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

By Richard Taite
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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.

 

 

http://jama.jamanetwork.com/article.aspx?articleid=1810389&resultClick=3

http://www.cdc.gov/pcd/issues/2014/13_0293.htm

http://www.cdc.gov/features/alcohol-deaths/

 



The Ineffectiveness of Opioids for Chronic Pain

By Richard Taite
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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.

 

http://www.neurology.org/content/83/14/1277

http://www.samhsa.gov/data/2k13/DataReview/DR006/nonmedical-pain-reliever-use-2013.htm

http://link.springer.com/article/10.1007%2Fs13181-012-0269-4

http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2008.02411.x/abstract

 



Addiction Changes the Way We Learn

By Richard Taite
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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.

 

http://www.nature.com/nature/journal/v512/n7515/full/nature13665.html

 



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

By Richard Taite
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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.

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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
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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.

 

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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
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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.

http://www.dovepress.com/drug-abuse-in-athletes-peer-reviewed-article-SAR

http://www.usada.org/substances/effects-of-performance-enhancing-drugs/

- See more at: http://www.cliffsidemalibu.com/richard-taite/sports-fans-lets-look-performance-enhancing-drugs/#sthash.9lnXWwXM.dpuf



Carefully Designed Drug Monitoring Programs Help Keep Addiction in Check

By Richard Taite
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Carefully Designed Drug Monitoring Programs Help Keep Addiction in Check

Despite challenges, prescription drug monitoring programs are essential tools in ensuring opioids and other addictive medicines are prescribed and used appropriately.

The field of medicine is being pulled in two directions. On one hand, doctors are becoming more aware of the consequences of pain, leading to the prescription of more and more aggressive pain medicines; and on the other hand, we are also becoming more aware of the addictive potential of many of these drugs. We see the necessity of using opioid painkillers for people in pain, but we see the destructiveness of these painkillers when mis-prescribed and/or misused.

One response to this dilemma has been the growth of prescription drug monitoring programs (PDMPs). PDMPs allow doctors to know who is getting what drugs from whom. That’s the promise of a PDMP – it can keep track of the doctors who are prescribing drugs, the pharmacists who are distributing them, and the patients who are using them, and will allow people in positions of authority along this chain of communication to ensure that dangerous and addictive drugs are being used cautiously and correctly.

An interesting article in the open access journal BMC Pharmacy and Toxicology explores the pros and also the cons of these PDMPs – and lists the challenges we need to answer as we further refine the use of these important programs.

Here are the “pros” the article lists: Reduce over prescription and doctor shopping; reduce fraudulent prescribing by physicians; improve quality of care (e.g. ensuring there are no accidental drug interactions from legitimate prescriptions); and track geographic trends of use (e.g. discovering geographic trends of misuse and also demographic trends in legitimate use).

Here are the “cons” the article lists: Physician concerns (e.g.  concern that legitimate, high prescribers will be unfairly flagged); tagging of “psuedo addicts” (e.g. patients who have legitimately moved between doctors searching for real pain relief); patient concerns about refusal of prescriptions; loss of privacy; interference of law enforcement with health care; and mandatory use of PDMPs forcing unnecessary demands on doctors’ already stretched time.

In my opinion, these prescription drug monitoring programs are somewhat similar to asking police officers to wear video recorders; prescribers who are doing their job well have nothing to worry about and, in fact, an extra layer of careful oversight may help many providers answer concerns about their legitimate prescribing patterns. When you’re doing a good job, it can be supportive to have someone watching. Physicians who are in hospice or palliative care, some of the fields that prescribe opioids more than other specialties, will also have support through tracking of their prescribing practices.

Of course, answering the remaining concerns becomes a challenge of doing the most good compared to the least bad. A carefully designed PDMP should flag more doctor-shopping addicts and patients at risk for addiction than it flags patients receiving legitimate prescriptions for chronic, debilitating pain, palliative care, or acute situations. In these cases of inappropriately flagged patients, individual reviews can ensure that people who are in pain receive the drugs they need. We need also to ensure in these processes that reviews are quick, made by medical professionals (not non-medical administrators), and that patients have access to critical medications during the review process.

Are prescription drug monitoring programs worth their drawbacks? What’s your opinion?

- See more at: http://www.cliffsidemalibu.com/addiction-treatment-and-program-resources/carefully-designed-drug-monitoring-programs-help-keep-addiction-check/#sthash.7AXWBKEa.dpuf



Research Results on Food Addiction

By Richard Taite
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Research Results on Food Addiction

Recent evidence suggests that palatable, high-calorie foods, think comfort foods like mac & cheese or burgers with fries or steaks cut half the size of your head, may have an addictive potential that can contribute to overeating. Impulsivity, obesity and overconsumption of such foods have been associated with addiction-like eating behavior. (I say addiction-like, because as of present, food addiction is not fully recognized as an addiction by treatment professionals.)

