|
The following letters are reprinted with the permission of the Salem Evening News
Dear Dr. Levy:
I was recently talking with some high school students and they told me
that some of their friends began drinking occasionally in the 8th grade! I
know this happens, but I was still surprised. My question is whether this
is a sign that they will grow up to be alcoholic? Thank you.
D
Dear D:
You ask a very interesting question. There have been some studies
that have tracked children to see whether early drinking predicts future
alcohol problems. One study looked at youth who began drinking in the 7th
grade. Students were broken into three categories: those who had never
drank alcohol, those who experimented, and drinkers. Experimenters were
defined as those who drank less than three times in the past year, and
never within the past month. Drinkers were those who drank three or more
times in the past year or who drank within the past month.
The researchers found that at age 23, only 17% of those who never
drank had developed alcohol dependence. This compares to 27% of those who
experimented and 41% of those who were defined as drinkers. So this is
clear evidence that drinking at an early age is related to higher rates of
alcohol problems in adulthood. I should also mention that those who drank
in the 7th grade also had higher incidences of marijuana use along with
other behavioral problems.
The researchers concluded that early drinkers do not necessarily
mature out of their drinking. Such youth should be targeted early for
intervention, which may have significant long term positive effects.
While the relationship between early drinking and later alcohol problems
is quite complex, and there are many related factors that are involved in
this relationship, early drinking is a predictor of future alcohol
problems. While not everyone who drinks at an early age develops alcohol
problems, there is still a strong relationship between the two.
Dear Dr. Levy:
I have been reading about additive-free cigarettes, which I believe
contain no chemicals other than tobacco. It has been reported that they
may be safer than regular cigarettes. Is there any truth to this? Thanks.
S
Dear S:
Additive-free cigarettes are made with whole-leaf tobacco and contain no
other chemical additives, preservatives, or reconstituted tobacco.
However, they are no safer than regular cigarettes and are every bit as
harmful, if not more harmful.
Researchers measured what happened when smokers smoked additive-free
cigarettes and regular ones. The additive-free cigarettes raised plasma
nicotine levels more than regular cigarettes. In addition, the
additive-free cigarettes raised the heart rates of smokers more than
regular cigarettes did. The researchers also found that smokers smoked the
additive-free cigarettes more than they smoked the regular cigarettes.
They concluded that these cigarettes present the same dangers as do regular
cigarettes, which includes an increased risk of cancers, respiratory
disease, and heart disease.
12-30-2003
Dear Dr. Levy:
I stopped drinking about 2 months ago and have been doing real well.
My question is if you have any ideas about how to stay clean during the
holidays. There are some holiday parties I have been invited to where I
know people will be drinking. I’m feeling pretty comfortable in my
sobriety, but I still wondered whether you had any advice. Thanks.
R
Dear R:
First, congratulations for stopping drinking. I must also say that
you are showing great decision-making by thinking about this ahead of
time. The first thing I want to say is that if you feel going to a
party could jeopardize your recovery, then it is probably best not to go
at all. Remember that a party is a one-time event that is over the next
day. Your recovery needs to be your number one priority. Missing a
party is not nearly as important as your staying abstinent. Now, if
you feel able to go, here are few ideas:
· Know beforehand if the main focus at the party is drinking or
instead, if drinking is just a part of the scene. I would not go if you know that most everyone at the party is a heavy drinker and that the main
activity at the party is drinking to get drunk. This would be a bad situation for you to be in. While you may think you can handle this, when
there, it could be a different story.
· If you can avoid it, don’t go to a party alone. Try to go with
someone who is a support person for you. Your support person knows that
you have made the decision to not drink and will be there to talk with and
help you to remain alcohol-free.
· Know what you will say if you are offered a drink and practice saying
it before you go to any party so that it is automatic.
· Get your own drink (non-alcoholic, of course); therefore you will be
less likely to be offered a drink and having to decline it.
· Don’t accept a drink without knowing the contents.
· Don’t fool yourself that you can have one drink because it is the
holiday season. As you probably know, one drink will almost always lead to
more and more, and possibly to a relapse.
· And remember, if at any time you begin to struggle, leave with your
support person.
Dear Dr. Levy:
I have heard about laser treatment for help a person quit smoking
cigarettes. It sounds hard to believe, but I wanted to know if you heard
anything about this. And if you have, is it effective and where can a
person get this kind of treatment?
L
Dear L:
I actually hadn’t heard of this, but I did some checking and here is
what I found. This type of treatment has been available in Canada and
England for many years and is now available in the United States. Freedom
Laser Therapy, Inc. is an organization that is based out of Santa Monica,
CA. It offers low level laser therapy for nicotine addiction. It uses a
soft laser that is no more powerful than a 60 watt light bulb and it
operates on similar principles to those used in acupressure point therapy
where specific energy points on the subject's ears, face and hands are
stimulated by a soft laser light. One 30-minute treatment includes the
laser procedure, education on coping with cravings, withdrawal symptoms,
and advice on remaining addiction-free. I am not familiar with the quality
of the research, but it has been reported that clinical studies have
revealed success rates as high as 85% to permanently end smokers'
addictions.
You can find out more about this by calling 1 (866) GOFREEDOM. Their
web site is www.freedomlasertherapy.com.
SEN 12-23-2003
Dear Dr. Levy:
Hi, I am interested in getting sober and wanted to know of some other
options other than AA. Are there any rehab centers around this area like
the ones I hear celebrities and athletes go to? It seems to me that these
high profile people do not end up in AA. If you have some other ways of
seeking treatment for alcoholics I would be very interested.
Thank You.
J
Dear J:
I am not aware of rehab centers in this area like the ones celebrities
go. However, I must say that the rehab center a person goes to is less
important than the person, him or herself. While programs in this area may
lack the pools, hot tubs, and other amenities that some "celebrity" rehabs
may have, there are still many excellent programs that offer good quality
treatment. And if a person is ready to stop using drugs, these programs
can be every bit as helpful.
However, that being said, rehab centers in this area are limited as
many programs no longer offer extended rehab treatment as insurance
companies generally no longer pay for residential care after
detoxification. The ones celebrities go are generally paid for
out-of-pocket rather than by using insurance. However, despite this, there
are still some options. McLean Hospital has a program called NAUKEAG and
that program can be reached at 1 (800) 230-8764. CAB Health & Recovery
Services also operates a rehab that is supported by state dollars that is
called CAB Transitions. Their number is (978) 851-8776. It is not a fancy
place, but can help a person build a foundation to get sober.
There are also many residential halfway house programs where people
can go for extended residential treatment. CAB operates several, but you
can find out about all of these programs by calling a state-wide helpline
at 1 (800) 327-5050.
Also, I am not sure what your resistance is to AA. While this program
is not for everyone and perhaps you have checked out AA and it wasn't for
you, AA has helped many people and could be considered. And I wouldn't be
surprised if some celebrities obtain or obtained benefit by going to AA.
Certainly, another self-help program is called SMART Recovery, which is
very different than AA. Information about this program can be found by
calling (440) 951-5357; website is smartrecovery.org.
If I can be of further help, please feel free to contact me. My best to you.
Dear Dr. Levy:
My friend has a problem that just recently began. He got into doing
cocaine and I feel it's really important to help him get away from it and
he also wants to get away from it. I was wondering if you had any
information on classes about this drug or if you had a place where we could
go somewhere to meet and hear from others who he might learn from. He does
not want get to treatment, but wants to learn more about this. If you
could give me any information at all that would be great. Thank you so
much for your time.
K
Dear K:
The first thing that comes to mind would be for him to check out an
Alcoholics Anonymous (AA) meeting. The people who attend AA often have
experienced drug problems in addition to problems with alcohol, and even
others have only had problems with drugs. There, he could certainly meet
and hear from others who have had problems with drugs. At a meeting, he
would see the how damaging alcohol and drugs can be, and this could have a
positive impact on him by helping him to see the road he doesn't want to
travel down. I think it could be an eye-opening experience for him.
