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Sunday, November 14, 2010
Millions of Americans in Denial About Their Own Drug Abuse
A Family History of Alcoholism
If you are among the millions of people in this country who have a parent, grandparent, or other close relative with alcoholism, you may have wondered what your family's history of alcoholism means for you. Are problems with alcohol a part of your future? Is your risk for becoming an alcoholic greater than for people who do not have a family history of alcoholism? If so, what can you do to lower your risk?
Many scientific studies, including research conducted among twins and children of alcoholics, have shown that genetic factors influence alcoholism. These findings show that children of alcoholics are about four times more likely than the general population to develop alcohol problems. Children of alcoholics also have a higher risk for many other behavioral and emotional problems. But alcoholism is not determined only by the genes you inherit from your parents. In fact, more than one–half of all children of alcoholics do not become alcoholic. Research shows that many factors influence your risk of developing alcoholism. Some factors raise the risk while others lower it.
Genes are not the only things children inherit from their parents. How parents act and how they treat each other and their children has an influence on children growing up in the family. These aspects of family life also affect the risk for alcoholism. Researchers believe a person's risk increases if he or she is in a family with the following difficulties:
- an alcoholic parent is depressed or has other psychological problems;
- both parents abuse alcohol and other drugs;
- the parents' alcohol abuse is severe; and
- conflicts lead to aggression and violence in the family.
If you are worried that your family's history of alcohol problems or your troubled family life puts you at risk for becoming alcoholic, here is some common–sense advice to help you:
Avoid underage drinking—First, underage drinking is illegal. Second, research shows that the risk for alcoholism is higher among people who begin to drink at an early age, perhaps as a result of both environmental and genetic factors.
Drink moderately as an adult—Even if they do not have a family history of alcoholism, adults who choose to drink alcohol should do so in moderation—no more than one drink a day for most women, and no more than two drinks a day for most men, according to guidelines from the U.S. Department of Agriculture and the U.S. Department of Health and Human Services. Some people should not drink at all, including women who are pregnant or who are trying to become pregnant, recovering alcoholics, people who plan to drive or engage in other activities that require attention or skill, people taking certain medications, and people with certain medical conditions.
People with a family history of alcoholism, who have a higher risk for becoming dependent on alcohol, should approach moderate drinking carefully. Maintaining moderate drinking habits may be harder for them than for people without a family history of drinking problems. Once a person moves from moderate to heavier drinking, the risks of social problems (for example, drinking and driving, violence, and trauma) and medical problems (for example, liver disease, brain damage, and cancer) increase greatly.
Talk to a health care professional—Discuss your concerns with a doctor, nurse, nurse practitioner, or other health care provider. They can recommend groups or organizations that could help you avoid alcohol problems. If you are an adult who already has begun to drink, a health care professional can assess your drinking habits to see if you need to cut back on your drinking and advise you about how to do that.
The Substance Abuse Costs to Society & Workplaces Are Huge
Alcoholism alone accounts for 500 million lost workdays each year. Casual drinkers, in aggregate, account for far more incidents of absenteeism, tardiness, and poor quality of work than those regarded as alcohol dependent.
Between 20 and 40 percent of all general hospital patients are admitted for complications related to alcoholism and other forms of substance abuse.
The human costs to the individual, family, and community are incalculable.
Substance Abuse Is a Workplace Problem
Today, almost 73 percent of all current drug users ages 18–49 are full- or part-time employed – more than 8.3 million workers.
About 7 percent of full-time workers use illicit drugs (6.3m), and about 7 percent are heavy drinkers.5 ¨ About 1.2 million full-time workers both abuse illicit drugs and are heavy alcohol users.
The highest rate of illicit drug abuse and heavy alcohol use is among 18–25 year olds, males, Caucasian, and those with less than a high school education.
In a survey of five work sites, 18 percent of persons who drank alcohol and 12 percent of illicit drug users reported that their performance at work had declined due to alcohol or drug use.
Between 44–80 percent of young adults ages 16–17 work during the year. Those working more than 20 hours per week are at high risk for substance abuse and injury. With our youth entering the workforce in greater numbers, this is a significant issue for workplaces to address.
