Sunday, November 14, 2010

Marijuana Facts for Teens

Q: What is marijuana? Aren't there different kinds?

A: Marijuana is a green, brown, or gray mixture of dried, shredded leaves, stems, seeds, and flowers of the hemp plant. You may hear marijuana called by street names such as pot, herb, weed, grass, boom, Mary Jane, gangster, or chronic. There are more than 200 slang terms for marijuana.

Sinsemilla (sin-seh-me-yah; it's a Spanish word), hashish ("hash" for short), and hash oil are stronger forms of marijuana.

All forms of marijuana are mind-altering. In other words, they change how the brain works. They all contain THC (delta-9-tetrahydrocannabinol), the main active chemical in marijuana. They also contain more than 400 other chemicals. Marijuana's effects on the user depend on the strength or potency of the THC it contains. THC potency of marijuana has increased since the 1970s but has been about the same since the mid-1980s.

Q: How is marijuana used?

A: Marijuana is usually smoked as a cigarette (called a joint or a nail) or in a pipe or a bong. Recently, it has appeared in cigars called blunts.

Q: How long does marijuana stay in the user's body?

A: THC in marijuana is strongly absorbed by fatty tissues in various organs. Generally, traces (metabolites) of THC can be detected by standard urine testing methods several days after a smoking session. However, in heavy chronic users, traces can sometimes be detected for weeks after they have stopped using marijuana.

Q: How many teens smoke marijuana?

A: Contrary to popular belief most teenagers have not used marijuana and never will. Among students surveyed in a yearly national survey, only about one in five 10th graders report they are current marijuana users (that is, used marijuana within the past month). Fewer than one in four high school seniors is a current marijuana user.

Q: Why do young people use marijuana?

A: There are many reasons why some children and young teens start smoking marijuana. Most young people smoke marijuana because their friends or brothers and sisters use marijuana and pressure them to try it. Some young people use it because they see older people in the family using it.

Others may think it's cool to use marijuana because they hear songs about it and see it on TV and in movies. Some teens may feel they need marijuana and other drugs to help them escape from problems at home, at school, or with friends.

No matter how many shirts and caps you see printed with the marijuana leaf, or how many groups sing about it, remember this: You don't have to use marijuana just because you think everybody else is doing it. Most teens do not use marijuana!

Q: What happens if you smoke marijuana?

A: The effects of the drug on each person depend on the user's experience, as well as:

  • how strong the marijuana is (how much THC it has);
  • what the user expects to happen;
  • where (the place) the drug is used;
  • how it is taken; and
  • whether the user is drinking alcohol or using other drugs.
Some people feel nothing at all when they smoke marijuana. Others may feel relaxed or high. Sometimes marijuana makes users feel thirsty and very hungry - an effect called "the munchies."

Some users can get bad effects from marijuana. They may suffer sudden feelings of anxiety and have paranoid thoughts. This is more likely to happen when a more potent variety of marijuana is used.

Q: What are the short-term effects of marijuana use?

A: The short-term effects of marijuana include:
  • problems with memory and learning;
  • distorted perception (sights, sounds, time, touch);
  • trouble with thinking and problem-solving;
  • loss of coordination; and
  • increased heart rate, anxiety.
These effects are even greater when other drugs are mixed with the marijuana; and users do not always know what drugs are given to them.

Q: Can a user have a bad reaction?

A: Yes. Some users, especially someone new to the drug or in a strange setting, may suffer acute anxiety and have paranoid thoughts. This is more likely to happen with high doses of THC. These scary feelings will fade as the drug's effects wear off.

In rare cases, a user who has taken a very high dose of the drug can have severe psychotic symptoms and need emergency medical treatment.

Other kinds of bad reactions can occur when marijuana is mixed with other drugs, such as PCP or cocaine.

Q: Does marijuana affect school, sports, or other activities?