You can call AA central service at (617) 426-9444 and they could give
you a listing of all meetings in your area. They will also send you a
booklet that lists all meetings.
SEN 12-16-2003
Dear Dr. Levy,
About one year ago, I got detoxified at CAB's Detox in Danvers because
I knew it was for the best to stop abusing alcohol, and I had an addiction
to lorazepam. I had detoxed myself from alcohol before I entered the
program. I had abused alcohol for about 2 years and I had been taking
lorazepam, prescribed for anxiety for about 6 years. The dosage started at
1 mg a day and went up to 6 mg a day. Sometimes I took more than the 6 mg
and sometimes less, depending on how much alcohol I consumed.
I was detoxified and didn't experience any seizures. However, I did
experience very disturbing bodily sensations of feeling like my body was
like lead and feeling like I was being pushed down onto the floor. That
got much better and is mostly gone now. However, I still have this
sensation that my body is bouncing around all the time, as though I was on
a boat being tossed around on rough waters. I'm not dizzy and I don't have
headaches or anything. This sensation is so annoying and I am so concerned
about it, that I had a complete physical; a MRI and MRA, EEG and a blood
test to see if I had any brain inflammation. Everything was fine.
I have never heard any others who have been detoxified from "benzos"
describe this sensation. They have felt very weak and some have even had
seizures after being clean for 6 months. I am worried and I don't know if
my "bouncing" sensation is all part of my recovery or if I need to pursue
this further medically. I haven't been able to get any answer as to why I
feel this way. I did see a neurologist and I think he thought I was nuts!
Anyway, this bouncing sensation and no explanation for it is driving
me crazy and interfering with my daily living. Is this sensation a thing
that happens to ex-"benzo" addicts like me? I would really like to know
for peace of mind. I am very grateful for my sobriety. I'm in a 12-Step
Program (AA) and I see a therapist and that helps me keep plugging along,
but I do wish I felt physically OK by now. Any information would be so
helpful. Feeling this "bouncing" all the time is awful; but having no
explanation for it makes it worse on top of it.
LS
Dear LS:
I am so sorry to hear about what you are experiencing. I spoke with
CAB's Medical Director as well as another physician who specializes in
treating addiction to alcohol and other drugs.. Your symptoms are
certainly unusual and atypical. If you hadn't had a full medical workup,
they would have suggested this to rule out anything else that could be
causing this bouncing feeling. However, given you have been worked up,
their best guess is that it could be due to some toxicity in your central
nervous system that was possibly caused by either the benzodiazepine or
alcohol use. And it is more likely that it may be due to your past alcohol
use.
They also stated that this symptom may eventually go away over time.
Unfortunately, for now, there isn't much that you can do, except to try not
to worry about it and accept that it could be a toxic reaction to past drug
or alcohol use. I must also say that it is wonderful that you no longer
using drugs. Keep up the excellent work!
12-9-2003
Dear Dr. Levy:
I recently read your article regarding the mother whose son is a drug
and alcohol addict. I am in a similar position as that mother. I have a
daughter who will be 20 years old next month who has a substance abuse
problem. She has been in and out of detoxes and rehabs for the past year,
and also attended an outpatient program. She started attending NA meetings
on a regular basis and everything was starting to look brighter for her,
making new friends and getting away from her old friends (drug addicts)
until the other day. She left home 2 days ago without her medication and
we haven't heard from her since. She has Bipolar illness, attention deficit
disorder, and borderline personality. She has been seeing a psychologist
and psychiatrist for over a year. I spoke with her counselor this morning
and she suggested I look into taking legal action to have her committed for
6 months to a drug rehab. I filed a missing person report this morning but
I'm not sure what the next step would be. If she is found she cannot be
forced to come home because she is of legal age. Any help or guidance you
could give me would be appreciated
A worried mother
Dear worried mother:
What a horrible and painful situation for you. It sounds like this
has been a long standing issue with your daughter. Unfortunately, for many
people who struggle with a drug problem in addition to other psychiatric
illnesses, it takes years for them to get their lives in order which
entails consistently taking prescribed medication, participating in
treatment, and achieving abstinence from illicit drugs.
A person cannot be committed to drug treatment for 6 months. Through
a Section 35, a person can be committed for period of up to 30 days.
Hopefully your daughter has been found and if you wanted to pursue this
option, you could go to the district court to file appropriate paperwork.
Your daughter will then be ordered to come to the court so a judge can
determine whether she should be committed to treatment. If she does not
show for court, a warrant for her apprehension will be issued.
If, on the other hand, she is acutely ill psychiatrically, she may
meet criteria for admission to a psychiatric hospital to keep her safe, to
stabilize her mental functioning, and for discharge planning.
This is an extremely difficult situation and there is only so much
that you can do. You can provide guidance, support, and compassion, but
you do not have the power to change her life course.
Dear Dr. Levy:
We are helping our son find sober living in Massachusetts. He is
currently on methadone, which makes it difficult. He is in counseling and
attends AA meetings. Our family has attended 12-step programs for over 20
yrs. so he has support in his decision. Could you make any recommendations
or suggestions? Thank you.
MG
Dear MG:
Unfortunately, it can be difficult to find a residential program that
takes clients on methadone. Many residential substance abuse treatment
programs still refuse to accept clients on methadone for philosophical
reasons that have no scientific validity.
CAB has a program in Lynn that is a working halfway house that accepts
clients on methadone. It is called Ryan House and the number is (781)
598-1270. I would suggest that you contact the program. There is also in
Massachusetts a helpline that perhaps could help you to find other
resources. The number is 1 (800) 327-5050. If I can be of further help,
please contact me.
SEN 12-2-2003
Dr. Levy:
I just threw my son out the door for stealing my checks. He has been
stealing my checks off and on, but then last weekend we found out he took
our credit cards and falsely charged gas! There is an obvious problem
here. I have tried to help him and I told him I would pay for a rehab or
anything, but he insisted there was no problem and he stated he would never
do this again. He got caught with marijuana three times and I am scared to
think what will happen to him. .Please I beg of you to give me some
direction. My whole family has been torn apart by this. We have all tried
to get to him and nothing is working. I am a heart broken mother and all I
seem to do is cry and shake at the thought of what he is facing. Please get
back to me soon.
I
Dear I:
What a difficult situation for you to be in! It sounds like he
is in total denial of his problem and his behavior is tearing you and your
family apart. It also seems that have spoken to him repeatedly without
success. So what I suggest is something called a family intervention. An
intervention is a strategy designed to help an individual who uses alcohol
or drugs and who has been resistant to treatment to make the decision to
seek help. An intervention is also a process to help family members and
others who are close to the addicted person.
In an intervention, a therapist initially meets with family members
and friends of the person who is using alcohol or drugs. If you were going
to organize the intervention, your job would be to get people close to your
son who want to be involved. During several meetings, people learn about
alcohol and drug problems and how the person's drug use may have affected
them. Eventually, everyone writes a speech that outlines how much they
care about the person, but at the same time, how much the person's drug use
has affected them. Very specific examples are given when the person's
drinking or drug use made them feel angry, hurt, scared, or embarrassed.
Finally, at the end of the speech, everyone again emphasizes how much they
care about the person and how much they want the person to stop using drugs
and get involved in treatment.
When this is completed, your son is invited to a session along with
everyone else. One by one, people read their speeches to him in an effort
to help him realize the impact his drug use is having on everyone. He will
also realize how much everyone still cares and wants to help. Although
your son is confronted, it is done is an extremely caring way.
An intervention is extremely powerful and can help a people to finally
do something about their addiction. And even if the person doesn't follow
through with the suggestions, it can be a healing experience for the
family. There are therapists who are specifically trained in doing
interventions. You can call your insurance company for a referral, or
through the yellow pages, contact an alcohol treatment provider in your
area for an appropriate referral. If I can be of further help, please do
not hesitate to contact me again. My best to you.