Whole Person Recovery
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Facts About Alcohol -- From "Social Drinking" to Dangerous Dependence
Alcohol use and abuse is associated with serious medical illnesses such as cancer, cardiovascular problems, liver cirrhosis, stroke, hypertension, and brain damage. There is also extensive evidence indicating that alcohol dependence elevates the risk for depression as well as all types of anxiety and personality disorders.
Recent Facts About Alcohol
Nearly 14 million people in the United States--1 in every 13 adults--abuse alcohol or are alcoholic.
Every day, more than 700,000 people in the U.S. receive treatment for alcoholism.
40% of children who start drinking before the age of 15 will become alcoholics at some point in their lives, compared with 25% for those who begin drinking at age 17, and about 10% for those who begin drinking at ages 21 and 22.
76 million Americans, about 43% of the U.S. adult population, have been exposed to alcoholism in the family.
22% of American adults are former drinkers.
Frequently Asked Questions About Alcohol Abuse and Alcoholism
What is meant by “alcoholism”?
Alcoholism, also known as "alcohol dependence," is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. Alcoholism is likely when an individual experiences at least 3 of the following symptoms during any 12-month period:
- Tolerance (increasing amounts of alcohol are required to achieve a desired effect); withdrawal symptoms (such as nausea, sweating, shakiness, and anxiety); drinking larger amounts over a longer period of time than intended.
- A persistent desire to drink, or unsuccessful efforts to control drinking.
- Giving up or reducing important social, occupational or recreational activities in favor of drinking.
- Spending a great deal of time obtaining alcohol, drinking or recovering from drinking.
- Continued drinking despite knowledge of having a persistent or recurring physical or psychological problem either caused or exacerbated by drinking.
Is alcoholism a disease?
Yes. Alcoholism is a chronic, often progressive disease, and, like many other diseases, it has a generally predictable course, recognized symptoms, and is influenced by both genetic and environmental factors that are being increasingly defined.
Is alcoholism inherited?
Alcoholism tends to run in families and genetic factors partially explain this pattern. Currently, researchers are on the way to finding the genes that influence vulnerability to alcoholism. A person’s environment, such as the influence of friends, stress levels, and the ease of obtaining alcohol, also may influence drinking and the development of alcoholism. Still other factors, such as social support, may help to protect even high-risk people from alcohol problems.
Risk, however, is not destiny. A child of an alcoholic parent will not automatically develop alcoholism—and a person with no family history of alcoholism can become alcohol dependent.
Can alcoholism be cured?
Not yet. Alcoholism is a treatable disease through treatment plans of therapy, medication, or a combination of both, but a cure has not yet been found. This means that if an alcoholic has been sober for a long time and has regained health, he or she may relapse and so must continue to avoid all alcoholic beverages and ensure professional mental health care help is always readily available to provide any necessary professional support.
Does alcohol treatment work?
Treatment outcomes for alcoholism compare favorably with outcomes for many other chronic medical conditions. The longer an individual abstains from alcohol, the more likely they are to remain sober. Ongoing support from mental health professionals, family members and others are extremely significant to recovery. It is important to remember that many people relapse once or even several times before achieving long-term sobriety. Relapses are common and do not mean that a person has failed or cannot eventually recover from alcoholism. If a relapse occurs, it is crucial to once again stop drinking and to get whatever professional help is needed to continue abstaining from alcohol.
Does a person have to be alcoholic to experience problems from alcohol?
No. Even if you are not alcoholic, abusing alcohol can have negative results. Alcohol abuse is likely if an individual exhibits at least one of the following traits:
- Continued use despite social or interpersonal problems by drinking.
- Recurrent drinking when alcohol use is physically hazardous.
- Recurrent drinking resulting in a failure to fulfill major obligations at work, school or home.
- Recurrent alcohol-related legal problems.
- Under some circumstances, serious problems can result from even moderate drinking, for example, when driving, during pregnancy, or when taking certain medications.
If I have trouble with drinking, can’t I simply reduce my alcohol use without stopping altogether?