A: It can. Marijuana affects memory, judgment and perception. The drug can make you mess up in school, in sports or clubs, or with your friends. If you're high on marijuana, you are more likely to make stupid mistakes that could embarrass or even hurt you. If you use marijuana a lot, you could start to lose interest in how you look and how you're getting along at school or work.
Athletes could find their performance is off; timing, movements, and coordination are all affected by THC. Also, since marijuana use can affect thinking and judgment, users can forget to have safe sex and possibly expose themselves to HIV, the virus that causes AIDS.

Q: What are the long-term effects of marijuana use?

A: Findings so far show that regular use of marijuana or THC may play a role in some kinds of cancer and in problems with the respiratory and immune systems.

Cancer – It's hard to know for sure whether regular marijuana use causes cancer. But it is known that marijuana contains some of the same, and sometimes even more, of the cancer-causing chemicals found in tobacco smoke. Studies show that someone who smokes five joints per week may be taking in as many cancer-causing chemicals as someone who smokes a full pack of cigarettes every day.

Lungs and Airways – People who smoke marijuana often develop the same kinds of breathing problems that cigarette smokers have: coughing and wheezing. They tend to have more chest colds than nonusers. They are also at greater risk of getting lung infections like pneumonia.

Immune System – Animal studies have found that THC can damage the cells and tissues in the body that help protect people from disease. When the immune cells are weakened, you are more likely to get sick.

Q: Does marijuana lead to the use of other drugs?

A: It could. Long-term studies of high school students and their patterns of drug use show that very few young people use other illegal drugs without first trying marijuana. For example, the risk of using cocaine is 104 times greater for those who have tried marijuana than for those who have never tried it. Using marijuana puts children and teens in contact with people who are users and sellers of other drugs. So there is more of a risk that a marijuana user will be exposed to and urged to try more drugs.

To better determine this risk, scientists are examining the possibility that long-term marijuana use may create changes in the brain that make a person more at risk of becoming addicted to other drugs, such as alcohol or cocaine. While not all young people who use marijuana go on to use other drugs, further research is needed to predict who will be at greatest risk.

Q: How can you tell if someone has been using marijuana?

A: If someone is high on marijuana, he or she might seem dizzy and have trouble walking; seem silly and giggly for no reason; have very red, bloodshot eyes; and have a hard time remembering things that just happened. When the early effects fade, over a few hours, the user can become very sleepy.

Q: How does marijuana affect driving?

A: Marijuana has serious harmful effects on the skills required to drive safely: alertness, the ability to concentrate, coordination, and the ability to react quickly. These effects can last up to 24 hours after smoking marijuana. Marijuana use can make it difficult to judge distances and react to signals and sounds on the road.

Marijuana may play a role in car accidents. In one study conducted in Memphis, TN, researchers found that, of 150 reckless drivers who were tested for drugs at the arrest scene, 33 percent tested positive for marijuana, and 12 percent tested positive for both marijuana and cocaine. Data have also shown that while smoking marijuana, people show the same lack of coordination on standard "drunk driver" tests as do people who have had too much to drink.

Q: If a woman is pregnant and smokes marijuana, will it hurt the baby?

A: Doctors advise pregnant women not to use any drugs because they could harm the growing fetus. One animal study has linked marijuana use to loss of the fetus very early in pregnancy.

Some scientific studies have found that babies born to marijuana users were shorter, weighed less, and had smaller head sizes than those born to mothers who did not use the drug. Smaller babies are more likely to develop health problems. There are also research data showing nervous system problems in children of mothers who smoked marijuana.

Researchers are not certain whether a newborn baby's health problems, if they are caused by marijuana, will continue as the child grows. Preliminary research shows that children born to mothers who used marijuana regularly during pregnancy may have trouble concentrating.

Q: What does marijuana do to the brain?

A: Some studies show that when people have smoked large amounts of marijuana for years, the drug takes its toll on mental functions. Heavy or daily use of marijuana affects the parts of the brain that control memory, attention, and learning. A working short-term memory is needed to learn and perform tasks that call for more than one or two steps.

Smoking marijuana causes some changes in the brain that are like those caused by cocaine, heroin, and alcohol. Some researchers believe that these changes may put a person more at risk of becoming addicted to other drugs, such as cocaine or heroin. Scientists are still learning about the many ways that marijuana could affect the brain.