11-25-2003
Dear Dr. Levy,
I read with great interest your article "Take the First Step,"
forwarded to me by a friend from the Salem Evening News (October 21,2003).
My mother is an alcoholic and I have attempted repeatedly to have her
license revoked/suspended by the Massachusetts RMV before she kills
somebody. Typically, after the agency issues a letter, she has her
psychiatrist attest that she is a fit driver as he claims that he has never
seen evidence of her drunk in therapy sessions.
Aside from letters to the Massachusetts RMV, the police have told me
my only other option is to hire an attorney to declare her legally
incompetent, thereby revoking her license. I would like to explore pursuing
the Section 35 option to force her into treatment, and most importantly,
get her off the road. Do you recommend this option, or to go the legally
incompetent route? Thanks so much for your assistance,
JL
Dear JL:
I am not an attorney, but from experience, it will be extremely
difficult, if not impossible, to get an individual with an alcohol problem
and who has no other psychiatric difficulties to be declared legally
incompetent. Generally, legal incompetence applies to individuals who are
so impaired that they are unable to make decisions about what is in their
best interests due to mental incapacity. And incapacity is due to having a
major mental illness (which doesn't include alcoholism) or some type of
cognitive difficulty due to a brain injury, dementia, or Alzheimer's
disease, to name just several possibilities.
A section 35 might be a better route. At least she will have the
opportunity to get involved in treatment, which may impact her and move her
to do something differently about her drinking. Unfortunately, there is
only so much that you can do to stop her from drinking and driving, and
preventing the possibility of her or others getting seriously hurt or
killed.
Dear Dr. Levy:
I don't know if you can help, but I was recently diagnosed with
Hepatitis C. I have been shooting drugs for many years, and as you
probably know, Hepatitis C is very common among drug addicts who shoot
dope. My question is whether you can give me some information about
Hepatitis C? I am seeing a doctor, but I was wondering whether there is
any information about this that is written for drug addicts. Thank you.
B
Dear B:
I am sorry to hear that you were recently diagnosed with Hepatitis C.
As you correctly mentioned, Hepatitis C is very common among individuals
who use drug intravenously. Within methadone treatment programs, it is
estimated that approximately 80% of clients are diagnosed with Hepatitis C.
Regarding resources for individuals diagnosed with Hepatitis C, there
is a telephone number that can be called, which provides access to a nurse
24 hours/day, who can answer any questions. The program is called "Moving
Forward" and the number is 1 (866) 444-3004. You can also get free
information sent to you, along with a video on Hepatitis C and an
inspirational book to help cope with this illness.
There is also an excellent website that is devoted to Hepatitis C. This
website also covers information specifically related to individuals who
have used drugs, including those who have used drugs intravenously. That
address is:
http://www.all-about-hepatitisc.com.
On this
website, you can even sign up to get access to a personal advisor, who can
confidentially answer any questions that you may have. My best to you.
SEN 11-4-2003
Dear Dr. Levy:
I am currently on a methadone treatment and detoxifying. I have a
family physician that I am seeing also to help me while I am detoxifying.
I am very much interested in the drug called lofexidine. Do you know if
the FDA has approved this and when? I am on 25 mg. of Methadone and would
like to be able to stop as soon as possible. Also, I have been doing a lot
of research and also found some other medicines such as bupernorphine and
suboxene. Can you give me a little more information on these?
DM
Dear DM:
For the reader who does not know, Lofexidine is called an adrenergic
agonist and is similar to a drug called Clonidine. When taken, it helps to
relieve withdrawal symptoms of opiate addiction. These symptoms include
chills, sweating, stomach cramps, diarrhea, muscle pain and runny nose and
eyes. It does not reduce craving, but only symptoms of withdrawal. This
drug, under the trade name BritLofex, is the leading detoxification agent
used in England to treat opiate addiction.
In this country, research has demonstrated that this drug is helpful
to manage physical withdrawal symptoms of opiate addiction. However, in
answer to your question, it is not yet approved by the Food and Drug
Administration (FDA), but it appears that approval is not far off.
Regarding your other question, Subutex and Suboxone are two new drugs
used to treat opiate addiction, which were approved by the FDA about one
year ago. Subutex is buprenorphine, which works like an opiate and an
opiate antagonist. Suboxone also contains naloxone, a pure opiate
antagonist, in addition to buprenorphine. Subutex is intended for use at
the beginning of treatment for opiate dependence and for detoxification.
Suboxone is used for the maintenance treatment of opiate addiction.
Adding naloxone to this drug guards against intravenous abuse of this drug
as if someone does this, it will cause the person to go into opiate
withdrawal. Both drugs are placed under the tongue and must be allowed to
dissolve.
These two new drugs are the first drugs to treat opiate addiction that
can be prescribed by physicians in their offices if they have received
certain training. To locate physicians who can prescribe these drugs,
please see the website www.buprenorphine.samhsa.gov. I would suggest that
you speak with your physician whether he or she has training to prescribe
these medications and whether these drugs might be indicated for you. You
should also know that these drugs are not used in addition to methadone,
but instead of methadone. If I can be of further help, please contact me.
Dear Dr. Levy:
Can you tell me the effects of a woman smoking cigarettes during
pregnancy? I know a woman should not do this, but I would like to know the
actual problems that this can cause. Thank you.
K
Dear K:
As you wrote, a woman should not smoke any kind of tobacco when
pregnant. In fact, a woman should not ingest any type of drug when
pregnant without her physician's consent. Regarding tobacco, the specific
possible effects of tobacco smoking on the fetus include the following:
lower birth rate; lower IQ; greater infant agitation; and a greater
likelihood that the infant will eventually use tobacco. And obviously,
potentially more severe and a greater number of problems are more likely
with heavier use of tobacco. The bottom line is that tobacco is a drug and
as with other drugs, its use can cause a variety of problems on the fetus.
SEN 10-28-2003
Dear Dr. Levy,
I have been reading your column in the Salem Evening News and I admit
that I have a problem with alcohol. I have been to AA, which is not
working, and have seen a psychiatrist. My pattern is to start drinking
after I get off of work, even before dinner and once I start, I can't seem
to stop. I don't like the way I act when intoxicated and I am inquiring
about other treatment options. Thank you.
F
Dear F:
First let me say that it is wonderful that you see the need to do
something about your drinking. Let me review some treatment options. And
it sounds like you may need some additional support, either instead of or
in addition to AA meetings.
I don't know whether you experience withdrawal when you do not drink,
but if you do, you might need to get medically detoxified. Based upon your
health insurance, there are a number of places that you can go to get
evaluated and detoxified. If you have no insurance, a number of programs
receive some support from the Bureau of Substance Abuse Services (BSAS) to
enable those with limited financial means to access treatment.
If you don't need detoxification, an outpatient program might make
sense. In such a setting, you can connect to a counselor on either a
one-on-one basis or in a group format. Your particular pattern of drinking
will get reviewed and a plan will get developed to enable you to stop
drinking. For example, as you stated in your letter, your pattern is to
start drinking after work and before dinner. Perhaps a plan can be
implemented that includes doing something entirely different after work
instead of going home, whether this is going to a health club, taking a
walk, going shopping, or what have you. The objective is to fill your time
when you used to drink with other activities that do not include drinking.
This can help to break your pattern and over time, it will get easier and
easier not to drink. And if once per week outpatient treatment does not
help, there are programs called intensive outpatient programs that people
are able to attend up to five days/week, which obviously offers
considerable structure and support. And some of these programs also
receive funding from BSAS to help those without means to pay for treatment.
Most importantly, do not give up hope. If you keep trying, you will
eventually succeed. My best and if I can be of further help, please contact
me.
