or off kilter in addicts. This keeps the addict trapped in perpetuating the same behavior again and again – in essence, not learning from the negative consequences of their actions.

When certain behaviors become habitual, they become problematic to one’s health and happiness. Once an addiction is triggered, it is hard to work away from activating the dopamine reward system. Therefore, special treatment that works to change the structure and function of the brain is necessary. Behavioral treatment approaches to addiction help engage people by providing incentives to remain abstinent and modify related attitudes and behaviors. This is why recovery can be a slow process that may require an extended stay in a treatment center and later in outpatient services.


How long until the California Legislature Gets It: What’s Wrong with SB1283

By Richard Taite

How long until the California Legislature Gets It: What’s Wrong with SB1283

Yet again, the California legislature makes a terrific blunder with SB1283, showing the electorate that they have no idea how to deal with the dangerous problem of synthetic drugs, in this case, synthetic marijuana and speed. Known as Spice, K2, or by a myriad of other names, synthetic marijuana has been a “legal” substitute to the real thing. Popular with teens and young adults who want to get high without running into legal troubles, Spice is actually little more than poison, leaves onto which all manner of chemicals are sprayed. Bath salts, synthetic speed, is also popular and just as insidiously dangerous for the user. These drugs are widely sold in head-shops and online, marketed directly to young people who are led to believe that they are “safe.” However, instead of making possession of the drug a reason to educate an individual or send them to treatment if their level of use warrants it, the drugs will now be illegal and subject to small fines for possession. We don’t need new crimes created; we need a humane and workable approach to substance abuse treatment.

The use of these synthetic drugs is a real problem and, to that extent, I agree with the legislature’s impulse to take action. According to the Centers for Disease Control and Prevention (CDC), more kids smoke marijuana than cigarettes. As marijuana legalization (and decriminalization) efforts are successful around the nation, young people believe, erroneously, that marijuana is “safe.” While it is clear that attitudes about marijuana are changing, there has been a great deal of research done showing that marijuana has significant negative impacts on the brain development of teens. Yet, synthetic cannabinoids are even worse for young people than the real thing. Forbes magazine tells the story that too few young people would like to believe, that Spice does not generally give the same effect as marijuana, a mellow, relaxed high. When describing how using Spice can feel in the short term, Forbes reporters tell us:

Not good, according to what users tell therapists and reports turning up on addiction blogs. Unlike weed, which in general causes relaxation and positive feelings, Spice causes: acute anxiety or paranoia, panic attacks, a feeling of alienation/disassociation from the world, hallucinations, constant coughing, feelings of nausea or actual vomiting,  inability to hold a thought for longer than a few seconds, irregular heart beat/palpitations, loss of concentration, psychotic episodes, tremors or seizures.

Bath salts, the most common street name for synthetic speed, is at least as bad if not worse than Spice. Bath salts are designed to give a high similar to a combination of methamphetamine, MDMA (ecstasy) and hallucinogens like LSD. In fact:

Like cocaine, meth, and speed, bath salts work by stimulating the central nervous system, kicking it into overdrive, if you will. But the drug also apparently causes paranoid delusions and/or hallucinations. Experts are saying it’s psychoactive, rather than hallucinogenic like acid, but the end result appears to be similar: delusional beliefs acted upon in violent ways.

With drugs so horrible for the health, it’s no surprise that the California legislature wishes to take action. The problem is that criminalizing these substances and making those who possess them subject to a fine does nothing to curb their use. Have we learned nothing at all from the “war on drugs”? It is really the best use of resources to put those in possession of these poisons in front of a judge and waste what I believe will amount to countless millions of dollars in court costs when instead, we could provide education and/or treatment to those in need? Wouldn’t a better use of our resources be an education campaign, along the lines of that which has reduced smoking (tobacco) significantly? What kind of deterrent is a $250 fine for possession?

As we march slowly toward the legalization of marijuana in more and more states, it is time that our legislators catch up with the times. The war on drugs is a failed experiment. Instead of creating new possession crimes, let’s treat individuals with substance abuse issues with humanity and compassion, providing treatment instead of punishment. SB1283 is the wrong approach to a serious problem.


Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also coauthor with Constance Scharff of the book Ending Addiction for Good.

The Upcoming Revised NFL Drug Use Policy

By Richard Taite

The Upcoming Revised NFL Drug Use Policy

The NFL is putting the final touches on a new drug policy. This new policy, which is the first major update since the last policy in 2010, is between the NFL Players Association and the NFL. The significant changes are with regard to HGH (Human Growth Hormone) testing and marijuana use. Having treated a number of active and former NFL players and worked with the NFL Players Association as well as being the founder and CEO of one of the leading addiction treatment centers in the nation, I feel comfortable making a comment on the subject of substance abuse in the NFL.

The NFL works diligently to do everything they can to limit the use of performance enhancing drugs the players use, to create an even playing field for all athletes. Athletes are tempted to use performance enhancing drugs to give them an edge in making a 53 man squad – and to get the benefits, financial and otherwise, that go with being a professional football player – paying the consequences later. The NFL will now be testing appropriately for HGH, a supplement that is used in conjunction with steroids to enhance performance. This is the first time the league will test for HGH. While athletes have found some ways to get around testing for steroids, the testing for and use of HGH is a tell and therefore it is appropriate for the NFL to test for this substance.