Q: Can people become addicted to marijuana?

A: Yes. While not everyone who uses marijuana becomes addicted, when a user begins to seek out and take the drug compulsively, that person is said to be dependent or addicted to the drug. In 1995, 165,000 people entering drug treatment programs reported marijuana as their primary drug of abuse, showing they need help to stop using the drug.

According to one study, marijuana use by teenagers who have prior serious antisocial problems can quicky lead to dependence on the drug.

Some frequent, heavy users of marijuana develop a tolerance for it. "Tolerance" means that the user needs larger doses of the drug to get the same desired results that he or she used to get from smaller amounts.

Q: What if a person wants to quit using the drug?

A: Up until a few years ago, it was hard to find treatment programs specifically for marijuana users.

Now researchers are testing different ways to help marijuana users abstain from drug use. There are currently no medications for treating marijuana addiction. Treatment programs focus on counseling and group support systems. There are also a number of programs designed especially to help teenagers who are abusers. Family doctors are also a good source for information and help in dealing with adolescent marijuana problems.

Source: National Institute on Drug Abuse

Adolescent Substance Abuse

Being a teenager and raising a teenager are individually, and collectively, enormous challenges. For many teens, illicit substance use and abuse become part of the landscape of their teenage years. Although most adolescents who use drugs do not progress to become drug abusers, or drug addicts in adulthood, drug use in adolescence is a very risky proposition. Even small degrees of substance abuse (for example, alcohol, marijuana, and inhalants) can have negative consequences. Typically, school and relationships, notably family relationships, are among the life areas that are most influenced by drug use and abuse.

One of the most telling signs of a teen's increasing involvement with drugs is when drug use becomes part of the teen's daily life. Preoccupation with drugs can crowd out previously important activities, and the manner in which the teen views him or her self may change in unrealistic and inaccurate directions. Friendship groups may change, sometimes dramatically, and relationships with family members can become more distant or conflictual. Further bad signs include more frequent use or use of greater amounts of a certain drug, or use of more dangerous drugs, such as cocaine, amphetamines, or heroin. Persistent patterns of drug use in adolescence are a sign that problems in that teen's environment exist and need to be addressed immediately.

What causes adolescent substance abuse?

There is no single cause of adolescent drug problems. Drug abuse develops over time; it does not start as full-blown abuse or addiction. There are different pathways or routes to the development of a teen's drug problems. Some of the factors that may place teens at risk for developing drug problems include:

  • insufficient parental supervision and monitoring
  • lack of communication and interaction between parents and kids
  • poorly defined and poorly communicated rules and expectations against drug use
  • inconsistent and excessively severe discipline
  • family conflict
  • favorable parental attitudes toward adolescent alcohol and drug use, and parental alcoholism or drug use

It is important to also pay attention to individual risk factors. These include:

  • high sensation seeking
  • impulsiveness
  • psychological distress
  • difficulty maintaining emotional stability
  • perceptions of extensive use by peers
  • perceived low harmfulness to use

How do you know when to seek help?

The earlier one seeks help for their teen's behavioral or drug problems, the better. How is a parent to know if their teen is experimenting with or moving more deeply into the drug culture? Above all, a parent must be a good and careful observer, particularly of the little details that make up a teen's life. Overall signs of dramatic change in appearance, friends, or physical health may be signs of trouble. If a parent believes his or her child may be drinking or using drugs, here are some things to watch for:

  • Physical evidence of drugs and drug paraphernalia
  • Behavior problems and poor grades in school
  • Emotional distancing, isolation, depression, or fatigue
  • Change in friendships or extreme influence by peers
  • Hostility, irritability, or change in level of cooperation around the house
  • Lying or increased evasiveness about after school or weekend whereabouts
  • Decrease in interest in personal appearance
  • Physical changes such as bloodshot eyes, runny nose, frequent sore throats, rapid weight loss
  • Changes in mood, eating, or sleeping patterns
  • Dizziness and memory problems

Howard Liddle, Ed.D.