Dear Dr. Levy:
You recently wrote about the physical withdrawal from marijuana. Is
there any research that documents the length of withdrawal? That is, how
long does withdrawal last? Thank you.
S
Dear S:
Research has shown that the most intense withdrawal symptoms from
stopping marijuana occur several days after first stopping use. Withdrawal
symptoms can include restlessness, increases in aggression, sleep
difficulties, mental confusion, and irritability.
These symptoms gradually disappear over the course of 2-3 weeks. By one
month, most all subjects report no continuing symptoms of withdrawal. I
should also mention that these are general parameters. As with withdrawal
from all drugs, there is considerable individual variation regarding the
intensity and duration of any withdrawal symptoms.
SEN 10-21-2003
Dear Dr. Levy:
I have a 39 year old son who is a drug addict and alcoholic. He just
lost his 100th job, is on the street, and living in a tent in the woods. I
am in a senior housing and cannot take him in without losing my place. I
need to know what I can do or what can be done to help my son. If he
doesn't get help soon, I'm afraid he will die on the street. He has been
like this since he was 9 or 11 years old. Please help me to help him. He
has a learning disability and cannot read or write very well so he cannot
get a good job. People hire him, work him, and don't pay him because of the
addiction. Please help us.
DC
Dear DC:
Let me first say what a painful situation this must be for you. It is
so very difficult for a parent to see his or her child caught up in an
addiction. Unfortunately, there is only so much that you can do to help
him. Most of the work is up to him, though he needs support so that he can
learn to help himself.
One thought is something called a Section 35. In the state of
Massachusetts, a family member can petition the court to mandate treatment
for an individual who has an alcohol and/or drug problem. Essentially, a
judge can force a person to enter inpatient treatment if after hearing
evidence, the judge believes that alcohol or drug use substantially injures
the person's health and the person's ability to function socially or
economically.
To begin a Section 35, you can go to district court and present
information about the person's alcohol or drug use. Based upon what is
presented, the judge can then order the person to appear in court for a
hearing. If the person refuses to go to court, an arrest warrant will be
issued. At the hearing, evidence is presented and the judge will make a
decision regarding whether the person should be mandated to go for
treatment.
While seeking a Section 35 to force a family member into treatment is
a difficult decision, it is an option you have. It gives the addict an
opportunity to obtain treatment and to consider changing with a clear mind.
It also sends a very important and strong message to the person that
alcohol and/or drug use is out-of-control, and it lets the person know that
you care enough to do this.
You can also consider getting some help for yourself so that his
alcohol and drug use do not affect you so much. Al-Anon can be of help,
which is a self-help organization designed to help people who are affected
by a loved one's alcohol use. They can be reached by calling (781)
843-5300 and they will tell you where meetings are held in your community.
Outside counseling can also be of assistance. If I can be of further help,
please contact me again. My best.
SEN 10-14-2003
Dear Dr. Levy:
I have heard that people can become addicted to antidepressants. If
that is true, do you think that they shouldn't be prescribed to someone in
recovery? Thank you.
S
Dear S:
Researchers have found that selective serotonin reuptake inhibitors
(SSRIs), a type of antidepressant medication, can cause withdrawal symptoms
when no longer taken. Withdrawal symptoms vary among people and this is
probably related to how long someone has been taking the drug, the amount
of the dose, the length of the tapering schedule, and the individual
patient. Symptoms may include anxiety, fatigue, headaches, sweating,
dizziness, diarrhea, and nausea, to name several. And these withdrawal
symptoms can occur among people with no history of substance abuse.
I would not say that people become addicted to these drugs. For me,
addiction signifies drug craving and wanting to take more and more of the
drug. This does not occur with SSRIs. Rather, these drugs can precipitate
a withdrawal syndrome when no longer taken.
At this time, taking such drugs is not contraindicated for patients
who struggle with depression and substance abuse difficulties. Taking
these drugs does not lead to relapse and as I stated, addiction to these
drugs does not occur. At this time, the Food and Drug Administration, who determines the value of all prescribed
medication, believes the advantage of these drugs outweighs any
disadvantages.
Dear Dr. Levy:
What in your opinion is a good dose of methadone? My son is on 80 mgs
and says that he needs more. Is it possible that 80 mgs isn't enough?
Thank you.
W
Dear W:
There is no one correct dose of methadone for all people and it is
possible that 80 mgs is not enough methadone for your son. The amount of
methadone an individual requires in order to not experience withdrawal
symptoms and to not experience over-medication is different for different
people. In fact, people given the same exact dose of methadone often have
different actual concentrations of active methadone in their brains. This
is influenced by many factors, including poor absorption in the stomach,
changes in urine acidity, continued drug abuse, diet, physical condition,
medication or herbal remedies, and even vitamins. Genetic factors also
account for differences among people in how their bodies respond to
methadone.
My suggestion is that your son should talk with the physician at his
methadone clinic who can review with him what he is experiencing and any
related symptoms. When indicated, a clinic can also order a test that can
determine how much methadone is in his blood just prior to dosing (called a
"trough" level). A methadone blood level of 400 nanograms per milliLiter
is generally considered necessary for successful stabilization.
In summary, it is certainly possible that your son may require a dose
increase to be properly maintained. And from experience, many individuals
require more than 80 mgs of methadone in order to accomplish this.
SEN 10-7-2003
Dear Dr. Levy:
Could you tell me how people can become so addicted to a drug that they
totally lose control of themselves? I know a person who was raised in a
good family, had everything going for himself, but got addicted to drugs,
which is ruining his life. He has two siblings, who are both doing well.
He is causing his family so much anguish, and I just can't understand how
this happened. Thank you.
W
Dear W:
You ask a great and complicated question. I view addiction as a
problem that can have biological, psychological, and environmental or
social causes. In addition, often several, if not all of these, play a
role in the causation of the problem. As an example, a person may have a
biological vulnerability to develop an addiction to a particular chemical.
Research has shown that some individuals do have an increased risk to
develop an addictive disorder. For complicated reasons, a particular
chemical may react to a person's biological system in such a way that it is
particularly pleasurable or helps him or her in some way to cope. And a
person with this vulnerability may be struggling with a variety of
emotional issues, and drug use helps the individual to feel better. In
addition, the person may live in an environment where drugs are readily
available and many of their friends may be using drugs as well. Such a
circumstance will increase the chance of the person turning to chemicals as
a way to cope.
On top of all of this, once people get heavily involved with drugs,
changes in the brain occur which makes it harder for them to stop their
drug use. Brain imaging studies clearly document that drug use can cause
changes in certain parts of the brain that can make repetitive behavior
very difficult to stop. These changes make feeling pleasure more difficult
as well. This is why addiction is often referred to as a brain disease and
can help to explain why individuals often relapse after a period of
abstinence.
There is much more that I can say, but hopefully that gives you some
sense of this very complicated issue.
Dear Dr. Levy;
Have you heard of an alcohol assessment called the CAGE? It is a quick
test to see whether someone has a drinking problem? If you have, can you
tell me where I can get a copy of this? Thank you.
NH
Dear NH:
The CAGE is a quick screening tool that is used to assess whether an
adult (19 years of age or older) may have an alcohol or drug problem. The
questions are the following:
In the last 12 months:
1. Have you ever felt you should Cut down on your drinking or drug use?
2. Have people Annoyed you by criticizing your drinking or drug use?
3. Have you ever felt bad of Guilty about your drinking or drug use?
4. Have you ever had a drink or drug first thing in the morning to
"steady your nerves" or get rid of a hangover (Eyeopener)?
If a person answers yes to one or more the questions, it may be a sign
of a problem. At least, it indicates the need for a further assessment.
Hopefully this helps.
SEN 9-30-2003
Dear Dr. Levy:
Is smoking marijuana addicting? People who smoke marijuana
heavily tell me that they can stop whenever they want without experiencing
any withdrawal. What is the truth?