Current data demonstrates that impulsivity is a trait that predicts the development of food addiction-like behaviors, including excessive intake, heightened motivation for food, and compulsive eating of foods with high fat, salt, and/or sugar content. Is the problem then impulsivity or lack of impulse control, or does something in the food cause impulsivity? Compulsivity is a behavioral trait frequently seen not only in drug-addicted individuals, but also in individuals who pathologically overeat. In this study, researchers hypothesized that a high impulsivity trait precedes and confers vulnerability for food addiction-like behavior.

Working with 4000 food addicts over twenty years, research scientist Philip Werdell found “bingeing clients reported “having to eat” and “bingeing on” the same foods scientists find most “addictive”: sugar, fat, flour, wheat, salt, artificial sweeteners, caffeine and volume.” Food-addicted individuals reported more frequent food cravings, higher eating disorder psychopathology and more depressive symptoms than non-addicted people. Furthermore, evidence indicating food abstinence relieves physical craving, enables sustained weight loss and supports internal recovery, provides a strong argument for the existence of both physical craving and food addiction.

A large 2013 study using a US-based population of women, documented the prevalence of food addiction by using a novel measurement scale in middle-aged and older women. Overall, 7839 (5.8%) of the women surveyed met the criteria for food addiction. The prevalence of food addiction was 8.4% in the younger cohort of women aged 45–64 years and 2.7% in the older cohort of women aged 62–88 years. The scientists hope the results may provide insight into the strong association between behavioral attributes of food consumption and the development of obesity.

Out of control consumption of food is related to pain reduction centers, which focus on the serotonin mechanisms in the brain, according to another study. This research showed malfunctions in serotonin processing correlates with an addiction to sugars and flours. Therefore, struggle with food addiction may have biological influences.

Existing evidence needs critical evaluation and food addiction should be considered for recognition as an addiction, no different than drugs or alcohol. There is now sufficient evidence to suggest that addiction, at least to sugar, is real and deserves treatment. Many holistic approaches help control other addictions, and food addiction warrants a more in-depth discussion for appropriate treatment options, to help those who struggle with this issue and the comorbid diseases of obesity, diabetes, and other disorders. Discuss concerns you may have with a medical professional for advice and development of a personal treatment plan for any addiction.

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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.



5 Myths about Healthcare Data Privacy from an Addiction Center CEO

By Richard Taite

Privacy.2It happened to Target and recently we learned it happened to UPS stores, too. It went on for a year at the Montana Health Department and it happened to millions of customers of Kaiser Permanente Northern California. It’s the theft of customer or patient data, and it can take place in many ways – a laptop goes missing, an employee downloads malware to an internal computer, someone on the inside intentionally leaks the data.

When this happens at a retail outlet like Target, customers can lose their credit card information, leading to a lengthy process of sorting out with the credit card company what you did and didn’t authorize. When this happens with a healthcare organization, the consequence can be the loss of your privacy, maybe even a social security number that links you with your identity in ways that are terribly difficult to disentangle.

In late July, Becker’s Hospital CIO published an article describing 7 HIPAA myths that hospitals, clinics, and other healthcare organizations need to keep in mind when trying to stay on the right side of privacy concerns. But there are things patients can do to safeguard their data, too. One of these things is simply knowing what healthcare organizations are and are not required to do to keep your data safe. Unfortunately, there’s HIPAA and then there’s what people think is true about HIPAA.

Following are 5 myths that I hear from patients in respect to their privacy. Of course many if not most healthcare settings, absolutely including my addiction treatment facility, have set their own best practices to answer these concerns. We go far above and beyond HIPAA requirements. But it’s still best to know what healthcare facilities have to do and what they choose to do with patient data. Knowing your rights can keep you safe. Be sure to ask your doctor, hospital, or addiction treatment center what they do to go beyond HIPPA’s basic privacy requirements.

1. HIPAA Requires a Consent Form before Treatment or Billing

Not only can a healthcare facility treat or bill you without a signed consent form, but it can pass along your information to another healthcare provider without signed consent, so that you can be treated and billed. When you move between healthcare institutions or even between some departments within an institution, another medical record may be created. The same is true of billing. Make sure you trust the clinic you are referred to as much as you trust the data security at the hospital where you started.

2. Healthcare Providers Can’t Tell Your Family about Your Medical Treatment

Believe me, I see this all the time; there is some information you might want to withhold from your family. But when it is in the “best interest” of the patient, healthcare providers are allowed under HIPAA to share your medical information. It’s even easier to share information with a family member that a patient has identified as a caregiver.