Teen Substance Abuse and Treatment

Being a teenager is often a confusing, challenging time, which can make teens vulnerable to falling into a destructive pattern of drug use. While most teens probably see their drug use as a casual way to have fun, there are negative effects that are a result of this use of alcohol or other drugs. Even if adolescent drug use does not necessarily lead to adult drug abuse, there are still risks and consequences of adolescent drug use. These negative effects usually include a drop in academic performance or interest, and strained relationships with family or friends.

Adolescent substance abuse can greatly alter behavior, and a new preoccupation with drugs can crowd out activities that were previously important. Drug use can also change friendships as teens begin to associate more with fellow drug users, who encourage and support one another's drug use. For adolescents, these changes as a result of substance abuse signal a problem in the teen's environment, and should be seen as a call to action for parents, teachers, or friends to seek help for their loved one.

Seeking Help

The sooner you can recognize that your teen is abusing alcohol or other drugs, the sooner you can seek help. Make sure to keep track of your teen, their friends, and where they are going. While your teen will probably call you a nag or become annoyed with the constant questions, it is more important to make sure that you know what is going on in your child's life, so that if a problem does arise you can take rapid action.

There are some things to look for in your adolescent's behavior that may be indications of drug use, which include changes in appearances, friends, behavior, and interests. Indications of substance abuse may include:

  • physical evidence of drugs or drug paraphernalia
  • behavior problems and a drop in academic performance
  • emotional distancing, depression, or fatigue
  • changes in mood, eating patterns, or sleeping patterns
  • change in friendships
  • increased hostility or irritability
  • decrease in interest in personal appearance
  • lying or increased evasiveness about school or weekend activities

If your teen exhibits these behaviors, they may have a problem with substance abuse, and the sooner you seek help for them, the better.


Once teens start using drugs, they are not usually motivated to stop. For many teens, drugs are a pleasurable way to relax and fit in. For teens, drugs also don't represent a serious threat because teens typically have the mentality that they are invincible. Because of this, it is important that parents and friends are involved in encouraging adolescents to enter treatment in order to help them achieve a drug free lifestyle. Without this support, it is unlikely that teens will seek help for their drug problem.

There is a variety of treatment programs for adolescent substance abuse, and when seeking help for a loved one, it is important that the treatment program that you choose suits their individual needs.

Treatment for adolescent substance abuse usually includes:

  • Detoxification: Detoxification is for adolescents who need safe, medically supervised relief from withdrawal symptoms when they first enter a rehabilitation program.
  • Residential Rehabilitation: Residential rehabilitation is for teens who cannot stop using drugs without 24 hour supervision. Teens in residential rehab are individuals who have continued to use despite knowledge of the risks and consequences, or have continued to use despite previous attempts to stop. In a residential rehab program, these teens can learn and practice new skills that will help them in recovery. Residential programs may include individual and group therapy, 12-step programs, and relapse prevention.
  • Intensive Outpatient Program: Intensive outpatient programs are for teens who have committed to staying drug free, but need treatment after school to prevent use and promote recovery. These programs can also include adolescents who have already completed residential treatment, but feel that they need further support in the transition back into daily life. These programs usually rely on support from friends and family.
  • Aftercare/continuing care: These programs are a very important part of recovery, and help adolescents to maintain a drug free lifestyle. These programs usually include family support groups, or alumni support groups of people who have also completed a treatment program to provide support for the adolescent in recovery.

These treatment programs are designed to teach teens the skills that will help them to maintain their recovery and to sustain a drug-free lifestyle.

Drug Rehab

Drug addiction is a complex illness.

It's characterized by compulsive--at times uncontrollable--drug craving, seeking, and use that persists even in the face of extremely negative consequences. For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence.

The path to drug addiction begins with the act of taking drugs. Over time, a person's ability to choose not to take drugs can become compromised. Drug seeking becomes compulsive, in large part as a result of the effects of prolonged drug use on brain functioning and, thus, on behavior.