B
Dear B:
Marijuana actually has the potential to be highly addicting. For
many people, smoking marijuana becomes a central preoccupation in their
lives. In fact, marijuana use can become so compulsive that it is smoked
daily and individuals begin to neglect or lose interest in other important
things, whether this is school, work, or other relationships. Individuals
addicted to marijuana often report that they cannot cut down their use or
stop smoking it, and that they have committed crimes to obtain money to buy
it.
While many individuals can abruptly stop using marijuana without
experiencing significant withdrawal, others report some withdrawal symptoms
that include anxiety, irritability, and some mental confusion. However,
whether or not a drug causes a severe withdrawal syndrome is not the
criteria that should be used to determine whether it is addicting. For
example, individuals addicted to cocaine do not experience severe
withdrawal when they stop using, yet cocaine is highly addicting.
So, although some marijuana users may be able to stop without
experiencing significant withdrawal, others do report withdrawal symptoms.
And regardless of physical withdrawal, marijuana can be used compulsively
and thus, can be addicting.
Dear Dr. Levy:
My husband is being forced into treatment for his drug problem by his
probation officer. While I think that is great, he is not really
interested in stopping (cocaine use). My question is can forcing someone
into treatment be beneficial? Doesn't a person have to want to get clean
if treatment is going to help? Thanks.
L
Dear L:
You ask a great question. I believe that forced or mandated treatment
can be helpful for one primary reason. It forces the person to at least
have the opportunity to get involved with and to experience treatment,
which in turn, may positively impact the person. There are many people who
do not want to get involved in treatment, whether this is due to not
wanting to stop their drug use, being afraid to look at themselves,
mistrusting others, not even thinking that they have a serious drug
problem, feeling hopeless about ever changing, being concerned about
privacy, or feeling ashamed about their lives, to name just a few reasons.
By forcing treatment, some people, who otherwise would never get involved
in treatment, will get engaged into the treatment process, and in turn,
they may start to do something about their problem. Treatment can also
help a person to look at him or herself, and eventually come to the
decision to stop using drugs.
Obviously, even with forced treatment, some people will not obtain
benefit as there is also truth that a person must at some point make the
decision to stop using drugs. Even with great treatment, if a person does
not want to change and stop using drugs, treatment will not be effective.
However, at a minimum, forcing treatment will at least give a person the
opportunity to get involved in treatment, and for many, this is the initial
"push" they need.
SEN 9-24-2003
Dear Dr. Levy:
I don't know where to turn for a solution to my problem. My mother is
in an assisted living facility at this time and I am trying to keep her
affairs in order and see that she has many happy years ahead as she is just
72. My problem is my brother. He is 49 years old and bleeding her dry.
He had lived in her house cost free for at least the last 8 years until Mom
sold it in June this year. The money from the sale of her house is for her
continued care and comfort for the rest of her life, but my brother keeps
asking her for money. He has an apartment but doesn't keep a job for long.
He has had alcohol issues all his adult life.
I guess I need to know how he can take control of his own life so he
can stop 'stealing' from my Mom's retirement. I was told a few years back
that since he owns a car, (paid for by Mom) he isn't eligible for welfare.
But I figure a car is the only way to be dependable at a job. He is in a
facility at this time recovering from a minor auto accident a few weeks
ago. I always doubt whatever he says since he lies to make himself look
better.
I am sure he will again be unemployed when he is released and hit Mom
up for more rent as well as all his living expenses. I have signed a
document stating that as joint account holder of her checking account, I
will only spent monies for her benefit. I don't want them coming after me
in a few years to collect all the money she is giving to him. I am at
wit's end!! Any information you can send my way will be gratefully
appreciated!!
DMD
Dear DMD:
This sounds like a very difficult and long standing problem. Your
question, "how your brother can take control of this own life so he can
stop 'stealing' from your mother" has no straightforward answer. I cannot
tell you how he can do this; this is something that your brother must do,
with help of course. You or your mother cannot do this for him, nor can
any therapist. It is largely up to him as he must make the decision to get
his life together.
I imagine that you have spoken with him many times about his drinking
without success. One thought is to get involved in a family intervention,
which consists of family members and other loves confronting your brother
in a very caring way. Sometimes this can be the catalyst for the person to
finally do something about his or her drinking. If you want more
information about this, please contact me again.
I also want to say that I know that you are very concerned about your
mother's financial status and I wonder if your mother is worried as well.
In truth, if your mother is competent, she has the right to spend her money
how she wants. However, if she is conflicted, perhaps she can use some
help to learn how to say "no" to him. Al-Anon can be of help, which is a
self-help organization designed to help loved one's of family members. You
might even find some benefit though this organization. They can be reached
by calling (781) 843-5300 and they will tell you where meetings are held in
your community. Outside counseling can also be of assistance.
Another thought is simply to focus on protecting your mother's assets
from him. Perhaps you and your mother can speak with an attorney for
guidance and an arrangement can be set up that will make if impossible for
him to get money from her without your consent. And if your mother is not
competent to make choices about how to spend her money, with an attorney,
you can become the legal authority regarding how her money gets spent,
which would also resolve the problem. My best to you and if I can be of
further assistance, please contact me.
SEN 9-16-2003
Dear Dr. Levy:
My husband and I are professionals in our mid- forties. We have always
considered ourselves "party people" and have surrounded ourselves with
friends who also enjoy a few cocktails. However, over the past year or so
the amount of alcohol that we consume and the frequency of "binge drinking"
have increased significantly. It has reached the level where we are both
very concerned for our health. I have read that there is a medication
available that reduces or prevents the pleasurable feeling associated with
drinking. Is this something that is available to the public, and if so, is
your center a place where we could come to be given the prescription? We
realize that in addition to a medication we will also have to be involved
in counseling sessions. Thank you very much for your time and response.
BG
Dear BG:
I believe that you are referring to a medication called naltrexone.
This medication is marketed under the names Revia or Depade. Research has
shown that individuals who take this medication drink less than those who
were given a placebo. One reason is that this medication minimizes the
pleasurable feelings that alcohol causes. It also reportedly decreases
craving for alcohol. This medication, in addition to other counseling
services, is offered at our outpatient office in Salem. This office can be
reached by calling 1 (978) 745-8890.
It is also good that you realize that medication is not the complete
answer. It is a tool that can help, within the context of an overall
treatment program. As changing one's pattern of drinking is a significant
life style change, I would encourage counseling as well. If I can be of
any further assistance, please contact me.
Dear Dr. Levy:
I am very worried about my daughter going off to college. I hear so
much about binge drinking. Is there anything that I can do as a parent to
try to help my daughter not to do this? I have spoken with her and she says
not to worry, but I still do. Any suggestions would be appreciated.
Dear M:
I can totally appreciate your concern. A task force report to the
National Institute on Alcohol Abuse and Alcohol stated that the
consequences of excessive drinking by college students are more
significant, more destructive, and more costly than many parents recognize.
And these problems can affect all students, whether they drink or not.
Reportedly, across the country, drinking by college students aged 18-24
contributes to about 1400 student deaths, 500,000 injuries, and 70,000
cases of sexual assault each year.
Let me say, though, that before you get even more worried, it is great
that you have already spoken with your daughter about the dangers of
drinking excessively. Don't assume that heavy drinking is inevitable. It
is important that children hear from their parents that they disapprove of
this and that heavy alcohol use can lead to sexual assault, violence, and
academic failure.
I would also suggest that during the school year, call your daughter
frequently to see how she is doing and ask about her roommates and general
living arrangements. Essentially, stay involved in her life even though
she is living away from you. And if possible, arrange to visit her as
well.
You can also inquire about campus alcohol policies if you have not
already done this. Let school administrators know that you are concerned
about drinking on campus and find out what campus policies they have that
help to address this problem. A number of colleges have been doing some
creative things to decrease alcohol use in their student population.