It depends. If you are diagnosed as an alcoholic, the answer is "no." Studies show that nearly all alcoholics who try to merely cut down on drinking are unable to do so indefinitely. Instead, receiving the necessary professional support for cutting out alcohol (that is, abstaining) is nearly always necessary for successful recovery. And anyone--moderate drinkers included--who finds it difficult to stay within their drinking limit should consider seeking professional care before what seems like a small problem becomes a serious one.
What is a safe level of drinking?
Most adults can drink moderate amounts of alcohol — up to two drinks per day for men and one drink per day for women and older people (one drink equals one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits).
However, certain individuals should not drink at all. They include:
- Recovering alcoholics.
- Anyone suffering with a psychological condition, just a few examples of which are extreme distress, depression, anxiety disorders or personality disorders.
- People who plan to drive or engage in other activities requiring alertness and skill.
- People taking certain medications, including some over-the-counter medications.
- People with medical conditions that can be worsened by drinking.
- Any woman who is pregnant or planning on becoming pregnant.
Why is it unsafe to drink during pregnancy?
Drinking during pregnancy can cause a number of seriously harmful pre-natal effects to the child, as early as during the first several weeks of pregnancy and continuing until childbirth. Risks to the child include mental retardation, organ abnormalities, hyperactivity, and eventual learning and behavioral problems. While it is not yet known how much alcohol is required to cause these problems, it is known that they are 100% preventable if a woman does not drink at all during pregnancy.
As people get older, does alcohol affect their bodies differently?
Yes. As a person ages, certain mental and physical functions tend to decline, including vision, hearing, and reaction time. It is also true that other physical changes associated with aging can make older people feel “high” after drinking fairly small amounts of alcohol. These combined factors make older people more likely to have alcohol-related falls, automobile crashes, and other kinds of accidents.
In addition, older people tend to take more medications than younger persons, and missing alcohol with many over-the-counter and prescription drugs can be dangerous (even fatal), and many medical conditions common to older people, including high blood pressure and ulcers, can be worsened by drinking.
Does alcohol affect a woman’s body differently from a man’s body?
Yes. Most women become more intoxicated than men after drinking the same amount of alcohol, even when differences in body weight are taken into account. This is because women’s bodies typically have proportionately less water than men’s bodies and, because alcohol mixes with body water, a given amount of alcohol becomes more highly concentrated in a woman’s body than in a man’s.
In addition, chronic alcohol abuse takes a heavier physical toll on women than on men and alcohol dependence and related medical problems, such as brain and liver damage, progress more rapidly in women than men.
If I am taking over-the-counter or prescription medication, do I have to stop drinking?
Possibly. More than 100 medications interact with alcohol, leading to increased risk of illness, injury and, in some cases, death. The effects of alcohol are increased by medicines that slow down the central nervous system, such as sleeping pills, antihistamines, antidepressants, antianxiety drugs, and some painkillers. In addition, medicines for certain disorders, including diabetes and heart disease, can be dangerous if used with alcohol. To be on the safe side, always ask your prescribing physician whether it is advisable to drink alcohol while taking any medication
Drug Addiction Treatment Methods
Drug addiction is a treatable disorder. Through treatment that is tailored to individual needs, patients can learn to control their condition and live normal, productive lives. Like people with diabetes or heart disease, people in treatment for drug addiction learn behavioral changes and often take medications as part of their treatment regimen.
Behavioral therapies can include counseling, psychotherapy, support groups, or family therapy. Treatment medications offer help in suppressing the withdrawal syndrome and drug craving and in blocking the effects of drugs. In addition, studies show that treatment for heroin addiction using methadone at an adequate dosage level combined with behavioral therapy reduces death rates and many health problems associated with heroin abuse.
In general, the more treatment given, the better the results. Many patients require other services as well, such as medical and mental health services and HIV prevention services. Patients who stay in treatment longer than 3 months usually have better outcomes than those who stay less time. Patients who go through medically assisted withdrawal to minimize discomfort but do not receive any further treatment, perform about the same in terms of their drug use as those who were never treated. Over the last 25 years, studies have shown that treatment works to reduce drug intake and crimes committed by drug-dependent people. Researchers also have found that drug abusers who have been through treatment are more likely to have jobs.
Types of Treatment Programs
The ultimate goal of all drug abuse treatment is to enable the patient to achieve lasting abstinence, but the immediate goals are to reduce drug use, improve the patient's ability to function, and minimize the medical and social complications of drug abuse.