The compulsion to use drugs can take over the individual's life. Addiction often involves not only compulsive drug taking but also a wide range of dysfunctional behaviors that can interfere with normal functioning in the family, the workplace, and the broader community. Addiction also can place people at increased risk for a wide variety of other illnesses. These illnesses can be brought on by behaviors, such as poor living and health habits, that often accompany life as an addict, or because of toxic effects of the drugs themselves.

Because addiction has so many dimensions and disrupts so many aspects of an individual's life, treatment for this illness is never simple. Drug rehabs must help the individual stop using drugs and maintain a drug-free lifestyle, while achieving productive functioning in the family, at work, and in society. Effective drug abuse and drug rehab treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences.

Three decades of scientific research and clinical practice have yielded a variety of effective approaches to drug addiction treatment. Extensive data document that drug addiction treatment is as effective as are treatments for most other similarly chronic medical conditions. In spite of scientific evidence that establishes the effectiveness of drug abuse treatment, many people believe that treatment is ineffective. In part, this is because of unrealistic expectations. Many people equate addiction with simply using drugs and therefore expect that addiction should be cured quickly, and if it is not, rehab is a failure. In reality, because addiction is a chronic disorder, the ultimate goal of long-term abstinence often requires sustained and repeated treatment episodes.

Find a Drug Rehab Here

Helping Kids Navigate Their Teenage Years

When Parents Need Help First

Parents can do much to help their teenage sons or daughters through a variety of difficult situations. Depression, violence, substance abuse, and bullying are all serious issues that parents and teens can work together to help resolve.

Sometimes, however, parents need to confront their own problems before they can help their teenager. Children who live in violent households, or homes where one of the caretakers uses drugs or abuses alcohol, often sustain severe emotional trauma that can last a lifetime. Even if a parent's violent behavior or substance abuse occurred when a child was small, the child may still suffer repercussions during his or her adolescent years.

Domestic violence and parental alcohol or other drug abuse adversely affect children.

Research shows that approximately 90% of children who live in homes where there is intimate partner violence see or hear the abuse. Further, children who are exposed to family violence are much more likely to become violent than are children from nonviolent families. Studies also show that if a parent uses alcohol or drugs, his or her children are more likely to drink or use drugs. Below are examples of situations where children have been affected by current, or even prior, parental behavior. If these situations sound familiar and if you need some help deciding what to do, consider seeking the advice of a local mental health professional.

Parental Alcohol or Substance Abuse

I was called to school by my daughter's principal. Apparently, when her math teacher corrected her in class, Deirdre threw a book at him and stormed out of the classroom. Deirdre's explanation was that "no one else cares, so why should I?" Today was a wake-up call. I have to admit it: My wife has a serious problem with alcohol. I'm not home much. I'm always avoiding the chaos. I know this is serious. What can I do now?

It sounds as though you recognize that your wife's alcohol abuse is affecting Deirdre. This is the first step. Parents with serious alcohol and other drug problems are often overly absorbed in their own needs and problems. They may not pre-pare meals, or be present at them. They may not carry their share of the household responsibilities. They may not properly supervise their children s homework and other aspects of their lives. Often their moods dominate the family. Their anger leaves other family members fearful and anxious. Roles may be confused and children end up taking care of the parents. Communication is often muddled.

Teens in such families feel isolated and alone, with no one to talk to. Their hurt and angry feelings may lead to depression, their own abuse of drugs, or may even erupt in violent behavior, as in your situation with your daughter. Children also sometimes seek attention and/or act out their feelings by shoplifting or committing other crimes.

So what can you do? First, children should not feel alone and abandoned, nor should they be caretakers for their parents. Deirdre needs a parent who will take responsibility and act as a parent should. Make it clear that you are assuming this responsibility and let her know that you love her. She also should know that you are aware that her mother has a problem, and that it is affecting the whole family. Take time to talk with Deirdre about what happened in school and about how she is feeling about things at home. Finally, you should encourage your wife to get help immediately.

If a family member with an alcohol or substance abuse problem is unwilling to seek help . . . Is there any way to get him or her into treatment?