Hopefully, doing these things will decrease the chances that your daughter
will drink heavily.
SEN 9-9-2003
Dear Dr. Levy:
I have a 34 year old son that has an addiction to alcohol. I believe
that he started drinking at the early age of 13. His alcohol addiction has
resulted in the loss of many, many jobs, relationship breakups, and a great
deal of pain to family. His self esteem is very low and he has very few
friends.
He has recently moved back in with me due to his girlfriend evicting
him. He has confided in me that he does have a drinking problem and is
ready to get help. I hope he means it.
I know that he cannot do this on his own. He has attended AA meetings
but they were court mandated and he was not ready to help himself. I am
reaching out to you and your treatment services to help my son get his life
back.
He is not eligible for health insurance at his current place of
employment. I understand that there are treatment services available at no
cost for those who do not have health benefits. I would appreciate it very
much if you would steer my son and I in the right direction to get help.
Thank you for your support.
JB
Dear JB:
There are many programs that receive funding from the Department of
Public Health's Bureau of Substance Abuse Services so that those without
health insurance or means to pay for treatment can obtain it, either free
or on a sliding fee basis. Funding, however, is limited and it is harder
to access free care or reduced care treatment slots than in the past.
CAB Health & Recovery Services does receive some funding both for
clients who require inpatient detoxification and for those who require
outpatient services. There are a limited number of slots and
unfortunately, often a client must repeatedly call to access one of these
slots. I don't know the type of care your son requires, but let me offer
the following:
For detoxification, your son can call our programs in Danvers or
Boston. The Danvers number is 1 (978) 739-7675. Boston is 1 (800)
763-5363. If he doesn't need detoxification, our Salem outpatient office
has some limited free care or reduced fee slots as well. They can be
reached at 1 (978) 745-8890. And if you don't know what program would make
most sense for him, you can call any of our offices and the intake
personnel should be able to steer you in the right direction.
There are also longer term residential treatment programs that are
largely funded through state funds. Health insurance is not needed for
these types of programs. CAB operates several of these types of programs
as well. If you want information about these, please contact me.
For other programs in the state that receive funding to help those
with limited financial resources, you can call the 24-hour substance abuse
hotline at 1 (800) 327-5050 for additional information. Again, please feel
free to contact me for further help.
Dear Dr. Levy:
I have heard of a new drug to treat alcoholism called Popiramate. Can
you tell me something about this?
C
Dear C:
Popiramate is an anticonvulsant and I have not heard of this drug
being used to treat alcoholism. I believe you may be referring to a drug
called Topiramate, which is also an anticonvulsant. Researchers found that
those given the medication were six times more likely than those taking a
placebo to abstain from alcohol over the course of one month. In
particular, 24% of the alcoholics who were taking the topiramate abstained
from alcohol for one month as compared to only 4% of those who took the
placebo. In addition, alcoholics who took topiramate binge drank less than
those who took the placebo. Reportedly, this drug seemed to decrease
craving as well.
This drug is not yet approved by the Food and Drug Administration
(FDA) for the treatment of alcohol dependence. While the findings of this
study are significant, more studies are needed before the FDA approves it.
SEN 9-2-2003
Dear Dr. Levy:
I know a woman who has a 22 year old son living at home, who is an
alcoholic. He is making her life miserable and she doesn't have any
experience handling this type of situations. She is looking for some help.
The boy has no insurance, has no job, and will not admit that he has a
problem. She would like to get him some type of treatment, but Al-Anon
provided no answers. Does she let him continue to keep drinking? At what
point does she throw her hands up in exasperation? This is a desperate
woman we're discussing here, and a desperate son who is hurting and doesn't
know what to do. Is there a treatment facility that he could get to,
either on an out-patient or residential basis that would help him? Money is
an issue.
D
Dear D:
Based upon your brief discussion of this situation, this woman needs
to learn how to not allow her son to affect her so much. You stated that
her son does not want help. As a result, there is only so much that she
can do to help him. She is powerless over whether he drinks, so if he is
not interested in any help at all, she simply cannot help him. Instead,
she needs to learn to detach from him and to not allow him to hurt her and
her life so much. Obviously, this is extremely difficult to do as most any
parent wants to assist his or her child.
You stated that she goes to Al-Anon. a program that can help
individuals to better cope with a loved one's addiction. If this isn't
giving her enough support, perhaps she could seek counseling as well. Our
Salem outpatient office has counselors who are able to work with people
affected by a family member's substance abuse. They can be contacted at
978 745-8890.
I should also mention that if her son was interested in help, our
programs do have some funds available for those who cannot afford
treatment. While resources are more limited than in the past, with effort,
individuals with limited financial resources can still receive help. If
can be of further help, please email me.
Dear Dr. Levy:
Is there any truth that Ecstasy can also cause heart problems? Is this
is rumor?
D
Dear D:
It is not a rumor. In addition to affecting the brain, ecstasy use
has been linked to heart problems. Researchers found that after giving
rats doses of Ecstasy similar to what humans use, it initially caused
increased arterial pressure, an episode of slowed heart rate, and then a
period of rapid heart rate. Over repeated binge use, Ecstasy caused
inflammation in the ventricles of the heart.
So Ecstasy can damage of the functioning of the heart. Researchers
caution that Ecstasy has the potential to alter cardiovascular functioning
and to produce potentially significant heart problems.
SEN 8-27-2003
Dear Dr. Levy:
I am the sister-in-law to a woman who is a cocaine addict, suffers
from mental illness (bipolar at least), released today from a psychiatric
ward for being caught forging a signature and stealing, overall,
approximately, $15,000 from her parents. The doctors knew she was lying to
them and let her leave, anyway!! She is also psychologically abusing her
parents who are not well. She is 31 years old and we need to get her
help!! Can you please give us some? Thank you.
J
Dear J:
This sounds like an extremely difficult situation with no easy
answers. Let me offer a few thoughts. In Massachusetts, a family member
can petition a judge in district court to commit a person to treatment if
the person is believed to be a danger to self, to others, or because
judgment so impaired that the person cannot care for him or herself. Your
sister-in-law sounds out-of-control and she may be in need of involuntary
treatment. This is called a Section 12 or "pink paper" and this is one
option.
Another option is to petition the district court under a Section 35.
A Section 35 provides forced treatment for individuals afflicted by alcohol
or drugs. If a judge feels that the person's alcohol or drug use is so
destructive that the person is in danger, treatment can be mandated to an
alcohol and drug abuse facility. Criminal charges can also be pressed
against the person for stealing, which could also help to force or mandate
treatment. I don't know how old her parents are, but if she is abusing an
elder(s), Elder Services can be contacted as well. An elder abuse hotline
number is 1 800 922-2275.
There is only so much you or anyone else can do for her. However, if
she can be forced into treatment, this may enable her to get the help she
so desperately needs. It is also very important for her parents to protect
themselves and this may entail limiting their contact with her. Hopefully
this gives you some direction.
Dear Dr. Levy:
Can you tell me how long marijuana can last in a person's body? My
son is getting urine testing related to some drug problems he has had. He
says that marijuana can last up to two months and I wanted to make sure
that this is true. Thank you.
K
Dear K:
Your son's report that marijuana can last up to two months is somewhat
exaggerated. While detection of marijuana and other drugs in urine has
some variability based upon a number of factors (e.g. fluid balance in
urine and state of hydration, amount used, person's physical condition,
etc.), there are some guidelines. In general, marijuana metabolites can be
found up to one month in former chronic heavy users of marijuana. Among
less heavy users, though still daily smokers, marijuana can last up to 10
days. Among individuals who use several times per week, marijuana can be
detected up to 4 days. And a one time use of marijuana can be detected up
to 3 days.
SEN 8-19-2003
Dear Dr. Levy:
This letter is in response to your advice to the parent who asked how
to help her child make the right choices in regards to drug use. My
question is when you listed the right things a parent can do, did you
consider how these suggestions may make a parent of a recovering addict
feel? One word covers it: guilt!