There are several types of drug abuse treatment programs. Short-term methods last less than 6 months and include residential therapy, medication therapy, and drug-free outpatient therapy. Longer term treatment may include, for example, methadone maintenance outpatient treatment for opiate addicts and residential therapeutic community treatment.
In maintenance treatment for heroin addicts, people in treatment are given an oral dose of a synthetic opiate, usually methadone hydrochloride or levo-alpha-acetyl methadol (LAAM), administered at a dosage sufficient to block the effects of heroin and yield a stable, noneuphoric state free from physiological craving for opiates. In this stable state, the patient is able to disengage from drug-seeking and related criminal behavior and, with appropriate counseling and social services, become a productive member of his or her community.
Outpatient drug-free treatment does not include medications and encompasses a wide variety of programs for patients who visit a clinic at regular intervals. Most of the programs involve individual or group counseling. Patients entering these programs are abusers of drugs other than opiates or are opiate abusers for whom maintenance therapy is not recommended, such as those who have stable, well-integrated lives and only brief histories of drug dependence.
Therapeutic communities (TCs) are highly structured programs in which patients stay at a residence, typically for 6 to 12 months. Patients in TCs include those with relatively long histories of drug dependence, involvement in serious criminal activities, and seriously impaired social functioning. The focus of the TC is on the resocialization of the patient to a drug-free, crime-free lifestyle.
Short-term residential programs, often referred to as chemical dependency units, are often based on the "Minnesota Model" of treatment for alcoholism. These programs involve a 3- to 6-week inpatient treatment phase followed by extended outpatient therapy or participation in 12-step self-help groups, such as Narcotics Anonymous or Cocaine Anonymous. Chemical dependency programs for drug abuse arose in the private sector in the mid-1980s with insured alcohol/cocaine abusers as their primary patients. Today, as private provider benefits decline, more programs are extending their services to publicly funded patients.
Methadone maintenance programs are usually more successful at retaining clients with opiate dependence than are therapeutic communities, which in turn are more successful than outpatient programs that provide psychotherapy and counseling. Within various methadone programs, those that provide higher doses of methadone (usually a minimum of 60 mg.) have better retention rates. Also, those that provide other services, such as counseling, therapy, and medical care, along with methadone generally get better results than the programs that provide minimal services.
Drug treatment programs in prisons can succeed in preventing patients' return to criminal behavior, particularly if they are linked to community-based programs that continue treatment when the client leaves prison. Some of the more successful programs have reduced the rearrest rate by one-fourth to one-half. For example, the "Delaware Model," an ongoing study of comprehensive treatment of drug- addicted prison inmates, shows that prison-based treatment including a therapeutic community setting, a work release therapeutic community, and community-based aftercare reduces the probability of rearrest by 57 percent and reduces the likelihood of returning to drug use by 37 percent.
Drug abuse has a great economic impact on society-an estimated $67 billion per year. This figure includes costs related to crime, medical care, drug abuse treatment, social welfare programs, and time lost from work. Treatment of drug abuse can reduce those costs. Studies have shown that from $4 to $7 are saved for every dollar spent on treatment. It costs approximately $3,600 per month to leave a drug abuser untreated in the community, and incarceration costs approximately $3,300 per month. In contrast, methadone maintenance therapy costs about $290 per month.
source:http://www.drug-rehabs.com/
Treatment Methods for Women
Addiction to drugs is a serious, chronic, and relapsing health problem for both women and men of all ages and backgrounds. Among women, however, drug abuse may present different challenges to health, may progress differently, and may require different treatment approaches.
Understanding Women Who Use Drugs
It is possible for drug-dependent women, of any age, to overcome the illness of drug addiction. Those that have been most successful have had the help and support of significant others, family members, friends, treatment providers, and the community. Women of all races and socioeconomic status suffer from the serious illness of drug addiction. And women of all races, income groups, levels of education, and types of communities need treatment for drug addiction, as they do for any other problem affecting their physical or mental health.