The changes with regard to marijuana use are a bit more complicated. On the one hand, it looks as if the new policy will allow for higher levels of marijuana to be in a person’s system before they test positive. This is important. Let me give an example. Because marijuana is so much more potent than it was in the past, it is now possible for an athlete to be in a state where marijuana use is legal and to make a poor choice, such as sitting in a small room playing cards or watching movies with friends who are smoking marijuana. We know of at least one case recently where this has happened and the evidence is indisputable that NFL players can test dirty for marijuana by being around those who use it. Such instances really aren’t a clear indication of problematic drug use. Keep in mind that in the last 20 years, the NFL has not changed its levels of marijuana needed to cause a positive test, but in that same period, the potency of marijuana has increased somewhere in the range of tenfold.

What does it take to test positive for marijuana? The current threshold for marijuana (THC) in the NFL has been 15 nanograms per milliliter (ng/mL). Compare that to the World Doping Agency for the Olympics (150 ng/mL). For airline pilots the threshold is 50 ng/mL. Clearly, the levels are far too low for the NFL and need to be revised to be appropriately in line with other sports.  Even a pilot who would fly a commercial jet with hundreds of lives in his hands has a higher allowable THC level than football players!

Also under consideration and revision is the use of non-performance enhancing drugs in the off-season. It is significant that there is no longer punishment handed down for illegal non-performance enhancing drug use in the off season. It is unclear at this point if illegal drug use in the off-season will count as a strike against the player, and it may because the NFL and the NFL Players Association logically would like to prevent substance abuse, especially that which rises to the level of addiction. What doesn’t make sense is that if someone is smoking marijuana in a social setting in a measured way, in a responsible way in the off-season and they don’t use in the regular season, then they don’t have a substance abuse problem, and it certainly doesn’t rise to the level of addiction. Addiction means you don’t have control over it, it has control over you. The addict can’t make that choice, but most social marijuana users can. In my opinion, if you use responsibly in the off season, that isn’t the business of your employer.

The NFL report isn’t finalized yet. They’re still refining it and it hasn’t been posted on the NFL’s website. But my initial impression is that the piece could use more work and revision, for the benefit and protection of both the franchises and the players. We know better and we can do better.



Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharffof the book Ending Addiction for Good

As Sports Fans, Let’s Look at Performance-Enhancing Drugs

By Richard Taite

The Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health, Madison, WI, recently published a review discussing drug abuse in athletes. Drug abuse occurs in almost all sports and at most levels of teen and adult competition. Doping, defined as use of drugs or other substances for performance enhancement, has become an important topic in sports.

Athletic life may lead to drug abuse for many reasons. Often first experimented with in high school or college for performance enhancement, athletes later continue use to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sports.

Performance-enhancing drugs (PEDs) are not restricted to illegal drugs or prescription medications, such as anabolic steroids. They include questionable dietary supplements and a variety of compounds that are available at grocery and health food stores and online. These substances may negatively affect hemoglobin, glucose and kidneys if misused, and evidence of actual performance enhancement is questionable.

Most if not all doping agents have potential short-term and long-term side effects. Unfortunately, given the high doses of the substances often used by athletes, it is difficult to confirm such effects. It would be unethical to give dosages as high as those used by athletes to participants in research studies. Information about side effects has come from empirical observation, reports of admitted users, and effects in patients prescribed specific medications for medical conditions. Research on this topic is extremely limited.

Athletes may receive comprehensive treatment and rehabilitation for physical injuries, but less often for mental illness, such as anxiety or depression due to extreme stress, possibly because of social views of mental illness as a sign of weakness. Untreated mental illness is often associated with substance use, perhaps in an effort to self-treat. Alternatively, substances of abuse may cause mental illness. This can certainly be true of performance enhancing drugs.

Athletes who use drugs are often skeptical of discussing this fact with their doctors. This may be partly with good reason, as many health care professionals are unfamiliar with the mentality of athletes or common drug abuse patterns in this population. Athletes also try to hide their drug abuse. Referral networks or team assistance programs consisting of health care professionals familiar with these issues should be established for the benefit of athletes, teams, trainers and coaches.

Co-occurrence of physical dependence and mental illness is commonplace.  The first level of addressing the problem of drug abuse by athletes should be prevention. Providers should assess for co-occurring mental illness and drug abuse in athletes with preventive measures, education, motivational interviewing, and other evidence-based interventions.

No athlete should ever have to consider PED use to succeed in sport. Simply put, PEDs have the potential to harm the human body and biological functions. These drugs can be extremely dangerous and, in certain situations, deadly. No matter how you look at it, using performance-enhancing drugs is risky business that does not benefit the sport, the athletes or the fans. Remember the film “The Wrestler?” That’s the true end result of PED use.

There are safe alternatives to PED use, including optimal nutrition, weight-training strategies, and psychological approaches to improving performance, all of which may help with athletes’ confidence in their natural abilities. It’s time we stop sullying athletic accomplishment with PED abuse. Talk to a professional for more information on substance use or addiction treatment options.

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