This can be a challenging situation. A person with an alcohol or substance abuse problem cannot be forced to get help except under certain circumstances, such as when a violent incident results in police being called, or when it is a medical emergency. This doesn't mean, however, that you have to wait for a crisis to make an impact. Based on clinical experience, many alcohol and substance abuse treatment specialists recommend the following steps to help a person with an alcohol or substance abuse problem accept treatment:

Stop all "rescue missions"

Family members often try to protect a person with an alcohol or substance abuse problem from the consequences of his or her behavior by making excuses and by getting him or her out of difficult situations caused by the alcohol or other drug abuse. It is important to stop all such rescue attempts immediately, so that the person with the problem will fully experience the harmful effects of his or her drinking or drug use-and thereby become more motivated to stop.

Time your intervention

Plan to talk with the person shortly after an incident related to the alcohol or other drug abuse has occurred-for example, a serious family argument in which drinking or drug use played a part. Also choose a time when he or she is straight and sober, when both of you are in a calm frame of mind, and when you can speak privately.

Be specific

Tell the family member that you are concerned about his or her drinking or drug use, and want to be supportive in getting help. Back up your concern with examples of the ways in which his or her drinking or drug use has caused problems for you or your teenagers, including the most recent incident. If the family member is not responsive, let him or her know that you may have to take strong action to protect your children and yourself. Do not make any ultimatums you are not prepared to carry out.

Be ready to help

Gather information in advance about local treatment options. If the person is willing to seek help, call immediately for an appointment with a treatment program counselor. Offer to go with the family member on the first visit to a treatment program and/or Alcoholics Anonymous or Narcotics Anonymous meeting. (Consult your telephone directory for local phone numbers.)

Call on a friend

If the family member still refuses to get help, ask a friend to talk with him or her, using the steps described above. A friend who is recovering from an alcohol or other drug problem may be particularly persuasive, but any caring, nonjudgmental friend may be able to make a difference. The intervention of more than one person, more than one time, is often necessary to persuade a person with a drug problem to seek help.

Find strength in numbers

With the help of a professional therapist, some families join with other relatives and friends to confront a person with an alcohol or substance abuse problem as a group. While this approach may be effective, it should only be attempted under the guidance of a therapist who is experienced in this kind of group intervention.

Get support

Whether or not the family member with an alcohol or other drug problem seeks help, you may benefit from the encouragement and support of other people in your situation. Seeking the help of a mental health professional can provide the kind of help, insight and support that will allow for long-lasting positive change for you and, in turn, the well-being of your whole family.

The 4 Medications Used to Treat Alcoholism

Can medication keep you sober? Probably not, but medication may help you stay sober, especially when medications approved for the treatment of alcoholism are combined with therapy.

While researchers have yet to find a real medication-based cure for alcoholism (and research continues in earnest), the U.S. Food and Drug Administration (FDA) has approved four medications for use in treating the disorder. These medications are all used to help people avoid relapse or decrease drinking.

The four medications approved by the FDA to treat alcoholism are:

  • Acamprosate
  • Oral naltrexone
  • Injectable naltrexone
  • Disulfiram

Why Use Medication?

Research shows that adding an approved medication for alcoholism to counseling or other forms of addiction treatment improves treatment outcomes. Alcoholism medications have been found to:

  • Reduce enduring symptoms of withdrawal that can prompt relapse (acamprosate)
  • Help minimize alcohol cravings
  • Help recovering alcoholics who temporarily slip back into drinking to avoid complete relapse
  • Prolong intervals between slips or relapses
  • Increase the benefits of counseling or other alcohol treatments

Medication can help an alcoholic in early recovery stay sober long enough to develop sober living and social skills that provide a continuing base for further sobriety. These medications also reduce the severity of cravings and withdrawal symptoms.

Acamprosate (Campral)

Acamprosate helps restore brain function damaged by alcoholism, and in doing so helps alcoholics maintain abstinence.

Alcohol causes intense but relatively brief withdrawal symptoms, and much longer lasting but milder symptoms of withdrawal. Although milder, these enduring withdrawal symptoms (such as difficulty sleeping, irritability and anxiety) can lead to alcohol relapse.