Considering the drug epidemic that is plaguing families on the North
Shore, and with all due respect to you, I feel that your advice holds no
service. I feel the populace is able to afford the opportunities to their
children that you suggest, especially in the North Shore. Belonging to a
self help group it has taken me years to begin realizing I did no wrong and
was on target with your suggestions to keep my child drug free.
After reading your article on July 8th I felt some professionals don't
understand the feelings or I should say are not sensitive to them (the
recovering parent). I would like to believe that you did not deliberately
set out to undermine the strides that parents like myself are trying to
make. You said, "The better your relationship is with your child, the less
chance they will turn to drugs". With a statement like this, the parent of
an addict has no choice but to keep their secret of having a family member
an addict a secret. If professionals don't state the true underlying
reasons for drug abuse, how will the society of drug free families look
upon the afflicted ? the parents ? suffering further with guilt after
reading your column?
Perhaps in a future "Take the First Step" column, you would consider
addressing parents who are suffering with guilt due to the drug addiction
of a child. How they too may find a road to recovery along with their
addict. Thanks you in advance for your effort in this matter.
CC
Dear CC:
Let me first say that my intention was not to make any parent feel
guilty about having a child who may have gotten involved with drugs. There
are many, many reasons why a person gets addicted to drugs, and many of
these have nothing to do with the quality of the parenting they received.
There are a number of factors that children are exposed to that may
increase the chances of getting heavily involved with drugs. These include
peers who use drugs, psychiatric illness, other emotional difficulties, the
need for sensation seeking, and inherited biological vulnerabilities, to
name just several. Often, parents need to learn to not take responsibility
for the fact that one of their children got addicted to drugs. Despite
excellent parenting, a child could become addicted to drugs. And in my
response, I clearly stated that despite a solid parent-child relationship,
there is no guarantee that a child will not turn to drugs. However, a good
parent-child relationship is still one the best protective factors that can
help minimize the chances that a child will turn to drugs.
The intention of my response was to inform the person who wrote in
that there are things parents can do to decrease the chance of their child
or children turning to drugs. If good parenting was instituted by all
parents and this could decrease the incidence of drug use by even 1-2%, we
would greatly impact on the drug problem in our area. And I believe that
even on the North Shore, for a whole host of reasons, some children do not
receive the parenting that they so desperately need.
Again, there is no guarantee that a solid parent-child relationship
will prevent drug use. However, it is still one of the best known
protective factors.
SEN 8-5-2003
Dear Dr. Levy:
When a person first stops using cocaine, I know they can get
depressed. My question is whether they can continue to feel depressed due
to using cocaine. Thank you.
J
Dear J:
You are right that when people first stop using cocaine, they may
experience depression that can fairly quickly resolve. However, research
has also shown that some users of cocaine may continue to feel depressed,
which may be related to cocaine use.
I must first say that a person's continuing depression may have
nothing to do with cocaine use; perhaps the depression is a separate
problem and in part, the person used cocaine to help cope with depression.
However, recent research suggests that cocaine can damage the brain, which
may help to explain why some people continue to feel depressed after using
cocaine.
Researchers found that former users of cocaine had lower levels of
dopamine, an important neurotransmitter in the brain that helps people to
feel pleasure. In addition, they had lower levels of a protein called
VMAT2, which is found in dopamine transporters. The researchers also found
that those who had lower levels of VMAT2 suffered from depression.
These findings suggest that chronic cocaine use may cause changes in
the brain that make it harder for a person to feel a sense of pleasure.
While more research is needed, researchers believe that this can help to
explain why some chronic users of cocaine continue to feel depressed. They
are also hopeful that these findings may help in the development of new
medications that can help the brain to recover from the effects of chronic
cocaine use.
Dear Dr. Levy:
I recently heard of a new drug to treat opiate addiction. I am not
sure of the name of it, but supposedly it is non-addicting. Do you have
any information about this? Thank you.
P
Dear P:
I believe you may be referring to a drug called Lofexidine.
Lofexidine is called an adrenergic agonist and is similar to a drug called
Clonidine, which may be familiar to you. When taken, this drug helps to
relieve withdrawal symptoms of opiate addiction. These symptoms include
chills, sweating, stomach cramps, diarrhea, muscle pain and runny nose and
eyes. It does not reduce craving, but only symptoms of withdrawal.
This drug, under the trade name BritLofex, is the leading
detoxification agent used in England to treat opiate addiction. In this
country, research has demonstrated that this drug is helpful to manage
physical withdrawal symptoms of opiate addiction. It is not yet offered in
this country, but it appears that it will soon be available.
Newer research in this country has also looked at giving individuals
Lofexidine in addition to an opiate antagonist, which is used to help
people to remain abstinent from opiates. Opiate antagonists essentially
prevent opiates from working. Researchers found that individuals given
Lofexidine along with the opiate antagonist were significantly more likely
to remain opiate-free, as compared to individuals only given the opiate
antagonist. The researchers were very encouraged by these findings and
believe that this drug may also have promise to help opiate addicts
maintain abstinence as well.
SEN 7-29-2003
Dear Dr. Levy:
Is it dangerous to drink and take antidepressants? My husband
recently started taking Paxil and still drinks. I told him that he
shouldn't, but he says that I shouldn't worry about this. What do you
think? Thank you.
R
Dear R:
The first thing I must say is that I am not a physician, however with
consultation with CAB's Medical Director, let me offer the following
information.
I am not aware of any huge concerns regarding having one or two drinks
with Paxil. In general, the class of medications that Paxil falls under
(selective serotonin reuptake inhibitors), do not interact with alcohol in
a significant way. The one exception is that there have been some reported
fatal overdoses with Fluoxetine (Prozac) alone or when combined with
alcohol. Also, some people report that when they drink and are taking an
antidepressant like Paxil, they feel the affects of the alcohol more
greatly. So a person should be somewhat concerned about feeling the
effects of alcohol more intensely if taking Paxil.
When you say your husband drinks, are you saying a few drinks or that
he has a problem with alcohol? Alcohol is a depressant and if someone is
taking Paxil due to depression and continues to drink heavily, it is likely
that the individual will not achieve benefit from the Paxil. For many
people, heavy drinking can lead to feelings of depression. So obviously,
heavy drinking is contraindicated.
Most importantly, my recommendation is for your husband to speak to
his prescribing physician about his drinking. His doctor should know any
other medication he takes, including alcohol, and his physician should
offer guidance to him about if and how much he can drink. Hopefully, this
information helps.
Dear Dr. Levy:
I am concerned about my husband. Often after work, he stops off at a
local bar to have a few drinks. While he is not intoxicated when he comes
home, I worry about him drinking and driving, not to mention the
possibility of getting arrested. He says that I shouldn't worry. What do
you think?
M
Dear M:
My view is that any drinking and driving is dangerous. I say this
because different people respond differently to alcohol. For some, even
one or two drinks of alcohol can affect their performance and judgment. In
fact, for a majority of people, two drinks will put them over the legal
limit of intoxication. Also, when a person drinks at a bar, it is possible
that stronger drinks are being mixed. Consequently, a person may think
that he or she only consumed two drinks, when in reality, three were drunk.
I should also mention that in general, smaller people need less alcohol to
become intoxicated than larger people.
From your letter, you stated that your husband has a "few" drinks.
This is certainly a concern. A few can be quite a lot. I would again try
to talk with him and perhaps you can even show him this letter.
Unfortunately, he may refuse to change his habits, and there is not much
that you can do. So often people only change their habits when something
bad happens, such as an arrest or accident.
SEN 7-22-2003
Dear Dr. Levy:
I am looking to find a local Al-Anon meeting. I live in the Salem Area.
My mother is an alcoholic, with very little time left, and I feel I need
someone to talk to and who can listen to me. Could you please point me in
the right direction? Thank you.