3. The Fact of Your Admission Is Confidential

This depends on the treatment facility. At my facility and most addiction centers, the fact of admission is confidential. But many hospitals list patients in an online directory and anyone that calls may be given your phone and room numbers. In most healthcare facilities, if you want your stay to be confidential, you have to request it specifically.

4. Your Sensitive Medical Information Won’t Be Emailed

What sits on the top of a fax machine tray may not stay on the top of a fax machine tray. And unless you have expressly communicated how you prefer to be communicated with, your healthcare provider can use email or even text. Most doctors and mental health providers are careful to offer disclaimers of non-confidentiality on all emails. Still, it’s easy to overlook what is and what is not secure.

5. Healthcare Providers Can’t Leave Messages on Answering Machines

In this day of personal smartphones, perhaps there’s less chance that an unsuspecting spouse or child will listen to the message describing the prescription that is ready for you at the pharmacy. Sure, providers are discouraged from leaving the specifics of medical information, but I’m sure you can imagine many cases in which a message leaving the provider’s name and the request to call back could raise privacy concerns. And providers are certainly within their rights to do so.

I don’t mean to sound like a conspiracy theorist. In most cases, healthcare providers will use your information to provide the best possible care – and this information will stay within the walls, or at least within the database, of your treatment provider. And again, most healthcare providers have internal policies that go above and beyond the bare-bones requirements of HIPAA. But it’s worth knowing your privacy rights – not just guessing that your information will be kept safe. At least if you know enough to be uncomfortable with the way your records have been handled, you will be able to request they be handled in a more secure way.

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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.

Image: Flickr/opensource.com cc license



Ecstasy by the Numbers: 869,000 New Users of an Impure Drug

By Richard Taite

Ecstasy.2According to the 2012 National Survey on Drug Use and Health, about 16 million people have used ecstasy at some point in their life, and during the 2012 year, 869,000 people used ecstasy for the first time, far higher than the number of new LSD and PCP users combined. The number of new ecstasy users is also greater than the number of new users of cocaine, stimulants, and inhalants. The percentage of people who will use ecstasy sometime in their life is between 2 percent and 3.5 percent. The average age for first-time users was 20.3 years old, smack dab in the middle of the college years.

Ecstasy has been and remains primarily a college drug. Not only is it a college drug, it’s a college party drug. It is a hallucinogen, and users report increased energy and feelings of connectedness to others.

An article in the Suffolk Journal quotes a student, Steve, saying, “It’s everything. In your head, you’re happy with the position you’re in. Physically, things around you feel good, familiar. You feel what it is and enjoy it.”

Perfect for a party, right?

According to a fact sheet from The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention, ecstasy also creates short term effects including severe anxiety, paranoia, teeth clenching, and sweating. Longer term effects include impulsivity and damage to areas of the brain involved in thinking and memory. Additional dangers include the frequent combination of ecstasy with other drugs including heroin and methamphetamines, which can cause physical harm to long-term overall health.

In 2001, there were 76 deaths attributed to ecstasy use, most due to heatstroke associated with dancing to the point of dehydration and exhaustion. Additional deaths are attributed to hyponatremia—drinking too much water without accompanying salts, due to the fear of heatstroke while taking ecstasy.

The risks of the drug extend far past use of the drug itself. Ecstasy is commonly known as the “love drug” and consequences of this love drug include everything you might expect when young people have sex without the use of their best judgment, from unplanned pregnancies to the spread of sexually transmitted diseases to legal problems due to unclear consent. College-aged ecstasy users are more likely to have unprotected sex. This population also has a higher rate of sexually transmitted diseases including HIV/AIDS and herpes. Finally, ecstasy use leads to a higher rate of unwanted sex, especially in young women who take the drug.

Additionally, the use of ecstasy increases suicide risk. Also quoted in the Suffolk Journal article, a student named Ryan says, “It gives you a feeling of euphoria for four or five hours, but then you feel like shit when it’s over. You feel depressed. You shouldn’t take it if you’re already depressed. You’ll just feel worse.” A study from the National Institutes of Health confirms this observation, finding almost double the risk for suicide in young adults that had used the drug in the past year and writing that, “Adolescent ecstasy users may require enhanced suicide prevention and intervention efforts.”

No matter its name—ecstasy, X, E, molly, or others like love drug, dancing shoes, skittles, or beansthe fact of the drug is that it is an unpredictable mix of lab chemicals produced in uncontrolled labs around the world, likely designed for stimulation and hallucination. With ecstasy, you simply don’t know what you’re getting and so you can’t predict its effect. Every time you take ecstasy is a roll of the dice. Is it really worth it?

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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

Image via Flickr by Vix Walker



 
 

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