Acamprosate helps motivated recovering alcoholics maintain abstinence by reducing the severity of these longer lasting withdrawal symptoms. Acamprosate is thought to reduce glutamate activity, but its exact means of action remains poorly understood.

How Well Does Acamprosate Work?

Some studies show that acamprosate can double durations of abstinence. Other studies have shown less impressive outcomes. Acamprosate seems to work best for people who are motivated to stay abstinent. It must be taken three times daily, so patient compliance is very relevant.

Advantages of Acamprosate

  • Acamprosate is not metabolized in the liver, and so can be used by patients with liver damage or cirrhosis.
  • It can be used by patients taking methadone or Suboxone, and by those who require opiates for pain control (unlike naltrexone).
  • It causes no withdrawal symptoms and can be stopped suddenly if needed. It can also be taken safely with benzodiazepines.
  • It cannot be abused and it is not dangerous, even at overdose quantities.
  • Side effects are generally minimal, and those that occur are well tolerated.

Acamprosate becomes fully effective between five and eight days after treatment initiation.

Oral Naltrexone (ReVia)

Patients taking oral naltrexone experience reduced cravings for alcohol and, while taking the medication, drinking alcohol won’t produce as much pleasure. Since drinking doesn’t make people on naltrexone feel as good, people that slip while taking the medication tend to drink lesser amounts.

Oral naltrexone works by blocking receptor neurons in the brain’s natural opioid system. With these receptors blocked, consuming alcohol is not as pleasurable. Additionally, neurons in the mesolimbic system (the opioid system) are thought to be responsible, at least in part, for alcohol cravings. Blocking these receptors with naltrexone reduces craving intensity.

How Well Does Oral Naltrexone Work?

Oral naltrexone is effective at helping people maintain abstinence or drink less. Studies of oral naltrexone have shown that, compared to people taking a placebo, people taking the medication:

  • Have lower rates of relapse
  • If they do drink, drink less often and drink less in a sitting

Advantages of Oral Naltrexone

  • It works well, particularly for people who experience heavy alcohol cravings and who are motivated to maintain abstinence.
  • It is well tolerated, causing few side effects (the most common side effect is nausea).
  • It has no abuse potential and causes no withdrawal symptoms.

Disadvantages of Oral Naltrexone

  • It cannot be used by some people with liver problems.
  • It cannot be used by anyone using methadone, Suboxone or requiring opiate pain medications.
  • It may increase a person’s vulnerability to opiate overdose by decreasing opiate tolerance.

Most people begin oral naltrexone therapy within three to seven days after achieving alcohol abstinence. Naltrexone is FDA-approved for up to three consecutive months of treatment.

Injectable Naltrexone (Vivitrol)

Injectable naltrexone works in the same way as oral naltrexone to reduce alcohol cravings and decrease the pleasures of alcohol consumption. While oral naltrexone needs to be taken daily, intramuscularly injected naltrexone works for a continuous month. With a monthly injectable dose, everyday compliance is not an issue.

Studies that have examined the efficacy of naltrexone as a treatment for alcoholism have consistently encountered patient non-compliance as a barrier to successful treatment.

The advantages and disadvantages of injectable naltrexone treatment closely mimic those of oral naltrexone treatment. The main benefit of injectable naltrexone is increased patient compliance. Some points of concern include:

  • The possibility of an injection site reaction.
  • The duration of effectiveness means that any adverse reactions experienced will be experienced for 30 days.

Disulfiram (Antabuse)

Patients talking disulfiram cannot consume alcohol without becoming very ill. Patients taking this medication know this, and so avoid drinking alcohol while taking the medication. This helps people in recovery prolong abstinence and avoid relapse.

How Does Disulfiram Work?

Normally, alcohol is metabolized by the body into acetaldehyde and then into acetic acid. Disulfiram disrupts the final stage of this process (the metabolization of acetaldehyde into acetic acid), causing a much higher level of acetaldehyde in the body after any alcohol consumption.