C
Dear C:
The best way to find out about Al-Anon meetings in the Salem area is
to contact Al-Anon directly. For readers who do not know, Al-Anon is a
self-help program for family members of alcoholics. The program helps
people to detach from the alcoholic in a way that gives them inner peace.
This program can help family members to accept the condition of their loved
ones and to not allow their drinking to affect them so much. You can call
Al-Anon at (781) 843-5300 and they will tell you where meetings are held in
your community. They will also send you a booklet that lists all of their
meetings.
I also want to say that if you want additional support beyond Al-Anon,
you may also consider counseling for yourself as well. While some
individuals receive all the benefit they need from Al-Anon, even others may
want the one-on-one support that can be achieved by seeing their own
counselor. My best to you.
Dear Dr. Levy:
Are there proven strategies that parents can use to help there
children to not use drugs? I have a 15 year old son and I want to do
everything I can to help him to make the right choices. Thank you.
M
Dear M:
There is much a parent can do to decrease the chance that his or her
child will turn to drugs. In fact, the most important factor in whether a
child turns to drugs is the quality of the parent-child relationship. Here
are some things to think about:
1. Be involved in your children's lives and have fun with them, planning
some regular parent-child activities that you both enjoy.
2. Know who your children's friends are and what your children's
interests are.
3. Take an interest in their lives and ensure that your children know
how important they are to you.
4. Talk with them early about the dangers of alcohol and drug use and
set a no-use rule.
5. Encourage your children to get involved in extracurricular activities
that they enjoy.
6. Know what are children are doing, who they are spending time with,
and what they are doing after school.
7. Encourage open dialogue and communication and be a parent who your
children can talk with.
8. Compliment them on their efforts and positively reinforce their
achievements.
9. Make and enforce clear rules, and consistently enforce them, though
consequences should not be severe if a rule is violated.
10. Be a positive role model and do not use drugs yourself.
Those are a few things to think about. While there is no guarantee
that a child will not turn to drugs, the better your relationship is with
your child, the less the chance that they will turn to drugs.
SEN 7-8-2003
Dear Dr. Levy:
I recently heard that there is a new drug that is being used to treat
alcoholism. I am not sure what the drug is called, but I think it was also
used to epilepsy. Do you know anything about this? Thanks.
MT
Dear MT:
The drug you are referring to is called topiramate. Researchers found
that those given the medication were six times more likely than those
taking a placebo to abstain from alcohol over the course of one month. In
particular, 24% of the alcoholics who were taking topiramate abstained from
alcohol for one month as compared to only 4% of those who took the placebo.
In addition, 50% of the alcoholics who took topiramate did not binge drink,
as compared to only 16% of the alcoholics who took the placebo. Reportedly,
this drug seemed to decrease craving as well. Researchers believe that
topiramate washes away the excess dopamine that is released by drinking,
and scientists believe that dopamine is what causes the pleasurable
feelings that result from drinking.
More studies are needed to verify these findings, but clearly, the
findings of this study are significant.
Dear Dr. Levy:
I had my last drink on Dec 31, 1992. I was spending $1000 a month
just on drinking. I worked my 40 hour a week job plus a part time job (25
hours/week). The part time job gave me the money for drinking. I was
arrested once for "driving under the influence of alcohol". After that, I
never drank and drove.
The only reason I quit drinking was the weight gain. I loved drinking.
I went to "driving under" classes after the arrest and learned a lot but I
continued to drink. They had me go to 7 AA meetings.
I quit drinking by myself. I never had to go to any meetings after I
quit drinking. But I know some people need these meetings.
I want to tell people if I could do it so can you!! Keep up your good
work, Doc.
From an ex-drunken lady
Dear ex-drunken lady:
Thank you for writing in! First, congratulations to you for stopping
drinking over 11 years ago. Your letter lets others know that stopping
drinking is possible and that a person should never give up hope on him or
herself.
Your letter also makes a couple of important points. First, despite
your love of drinking, you decided to quit because you no longer wanted to
deal with the consequences of drinking. In your case, it was weight gain.
Whatever the reason, the point is that despite wanting to drink, a person
can make the choice not to drink. Loving drinking is not a reason to
continue to drink.
Second, there are many paths into recovery and there is no right or
wrong way to do this. Different people require different approaches.
Whether or not one seeks treatment, a strong commitment to change must be
there. In your case, it sounds like you made up your mind to get away from
the alcohol and you did this without treatment. I always tell people that
treatment, while critical for some, is no "magic bullet". The most
important factor in success is the person, him or herself.
Again, thanks for writing in.
SEN 7-1-2003
Dear Dr. Levy:
I read your column in the Salem News and although I suppose I'm
grasping at straws emailing you, I figured it couldn't hurt. I'm an
alcoholic that desperately wants to quit but just can't seem to do so. I'm
a successful business person, married with young kids, living the
"perfect", "normal" life, except for one dark secret. I drink anywhere from
a half to a full pint of booze, plus several beers, every night after work
(I usually start a bit earlier in the afternoon on my days off). I've been
stuck in this pattern for several years now, with an occasional day or two
hiatus. No matter what I try, I just can't seem to quit. I've
largely
gotten away with it. I've hardly ever been called on being drunk, but I
think I must just hide it well. My drunkenness has only a few times caused
a negative impact on my daily life, but I know I'm just a time bomb waiting
to explode. There have been a few instances of "near-misses".
Although I've tried desperately to quite on my own, I've never sought out
outside or professional help. Too embarrassed, perhaps, or more likely,
wanting (needing?) to keep it from my family and work.
So, is there any magic bullet for me? Anything I can try on my own to help
quit? I doubt it, but again, figured it couldn't hurt to ask. Thanks.
M
Dear M:
First, it is wonderful that you can admit that you have an alcohol
problem and want to do something about it. The first step is admitting
that you need to do something about your use of alcohol.
The first thing I want to say is that I am not sure why you are so
embarrassed. Having an alcohol problem is simply drinking too much and
this has nothing to do with your character nor is it a sign of personal
weakness. Try not to beat yourself up and feel so bad about your drinking.
Most everyone gets stuck in some way, whether this is being unable to
control one's anger, one's food intake, one's jealousy, or one's drinking.
Try to keep in mind that you drink too much and that you are still a
worthwhile, competent person.
Unfortunately, there are no "magic bullets", though there are numerous
treatments. It sounds like you have been trying to do it totally on your
own without success, so it seems you need some type of help outside of
yourself.
To begin, if you experience withdrawal symptoms when you do not drink,
a detoxification may be in order and for some people, this can be done on
an outpatient basis through your physician.
If you don't need to be detoxified, a minimal intervention is to speak
with your doctor about getting Antabuse. This is a drug that when taken,
will cause a violent physical reaction if people drink or if they have
alcohol in their system. Many people who are serious about stopping
drinking can get much benefit from this. However, this is not a magic
bullet and I would suggest that in addition to this, talking to a counselor
for some support might be helpful. And whatever you say to a counselor is
totally confidential, as is even the fact of coming for treatment.
Naltrexone is another medication that can help as well, and again, you
can speak to your physician about this. Research has shown that Naltrexone
can help to decrease cravings to use alcohol. And again, this is no "magic
bullet" and seeing a counselor in addition would probably be helpful.
Self-help meetings could also be considered. AA stands for Alcoholics
Anonymous which means that everything remains anonymous including who even
attends meetings. If you attend some meetings, you will find that many,
many people struggle with alcohol consumption, which could help you not to
feel so bad about this. There is also another type of self-help group
called SMART Recovery, which you could consider as well.
I know that I mentioned a number of suggestions. If you
would like any more information about any of these options, please contact
me. But one point I again want to make is that you have nothing to be
embarrassed about. Don't be so hard on yourself.
SEN 6-24-2003
To view more questions and answers archives- CLICK HERE
-
|