Many women who use drugs have faced serious challenges to their well-being during their lives. For example, research indicates that up to 70 percent of drug abusing women report histories of physical and sexual abuse. Data also indicate that women are far more likely than men to report a parental history of alcohol and drug abuse. Often, women who use drugs have low self-esteem and little self-confidence and may feel powerless. In addition, minority women may face additional cultural and language barriers that can affect or hinder their treatment and recovery.
Many drug-using women do not seek treatment because they are afraid: They fear not being able to take care of or keep their children, they fear reprisal from their spouses or boyfriends, and they fear punishment from authorities in the community. Many women report that their drug-using male sex partners initiated them into drug abuse. In addition, research indicates that drug-dependent women have great difficulty abstaining from drugs, when the lifestyle of their male partner is one that supports drug use.
Consequences of Drug Use for Women
Research suggests that women may become more quickly addicted than men to certain drugs, such as crack cocaine, even after casual or experimental use. Therefore, by the time a woman enters treatment, she may be severely addicted and consequently may require treatment that both identifies her specific needs and responds to them.
These needs will likely include addressing other serious health problems-sexually transmitted diseases (STDs) and mental health problems, for example. More specifically, health risks associated with drug abuse in women are:
Poor nutrition and below-average weight
Low self-esteem
Depression
Physical abuse
If pregnant, preterm labor or early delivery
Serious medical and infectious diseases (e.g., increased blood pressure and heart rate, STDs, HIV/AIDS)
Drug Abuse and HIV/AIDS
AIDS is now the fourth leading cause of death among women of childbearing age in the United States. Substance abuse compounds the risk of AIDS for women, especially for women who are injecting drug users and who share drug paraphernalia, because HIV/AIDS often is transmitted through shared needles, and other shared items, such as syringes, cotton swabs, rinse water, and cookers. In addition, under the influence of illicit drugs and alcohol, women may engage in unprotected sex, which also increases their risk for contracting or transmitting HIV/AIDS.
From 1993 to 1994, the number of new AIDS cases among women decreased 17 percent. Still, as of January 1997, the Centers for Disease Control and Prevention had documented almost 85,500 cases of AIDS among adolescent and adult women in the United States. Of these cases,
About 62 percent were related either to the woman's own injecting drug use or to her having sex with an injecting drug user.
About 37 percent were related to heterosexual contact, and almost half of these women acquired HIV/AIDS by having sex with an injecting drug user.
Treatment for Women
Research shows that women receive the most benefit from drug treatment programs that provide comprehensive services for meeting their basic needs, including access to the following:
Food, clothing, and shelter
Transportation
Job counseling and training
Legal assistance
Literacy training and educational opportunities
Parenting training
Family therapy
Couples counseling
Medical care
Child care
Social services
Social support
Psychological assessment and mental health care
Assertiveness training
Family planning services
Traditional drug treatment programs may not be appropriate for women because those programs may not provide these services. Research also indicates that, for women in particular, a continuing relationship with a treatment provider is an important factor throughout treatment. Any individual may experience lapses and relapses as expected steps of the treatment and recovery process; during these periods, women particularly need the support of the community and encouragement of those closest to them. After completing a drug treatment program, women also need services to assist them in sustaining their recovery and in rejoining the community.
Extent of Use
The National Household Survey on Drug Abuse (NHSDA)* provides yearly estimates of drug use prevalence among various demographic groups in the United States. Data are derived from a nationwide sample of household members aged 12 and older.
In 1996, 29.9 percent of U.S. women (females over age 12) had used an illicit drug at least once in their lives-33.3 million out of 111.1 million women. More than 4.7 million women had used an illicit drug at least once in the month preceding the survey.
The survey showed 30.5 million women had used marijuana at least once in their lifetimes. About 603,000 women had used cocaine in the preceding month; 241,000 had used crack cocaine. About 547,000 women had used hallucinogens (including LSD and PCP) in the preceding month.
In 1996, 56,000 women used a needle to inject drugs, and 856,000 had done so at some point in their lives.
In 1996, nearly 1.2 million females aged 12 and older had taken prescription drugs (sedatives, tranquilizers, or analgesics) for a nonmedical purpose during the preceding month.
In the month preceding the survey, more than 26 million women had smoked cigarettes, and more than 48.5 million had consumed alcohol.