High levels of acetaldehyde in the bloodstream lead to very uncomfortable reactions, such as the following:

  • Hyperventilation
  • Thirst
  • Nausea and vomiting
  • Chest pains
  • Dizziness
  • Confusion
  • Muscle weakness

At higher doses, the combination of disulfiram and alcohol can lead to serious reactions that can include symptoms such as:

  • Seizures
  • Heart failure
  • Respiratory depression
  • Death

Disulfiram is no longer given in doses high enough to likely cause a very severe or dangerous reaction. In the past, disulfiram was given in high dosages to patients in combination with alcohol, but that is no longer accepted medical practice.

Does Disulfiram Work?

Studies have shown that disulfiram helps to reduce drinking days amongst the actively drinking, but does not seem to work better than placebo in supporting abstinence. Patients who are supervised while taking their medication (to ensure compliance) seem to do better than those who are left unsupervised.

Disulfiram is not an appropriate medication for people with any of the following:

  • Mental illness
  • Poor impulse control
  • Cognitive impairments

No one should take disulfiram without a full understanding of the effects and potential consequences of the medication.

Medications Can Help Support Recovery

Medications can play a very supportive role as one of several pillars in a foundation of recovery. No medication yet available for the treatment of alcoholism works very well when offered as a standalone therapy — all must be combined with other therapies.

If you are interested in quitting drinking or reducing your consumption of alcohol, talk to your doctor about your suitability for any of the above medications. To find a doctor versed in alcoholism recovery, contact the National Resource Center at (866) 762-3712. The center is a free service providing treatment specialists 24 hours a day to answer your questions and put you in contact with appropriate healthcare professionals in your area.

Treatment for Dual Diagnosis: Substance Abuse and Mental Illness

People who have both a mental or emotional disorder and a drug or alcohol addiction are said to have a dual diagnosis disorder. A dual diagnosis disorder is very common and it’s also very treatable. For the best chance of recovery, people with a dual diagnosis need integrated treatment for both substance abuse and their mental or emotional disorder at the same time.

How Common Is a Dual Diagnosis?

  • More than half of all people with a serious mental illness also have an alcohol or drug abuse or addiction problem, according to the Substance Abuse and Mental Health Services Administration.
  • More than fifty percent of drug abusers and 37 percent of alcohol abusers have a mental illness, according to the Journal of the American Medical Association.

Why Is Integrated Treatment so Important?

Each condition worsens and can prompt the other:

  1. Alcohol and drugs can worsen psychiatric symptoms, reduce the effectiveness of psychiatric medications and reduce the likelihood of treatment compliance.
  1. Symptomatic mental illness can prompt the use of alcohol or drugs as self medication, and can reduce the resolve or ability to stay abstinent.

For a better chance at lasting recovery, treatment must address both problems at the same time — and, ideally, should be from the same team of doctors, therapists and healthcare professionals.

Effective Dual Diagnosis Treatment

The first step in dual diagnosis treatment, if needed, is medical detoxification, which focuses primarily on the addiction. After successfully withdrawing from drugs or alcohol, the client can then participate in more integrated treatment for both addiction and mental illness.

Some components of effective dual diagnosis treatment programs include the following:

  • Programs that are developed exclusively for the treatment of dual diagnosis patients and that offer group therapy sessions comprised of patients undergoing similar challenges.
  • Programs that offer case management services, ensuring that the therapeutic services of a team of clinicians are delivered in an integrated manner and with full cooperation and communication between all involved.
  • Programs that bring in family members for support, education and involvement in the recovery process.
  • Programs that offer life-skills training, education or employment assistance programs.
  • Programs staffed by doctors able and willing to prescribe medications as appropriate.

Recovery From a Dual Diagnosis is Very Possible

A dual diagnosis can complicate the situation, treatment can take longer and dual diagnosis patients should seek out care specific to their needs — but dual diagnosis treatment can and does work.

Call the National Resource Center at (866) 762-3712 to learn more about treatment programs in your area that meet the needs of those with both mental illness and addiction.